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Nursing Informatics

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Nursing Informatics

Create a 1-page fact sheet that your healthcare organization could hypothetically use to explain the health or nursing informatics policy/regulation you selected. Your fact sheet should address the following:

Briefly and generally explain the policy or regulation you selected.

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Address the impact of the policy or regulation you selected on system implementation.

Address the impact of the policy or regulation you selected on clinical care, patient/provider interactions, and workflow.

Highlight organizational policies and procedures that are/will be in place at your healthcare organization to address the policy or regulation you selected. Be specific. Research and select one health or nursing informatics policy (within the past 5 years) or regulation for further study.

Nursing Informatics

 

Nursing Informatics

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Nursing Informatics

In a 4- to 5-page project proposal written to the leadership of your healthcare organization, propose a nursing informatics project for your organization that you advocate to improve patient outcomes or patient-care efficiency. Your project proposal should include the following:

Describe the project you propose.

Identify the stakeholders impacted by this project.

Explain the patient outcome(s) or patient-care efficiencies this project is aimed at improving and explain how this improvement would occur. Be specific and provide examples.

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Identify the technologies required to implement this project and explain why.

Identify the project team (by roles) and explain how you would incorporate nurse informatics into the project team.

Use APA format and include a title page and reference page.

Nursing Informatics

Nursing informatics

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Nursing informatics

Answer all of the following questions using headers to separate topics. 1. Patient stays in the hospital are being

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reduced for any number of reasons, but that does not mean the patients should not be monitored. In your opinion, identify no more than four new real-time devices you believe are crucial for a large enough pool of patients that every patient should be tethered to them, both in the hospital and at home during recuperation and rehabilitation. Explain your rationale and provide evidence. 2. Explain how data analytics leads to improved outcomes from both what you have read and from any personal experiences you can share. 3. In combat aviation, the concept of situational awareness and data fusion is critical. Attack or defend the notion that healthcare providers need similar kinds of data fusion to provide a more robust patient situational awareness, especially in situations of noisy and conflicting data. 4. Explain the key concepts behind six sigma analytics and explain why or why such approaches should not be used. Explain and support your position Answer all of the following questions using headers to separate topics. 1. From your personal experiences with healthcare workflows as a professional (if possible, else as a patient) and from the lessons you have been learning from this course, do you see the adoption of information technology as having been a smooth and graceful experience or a turbulent and sometimes painful one? Dig more deeply into your experiences and point to what you believe were the most critical contributors to the success or the causes of problems with the adoption. Be specific and support your position with references. 2. Based on your reflective analysis in question 1, which do you believe is a larger problem, lack of enough information or information overload? What evidence do you have to support your position? 3. Attack or defend the following assertion: “While it is true that a very small fraction of the population accounts for a significantly large fraction of total costs (e.g. “hot spots”), many of the root causes for these conditions have taken years if not decades to develop and to eliminate these hot spots will require significant life style changes, some with strong cultural reinforcements, long before the symptoms appear.” Support your position with solid evidence. 4. You have been brought in to help a regional hospital implement a major informatics upgrade that promises to significantly improve efficiency and patient outcomes. Leadership is nervous due to concerns that many of the “older” professionals will resist these changes. What strategy would you employ to maximize the probability of success with this new adoption effort? Explain the underlying rationale and support your position with evidence.
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Nursing informatics

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Nursing informatics

Health information technology (HIT) is pivotal to the transformation of healthcare but in order for that potential to

