1. Nursing Informatics:
General purposes
Presenter:
MRS HEENA MEHTA
S.Y.M.Sc. NURSING

2. Introduction
x The worlds of health care, communication, and
information technologies are ever growing,
separately and together.
x As nurses in the community expand their practice
definition to embrace new information
technologies, opportunities for improved health
care to populations seem endless.

3. Introduction……………..
x This advancement is seen as a union of health care
technology with information and communications
technology, nurturing the design and implementation of
health care management information systems in a variety of
clinical practice settings.
New technology
Acute care in Community
hospital based setting
setting environment

4. What is Informatics?
x Organizations such as hospitals and community-based
agencies such as public health departments and home
agencies use information and communications
technologies to collect, restore, retrieve, analyze, and
present client care data in the care delivery settings.
x Decisions related to client care continue to increase in
complexity, with the need for rapid, accurate
information for clinical decisions making as a priority
for effective care.

5. Health Informatics
x Application of information technology to the health
sector has tremendous potentiality for efficacy of
health care delivery institutions and provision of cost-
effective health care.
x Health care delivery institutions will need and use
information technology to meet their client demands
and stay competitive, since, the future for them lies in
cost-effective health care.

6. Health Informatics
x That is why a host of solutions, standards and
services are emerging to meet needs of the health
sector.
x Application of information technology to the domain
of health care delivery is referred to as Health
Informatics.
.

7. What is Nursing Informatics?
x Nursing informatics is a field within the
field of health informatics, where people
who have a nursing degree are involved
in the implementation of a computer
application in a hospital, nursing home,
doctor’s office, public health clinics, or
other healthcare setting.

9. Definition………..Informatics
x Informatics generally can be defined as
the art and science of turning data
into information. The more recently
informatics defined as the study of the
application of computer technology and
statistical techniques to the
management of information.

10. Definition…Nursing Informatics
ANA
x Nursing informatics (NI) is a specialty that
integrates nursing science, computer science,
and information science to manage and
communicate data, information, knowledge,
and wisdom in nursing practice.
x NI supports consumers, patients, nurses, and
other providers in their decision- making in
all roles and settings.
x This support is accomplished through the use
of information structures, information
processes, and information technology.

11. Nursing Informatics… Definition
x Nursing Informatics uses nursing science,
computer and communications
technologies to produce effective and
efficient client outcomes for individuals
and communities.

12. Nursing Informatics… Definition
x 1989—Graves and Corcoran defined
Nursing Informatics as
x “Computer science, information science, and
nursing science combined 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.”

13. Nursing Informatics - Definition
x “The use of technology and / or a computer system to
collect, store, process, display, retrieve, and
communicate timely data and information in and
across health care facilities that:
x Administer nursing services and resources;
x Manage the delivery of patient and nursing care;
x Link research resources and findings to nursing practice;
x Apply educational resources to nursing education” (Saba,
1996).

14. How it all began….
x Late 1960’s first computer systems were
implemented in hospitals
x Computer nurses began to appear in hospitals
x Excellentclinicians
x Technically curious and willing to try new things

15. Nursing Informatics - Focus
x Nursing informatics focuses on the use of
“nursing information system” (NIS) to
administer nursing resources:
x To assist in effective information management;
x Monitor the quality, effectiveness, and
outcomes associated with the provision of care;
x Protect the confidentiality and privacy of
patient data.

16. Conceptual Framework
Nursing Process
Data Information Knowledge
(raw facts) (interpreted facts) (synthesized information)
minute level Synthesis
Information and
Communication Technology

18. Nursing
Classification
Systems

20. Reasons for Classification System
Development
x To standardize classification
x To expand nursing knowledge
x To develop information systems
x To teach decision making
x To determine nursing costs
x To allocate nursing resources
x To communicate nursing to non-nurses
x To link nursing knowledge

21. Basic concepts
Basic concepts for information systems:
x Nursing data: refers to unstructured raw facts; Are
discrete entities; Lack interpretation. Forms the
basis for a nursing information system.
x Nursing information: data that has been given shape
and has been interpreted.
x Nursing knowledge: synthesized information
derived from the analysis of data that has been
processed.

