Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Handbook of Informatics for Nurses
and Healthcare Professionals
Chapter 1
Informatics in the
Healthcare Profession
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Definition of Nursing
• Nursing encompasses autonomous and
collaborative care of individuals of all
ages, families, groups and communities,
sick or well and in all settings. Nursing
includes the promotion of health,
prevention of illness, and the care of ill,
disabled and dying people.
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Definition of nurse
• noun
1a person trained to care for the sick or
infirm, especially in a hospital.
• verb
1give medical and other attention to (a sick
person): he was gradually nursed back to
health
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
What is it anyway?
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Nursing Informatics
• A field that combines
•
nursing and computers
Informatics is computer
science plus
information science
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Medical informatics
…application of information science and
technology to acquire, process, organize,
interpret, store, use, and communicate
medical data in all of its forms in medical
education, practice and research, patient
care and health management
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Definition of Nursing Informatics
• Informatics is derived from the French term
informatique, as an area of nursing
specialization; nurses with expertise in
informatics are often referred to as nursing
informaticians. (Graves and Corcoran1989)
• In 1980, Scholes and Barber applied this new term to the
art and science of nursing, coining the term, “nursing
informatics”, which they defined as “...the application of
computer technology to all fields of nursing-- nursing
services, nurse education, and nursing research”
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Nursing informatics
“…integrates nursing science, computer science,
and information science to manage and
communicate data, information, knowledge and
wisdom into nursing practice. …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” (American Nurses Association
[ANA] 2007, p. 1).
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
The goal of nursing informatics
• It is to improve the health of populations,
•
•
•
•
•
communities, families, and individuals by
optimizing information management and
communication. This includes
Using technology in the direct provision of care;
Establishing administrative systems;
Management and delivering educational
experiences;
Supporting life-long learning,
Supporting nursing research.
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Nursing Informatics Roles
There are needs to utilize more systematic arid informed approaches to
the application of in for-nation science and technology hi order to
take fall advantage of its potential to enhance and facilitate
community health activities. These are embodied in the
nurses' informatics roles;
'
• Project Management
• Consultant
• Educator
• Researcher
• Development supporter
:
•.Decision support/outcomes management'
• Advocacy/policy development.
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Informatics
The art and science of turning data into
information
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Nursing Informatics
• management and processing of nursing data,
•
•
•
information, and knowledge to support the
practice of nursing and the delivery of
nursing care.
Data-objective entry without interpretation
Information- data that is interpreted
organized, or structured
Knowledge- information that has been
synthesized so that interrelationships are
identified and formalized.
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Example
• Data= 9:00 am -100, 4:00 am 180
• Information= time glucose
9:00 AM
4:00 PM
100
180
• Knowledge= My clients glucose level
rises in the late afternoon. His insulin
dose needs to be adjusted
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Data → Wisdom
• Data—characters, numbers, or facts gathered
•
•
•
for analysis and possibly later action
Information—interpreted data, i.e., B/P readings
Knowledge—synthesis of information from
several sources to produce a single concept
Wisdom—occurs when knowledge is used
appropriately to manage and solve problems
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Knowledge Work
• Healthcare settings are knowledgeintensive
• Exponential growth in knowledge
• Information technology supports evidencebased practice through just-in-time access
to information
• Nurses detect patterns to create new
knowledge
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Knowledge Worker Roles
• Data gatherer. Collects clinical data
• Information user. Interprets clinical data and
•
•
uses it to monitor patients, aids with
decisions
Knowledge user. Compares data to current
knowledge
Knowledge builder. Amasses data to show
patterns that can be interpreted using existing
knowledge or used to create new knowledge
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Information vs. Knowledge
Management
• Good information management provides
the right information at the right time to the
right people
• Knowledge management creates systems
that enable organizations to tap into the
knowledge, experiences, and creativity of
their staff to improve their performance
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Informatics Competencies
•
•
•
•
Entry level
The experienced nurse
The informatics nurse
The informatics nurse specialist (INS)
(ANA, 2007)
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Entry Level Competencies
• Basic computer skills
• Use information technology to support
clinical and administrative processes
• Accesses data and charts electronically
• Support patient safety initiatives via the
use of information technology
• Recognizes role of informatics in nursing
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Experienced Nurse Competencies
• Basic computer skills
• Supports specialty area, including quality
improvement and other activities, via IT
• Uses evidence based databases
• Promotes technology applications
• Uses information systems and works with
IT staff to enact system improvements
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Informatics Nurse
• Proficient with informatics applications to
•
•
•
•
support all areas of nursing practice
Fiscal management
Integration of multidisciplinary
language/standards of practice
Demonstrates critical thinking, data
management, decision-making, and
system development and computer skills
Identifies/provides data for decisionmaking
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Informatics Nurse Specialist
• More sophisticated level of understanding
and skills
• Innovator
• Conducts informatics research and
generates informatics theory
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Forces Driving Information
Technology
• Push for patient safety
• The nursing shortage
• The move towards evidence-based
•
•
•
•
practice
Genomics
Demands for cost-efficient, quality care
Research
Pay for performance
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
The Push for Patient Safety
• Accurate Patient Identification
• Computerized Provider Order Entry
(CPOE)
• E-Prescribing
• Bar-Code and Medication Administration
• Decision support software (DSS)
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
The Nursing Shortage
• Flight out of the profession
• Aging nurses
• Workflow changes to support nurses
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Evidence-Based Practice
• Move towards “proven” interventions
• Driven by demands for greater quality and
cost efficiency
• Provides greater consistency in care from
institution-to-institution and provider to
provider
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Genomics
• The study of genes and their function with
the subsequent ability to tailor treatments
to the individual
• Outgrowth of demands for quality and
efficiency
• Means to provide care tailored to the
individual
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Demands for Quality, Affordable
Care
•
•
•
•
•
Online report cards
Consumer transparency
Remote clinical monitoring
Disease management
Magnet hospital movement
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Informatics Benefits
• Prompts to improve
•
•
documentation
Improved safety with
better patient
identification, decision
support, and tracking
Improved
communication and
access to information
• Support for work
•
•
•
•
processes
Improved records
Decreased
redundancy
Increased
convenience
Improved data
collection
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Educational Opportunities
• Information technology expands access to
all types of education primarily through the
use of the Internet
• Formal and information programs exist to
promote informatics skills
• Web searches can be used to locate
information on specific programs
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
The Future
• Help clinicians to develop needed
•
•
•
•
competencies
Develop and implement information
technology
Generate new knowledge
New roles with consumers
New technology—genomics, robotics,
wearable monitoring devices,
developments in educational technology
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Use of Computers in Nursing Education
•
•
•
•
•
•
Literature Access and Retrieval
Computer Assisted Instruction
Classroom Technology
Distance Learning
Testing
Student and Course Record
Management
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Use of Computers in Nursing Practice
• Bedside Data Entry (medication record
•
•
•
•
•
etc)
Computer-Based Patient Records
Client Monitoring- Local and Distant
Telenursing
Practice Management
(scheduling)
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Use of Computers in Nursing Administration
•
•
•
•
•
Human Resources
Medical Records
Quality Assurance
Accreditation
Budget and Finance
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Use of Computers in Nursing Research
• Literature Search
• Data Collection
• Data Analysis
• Research Dissemination
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
ErgonomicsMost common injuries- muscle and eye strain
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Proper Posture
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.