Changing
Information of
Nursing
HOUSE KEEPING
This is 1.5 Hour class
Restrooms are located…
Cell Phones
Please turn off or change to vibrate
If you must answer a call, please leave the room.
2
Learning
Objectives
• Identify the evolution of Nursing Informatics (NI)
•
•
•
in health care
Identify the evolution of the Department of
Veterans Administration (VA) Nursing informatics
roles and articulate the role of existing strategic
visions and missions of the Office of Nursing
Service Informatics (ONSI) and the Chief Health
Informatics Office (CHIO)
Describe the link between NI competencies and
quality, safety, efficiency, and a healthy work
environment
Describe the relationship of how NI can support
informatics across the health care industry
3
Introduction
4
Introduction
•
•
•
•
•
Technology adoption improves safety, quality
and access to care - supporting nursing
informatics competencies development
Health and information technology
exponential growth
Focus on quality, safety, & efficiency
Woven into the fabric of nursing practice,
administration, education and research
Nursing leaders should define nursing
informatics infrastructures at
enterprise/system & facility/local level
5
What is Nursing Informatics?
Presentations, publications and surveys on the
functions of the nurse Informaticist:
 http://www.himss.org/ASP/topics_FocusDynamic.asp
?faid=243
 Nursing and Informatics for the 21st Century: An
International Look at Practice, Trends and the Future
- Book (2/8/2008)
 Nursing Informatics 2007 Workforce Survey - Who
Are We Now? - Survey Result (2/8/2008)
 Nursing Informatics 2004 Workforce Survey - Who
are we? - Survey Result (2/8/2008)
 Nursing Informatics 101 - Presentation (2/8/2008)
 An Emerging Giant: Nursing Informatics - Other Pubs
(11/13/2007)
6
Nursing Informatics Definition

The integration of nursing science, computer
and information science, and cognitive science
to manage communication and expand the data,
information, knowledge and wisdom of nursing
practice
(ANA, 2008)
7
Nursing Informatics Definition
(cont.)
“Nursing Informatics is a 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, information,
knowledge, and wisdom to support patients,
nurses and other providers in their decisionmaking in all roles and settings. This support
is accomplished through the use of information
structures, information processes, and
information technology.”
(ANA Scope and Standards of Nursing Informatics Practice, 2008, pg 1)
8
Nursing Informatics Definition
(cont.)
Nursing informatics is using technology,
research, and professional experience to
manage nursing data, information, and
knowledge to improve practice and deliver better
health care.
Simpson, Roy (2006). In H. A. Park, P. Murray,& C. Delaney, C. (Eds.). Consumer-Centered Computer-Supported
Care for Healthy People. Amsterdam, Netherlands: IOS Press, p 5
9
Domains of Nursing Informatics






System Lifecycle
Human Factors
Information Technology
Information Management
Professional Practice
Models and Theories
10
Nursing Informatics
Competencies
Informatics Nurse Specialist skills common to
Nurse Executive skills
• Computer literacy skills
• Information literacy skills
• Project management skills
• Information management and communication
• Leadership
• Make judgments based on data trends and
patterns
• Change Management
• Innovation
11
Nursing Informatics
Functional Areas
•
•
•
•
•
•
•
•
•
Administration, leadership and management
Analysis
Compliance & integrity management
Consultation
Coordination, facilitation, and integration
Development
Educational & professional development
Policy development & advocacy
Research evaluation
12
Analyst Role
Quality and Safety
• Outcomes management
• Synthesize knowledge
• Performance improvement
• Maintain data integrity and reliability
• Aggregate data
• Identify benchmarks
• Develop performance measures
• Assess workflow
13
Benefits of IT in Healthcare
Safety
•
Computer technologies can place safety
barriers within high risk processes to
improve patient safety
14
Benefits of IT in Healthcare
(cont.)
Efficiency
•
•
•
•
Achieved through the use of computers and
computer technology as a data management
tool
Moving away from paper records – improves
access to the data you need without flipping
through a bulky patient record
Easier retrieval of data associated with a
particular process
Data sharing is improved between disciplines
15
Benefits of IT in Healthcare
(cont.)
Quality Improvement
•
•
Allows for auditing to assure a consistent
standard of care
Measurement of performance against
standards of practice to identify systems
issues and opportunities for improvement
16
Benefits of IT in Healthcare
(cont.)
Decision Support
•
Cues and information built into the system
to assist the clinician in making care
decisions
17
HIMSS 2007 Nursing
Informatics Survey

Nursing Informatics Job Titles
 14% “clinical analysts”
 14% “informatics nurse specialist” or “nursing
informatics specialist”
 9% “consultant”
 40% identified “other”