22. Nursing Data Standards
x Needed for the management, documentation
and communication of nursing diagnosis,
interventions, and outcomes (patient and
nursing sensitive).
x researchedand supported by the ANA
Council on Computer Applications in
Nursing and the NLN’s Council for Nursing
Informatics.

23. Nursing information
x Nursing information systems exists within the
background of the total continuum of the “integrated
patient record system”.
x Health care is, and will continue to be an information-
intensive attempt.
x Information is a critical resource in the health care
delivery environment.
x Nursing Practice is essentially an information-
processing activity.

24. Nursing information……
x Nursing information is essential to the
accuracy of integrated systems (both health
care delivery and information systems).
x Patient-specific data are the central point of
a totally integrated patient-record system.
x Atomic-level data, captured within a
Nursing Information System will be used
for many purposes.

25. Nursing Knowledge
x Data and data elements required for
nursing information systems are
developing.
x To ensure high-quality practice, nurses
need access to sources of data that are
”beyond institutional, patient-specific
data”.
x “There will always be a need for human
interpretation of computer-processed
data”.

26. Nursing Classification
System’s Integration
Into Nursing Practice

27. x Information systems development.
x Need for standards-based, evidenced based
practice. guidelines.
x Need for standardized language across the
continuum and across nursing practice settings.
x Integrated from a trans-disciplinary, integrated
healthcare delivery perspective.

28. The Need of Nurse Informaticists
x Analyze clinical and financial data
x Promote and facilitate access to resources and
references
x Provide nursing content to standardized
languages
x Enable cost savings and productivity goals
x Source

29. The Need of Nurse
Informaticists ……….
x Nurses do not want to be passive
consumers of technology
x Nurses want devices that are
integrated, voice activated, handheld,
use biometrics, provide translation,
are portable, are wireless, auto settle,
and are “smart”
x Greater nurse satisfaction leads to
greater patient satisfaction

30. The Benefits of Nurse Informaticists
x Nurse Informaticists promote and facilitate access to
resources and references
x Support for their mission to deliver high quality,
evidence-based care
x Support for better service by facilitating true
interdisciplinary care
x Improvement in key relationships with
x providers & care recipients
x Enable cost savings and productivity goals
x Facilitate change management
x Enhance continuity of care

31. Trends In Nursing Informatics

32. Introduction
Technologies emerging in the fields of
telecommunications, video and digital imaging, and
microprocessing are shaping the future of nursing
practice. To measure up to the future needs of
nursing, nurses of today must have the vision and
desire to become computer aware and
technologically literate.

33. Definition
x Nursing Informatics (NI) is the 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 and knowledge 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. (Scope of Standards
of Nursing Informatics Practice -American Nurses
Association 2001)
x Nursing informatics refers to electronic information
combined with nursing and any aspect of clinical practice,
administration, research, or education (Guenther, 2006).

34. Goal
x 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, in
managing and delivering education experiences, in
supporting life-long learning, and in supporting
nursing research.

35. Standards of practice
Organized around a general problem-solving framework that
closely resembles the familiar nursing process of
x Assessment
x Diagnosis
x Planning
x Identification of Outcomes
x Implementation
x Evaluation
Supports all facets of Informatics Practice, including those
without technology

36. Solution
An informatics solution may encompass technology and non
technology products such as:
xDeveloping a database
xPurchasing a new computer application
xCreating nursing vocabulary
xDesign informatics curricula
xCreating a spreadsheet
xTailoring an application to a particular environment
x Designing a research study to describe required informatics
competencies
xDescribing information flow in a process redesign
xCreating a structure for information presentation

37. History
x For three decades or more, nurses have held
informatics roles and been key stakeholders in
developing, implementing, an devaluating
informatics solutions. Although implementing
x informatics solutions continues to be very
important, more recently informatics nurse
specialists have worked to develop and refine
nursing’s language, implement tele-health
systems, establish NI educational programs and
expand the focus.

