Changing Information of

Nursing

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HOUSE KEEPINGThis is 1.5 Hour class

Restrooms are located…

Cell Phones

Please turn off or change to vibrate

If you must answer a call, please leave the room.

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Learning Objectives• Identify the evolution of Nursing Informatics (NI)

in health care • Identify the evolution of the Department of

Veterans Administration (VA) Nursing informatics roles and articulate the role of existing strategic visions and missions of the Office of Nursing Service Informatics (ONSI) and the Chief Health Informatics Office (CHIO)

• Describe the link between NI competencies and quality, safety, efficiency, and a healthy work environment

• Describe the relationship of how NI can support informatics across the health care industry

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Introduction

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Introduction• Technology adoption improves safety, quality

and access to care - supporting nursing informatics competencies development

• Health and information technology exponential growth

• Focus on quality, safety, & efficiency • Woven into the fabric of nursing practice,

administration, education and research • Nursing leaders should define nursing

informatics infrastructures at enterprise/system & facility/local level

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What is Nursing Informatics?

Presentations, publications and surveys on the functions of the nurse Informaticist:

http://www.himss.org/ASP/topics_FocusDynamic.asp?faid=243 Nursing and Informatics for the 21st Century: An International Loo

k at Practice, Trends and the Future - Book (2/8/2008)

Nursing Informatics 2007 Workforce Survey - Who Are We Now? - Nursing Informatics 2007 Workforce Survey - Who Are We Now? - Survey ResultSurvey Result (2/8/2008) (2/8/2008)

Nursing Informatics 2004 Workforce Survey - Who are we? - Nursing Informatics 2004 Workforce Survey - Who are we? - Survey ResultSurvey Result (2/8/2008) (2/8/2008)

Nursing Informatics 101 - Nursing Informatics 101 - PresentationPresentation (2/8/2008) (2/8/2008) An Emerging Giant: Nursing Informatics - An Emerging Giant: Nursing Informatics - Other PubsOther Pubs

(11/13/2007)(11/13/2007)

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Nursing Informatics Definition

The integration of nursing science, computer and information science, and cognitive science to manage communication and expand the data, information, knowledge and wisdom of nursing practice

(ANA, 2008)

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Nursing Informatics Definition (cont.)

“Nursing Informatics is a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, and knowledge in nursing practice.  Nursing informatics facilitates the integration of data, information, knowledge, and wisdom to support patients, nurses and other providers in their decision-making in all roles and settings.  This support is accomplished through the use of information structures, information processes, and information technology.” 

 (ANA Scope and Standards of Nursing Informatics Practice, 2008, pg 1)

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Nursing Informatics Definition (cont.)

Nursing informatics is using technology, research, and professional experience to manage nursing data, information, and knowledge to improve practice and deliver better health care.

Simpson, Roy (2006). In H. A. Park, P. Murray,& C. Delaney, C. (Eds.). Consumer-Centered Computer-Supported Care for Healthy People. Amsterdam, Netherlands: IOS Press, p 5

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Domains of Nursing Informatics

System Lifecycle Human Factors Information Technology Information Management Professional Practice Models and Theories

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Nursing Informatics Competencies

Informatics Nurse Specialist skills common to Nurse Executive skills

• Computer literacy skills• Information literacy skills• Project management skills• Information management and communication• Leadership • Make judgments based on data trends and

patterns• Change Management • Innovation

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Nursing Informatics Functional Areas

• Administration, leadership and management• Analysis• Compliance & integrity management• Consultation• Coordination, facilitation, and integration• Development• Educational & professional development• Policy development & advocacy• Research evaluation

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Analyst Role

Quality and Safety• Outcomes management • Synthesize knowledge• Performance improvement• Maintain data integrity and reliability• Aggregate data • Identify benchmarks • Develop performance measures• Assess workflow

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Benefits of IT in Healthcare

Safety• Computer technologies can place safety

barriers within high risk processes to improve patient safety

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Benefits of IT in Healthcare (cont.)

Efficiency • Achieved through the use of computers and computer

technology as a data management tool• Moving away from paper records – improves access to

the data you need without flipping through a bulky patient record

• Easier retrieval of data associated with a particular process

• Data sharing is improved between disciplines

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Benefits of IT in Healthcare (cont.)

Quality Improvement• Allows for auditing to assure a consistent

standard of care• Measurement of performance against

standards of practice to identify systems issues and opportunities for improvement

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Benefits of IT in Healthcare (cont.)