Director of Clinical Informatics, Clinical Informatics
Coordinator, Clinical Systems Analyst, Clinical
Informatics Specialist
18
What Can I Do For You?
Data Management
Workload statistics
 Performance monitoring
 Performance improvement projects

 Identification
of problem areas
 Before and after data

Regulatory compliance
19
What Can I Do For You?
(cont.)
Project Management


New applications
The job isn’t over when the software is
implemented
 Monitoring local usage
 Reporting to oversight bodies
 Training
20
What Can I Do For You?
(cont.)
Training and Education
•
•
•
•
•
New employees
Student nurses
Updates
Annual education/competency
Ongoing reminders
21
What Can I Do For You?
(cont.)
Be a National Voice
•
•
•
•
•
Software work groups
Alpha testing
Beta testing
National presentations
Oversight boards
22
Informatics Attitudes




Appreciate the necessity for all health
professionals to seek lifelong, continuous
learning of information technology skills
Value technologies that support clinical decisionmaking, error prevention, and care coordination
Protect confidentiality of protected health
information in electronic health records
Value nurse’s involvement in the design,
selection and implementation of information
systems
23
Evolution of Nursing
Informatics in VA
Nursing Automated Data Processing
Application Coordinator (ADPAC)
 Clinical Application Coordinator (CAC)
 Bar Code Medication Administration
Coordinator (BCMA-C)
 VA Nursing Outcomes Database
Coordinator (VANOD) & Nurse Information
Specialist
24

Evolution of Nursing
Informatics in Industry
25
Murielle Beene, Chief Nursing
Informatics Officer
Creating a Nursing Informatics
Infrastructure
 Nursing Strategic Plan, Role of the Chief
Nurse Informatics Officer
 Nursing Informatics Leadership

26
Creating Nursing Informatics
Infrastructure
Defined roles, responsibilities and
resources for Nursing Informatics
 Enterprise/system level

 Emerging


role
Chief Nursing Informatics Officer (CNIO)
Facility/local level
27
Why a Nursing Informatics
Department?

Historical absence of administrative or
informatics infrastructure

Disparate data sources and reports

No formal process for data validation

No formal process to assess data accuracy

Under resourced nursing management team

Missing link to the operations – important data to
inform decisions making
28
29
Typical Leadership
Relationships
CEO
CNO
CMO
COO
30
Chief Nurse Executive Role
Critical in selection, implementation, and
evaluation
 Overall facility/healthcare system impact
 Nurse Executive must be actively involved
in over-all decision-making and
implementation process

31
VHA Nursing Strategic Plan
2008-2012

National Nursing goals:
 Nursing Practice
Transformation
 Evidence-Based
Practice
 Excellence in
Leadership
 Workforce
Management

Interconnected &
Interdependent Critical
Programs:
 Informatics &
Technology
 Data Management
 Research
 Advanced Practice
32
Proposed Informatics
Relationships
CIO
CNIO
CMIO
33
Emerging Chief Nurse
Informatics Officer Role
Set strategic vision for nursing
informatics to support a collaborative
practice that reaches across and
between service lines
 Develop a vision, mission, and strategic
plan for nursing informatics
 Leverage technology to create synergy in
practice that will improve patient care
delivery, efficiency, quality, and safety

34
Chief Nurse Informatics
Officer Focus Area
Strategic vision for informatics and
impact on nursing practice and care
delivery
 Human factors and ergonomics
 Technology assessment
 Data and databases
 Communication
 Resource planning and utilization
 Research, development and evaluation

35
Proposed Enterprise
Infrastructure
36
Proposed Local
Infrastructure
37
On Leadership…

“Innovation distinguishes between a leader
and a follower.”


Steve Jobs
“A leader has the vision and conviction
that a dream can be achieved. He inspires
the power and energy to get it done”

Ralph Nader
38
NI Leadership Skills
•
•
•
•
•
•
•
Superb communication
Change management
Risk Assessment
Coalition building
Political finesse
Business acumen
Strategic application
(ANA, 2008)
39
NI Leadership Role
Evidence-based practice
 Computer literacy skills
 Information literacy skills
 Project management skills
 Change management skills
 Process management skills
 Information management
and communication
 Data analysis
 Trending & forecasting

Resource planning,
utilization and evaluation
 Technology assessment
 Administration
 Safety and quality
 Make judgments based on
data trends and patterns
 Consultant
 Innovator

40
Leadership Pearls

DREAM, DARE, AIM to be an INNOVATOR

Keep abreast of “latest greatest” technology
trends

Assess newest technology for “fit” and potential
applicability in the clinical environment

Leverage technology to improve quality, safety
and nursing outcomes as you continue the
ongoing journey toward innovation and clinical
excellence
41
Questions?
42