Nursing Informatics: Reflect On Your Own Practice
Reflect on your own practice(Register Nurse in a Rehab/LTC setting).
Discuss how informatics is used in your practice. What is your primary area where you would use informatics? From completing the Pre-TANIC TIGER assessment for this week, what do you plan to achieve in this course? How did you feel your competency level was compared to the assessment?
Must use APA format and 350 words references must be with in than 5yrs old
Health information technology (HIT) is pivotal to the transformation of healthcare but in order for that potential to be realized, healthcare leaders at all levels—national, regional, and local—must first understand what nursing informatics is in order to understand (McGonigle, Hunter, Sipes, & Hebda, 2014) strategies to create the necessary framework.
As future leaders, you share a responsibility for this transformation. Some of the groundwork has been laid—the identification of needed knowledge and skills, standardized terminologies, and key HIT legislation, but more work lies ahead.
Strategies to transform healthcare with HIT also call for coordination and simultaneous changes in healthcare delivery processes to accomplish specific results, such as increased patient safety, cost reduction, increased access to care, integration of evidence-based care practices, improved coordination of care, better patient tracking, ongoing quality improvements, and improved patient outcomes (Mendelson & Johnson, 2011;Totten & Paloski, 2012).
HIT is more than electronic health record (EHR) systems. EHRs provide much useful individual and aggregate data, but real-time data and information supplied by clinical decision support (CDS) tools outside of EHRs and analytics are needed to predict changes and support informed decisions across all sectors of healthcare and nursing. And that doesn’t even begin to look at applications such as telehealth, monitoring technologies, and many smart technologies! Most current systems do not have the real-time data and CDS tools to see “the big picture,” but the healthcare industry is moving to embrace these tools (Emerging models, 2013; Hogan, 2012; Johnson et al., 2012).
Healthcare also needs to “leverage the potential of the Internet” and patient portals to access records, support patient-provider communication and education, and facilitate self management of care (Mendelson & Johnson, 2011). What is analytics? If you have signed up for special discounts with a retail store and have a special card or key fob that you use to get store discounts, data is collected about your shopping habits and to tailor ads to you. For example, are you a pet “parent?” Do you buy expensive brands of cat or dog food?
This collection and use of data is one example of analytics which is the discovery and communication of meaningful patterns in data which can then be used to improve marketing, or in healthcare services for the demographics served. Other terms to describe analytics include data mining and knowledge discovery in databases.
HIT has the very useful capability to examine relationships among trends, interventions, and outcomes, which can aid planning or be used to stem unwanted events (Mendelson & Johnson, 2011). “2016 will be a year of firsts for players within healthcare as the industry adapts to the main forces driving the new health economy: The rise of consumerism, the focus on value, downward pressure on costs, technological innovation and the impact of new entrant,” (PricewaterhouseCoopers, 2015).
Realizing this potential requires a knowledgeable, prepared nurse leader and nursing workforce. Technology Versus Informatics The presence of technology does not mean that it will be used or used well. Technology is only a tool that is useless if you don’t know what it can do or how to use it to your advantage.
You wouldn’t use a syringe to check your blood pressure! That is where the importance of informatics comes into play. Informatics provides the knowledge, skills, and understanding that allow us to harness the tools at hand and to use them well to enact improvement. So what is informatics? What Is Informatics? The term informatics comes from the French word informatique, which refers to the use of computers and statistical methods to manage information (Hebda & Czar, 2013).
Informatics has since gained recognition as a specialty area that applies concepts from computer, cognitive, and information sciences, as well as other emerging areas, to manage and communicate data, information, knowledge, and wisdom. For the sake of clarity, let’s discuss these foundational sciences briefly.
Computer science studies the theory underpinning information and computation and their implementation in computer systems. Facets include hardware, software, and communications as well as solutions to related problems. Cognitive science looks at how the human mind works from an information processing perspective. Information science deals with the retrieval and management of information as well as human-computer interaction.
Informatics can be applied to many different domains or disciplines. In healthcare, the terms healthcare informatics or medical informatics are widely used and are often used as “umbrella terms” to include each of the healthcare disciplines and consumers. While this approach has some merit, it does not consider the needs of individual disciplines such as nursing, pharmacists, or dieticians—shrouding them in a cloak of invisibility.
What is nursing informatics? Nursing informatics is all about supporting both the work that nurses do and the decision-making process for healthcare consumers and other providers to enable optimal outcomes. We will discuss nursing informatics as a specialization next week, but now our focus is why nurses need informatics knowledge and skills.
Nurses have a long history of collecting data, turning it into information, creating knowledge, and ultimately wisdom. This process is known as knowledge work and nurses are knowledge workers. Technology can aid knowledge work by helping nurses to collect data, see trends, process information, and create knowledge that can be used to create wisdom, but nurses need to understand the processes that allow this to happen as well as the tools that HIT offers them.
