01 issues in informatics

8/12/2019 01 Issues in Informatics

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Theories, Models, andFrameworks

NURSING INFORMATICS

NURSING INFORMATICS

Is an established and growing area ofspecialization in nursing

All nurses employ informationtechnologies in their practice.

Computersare incredibly fast , accurateand stupid.

Human beings are incrediblyslow , inaccurate and

brilliant .

Together they are powerful beyondimagination

Albert Einstein

Why do we NEED to study N.I?

In the 21st Century, information is

doubling every 5yrs , if not tripling inquantity and quality.

Information is POWER

Technology also facilitates thecreative process in nurses, affordingamazing vehicles for patienteducation, teaching and learning, andproviding general health promotionand prevention information on aglobal scale.

This can only become a commonreality if nurses are comfortableworking with computers and

advanced technology while providingevidence based care for their clients .

The healthcare of our clients islargely dependent on information.

Every action taken depends onprevious information and knowledge.

THE HIGH TECH AND THE HIGHTOUCH


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WHAT DO WE NEED TO ACHIEVENURSING INFORMATICS?

SOFTWARE

HARDWAREPEOPLE

Nursing practice will berevolutionized and we will

truly be a profession ofnurses with our own

classification systems,bibliographic systems, and

payment systems .

We need to think outside the box?

We need to use the Internet to enhanceour practice and provide tele-nursing care. We need to become wireless and conductour services using all the newer IT tools.

We have a long way to go, but if weutilize information technology effectively,informatics will become an integral part ofour profession and the health careindustry. I do believe we have theknowledge and perseverance and I amconvinced it will come to pass.-Dr.Virginia Saba

What is informatics

1957 - First coined by KarlSteinbuch as informatiks.

1962 Phillipe Dreyfus usedinformatique

Walter Bauer translated it intoinformatics


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What is informatics

Combined the terms informationand automation which meansautomatic information processing.

What is informatics

A science that combines a domain

science, computer science,information science and cognitivescience.

Multidisciplinary science drawing fromvaried theories and knowledgeapplications.

What is informatics

a broad academic field encompassinghuman-computer interaction,information science, informationtechnology, algorithms, and socialscience

What is informatics

Computer science, the study of

complex systems, information andcomputation using appliedmathematics, electrical engineeringand software engineering techniques.

What is informatics

Information science is thestudy of the processing,

management, and retrieval ofinformation

In 1980, Scholes and Barber appliedthis new term to the art and scienceof nursing, coining the term,nursing informatics, which they

defined as ...the application ofcomputer technology to all fields ofnursing-- nursing services, nurseeducation, and nursing research.


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WHAT IS HEALTH INFORMATICS?

HEALTH INFORMATICS

Integration of healthcare sciences,

computer science, informationscience, and cognitive science toassist in the management ofhealthcare information.

A subdiscipline of informatics

ACTIVITY

Present an illustration using thedescription delineating HealthInformatics and its sub disciplines.Health informatics have subdomains

such as medical informatics, dentalinformatics, pharmacy informatics,nursing informatics, etc.

Each of these subdomains haveintegrated content and which arecollaboratively working with eachother.

ACTIVITY

Limit your illustration using onlycircles, squares and arrows and texts.

Use any application (paint, Msword,Ppt) in making your diagram.

Finally present the illustration usingpowerpoint.

Further explain your diagram.

CORRECT

HEALTHINFORMATICS

DentalInformatics

NursingInformatics

PharmacyInformatics

MedicalInformatics

NURSING INFORMATICS

1985 Kathryn Hannah;..is theuse of information technologies in

relation to any nursing functions.


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NURSING INFORMATICS

1989 Graves & Corcoran .. Is a

combination of computer science,information science and nursingscience designed to assistmanagement and processing ofnursing data, information, andknowledge to support the practice ofnursing and the delivery of nursingcare.

NURSING INFORMATICS

1994 ANA .. Specialty that

integrates nursing science, computerscience, and information science inidentifying, collecting, processing,and managing data and informationto support nursing practice,administration, education, researchand the expansion of nursingknowledge.