Decision Support• Cues and information built into the system

to assist the clinician in making care decisions

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HIMSS 2007 Nursing Informatics Survey

Nursing Informatics Job Titles14% “clinical analysts”14% “informatics nurse specialist” or “nursing

informatics specialist”9% “consultant”40% identified “other”

Director of Clinical Informatics, Clinical Informatics Coordinator, Clinical Systems Analyst, Clinical Informatics Specialist

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What Can I Do For You?Data Management

Workload statistics Performance monitoring Performance improvement projects

Identification of problem areas Before and after data

Regulatory compliance

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What Can I Do For You? (cont.)

Project Management

New applications The job isn’t over when the software is

implemented Monitoring local usageReporting to oversight bodiesTraining

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What Can I Do For You? (cont.)

Training and Education

• New employees• Student nurses• Updates• Annual education/competency• Ongoing reminders

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What Can I Do For You? (cont.)

Be a National Voice

• Software work groups• Alpha testing• Beta testing• National presentations• Oversight boards

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Informatics Attitudes

Appreciate the necessity for all health professionals to seek lifelong, continuous learning of information technology skills

Value technologies that support clinical decision- making, error prevention, and care coordination

Protect confidentiality of protected health information in electronic health records

Value nurse’s involvement in the design, selection and implementation of information systems

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Evolution of Nursing Informatics in VA

Nursing Automated Data Processing Application Coordinator (ADPAC)

Clinical Application Coordinator (CAC) Bar Code Medication Administration

Coordinator (BCMA-C) VA Nursing Outcomes Database Coordinator

(VANOD) & Nurse Information Specialist

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Evolution of Nursing Informatics in Industry

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Murielle Beene, Chief Nursing Informatics Officer

Creating a Nursing Informatics Infrastructure

Nursing Strategic Plan, Role of the Chief Nurse Informatics Officer

Nursing Informatics Leadership

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Creating Nursing Informatics Infrastructure

Defined roles, responsibilities and resources for Nursing Informatics

Enterprise/system level Emerging role

Chief Nursing Informatics Officer (CNIO)

Facility/local level

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Why a Nursing Informatics Department?

Historical absence of administrative or informatics infrastructure

Disparate data sources and reports No formal process for data validation No formal process to assess data accuracy Under resourced nursing management team Missing link to the operations – important data to

inform decisions making

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Typical Leadership Relationships

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Chief Nurse Executive Role Critical in selection, implementation, and

evaluation Overall facility/healthcare system impact Nurse Executive must be actively involved

in over-all decision-making and implementation process

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VHA Nursing Strategic Plan 2008-2012

National Nursing goals: Nursing Practice

Transformation Evidence-Based

Practice Excellence in

Leadership Workforce

Management

Interconnected & Interdependent Critical Programs: Informatics &

Technology Data Management Research Advanced Practice

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Proposed Informatics Relationships

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Emerging Chief Nurse Informatics Officer Role

Set strategic vision for nursing informatics to support a collaborative practice that reaches across and between service lines

Develop a vision, mission, and strategic plan for nursing informatics

Leverage technology to create synergy in practice that will improve patient care delivery, efficiency, quality, and safety

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Chief Nurse Informatics Officer Focus Area

Strategic vision for informatics and impact on nursing practice and care delivery

Human factors and ergonomics Technology assessment Data and databases Communication Resource planning and utilization Research, development and evaluation

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Proposed Enterprise Infrastructure

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Proposed Local Infrastructure

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On Leadership… “Innovation distinguishes between a leader

and a follower.” Steve Jobs

“A leader has the vision and conviction that a dream can be achieved. He inspires the power and energy to get it done”

Ralph Nader

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NI Leadership Skills • Superb communication• Change management • Risk Assessment• Coalition building• Political finesse• Business acumen• Strategic application

(ANA, 2008)

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NI Leadership Role Evidence-based practice Computer literacy skills Information literacy skills Project management skills Change management skills Process management skills Information management

and communicationData analysisTrending & forecasting

Resource planning, utilization and evaluation

Technology assessment Administration Safety and quality Make judgments based on

data trends and patterns Consultant Innovator

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Leadership Pearls DREAM, DARE, AIM to be an INNOVATOR Keep abreast of “latest greatest” technology

trends Assess newest technology for “fit” and potential

applicability in the clinical environment Leverage technology to improve quality, safety

and nursing outcomes as you continue the ongoing journey toward innovation and clinical excellence

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Questions?