NURSING INFORMATICS JINKY AYALA NOTES UNIT 1: Introduction to Information Technology Lesson 1: Overview of Nursing Informatics Lesson 2: Informatics Science Lesson 3: Historical Perspective of nursing informatics Lesson 4: History of Nursing Informatics in the Philippines INFORMATION TECHNOLOGY • • It is the study, design, development, implementation, support, or management of computerbased information systems, particularly software applications and computer hardware. It deals with the use of electronic computers and computer software to convert, store, protect, process, transmit, and retrieve information securely. Impacts of IT in the society • • • • • • Business and economy Education Workplace and labor market Private life and society Government Health sciences Business and economy • It promotes market like forms of production and distributions • For example, Lazada, Shopee, Amazon, Grab Workplace and Labor Market • Allows individuals to communicate with one another in ways complementary to traditional face to face and telephonic mode Education – the integration of information technology in classroom learning and teaching define how the students are motivated and given importance in their learned knowledge and skills. Internet portrays a significant role in delivering quality learning and instructions through distance learning education. Government – it promotes transparency, increase civic awareness as well as accountability and efficiency of government leaders and officials. • Government organizations can post select documents online, which allows citizens easy and quick access to commonly sought information on-demand. Government organizations can deploy a public document portal for citizens and media groups seeking information about proposals that are public information. Transparency is used as a means of holding public officials accountable and fighting corruption. When a government's meetings are open to the press and the public, its budgets may be reviewed by anyone, and its laws and decisions are open to discussion, it is seen as transparent. Private Life and Society – increasing representation of wide variety of content in digital form results in an easier and cheaper duplication and distribution of information • For example, Facebook, Twitter, Instagram, Tik-Tok, and such. Health Sciences – through information technology, the level of healthcare as compared to before elevates. It allows patients to be given quality health services with the implementation of Electronic Health Record, Telemedicine, and medical equipment technology • Electronic Health Record – it helps in maintaining the patient’s medical history for better diagnosis and treatment of diseases • Medical Equipment Technology – the idea of non-invasive procedure which allows diagnosis of disease internally as well as the minimal-invasive surgery through robotics which leaves less scars and allows faster treatment to the patients. WHAT IS NURSING INFORMATICS? It is the integration of nursing science, computer science, cognitive science, and information science designed to assist in the management and processing of nursing data, information, and knowledge to support nursing practice, education, and research. WHAT IS THE GOAL OF NURSING INFORMATICS? 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 managing and delivering educational experiences, supporting life-long learning, and supporting nursing research. APPLICATIONS OF NURSING INFORMATICS PRACTICE EDUCATION ADMINISTRATION RESEARCH PRACTICE • Work lists to remind staff of planned nursing interventions • Computer generated client documentation including discharge instruction and medication information • Monitoring devices that record vial signs and other measurement directly into the client • Computer generated nursing care plans and critical pathways EDUCATION • Online course registration and scheduling • Computerized student tracking and grade management • Computer-assisted instruction • Course delivery and support for web-based education • Remote access to library and internet resources • Teleconferencing and webcast capability • Presentation software for preparing slides and handouts • Online test administration • Communication with students ADMINISTRATION • Automated staff scheduling • Online bidding for unfilled shifts • Electronic mail for improved communication • Cost analysis and finding trends for budget purposes • Quality assurance and outcome analysis • Patient tracking and placement for case management RESEARCH • Computerized literature searching • The adoption of standardized language related to nursing terms • The ability to find trends in aggregate data, which is data derived from large population groups • Use of the internet for obtaining data collection tools and conducting research • Collaborate with other nurse researchers EVOLUTION OF NURSING INFORMATICS 1950s – computers were initially used in healthcare facilities for basic office administrative and financial accounting functions. These early computers used punch cards to store data and card readers to read computer programs, sort, and prepare data for processing. 