Collective Action
Nursing Informatics
Collective Action
O Activities that are undertaken by
a group of people who have
common interests.
O Aids nurses in advocating for
patients, families, and
communities in healthcare and
political arenas
Four Main Purposes of
Collective Action for Nurses
O To promote the practice of professional
nursing
O To establish and maintain standards of
care
O To allocate resources effectively and
efficiently
O To create satisfaction ad support in the
practice environment
Nursing Governance
O The method or system by
which a department of
nursing controls and directs
the formulation and
administration of nursing
policy.
The Focus
O Nurses have three strategies
to achieve collective action:
O Shared governance
O Workplace advocacy
O Collective bargaining
Shared Governance
O A democratic, egalitarian
concept
O A dynamic process
O A process of shared decision
making and accountability
Shared Governance Can:
O Lead to better decisions.
O Be more effective in day-to-
day practices.
O Generate additional ideas for
implementation.
Workplace Advocacy
O The objective is to equip nurses
to practice in a rapidly changing
environment. Advocacy occurs
within a framework of mutuality,
facilitation, protection, and
coordination.
Manifestations of Workplace
Advocacy
O Ensuring relevant information
O Enabling the selection of
information
O Disclosing a personal view
O Providing support for making and
implementing decisions
O Helping determine personal values
Collective Bargaining
“…the performance of mutual obligation
of the employer and the
representatives of the employees to
meet at reasonable times and confer
in good faith with respect to wages,
hours, and other terms and conditions
of employment or the negotiation of
any agreement or any question arising
thereunder...”
8
Labor Management Reporting Act, 1947, Section
Collective Bargaining cont.O Nurses have a low rate of
unionization.
O Nurses are a prime target for
membership growth.
O Constant challenges exist to the
way nurses are viewed for
collective bargaining purposes.
Nurses as Knowledge Workers
O Nurses have multiple degrees
and certifications
O Practice is guided by science
rather than procedure
O Collective action is geared
towards improving patient
outcomes/quality of care
Union or At Will
O At will employees can be terminated
for any reason except discrimination
within reason of the law
O Employees are at the “will” of the
employer
O Unions require employers to follow
due process. Unionized employees
have more “rights” and are
represented by the union
Whistleblower Protection
O Whistleblowing “refers to a warning issued
by a current or former employee of an
organization to the public about a serious
wrongdoing or danger created or concealed
within the organization” (Hunt, 1995, p.
155).
O The 1989 Whistle Blower Protection Act
protects federal workers. The law does not
cover the private sector.
Selecting a Bargaining Agent
O A strong commitment to nursing practice,
O
O
O
O
legislation, regulation, and education
A well-prepared practice, policy, and labor staff;
a minimum of a bachelor’s degree in nursing
Representative of those the bargaining unit
represents in both gender and ethnic makeup
National scope and local implementation
Control by individual members over bargaining
unit activities
Selecting a Bargaining Agent
O ANA created the UAN in 1999 to ensure that
nurses have access to collective bargaining
O Today it has joined with other nursing
organizations to form the National Nurses
United
O Not all nurses are eligible to join a union;
nurses who are statutory supervisors are
not eligible.
Caring, Communicating, and
Managing with Technology
Chapter 11
Nurses and Technology
O Nurses are knowledge workers; they
need data and information to do their
jobs effectively
O Nurse knowledge workers need
support from information technologies
Types of Technology
O Biomedical
O Informational
O Knowledge
Biomedical Technology
O Four types of technologies:
O Physiologic monitoring – EKG, ICP
monitoring
O Diagnostic testing – Can also be EKG, ICP
monitoring
O Drug administration – Automated
Dispensing Cabinets (Pyxis)
O Therapeutic treatments – insulin pumps
Information Technology
O Computers:
O Store.
O Organize.
O Retrieve.
O Communicate.
Structured Terminologies
O Collecting information from every
patient and every health care
encounter can be used to make
comparisons among patients,
organizations, and countries
O The Nursing Minimum Data Set
(NMDS) was created to define
essential data elements to be
collected on all patients
Four Purposes of NMDS
O Establish the comparability of patient care
O
O
O
O
across clinical populations, settings,
geographical areas and time
Describe the care of patients and families in
various settings
Provide a means to mark the trends in the care
provided and the allocation of nursing resources
based on health problems or nursing diagnosis
Stimulate nursing research through links to
existing data
Provide data about nursing care to influence and
facilitate health care policy decision making
Information Systems
O Issues:
O Patient safety
O Ethics
O Information security
O Privacy
Nursing Informatics
O Informatics is “A science that combines a
domain science, computer science,
information science, and cognitive science”
(Hunter, 2001, p. 180)
O Nursing Informatics is “ the application of
computer technology to all fields of nursing
– nursing services, nurse education, and
nursing research”
O Nursing informatics is the transformation of
data into information then knowledge
Knowledge Technology
O Systems that generate or process
knowledge and provide clinical decision
support
O Clinical decision support systems are a
clinical computer system, application or
process that helps health professionals
make clinical decisions to enhance patient
care; they mimic the inductive and deductive
reasoning a human expert
Evidenced-Based Practice
(EBP)
O Whether you are a leader, a manager,
or a follower, you have to rely on
evidence-based practices to enact
your profession.
O A systematic approach to clinical
decision making to provide the most
consistent and best possible care to
patients
Five Key Elements of EBP
O Ask a clinical question.
O Acquire the evidence.
O Appraise the evidence.
O Apply the evidence.
O Assess the outcomes.
Ask a Clinical Question
O PICO
O Population
O Intervention
O Comparison
O Outcome
PICO determines the nature of the
question.
Acquire the Evidence
O Only through computerized
technologies can we search
the literature in an efficient
manner.
Appraise the Evidence
O Answer these questions
about the evidence found:
O Is it valid?
O Is it important?
O Is it important to the
patient?
Apply the Evidence
O Depending on your
organization, you need to
apply the new evidence or
propose a practice change to
the appropriate body.
Assess the Outcomes
O Informatics plays an
important role in the
measurement of daily
practices and the
synthesizing of data into
reports.
Technology and Health Care:
Smart Cards
O Patient demographics/photo identification
O ICE—In Case of Emergency—contact and other
O
O
O
O
key information
Patient medical history: allergies, medications,
immunizations, laboratory results, etc.
Past care encounter summaries, including
surgical procedures
Patient record locations and electronic address
information
Ability to upload or download patient information
10 C’s for Evaluating Internet
Sources
O
O
O
O
O
O
O
O
O
O
Content
Credibility
Critical thinking
Copyright
Citation
Continuity
Censorship
Connectivity
Comparability
Context
Reference
O Yoder-Wise, P.S. (2011).
Leading and Managing in
Nursing (5th ed). St. Louis,
MO: Elsevier-Mosby, Inc.