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be realized, healthcare leaders at all levels—national, regional, and local—must first understand what nursing informatics is in order to understand (McGonigle, Hunter, Sipes, & Hebda, 2014) strategies to create the necessary framework. As future leaders, you share a responsibility for this transformation. Some of the groundwork has been laid—the identification of needed knowledge and skills, standardized terminologies, and key HIT legislation, but more work lies ahead Strategies to transform healthcare with HIT also call for coordination and simultaneous changes in healthcare delivery processes to accomplish specific results, such as increased patient safety, cost reduction, increased access to care, integration of evidence-based care practices, improved coordination of care, better patient tracking, ongoing quality improvements, and improved patient outcomes (Mendelson & Johnson, 2011;Totten & Paloski, 2012). HIT is more than electronic health record (EHR) systems. EHRs provide much useful individual and aggregate data, but real-time data and information supplied by clinical decision support (CDS) tools outside of EHRs and analytics are needed to predict changes and support informed decisions across all sectors of healthcare and nursing. And that doesn’t even begin to look at applications such as telehealth, monitoring technologies, and many smart technologies! Most current systems do not have the real-time data and CDS tools to see “the big picture,” but the healthcare industry is moving to embrace these tools (Emerging models, 2013; Hogan, 2012; Johnson et al., 2012). Healthcare also needs to “leverage the potential of the Internet” and patient portals to access records, support patient-provider communication and education, and facilitate selfmanagement of care (Mendelson & Johnson, 2011). What is analytics? If you have signed up for special discounts with a retail store and have a special card or key fob that you use to get store discounts, data is collected about your shopping habits and to tailor ads to you. For example, are you a pet “parent?” Do you buy the expensive brands of cat or dog food? This collection and use of data is one example of analytics which is the discovery and communication of meaningful patterns in data which can then be used to improve marketing, or in healthcare services for the demographics served. Other terms to describe analytics include data mining and knowledge discovery in databases. HIT has the very useful capability to examine relationships among trends, interventions, and outcomes, which can aid planning or be used to stem unwanted events (Mendelson & Johnson, 2011). “2016 will be a year of firsts for players within healthcare as the industry adapts to the main forces driving the new health economy: The rise of consumerism, the focus on value, downward pressure on costs, technological innovation and the impact of new entrant,” (PricewaterhouseCoopers, 2015).Realizing this potential requires a knowledgeable, prepared nurse leader and nursing workforce. Technology Versus Informatics The presence of technology does not mean that it will be used or used well. Technology is only a tool that is useless if you don’t know what it can do or how to use it to advantage. You wouldn’t use a syringe to check a blood pressure! That is where the importance of informatics comes into play. Informatics provides the knowledge, skills, and understanding that allow us to harness the tools at hand and to use them well to enact improvement. So what is informatics? What Is Informatics? The term informatics comes from the French word informatique, which refers to the use of computers and statistical methods to manage information (Hebda & Czar, 2013). Informatics has since gained recognition as a specialty area that applies concepts from computer, cognitive, and information sciences, as well as other emerging areas, to manage and communicate data, information, knowledge, and wisdom. For the sake of clarity, let’s discuss these foundational sciences briefly. Computer science studies the theory underpinning information and computation and their implementation in computer systems. Facets include hardware, software, and communications as well as solutions to related problems. Cognitive science looks at how the human mind works from an information processing perspective. Information science deals with the retrieval and management of information as well as human-computer interaction. Informatics can be applied to many different domains or disciplines. In healthcare, the terms healthcare informatics or medical informatics are widely used and are often used as “umbrella terms” to include each of the healthcare disciplines and consumers. While this approach has some merit, it does not consider the needs of individual disciplines such as nursing, pharmacists, or dieticians—shrouding them in a cloak of invisibility. What is nursing informatics? Nursing informatics is all about supporting both the work that nurses do and the decision-making process for healthcare consumers and other providers to enable optimal outcomes. We will discuss nursing informatics as a specialization next week, but now our focus is why nurses need informatics knowledge and skills. Nurses have a long history of collecting data, turning it into information, creating knowledge, and ultimately wisdom. This process is known as knowledge work and nurses are knowledge workers. Technology can aid knowledge work by helping nurses to collect data, see trends, process information, and create knowledge that can be used to create wisdom, but nurses need to understand the processes that allow this to happen as well as the tools that HIT offers them. Today’s nurse needs a solid knowledge base, clinical competency, and skill sets that include informatics competencies in order to provide safe, effective, efficient, patientcentered care. This is particularly true at a time when the achievement of a birth-todeath electronic health record (EHR) for every American is a national goal and HIT has been proposed as a means to address the problems seen in the healthcare delivery system. The Quality and Safety Education in Nursing (QSEN) project identified informatics as one of the six key skill areas that nurses need to achieve optimal patient care. More specifically, QSEN identified the knowledge, skills, and attitudes that nurses need in the following six areas to achieve this level of care (American Association of Colleges of Nursing QSEN Consortium, 2012). • • • • • • Quality: The ability to use data for quality improvement purposes Safety: The ability to minimize risk of harm to both patients and providers Teamwork and Collaboration: The ability to work collaboratively and as a member of a team Patient-Centered Care: Recognition of the patient as the locus of control and partner in his or her own care Evidence-Based