1960s – studies were conducted to determine the effective utilization of the computer technology in health care industry and to identify the areas of nursing that needs to be automated. Hospital information systems (HIS) were developed primarily to process financial transactions and serve as billing and accounting system 1970s – hospital began developing computer-based information systems which initially focused on physician order entry and results reporting, pharmacy, laboratory, and radiology reports, information for financial purposes. Several states and large community health agencies developed and or contracted for their own computer-based systems (MIS) 1980s – during this decade, the field of informatics emerged in the healthcare industry and nursing. NI became an accepted specialty and many nursing experts entered the field. Technology challenged creative professionals and the use of computers in nursing became revolutionary. Discharge planning systems were developed and used as referrals to community health care facilities in the continuum care. 1990s – computer technology became an integral part of healthcare servicing, nursing practice and the nursing profession. Policies and legislation were adopted promoting computer technology in healthcare including nursing. 2000s – clinical information systems became individualized in the electronic patients record (EPR) or electronic health record. Information technologies continued to advance with mobile technology such as with wireless tablet computer, personal digital assistants (PDAs), and cellular phones. Telenursing is increasing in popularity and providing patient care in an efficient expeditious fashion. HISTORY OF NURSING INFORMATICS IN THE PHILIPPINES 1996 – The Philippine Medical Informatics Society was officially registered under the Securities and Exchange Commission by its board composed of eleven physicians. The organization was headed by Dr. Alvin Marcelo. The PMA and its founders had strong influence in the development of health informatics in the Philippines 1998 – faculty members of the University of the Philippines began formal education and training in medical informatics and information science Dr. Herman Tolentino took a post-doctoral fellowship in medical informatics at the University of Washington. Dr. Alvin Marcelo for his training at the National Library of Medicine Dr. Cito Maramba went to Coventry for his master’s in information sciences at the University of Warwick. They were later followed by other physicians such as Dr. Michael Muin and Sr. Ryan Banez. 1999 – A study group was formed headed by the National institute of Health of the University of the Philippines Manila. This group identified international standards for health information and their adaptability in the Philippines. Standards of Health Information of the Philippines 1999 (SHIP99) was established. It was headed by National Institute of Health of the UP Manila with the collaboration of Philippine Nurses Association. 2008 – nursing informatics course in the undergraduate curriculum was defined by the Commission on Higher Education (CHED) Memorandum Order % Series of 2008. This was later revised and included as health Informatics course in CHED Memorandum Order 14 Series of 2009. This was first implemented in the summer of 2010. CURRENT ISSUES AND PROBLEMS • • • • Lack of devices, machines, resources, and methods of utilizing information, computers, and nursing science in nursing. It is costly to train nurses on the use of the program for electronic documentation Nurse Informatics are also scarce in the Philippines Some nurses in the Philippines are computer illiterate. NURSING INFORMATICS MODEL (THEORIES, FRAMEWORKS, AND MODELS OF NURSING INFORMATICS) GENERAL MODELS: 1. 2. 3. 4. 5. Graves and Corcoran’s model Schiwirian’s model Turley’s model Data Information Knowledge (D-I-K) Benner’s Novice to Expert Model. 1. GRAVES AND CORCONAN’S MODEL (1989 – 1995) • A combination of computer science, information science, and nursing science is designed 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. MANAGEMENT DATA INFORMATION KNOWLEDGE Management processing is integrated within each element, depicting nursing informatics as the proper management of knowledge, from data as it is converted into information and knowledge. SCHIWIRIAN’S MODEL (1986) • • According to this model, nursing informatics involves identification of information needs, resolution of the needs, and attainment of nursing goals/objectives. Patricia Schiwirian proposed a model intended to stimulate and guide systematic research in nursing informatics, model or framework that enable identification of significant information needs, that can foster research. TURLEY’S MODEL (1996) • • Nursing informatics is the intersection between the discipline-specific science (nursing) and the areas of informatics. And in this model, there are 3 core components of nursing informatics, namely: 1. Cognitive science 2. Information science 3. Computer science DATA INFORMATION KNOWLEDGE (2001) • • According to this model, NI is a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, knowledge, and wisdom into nursing practice. Nursing informatics is an evolving, dynamic process involving the conversion of data into information, and subsequently knowledge. BENNER’S NOVICE TO EXPERT MODEL • Benner noted that the novice to expert model is a situational model, not a trait model. This means that when a nurse educator is placed in a different situation in which one has little experience, the person reverts to using context-free rules and theory to guide action (Benner, Tanner, & Chesla, 2009). 1. Novice – individuals with no experience of situations and related content in those situations where they ae expected to perform tasks 2. Advance beginner – marginally demonstrate acceptable performance having built on lessons learned in their expanding experience base; needs supervision. 3. Competent – enhanced mastery and the ability to cope with and manage many contingencies. 4. Proficient – evolution through continuous practice of skills, combined with professional experience and knowledge; individual who appreciates standards of practice as they apply in nursing informatics 5. Expert – individual with mastery of the concept and capacity to intuitively understand the situation and immediately target the problem with minimal effort or problem solving.