NURSING INFORMATICS

2001 ANA .. a specialty thatintegrates nursing science,computer science, andinformation science to manageand communicate data,information and knowledge innursing practice

NURSING INFORMATICS

2001 ANA .. facilitates theintegration of data, information, andknowledge to support patients,nurses, and other providers in theirdecision-making in all roles andsettings. The support isaccomplished through the use ofinformation structures, information

processes, and informationtechnology

SCOPE OF PRACTICE

P RACTICE

E DUCATION

R ESEARCH A DMINISTRATION

NURSINGINFORMATICSSCOPE


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Standard Areas of NURSING:

Nursing P racticeNursing E ducation

Nursing R esearch

Nursing Administration

COMPUTERS IN NURSING EDUCATIONS

COMPUTER Assisted Education

PDA (Personal Digital Assistants)

LCD Projectors

Wireless Routers

Desktops

Laptops

Smartphone

VIDEOS/ANIMATIONS

Distance learning

Testing (NCLEX)

Student and course recordmanagement

COMPUTERS IN NURSING PRACTICE

Functions

Records client information

Provides access to other departments

Used to manage client scheduling


DOCUMENTATION OF CLIENT STATUS

AND MEDICAL RECORDS KEEPING

Provides access to standardized forms,policies and procedures

Access data about client that may besomewhere in the medical record orelsewhere in health care agency.

BEDSIDE DATA ENTRY

records clients assessments, medicationadministration, progress notes, care planupdating, client acuity and accrued charges

COMPUTER BASED CLIENT RECORD

EMRs/CPRs

Provides easy retrieval of specific datasuch as trends in vital signs,immunization records, current problems

It can be designed to work providersabout conflicting medications or clientparameters that indicate dangerousconditions


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ELECTRONIC ACCESS TO CLIENTS

Used extensively in health care toassess and monitor clients

conditionsData accumulated from various

electronic devices are stored forresearch purposes

Can monitor client

Computerized diagnosis

Telemedicine

PRACTICE MANAGEMENT

Used to order supplies, tests, meals,and services, from other departments

Allows nursing service to determine themost costly items used by a particularnursing unit.

May provide information or decisionsto modify budget, provide differentstaffing, move supplies to differentlocations, or make other changes formore efficient and higher quality care


A. Human resources

All employers must maintain a data a database oneach employee

Administrators can use this database tocommunicate with employees, examine staffingpatterns, and create budget programs

B. Medical records management

Allow client records to be searched for trends,number of cases, most expensive cases, and clientoutcomes.

Nurse informaticist can assist administrators withthe design and implementation of systems that allow

such searches to be generated, analyzed, printed,and distributed.

C. Facilities management

heating, air conditioning, ventilation,alarm systems are computer controlled.

D. Budget and financeclaims are transmitted much more

quickly

Can also effect cost-savings by reducingthe desired services time needed foraccounts payable and receivables.

COMPUTERS IN RESEARCH

1. problem identification

Useful in locating currentliterature about the problem andrelated concepts

Helps in searching for existingdocuments, and e-mail tocolleagues.

2. literature review

Software facilitate searches,contains thesauruses so that themost appropriate terms can beselected.


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COMPUTERS IN RESEARCH3. research design

Search literature for instruments that havealready been established or to design andtest instruments that need to be developed

for past study.4. Data collection and analysis

Helps create form for the collection of datasuch as informed consent, demographicdata, and recording forms.

Commonly used software for quantitativedata analysis: SPSS ( statistical package forsocial sciences), SAS ( statistical analysissystem), Sys STAT, MYSTAT

5. Research dissemination

computer word processing programs areused to author the final reports of researchand send research to various readerships.

Help speeds completion or research projects

NI as a SPECIALTY

1992 ANA established nursing

informatics as a distinct specialtyin nursing with a distinct body ofknowledge.

INDIVIDUAL ACTIVITY

Use a Word Processor

Explain how nursing informatics isconsidered as a distinct specialty.

Specifically describe the role ofinformatics nurses compared tonurses of other fields of nursing.

200 words minimum..

INDIVIDUAL ACTIVITY

Use a Word Processor

Use Times New Roman

Font Size: 12.5 Line Spacing: 1.5 1 tab indent each paragraph

Justify each paragraph

Margins: 0.75 top, 0.75 bottom, 1 left; 1right.

Orientation: Portrait Paper Size: Long Bond Paper

Title at Center (Make your own)

Save File: Act1YourName.doc

Informatics Nurse Specialists

Is a professional with a formal RNgraduate degree and passed thecredentialing in nursing informatics of

a state.


Nursing informatics specialistspractice in a wide variety of roles thatare ultimately aimed at improving

patient care delivery and the nursingpractice experience.


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Some of those roles are: Project manager

Educator Product developer Decision support/outcomes manager Systems analyst Consultant Programmer Advocate/policy developer Web developer CIO, CEO, CNO Entrepreneur Researcher Sales and marketing

COMPONENTS of PRACTICE

Transformation of Data to Wisdom

Data discrete entities that are describedobjectively without interpretation.

ex. A systolic blood pressure, a nursingintervention, a patient problem, anoutcome



Information reflects interpretation,organization, or structuring of data.

- are processed data

- data with meaning



Knowledgetransformation ofinformation.

- information that is synthesized sothat relationships are identified andformalized



WISDOMhighest form of datatransformation.

- is the application of ethics in usingknowledge.