38. Nursing Informatics (NI) – future
x Ubiquitous computing is becoming a reality and the continued innovation
and miniaturization of technology is evident. Consequently partnering
between nurses in all specialties and new technologies is becoming
imperative.
x Technological innovations are challenging many traditional processes,
Telecommunications technologies are one set of tools used in nursing
practice.
x Core competencies across informatics specialties should be identified in
the near future. The distinctions among informatics specialties will
continue to blur.
x The speed of information transfer and the increasing availability of
communication technologies will impact nurses and informatics nurse
specialists in the future, making nursing practice and NI, in particular,
more international in practices with world-wide standards, competencies
and curricula.

39. Trends In Nursing Informatics
x Mature and Ubiquitous Technology Solutions
x Mid-Stage Technology Solutions
x Emerging Technology Solutions

40. Mature and Ubiquitous Technology Solutions
x Order Management & Communication
x Clinical Repositories
x Departmental Systems (LAB, RAD, etc.)
x Picture Archiving Communication System(PACS)
x Online Electronic Bed Management Systems
x Departmental Scheduling
x Staff Scheduling
x Intranet/Internet Based Reference Materials (Orders,
Protocols, Drug Monographs) Phones, Pagers, In-house
Communication Devices
x Wide Variety of Fixed & Mobile Devices

41. Clinical Systems
x Order Management & Communication
x Clinical Repositories
x Departmental Systems
x PACS

42. Order Management &
Communication
x Communication
management as a
second-order
management function:

43. CLINICAL REPOSITIORIES
The solution is
optimised for
healthcare
enterprises and
collects all digital
medical images,
electronic health
records and
associated
metadata related
to patient care.

44. DEPARTMENTAL SYSTEM
x Understan
ding the
organizatio
n and
functions
of the
hospital
x Quality of
care -
x Leadership

45. PACS
x n. picture archiving and
communication system:
an electronic system
enabling the storage of
digital images on
electronic media, for
later retrieval and
subsequent display on
high-resolution
monitors.

46. Enterprise Systems
 Online Electronic Bed Management Systems
x Nurse assignments are no longer hand written
x Determine the real-time census of units
x Reports available to track lengths of stay
x Monitor delays in patient movement
x Determine bed availability quickly
x Spend less time negotiating on the telephone
 Departmental Scheduling Systems
x Deployed as standalone or in centralized models

47. Administrative & General Workflow
 Staff Scheduling
x Allows healthcare facilities to create templates for the various
skills and skill mixes that exist across their units and facilities
Using this template a computerized system optimizes staffing
based on identified and known constraints.
x Facilitates identification of staff preferences in mind
x Logic identifies when a skill mix is off
x Logic identifies when a nurse is being asked to go to an area that
she/he is not trained for
x Time required for schedule creation has decreased significantly
x Staff satisfaction has improved

48.  Intranet Based Reference Materials (Orders, Protocols, Drug
Monographs)
 Phones, Pagers, In-house Communication Devices
x Wide Variety of Mobile Devices
x Designed to augment clinical workflow needs can be
personalized to the care giver and specific documentation or
data entry needs
x Laptops
x PDAs
x Notebooks
x COWs (Computers on Wheels)
x Many Others

49. Mid-Stage Technology Solutions
Online and Integrated Electronic Patient Documentation
x Integrated Hemodynamic Monitors (Vitals Signs) with EMR
x Hand-held Devices for Data Collection & Input
x Online Fully Integrated Medication Administration Record
x Online and Integrated Rules and Alerts
x CPOE – Computerized Provider Order Entry
x Bar Code Technology
x Access and Security Technology
x Sophisticated Implementation Methodologies
x Organization of Nursing Practice through Technology- Time and
Motion Templates, Nomenclature/Data Standardization Tools,
Care Plan Standardization and Tool Sets

50. Clinician’s Access to patient record system
x Attending Physician, Nursing, Consulting
Physician(s), Respiratory Care, Case Management
x Nutritional Services, Risk Management, IV Team,
Patient Financial Services, Infection Control
x Wound Management, Pastoral Care, Clinical Process
Improvement, Cardiology, PT/OT/Speech, Others.

