New nursing informatics by heena
- 1. Nursing Informatics: General purposes Presenter: MRS HEENA MEHTA S.Y.M.Sc. NURSING
- 2. Introduction x The worlds of health care, communication, and information technologies are ever growing, separately and together. x As nurses in the community expand their practice definition to embrace new information technologies, opportunities for improved health care to populations seem endless.
- 3. Introduction…………….. x This advancement is seen as a union of health care technology with information and communications technology, nurturing the design and implementation of health care management information systems in a variety of clinical practice settings. New technology Acute care in Community hospital based setting setting environment
- 4. What is Informatics? x Organizations such as hospitals and community-based agencies such as public health departments and home agencies use information and communications technologies to collect, restore, retrieve, analyze, and present client care data in the care delivery settings. x Decisions related to client care continue to increase in complexity, with the need for rapid, accurate information for clinical decisions making as a priority for effective care.
- 5. Health Informatics x Application of information technology to the health sector has tremendous potentiality for efficacy of health care delivery institutions and provision of cost- effective health care. x Health care delivery institutions will need and use information technology to meet their client demands and stay competitive, since, the future for them lies in cost-effective health care.
- 6. Health Informatics x That is why a host of solutions, standards and services are emerging to meet needs of the health sector. x Application of information technology to the domain of health care delivery is referred to as Health Informatics. .
- 7. What is Nursing Informatics? x Nursing informatics is a field within the field of health informatics, where people who have a nursing degree are involved in the implementation of a computer application in a hospital, nursing home, doctor’s office, public health clinics, or other healthcare setting.
- 9. Definition………..Informatics x Informatics generally can be defined as the art and science of turning data into information. The more recently informatics defined as the study of the application of computer technology and statistical techniques to the management of information.
- 10. Definition…Nursing Informatics ANA x Nursing informatics (NI) is a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, knowledge, and wisdom in nursing practice. x NI supports consumers, patients, nurses, and other providers in their decision- making in all roles and settings. x This support is accomplished through the use of information structures, information processes, and information technology.
- 11. Nursing Informatics… Definition x Nursing Informatics uses nursing science, computer and communications technologies to produce effective and efficient client outcomes for individuals and communities.
- 12. Nursing Informatics… Definition x 1989—Graves and Corcoran defined Nursing Informatics as x “Computer science, information science, and nursing science combined to assist in the management and processing of nursing data, information and knowledge to support the practice of nursing and the delivery of nursing care.”
- 13. Nursing Informatics - Definition x “The use of technology and / or a computer system to collect, store, process, display, retrieve, and communicate timely data and information in and across health care facilities that: x Administer nursing services and resources; x Manage the delivery of patient and nursing care; x Link research resources and findings to nursing practice; x Apply educational resources to nursing education” (Saba, 1996).
- 14. How it all began…. x Late 1960’s first computer systems were implemented in hospitals x Computer nurses began to appear in hospitals x Excellentclinicians x Technically curious and willing to try new things
- 15. Nursing Informatics - Focus x Nursing informatics focuses on the use of “nursing information system” (NIS) to administer nursing resources: x To assist in effective information management; x Monitor the quality, effectiveness, and outcomes associated with the provision of care; x Protect the confidentiality and privacy of patient data.
- 16. Conceptual Framework Nursing Process Data Information Knowledge (raw facts) (interpreted facts) (synthesized information) minute level Synthesis Information and Communication Technology
- 18. Nursing Classification Systems
- 20. Reasons for Classification System Development x To standardize classification x To expand nursing knowledge x To develop information systems x To teach decision making x To determine nursing costs x To allocate nursing resources x To communicate nursing to non-nurses x To link nursing knowledge
- 21. Basic concepts Basic concepts for information systems: x Nursing data: refers to unstructured raw facts; Are discrete entities; Lack interpretation. Forms the basis for a nursing information system. x Nursing information: data that has been given shape and has been interpreted. x Nursing knowledge: synthesized information derived from the analysis of data that has been processed.
- 22. Nursing Data Standards x Needed for the management, documentation and communication of nursing diagnosis, interventions, and outcomes (patient and nursing sensitive). x researchedand supported by the ANA Council on Computer Applications in Nursing and the NLN’s Council for Nursing Informatics.
- 23. Nursing information x Nursing information systems exists within the background of the total continuum of the “integrated patient record system”. x Health care is, and will continue to be an information- intensive attempt. x Information is a critical resource in the health care delivery environment. x Nursing Practice is essentially an information- processing activity.
- 24. Nursing information…… x Nursing information is essential to the accuracy of integrated systems (both health care delivery and information systems). x Patient-specific data are the central point of a totally integrated patient-record system. x Atomic-level data, captured within a Nursing Information System will be used for many purposes.
- 25. Nursing Knowledge x Data and data elements required for nursing information systems are developing. x To ensure high-quality practice, nurses need access to sources of data that are ”beyond institutional, patient-specific data”. x “There will always be a need for human interpretation of computer-processed data”.