Complexity

HumanIntellect

DataInformation

Knowledge

Wisdom


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REGISTERED NURSES as KNOWLEDGEWORKERS

Knowledge work is the exercise of

specialist knowledge andcompetencies.

SCREEN CASTING

Create a powerpoint presentation of yourreport.

Using the powerpoint report record asvideo + audio and edit the report forscreencasting. Record the narration likeyou are explaining your slides on class.

Utilize your knowledge on video editing. Maximum minutes of screencast is 10

minutes only. Number of members per group = 3..no

exceptions.

COMPETENCIES

Research; Article search (Use ofinternet)

Staggers, Gassert, and Curran, 2001

ANCC

Informatics Exam Content

HIMSS (Healthcare Information andManagement Systems Society)

TERMINOLOGIES

What is the use of standardterminologies/languages?

What is a data set?

What is nursing minimum data set(NMDS)?

Enumerate the different ANA-recognized terminologies.

Describe each briefly.

TENETS

Distinct specialty practice and body ofknowledge

Includes both clinical and non-clinical

Supports nurses to improve quality of careand welfare of health care consumers

Focus is delivering right information to rightperson at the right time

TENETS

Human factors concepts are interwoven inpractice

Ensure confidentiality and security of data andinformation and advocates privacy

Promotes innovative, emerging and establishedinformation technology

Collaborates with and is closely linked to otherhealth-related informatics specialties


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ELECTRONIC HEALTH RECORD ELECTRONIC HEALTH RECORD

any information related to the past,

present, or future physical/mentalhealth, or condition of an individual.The information resides in electronicsystem(s) used to capture, transmit,receive, store, retrieve, link, andmanipulate multimedia data for theprimary purpose of providinghealthcare and health relatedservices..

ELECTRONIC HEALTH RECORD

Increased patient safety:All informationabout the patients existing conditions,allergies and drug intolerances is availablewhen Physicians need it, where they need itso that they can make the best decisions fortheir patients.

Increased efficiency:A single source ofaccurate patient data means Physicians don'tneed to spend time logging in to differentspecialist clinical systems or contacting

other healthcare institutions for information.

ELECTRONIC HEALTH RECORD

Trend and data analysis:A central

clinical repository of clinical informationmeans that information can be minedand analyzed to contribute to moreeffective healthcare delivery in thefuture, and can give a betterunderstanding of trends, patterns andepidemiology in public health.

HIPAA and Technology

Influx of new technology is creatingimplications for the protection ofprivacy and security.

Simple precautions to secure clientinfo: Use data encryption

Use password when logging on, and atime-out to reactivate the password

If using PDA, disable the infrared ports

Privacy Confidentiality Security

The role of staff nurses as the protectorof patient information is becomingmore crucial as more health care

information becomes part of themedical record and as it becomes moreavailable electronically instead of onpaper.


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The staff nurse may be ask to provide

information such as a printed medicaladministration list from an electronicmedical record to the patient, thepatients family member, a medicalstudent, or an attending physician.

Accountability among nurses is highly aconcern.


is a means of protecting health

information so that it is not used ordisclosed except as authorized by theindividual. It protects the privacy of theindividual.


means that information,once allowed to be disclosed by theindividual, will not be shared without thepermission of the individual therebykeeping it confidential.

Example: Nurses should not talk toanyone except those under privilegedcommunication regarding patientsinformation, including securityinformation.


is a means by which data is

stripped of identifiers that mightotherwise be used to identify a givenindividual.

Ex. Use of passwords and PIN Codes

What is a Clinical Information System(CIS)?

Collections of Information TechnologyApplications equaling a repository(database) of information for client care

Contains information about client historyof illness, interaction with providers,genetic, environmental and social data

Creates record of status of decisions,actions underway and information to assistin performing targeted actions

What is an Electronic Record (EHR)?

Other common names computerized patient record(CPR), electronic medicalrecord (EMR) and theelectronic patient record (EPR)

Part of CIS

Resides in a software programproviding the health provideran instrument to obtainclinical information andtranscribe data into thecomputer

Classified in three groups: (1)Office Based (2) Web-based (3)Handheld or Wireless System

ADVANTAGES- Instant Access- Legibility- Safer data (protects from loss)- Confidentiality- Flexible Layout

- Integration with other inforesources

- Electronic data- Continuous data processing- Assisted Search- Tailored Paper Output- Always Current!


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Clinical DSS focus in EHR for Nurses

CPOE Computerized Prescriber Order

Entry

BCMA Bar Code MedicationAdministration

Integrated EHR Features

Digital Imaging (LaboratoryInformatics)

Integrated EHR Features Integrated EHR Features


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Nursing Documentation


Nursing Documentation

01 issues in informatics

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