Role of Nursing Informatics Role of Nursing Informatics in Hospital Information in Hospital Information

systemsystemMs.Ansamma Neelakantan

Deputy Nursing SuperintendentAIIMS

Information technology

• Any technology which processes and

communicates data, includes: – computers, voice,

data and image sensing and communications

devices, graphics devices, multi- media storage,

etc. – pen, paper, telephones and fax machines

What is the significance of information systems for health care?

– Information processing is an important quality Information processing is an important quality factor, but an enormous cost factor as well. It factor, but an enormous cost factor as well. It is also becoming a productivity factor. is also becoming a productivity factor.

– Information processing should offer a holistic Information processing should offer a holistic view of the patient and of the hospital. view of the patient and of the hospital.

– A hospital information system can be regarded A hospital information system can be regarded as the memory and nervous system of a as the memory and nervous system of a hospitalhospital

Information processing as a quality factor

Decisions of health care professionals are based on vast amounts of information about the patient's health state

It is essential for the quality of patient care and for the quality of hospital management to fulfill these information needs. Information should be documented adequately, available on time, and to be up-to-date and valid which enable health care professionals to make sound decisions This is also increasingly important for the competitiveness of hospitals

Examples:

• When a patient is admitted to a hospital, a physician or nurse first needs information about the reason for patient admission and about the patient history. Later, she or he needs results from services such as laboratory and radiology which are some of the most frequent diagnostic procedures

• Incorrect reports, e.g. lab report, may lead to erroneous and even harmful treatment decisions

• Repeated examinations or lost findings have to be searched for, the costs of health care may increase

Holistic view of the patient

Information processing in a hospital should offer a comprehensive, holistic view of the patient and of the hospital

This holistic view on the patient can reduce undesired consequences of highly specialized care with various departments and health care professionals involved in patient care

A hospital information system might be regarded as the memory and the nervous system of a hospital

A hospital information system, comprising the information processing and storage in a hospital to a certain extent can be compared to the information processing of a human being

The hospital information system also receives, transmits, processes, stores, and presents information

Hospital information system as memory and nervous system

Nursing Informatics

• 1989—Graves and Corcoran defined Nursing

Informatics as

– “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.”

New Definition -- ANA

• “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, 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.”

ANA (2001)p. 17

How it all began….

• Late 1960’s first computer systems were

implemented in hospitals

• Computer nurses began to appear in hospitals

– Excellent clinicians

– Technically curious and willing to try new

things

The First Informatics Nurse?

• “In attempting to arrive at the truth, I have applied everywhere for information, but scarcely an instance have I been able to obtain hospital records for any purposes of comparison. If they could be obtained, they would enable us to decide many other questions besides the one alluded to. They would show subscribers how their money was spent, what amount of good was really being done with it, or whether the money was not doing mischief rather than good.”

American Nurses Association

• Recognized as a specialty in 1992

• Defined NI, outlined roles and responsibilities and

developed standards for practice.

• Certification for generalist

Who Should Become a Nurse Informaticist?

• You do not have to be a computer expert to

consider a career as a nurse informaticist.

Everyone must start somewhere. If you see the

computer as a problem-solving tool instead of an

inconvenience, then you are a prime candidate to

be a nurse informaticist (Bridges, 2007)

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.

Example

• Data= 9:00 am -100mg/dl, 4:00 pm 180mg/dl• Information=

• Knowledge= My clients glucose level rises in the late afternoon. His insulin dose needs to be adjusted

Time Glucose

9.00 am 100 mg/dl

4.00pm 180mg/dl

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)

Use of Computers in Nursing Research

• Literature Search

• Data Collection

• Data Analysis

• Research Dissemination

Use of Computers in Nursing Administration

• Human Resources

• Medical Records

• Quality Assurance

• Accreditation

• Budget and Finance

Issues Related to Computers in Nursing

• Legal/Ethical Issues

• privacy/confidentiality

• access to data for research and other purposes

• informed consent

• License issues with telenursing

• Copy right of materials on the Web

Impact of NI on hospital information system

• Progress in information and communication technology (ICT) changes societies and affects the costs and quality of information processing in health care

• Important progress due to improvements in modern ICT can also be observed in information systems of health care organizations.

• The role of computer-supported information systems, together with clinical documentation and knowledge-based decision support systems, can hardly be overestimated in respect to the quality of health care, as the volume of data available today is much greater than it was a few years ago

•

Contd….

Due to the importance of information processing as a quality and cost factor, an institution has to invest systematically in its health information system

These investments concern both staff and tools for information processing. They aim at increasing quality of patient care and at reducing costs

Unsystematic information processing normally leads to a low quality of health information systems, and the information needs of the staff and departments cannot be adequately satisfied

When health information systems are not systematically managed, they tend to develop in a chaotic way

This has severe consequences: decreased data quality, and higher costs, especially for tools and information processing staff, not to mention aspects such as data protection and data security violation

Insufficiently managed information systems can contribute to breakdowns in established clinical workflows, to a reduced efficiency of care, to user boycott, to decreased quality of care and even endanger patient safety

To adequately process information and apply information and communication technology, knowledge and skills for these tasks are required

Ergonomics-Most common injuries- muscle and eye

strain

Proper Posture

September 2014