51. Barriers
x Record must be on unit
x All clinicians and support, personnel must walk to
location of chart
x One person can access the chart at a time
x Legibility of chart input
x Timely filing of data results into chart
x Finding clipboard for most current information
x Redundant information

52. Clinician’s Access to online record
Electronic patient data barriers:
• Systems Availability
• User Acceptance

53. Integrated Hemodynamic Monitors (Vital Signs)
with EMR
xVital signs are automatically updated to the patient
EMR
xEliminates paper documentation and accurately
captures patient information at the point of care
xDevices are fixed in the patient room or mobile on
COWs (Computers on Wheels)

54. Hand-held Devices for Data Collection & Input
xAssist with obtaining, verifying, and communicating
data
xCardiology, Transplant, and other clinically
significant data can be entered directly online
xEliminates the need for bulky data collection sheets
xEnhances the ability for version control of data entry
Documents

55. Online Fully Integrated Medication Administration
Record
xSignificant time reduction associated to documenting
medications
xSignificant time reduction associated with
transcription of medications to paper MAR
xDecreased transcription errors
xIncreased patient safety

56. Online and Integrated Rules and Alerts
(Workflow)
xDrug-allergy alerts based on order entry functionality
xDrug-drug interaction alerts
xAlerts for abnormal lab values and vital signs
xAlerts for new orders
xAlerts for order renewals
xAlerts for scheduled patient events

57. CPOE – Computerized Provider Order Entry
xNurses no longer struggle to read physician
handwriting
xReduces verbal orders
xAll providers can enter orders directly online -
Integrated rules and alerts, Integrated allergy check
xDecreases chances for transcription error
xReduces delays in patient care

58. x Bar Code Technology
x Barcodes on patient bands and medication
packaging helps to double check that the right
medication is being given to the right patient at the
right time
x System alerts the nurse immediately if any
inconsistencies or potential problems exist
x Internal back-up systems are in place to back-up
information regularly so a MAR can be printed in
the event of system downtime
x Integration with electronic MAR and documentation
systems becoming more common place

59. Access and Security Technology
x Single Sign-On
x Biometric
Sophisticated Implementation Methodologies
x Sophisticated planning and implementation methodologies
take the guess work out of project management
x Include workflow, communication, risk mitigation, system
design and analysis, as well as overall task management
activities
x Tightly integrated financial management tools to ensure
projects stay on track and in budget

60. x Organization of Nursing Practice through
Technology
x Time and Motion Templates
x Nomenclature/Data Standardization Tools
x Care Plan Standardization and Tools Sets

61. Emerging Technology Solutions
x National Patient Databases for comprehensive
patient record across disparate providers
x Patient Health Cards – contain all medical records
and information
x Advanced Biometric Access and Security
functionality
x Voice recognition within electronic medical
records
x Hands free communication tools

62. Journals on Informatics Nursing
x CIN: Computers Informatics Nursing (formerly,
Computers in Nursing)
x Journal of the American Medical Informatics
Association (JAMIA)
x International Journal of Medical Informatics (IJMI)
x International Journal of Bio-Medical Computing
(IJBC)
x Online Journal of Nursing Informatics (OJNI)

63. x SUMMARY
x MEANING AND DEFINITION
x NURSING INFORMATICS
x HISTORY
x NURSING CLASSIFICATION SYSTEM
x BASIC CONCEPT

64. x NEED OF NURSING INFORMATICS
x BENEFIT
x TRENDS AND DEFINITION
x TRENDS IN NURSING INFORMATICS.

65. Conclusion
x Nursing informatics is a developing field of
study that is highly interdisciplinary. It is
strongly connected to education, business,
and computer science.

66. BIBLIOGRAPHY