- 26. Nursing Classification System’s Integration Into Nursing Practice
- 27. x Information systems development. x Need for standards-based, evidenced based practice. guidelines. x Need for standardized language across the continuum and across nursing practice settings. x Integrated from a trans-disciplinary, integrated healthcare delivery perspective.
- 28. The Need of Nurse Informaticists x Analyze clinical and financial data x Promote and facilitate access to resources and references x Provide nursing content to standardized languages x Enable cost savings and productivity goals x Source
- 29. The Need of Nurse Informaticists ………. x Nurses do not want to be passive consumers of technology x Nurses want devices that are integrated, voice activated, handheld, use biometrics, provide translation, are portable, are wireless, auto settle, and are “smart” x Greater nurse satisfaction leads to greater patient satisfaction
- 30. The Benefits of Nurse Informaticists x Nurse Informaticists promote and facilitate access to resources and references x Support for their mission to deliver high quality, evidence-based care x Support for better service by facilitating true interdisciplinary care x Improvement in key relationships with x providers & care recipients x Enable cost savings and productivity goals x Facilitate change management x Enhance continuity of care
- 31. Trends In Nursing Informatics
- 32. Introduction Technologies emerging in the fields of telecommunications, video and digital imaging, and microprocessing are shaping the future of nursing practice. To measure up to the future needs of nursing, nurses of today must have the vision and desire to become computer aware and technologically literate.
- 33. Definition x Nursing Informatics (NI) is the 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 and knowledge 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. (Scope of Standards of Nursing Informatics Practice -American Nurses Association 2001) x Nursing informatics refers to electronic information combined with nursing and any aspect of clinical practice, administration, research, or education (Guenther, 2006).
- 34. Goal x The goal of Nursing Informatics is to improve the health of populations, communities, families, and individuals by optimizing information management and communication. This includes the use of technology in the direct provision of care, in establishing effective administrative systems, in managing and delivering education experiences, in supporting life-long learning, and in supporting nursing research.
- 35. Standards of practice Organized around a general problem-solving framework that closely resembles the familiar nursing process of x Assessment x Diagnosis x Planning x Identification of Outcomes x Implementation x Evaluation Supports all facets of Informatics Practice, including those without technology
- 36. Solution An informatics solution may encompass technology and non technology products such as: xDeveloping a database xPurchasing a new computer application xCreating nursing vocabulary xDesign informatics curricula xCreating a spreadsheet xTailoring an application to a particular environment x Designing a research study to describe required informatics competencies xDescribing information flow in a process redesign xCreating a structure for information presentation
- 37. History x For three decades or more, nurses have held informatics roles and been key stakeholders in developing, implementing, an devaluating informatics solutions. Although implementing x informatics solutions continues to be very important, more recently informatics nurse specialists have worked to develop and refine nursing’s language, implement tele-health systems, establish NI educational programs and expand the focus.
- 38. Nursing Informatics (NI) – future x Ubiquitous computing is becoming a reality and the continued innovation and miniaturization of technology is evident. Consequently partnering between nurses in all specialties and new technologies is becoming imperative. x Technological innovations are challenging many traditional processes, Telecommunications technologies are one set of tools used in nursing practice. x Core competencies across informatics specialties should be identified in the near future. The distinctions among informatics specialties will continue to blur. x The speed of information transfer and the increasing availability of communication technologies will impact nurses and informatics nurse specialists in the future, making nursing practice and NI, in particular, more international in practices with world-wide standards, competencies and curricula.
- 39. Trends In Nursing Informatics x Mature and Ubiquitous Technology Solutions x Mid-Stage Technology Solutions x Emerging Technology Solutions
- 40. Mature and Ubiquitous Technology Solutions x Order Management & Communication x Clinical Repositories x Departmental Systems (LAB, RAD, etc.) x Picture Archiving Communication System(PACS) x Online Electronic Bed Management Systems x Departmental Scheduling x Staff Scheduling x Intranet/Internet Based Reference Materials (Orders, Protocols, Drug Monographs) Phones, Pagers, In-house Communication Devices x Wide Variety of Fixed & Mobile Devices
- 41. Clinical Systems x Order Management & Communication x Clinical Repositories x Departmental Systems x PACS
- 42. Order Management & Communication x Communication management as a second-order management function:
- 43. CLINICAL REPOSITIORIES The solution is optimised for healthcare enterprises and collects all digital medical images, electronic health records and associated metadata related to patient care.
- 44. DEPARTMENTAL SYSTEM x Understan ding the organizatio n and functions of the hospital x Quality of care - x Leadership
- 45. PACS x n. picture archiving and communication system: an electronic system enabling the storage of digital images on electronic media, for later retrieval and subsequent display on high-resolution monitors.