Practice Informatics: The use of information and technology to communicate, manage knowledge, minimize error, and support decisions The QSEN project initially concentrated on prelicensure students, but has since identified graduate-level competencies in collaboration with the American Association of Colleges of Nursing to prepare future leaders in all areas of nursing practice in accordance with the recommendations of the Institute of Medicine (2011) in its Future of Nursing report. The demands of the healthcare delivery system and ensuring that all nurses are adequately prepared with essential skills have implications for master’s-prepared nurses. First, there is a need to understand what informatics—particularly nursing informatics—is and its potential benefits. Second, there is a need to develop informatics competencies expected of graduate-level nurses. And third, and as future leaders in practice, administration, education, and research (Future of Nursing, 2011; AACN QSEN Educational Consortium, 2012), nurses prepared at the master’s level need to ensure that all nurses develop and demonstrate informatics competencies appropriate to their levels of preparation and practice. If there are any doubts about what these competencies might be, The Technology Informatics Guiding Education Reform (TIGER) Initiative (2009), compiled and posted a list of competencies on its website that every nurse should display. TIGER first came into being with an invitation-only summit, Evidence and Informatics Transforming Nursing, in 2006, which invited leaders from nursing, government, informatics and technology organizations, and other stakeholders to come together to create a vision to transform nursing to bridge the quality chasm through the use of technology (TIGER, 2013a). TIGER continues its focus on the use of informatics and technology ‘to make healthcare safer, more effective, efficient, patientcentered, timely and equitable by interweaving evidence and technology seamlessly into practice, education and research fostering a learning healthcare system’ and is a useful resource (The TIGER Initiative, 2013b). The American Association of Colleges of Nursing has also identified informatics competencies expected for each program graduate in their Essentials documents as well as a cross walk document that provides a quick comparison by program level (American Association of Colleges of Nursing, n.d.). Reflection Consider one example of a nursing informatics skill or competency that is routinely seen in nursing practice. What is it? Would most practicing nurses consider it a nursing skill or a nursing informatics skill? What is your rationale for this reply? Reflection Consider one example of a nursing informatics skill or competency that you feel you do well. Did you always consider it a nursing skill or a nursing informatics skill? What is your rationale for your response? Summary Informatics competencies are essential in a healthcare delivery system that is not only heavily dependent upon HIT, but attempting to use it as a means to transform healthcare delivery. All nurses need informatics competencies. The master’s-prepared nurse, as a leader in nursing practice, needs to demonstrate a higher level of competencies than nurses prepared at lower levels. Informatics provides the ability to support nursing, healthcare consumers, and other professions through the use of information, information structures, processes, and technology. References American Association of Colleges of Nursing (AACN). (n.d.). Crosswalk of the master’s essentials with the baccalaureate and DNP essentials. Retrieved from http://www.aacn.nche.edu/faculty/faculty-tool-kits/masters-essentials/Crosswalk-ofMasters.pdf American Association of Colleges of Nursing QSEN Consortium. (2012). Graduate-level QSEN competencies: Knowledge, skills and attitudes. Retrieved from http://www.aacn.nche.edu/faculty/qsen/competencies.pdf American Nurses Association. (2015). Nursing informatics: Scope and standards of practice. Silver Spring, MD: Nursebooks.org. Clarke, S., & French, S. (2013). Healthcare reform in 2013: Enduring and universal challenges. Nursing Management, 44(3), 45–47. doi:10.1097/01.NUMA.0000427185.42306.14 Emerging models of care take direct aim at the changing needs of the industry. (2013). Managed Care Outlook, 26(6), 2–6. Health IT hits federal and industry agendas. (2013). hfm (Healthcare Financial Management), 67(4), 12–13. Hebda , T. & Czar, P. (2013). Handbook of informatics for nurses & healthcare professionals (5th ed.). Upper Saddle River, NJ: Prentice Hall. Institute of Medicine. (2011). The future of nursing: Leading change, advancing health. Washington, DC: The National Academies Press. Johnson, J. E., Veneziano, T., Malast, T., Mastro, K., Moran, A., Mulligan, L., & Smith, A. L. (2012). Nursing’s future: What’s the message? Nursing Management, 43(7), 36–41. doi:10.1097/01.NUMA.0000415493.20578.f2 McGonigle, D., Hunter, K., Sipes, C., & Hebda, T. (2014). Why nurses need to understand nursing informatics. AORN Journal, 100(3), 324-327 doi:10.1016/j.aorn.2014.06.012 PricewaterhouseCooprers, (2015). Merger mania, drug pricing and new tech: PwCs Research Institute of Top Health Industry Trends for 2016. link to article (Links to an external site.)Links to an external site. The TIGER Initiative. (2013a). TIGER Summit October 30–November 1, 2006. Retrieved from http://www.thetigerinitiative.org/phase1.aspx The TIGER Initiative. (2013b). About TIGER: TIGER vision statement. Retrieved from http://www.thetigerinitiative.org/about.aspx Totten, M. K., & Paloski, D. (2012). Transforming healthcare: The board’s role. Healthcare Executive, 27(1), 74–77. McGonigle, D. & Mastrian, K. (2018). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones and Bartlett. • • • • • Section I: Building blocks of NI Chapter 1: Nursing Science and the Foundation of Knowledge pp. 7-19 Chapter 2: Introduction to Information, Information Science, and Information Systems pp.21-33 Chapter 3: Computer Science and the Foundation of Knowledge Model pp.33-62 Chapter 4: Introduction to Cognitive Science and Cognitive Informatics pp.65-74 McGonigle, D., Hunter, K., Sipes, C., & Hebda, T. (2014). Why nurses need to understand nursing informatics. AORN Journal, 100(3), 324-327 doi:10.1016/j.aorn.2014.06.012 Matney, S. A., Avant, K., & Staggers, N. (2016). Toward an understanding of wisdom in nursing. Online Journal Of Issues In Nursing, 21(1), 7 doi:10.3912/OJIN.Vol21No01PPT02 Quality and Safety Education for Nurses (QSEN). (2017). Graduate QSEN competencies. Retrieved from http://qsen.org/competencies/graduate-ksas/. Link (Links to an external site.)Links to an external site. Optional reading: American Association of Colleges of Nursing (AACN) (2017). AACN essentials. Retrieved from http://www.aacnnursing.org/Education-Resources/AACN-Essentials.
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