Today’s nurse needs a solid knowledge base, clinical competency, and skill sets that include informatics competencies in order to provide safe, effective, efficient, patient centered care. This is particularly true at a time when the achievement of a birth-to-death electronic health record (EHR) for every American is a national goal and HIT has been proposed as a means to address the problems seen in the healthcare delivery system.
The Quality and Safety Education in Nursing (QSEN) project identified informatics as one of the six key skill areas that nurses need to achieve optimal patient care. More specifically, QSEN identified the knowledge, skills, and attitudes that nurses need in the following six areas to achieve this level of care (American Association of Colleges of Nursing QSEN Consortium, 2012). • • • • • • Quality:
The ability to use data for quality improvement purposes Safety: The ability to minimize risk of harm to both patients and providers Teamwork and Collaboration: The ability to work collaboratively and as a member of a team Patient-Centered Care: Recognition of the patient as the locus of control and partner in his or her own care Evidence-Based Practice Informatics: The use of information and technology to communicate, manage knowledge, minimize error, and support decisions.
The QSEN project initially concentrated on pre-license students, but has since identified graduate-level competencies in collaboration with the American Association of Colleges of Nursing to prepare future leaders in all areas of nursing practice in accordance with the recommendations of the Institute of Medicine (2011) in its Future of Nursing report.
The demands of the healthcare delivery system and ensuring that all nurses are adequately prepared with essential skills have implications for master’s-prepared nurses. First, there is a need to understand what informatics—particularly nursing informatics—is and its potential benefits. Second, there is a need to develop informatics competencies expected of graduate-level nurses.
And third, and as future leaders in practice, administration, education, and research (Future of Nursing, 2011; AACN QSEN Educational Consortium, 2012), nurses prepared at the master’s level need to ensure that all nurses develop and demonstrate informatics competencies appropriate to their levels of preparation and practice. If there are any doubts about what these competencies might be, The Technology Informatics Guiding Education Reform (TIGER) Initiative (2009), compiled and posted a list of competencies on its website that every nurse should display.
TIGER first came into being with an invitation-only summit, Evidence and Informatics Transforming Nursing, in 2006, which invited leaders from nursing, government, informatics and technology organizations, and other stakeholders to come together to create a vision to transform nursing to bridge the quality chasm through the use of technology (TIGER, 2013a). TIGER continues its focus on the use of informatics and technology ‘to make healthcare safer, more effective, efficient, patient centered, timely and equitable by interweaving evidence and technology seamlessly into practice, education and research fostering a learning healthcare system’ and is a useful resource (The TIGER Initiative, 2013b).
The American Association of Colleges of Nursing has also identified informatics competencies expected for each program graduate in their Essentials documents as well as a crosswalk document that provides a quick comparison by program level (American Association of Colleges of Nursing, n.d.). Reflection Consider one example of a nursing informatics skill or competency that is routinely seen in nursing practice.
What is it? Would most practicing nurses consider it a nursing skill or a nursing informatics skill? What is your rationale for this reply? Reflection Consider one example of a nursing informatics skill or competency that you feel you do well. Did you always consider it a nursing skill or a nursing informatics skill? What is your rationale for your response? Summary Informatics competencies are essential in a healthcare delivery system that is not only heavily dependent upon HIT, but attempting to use it as a means to transform healthcare delivery. All nurses need informatics competencies.
The master’s-prepared nurse, as a leader in nursing practice, needs to demonstrate a higher level of competencies than nurses prepared at lower levels. Informatics provides the ability to support nursing, healthcare consumers, and other professions through the use of information, information structures, processes, and technology.
- American Association of Colleges of Nursing (AACN). (n.d.). Crosswalk of the master’s essentials with the baccalaureate and DNP essentials. Retrieved from http://www.aacn.nche.edu/faculty/faculty-tool-kits/masters-essentials/Crosswalk-ofMa sters.pdf
- American Association of Colleges of Nursing QSEN Consortium. (2012). Graduate-level QSEN competencies: Knowledge, skills and attitudes. Retrieved from http://www.aacn.nche.edu/faculty/qsen/competencies.pdf
- American Nurses Association. (2015). Nursing informatics: Scope and standards of practice. Silver Spring, Nursing informatics: Reflect on your own practice
- MD: Nursebooks.org. Clarke, S., & French, S. (2013). Healthcare reform in 2013: Enduring and universal challenges. Nursing Management, 44(3), 45–47. doi:10.1097/01.NUMA.0000427185.42306.14
- Emerging models of care take direct aim at the changing needs of the industry. (2013). Managed Care Outlook, 26(6), 2–6. Health
- IT hits federal and industry agendas. (2013). hfm (Healthcare Financial Management), 67(4), 12–13. Hebda , T. & Czar, P. (2013). Handbook of informatics for nurses & healthcare professionals (5th ed.).