- 46. Enterprise Systems Online Electronic Bed Management Systems x Nurse assignments are no longer hand written x Determine the real-time census of units x Reports available to track lengths of stay x Monitor delays in patient movement x Determine bed availability quickly x Spend less time negotiating on the telephone Departmental Scheduling Systems x Deployed as standalone or in centralized models
- 47. Administrative & General Workflow Staff Scheduling x Allows healthcare facilities to create templates for the various skills and skill mixes that exist across their units and facilities Using this template a computerized system optimizes staffing based on identified and known constraints. x Facilitates identification of staff preferences in mind x Logic identifies when a skill mix is off x Logic identifies when a nurse is being asked to go to an area that she/he is not trained for x Time required for schedule creation has decreased significantly x Staff satisfaction has improved
- 48. Intranet Based Reference Materials (Orders, Protocols, Drug Monographs) Phones, Pagers, In-house Communication Devices x Wide Variety of Mobile Devices x Designed to augment clinical workflow needs can be personalized to the care giver and specific documentation or data entry needs x Laptops x PDAs x Notebooks x COWs (Computers on Wheels) x Many Others
- 49. Mid-Stage Technology Solutions Online and Integrated Electronic Patient Documentation x Integrated Hemodynamic Monitors (Vitals Signs) with EMR x Hand-held Devices for Data Collection & Input x Online Fully Integrated Medication Administration Record x Online and Integrated Rules and Alerts x CPOE – Computerized Provider Order Entry x Bar Code Technology x Access and Security Technology x Sophisticated Implementation Methodologies x Organization of Nursing Practice through Technology- Time and Motion Templates, Nomenclature/Data Standardization Tools, Care Plan Standardization and Tool Sets
- 50. Clinician’s Access to patient record system x Attending Physician, Nursing, Consulting Physician(s), Respiratory Care, Case Management x Nutritional Services, Risk Management, IV Team, Patient Financial Services, Infection Control x Wound Management, Pastoral Care, Clinical Process Improvement, Cardiology, PT/OT/Speech, Others.
- 51. Barriers x Record must be on unit x All clinicians and support, personnel must walk to location of chart x One person can access the chart at a time x Legibility of chart input x Timely filing of data results into chart x Finding clipboard for most current information x Redundant information
- 52. Clinician’s Access to online record Electronic patient data barriers: • Systems Availability • User Acceptance
- 53. Integrated Hemodynamic Monitors (Vital Signs) with EMR xVital signs are automatically updated to the patient EMR xEliminates paper documentation and accurately captures patient information at the point of care xDevices are fixed in the patient room or mobile on COWs (Computers on Wheels)
- 54. Hand-held Devices for Data Collection & Input xAssist with obtaining, verifying, and communicating data xCardiology, Transplant, and other clinically significant data can be entered directly online xEliminates the need for bulky data collection sheets xEnhances the ability for version control of data entry Documents
- 55. Online Fully Integrated Medication Administration Record xSignificant time reduction associated to documenting medications xSignificant time reduction associated with transcription of medications to paper MAR xDecreased transcription errors xIncreased patient safety
- 56. Online and Integrated Rules and Alerts (Workflow) xDrug-allergy alerts based on order entry functionality xDrug-drug interaction alerts xAlerts for abnormal lab values and vital signs xAlerts for new orders xAlerts for order renewals xAlerts for scheduled patient events
- 57. CPOE – Computerized Provider Order Entry xNurses no longer struggle to read physician handwriting xReduces verbal orders xAll providers can enter orders directly online - Integrated rules and alerts, Integrated allergy check xDecreases chances for transcription error xReduces delays in patient care
- 58. x Bar Code Technology x Barcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right time x System alerts the nurse immediately if any inconsistencies or potential problems exist x Internal back-up systems are in place to back-up information regularly so a MAR can be printed in the event of system downtime x Integration with electronic MAR and documentation systems becoming more common place
- 59. Access and Security Technology x Single Sign-On x Biometric Sophisticated Implementation Methodologies x Sophisticated planning and implementation methodologies take the guess work out of project management x Include workflow, communication, risk mitigation, system design and analysis, as well as overall task management activities x Tightly integrated financial management tools to ensure projects stay on track and in budget
- 60. x Organization of Nursing Practice through Technology x Time and Motion Templates x Nomenclature/Data Standardization Tools x Care Plan Standardization and Tools Sets
- 61. Emerging Technology Solutions x National Patient Databases for comprehensive patient record across disparate providers x Patient Health Cards – contain all medical records and information x Advanced Biometric Access and Security functionality x Voice recognition within electronic medical records x Hands free communication tools
- 62. Journals on Informatics Nursing x CIN: Computers Informatics Nursing (formerly, Computers in Nursing) x Journal of the American Medical Informatics Association (JAMIA) x International Journal of Medical Informatics (IJMI) x International Journal of Bio-Medical Computing (IJBC) x Online Journal of Nursing Informatics (OJNI)
- 63. x SUMMARY x MEANING AND DEFINITION x NURSING INFORMATICS x HISTORY x NURSING CLASSIFICATION SYSTEM x BASIC CONCEPT
- 64. x NEED OF NURSING INFORMATICS x BENEFIT x TRENDS AND DEFINITION x TRENDS IN NURSING INFORMATICS.
- 65. Conclusion x Nursing informatics is a developing field of study that is highly interdisciplinary. It is strongly connected to education, business, and computer science.
- 66. BIBLIOGRAPHY