How Technology and

Informatics Has Influenced

Nursing Practice

Madeline Gervase RN,MSN,CCRN,FNP

Advanced Practice Nurse
 Objectives:
Identify the role of informatics in nursing.
Identify the current uses of technology and how
technology will affect clinical practice.
Understand the advantages and disadvantages
of using technology.
Demonstrate an understanding to the
techniques and tools used to protect client
confidentiality in practice.
Informatics

The science of
information
 Skills nurses need related to
informatics & technology
Use information & communication technology
to document & evaluate patient care, advance
patient education, & enhance the accessibility
of care
Use appropriate technology to assess & monitor
patients
Work on an interdisciplinary team to make
ethical decisions regarding the application of
technologies & the acquisition of data
 Nursing Skills:

Adapt the use of technologies to meet patient

needs
Teach patients about health care technologies
Protect the safety & privacy of patients in
relation to the use of health care & information
technologies
Use information technologies to enhance ones
own knowledge base
International Medical Informatics
Association
Forty-one
recommendations for using
informatics in health care
delivery
Identified 313
competencies for nurses
with various levels of
education & practice
responsibilities
 IMIA
www.imia.org

Two specialized areas for development:

Informatics and healthcare delivery
Specialists design software & create
integrated information systems for health
care delivery
 IMIA Nursing Evaluation
Novice Nurse Competency:
Novice nurse: use of administrative
application, telecommunication devices,
e-mail, database management program,
client care devices, & the Internet while
being able to find resources to address
ethical decision making related to
computing
 Seasoned Nurse Competency:
Experienced nurse: same as the beginner
with the addition of ability to use
diagnostic coding application, evaluate
computerized assisted instruction
programs, integrate selected resources
into client record, & evaluate accuracy of
health care information found on the
Internet
 IMIA Competencies for the
Nursing Informatics Specialist

Graduate education
Able to integrate established technologies
into clinical practice
 IMIA Competencies for the
Nursing Informatics Innovator
Doctorate Degree
Designs and develops new technological
systems, techniques, & conceptual models
for databases
Evaluates safety, effectiveness, cost, &
social impacts of technological systems
Researches & develops theoretical
foundations for the specialty
 Components of an Integrated
Delivery System (IMIA, 1999)
Hyperlinks to the latest information for client
care
Nursing care planning programs
Specific client teaching materials
On-line clinical practice manuals with evidence-
based nursing care protocols
Data collection for best health care practices
Client billing systems
Health care insurance reimbursement programs
 Informatics & Technology in
Client Care
Handheld monitors
(e.g., pulse oximetry & peripheral blood
glucose monitors)
Wireless technology with automatic nurse
paging capability when client
measurements fall outside of normal
parameters
 Technology & Informatics in
Client Care :
Computerized clinical decision-making
programs
Nurse personal digital assistants
Care-planning software programs
Handheld clinical resource information
devices
Intravenous pumps for medication
delivery
 Informatics & Technology in
Record Keeping
Financial reimbursement applications for
services rendered
Nursing documentation systems:
CERNER
Integrated health record systems to
denote past medical history & allergies
Electronic health records
 Informatics & Technology in
Communication
Wireless telephone systems
Wireless paging systems
Alphanumeric paging systems
Handheld computers to record & receive
client information
E-mail
 Components of a Health
Information System Currently
Used by Health Care Institutions
 Current uses of Informatics
Applications in Healthcare:
Admission, discharge, & transfer
Patient Access Record
Financial parameters
Physician order entry
Ancillary department
Documentation
 Informatics Applications in
Healthcare:
Scheduling
Pharmacy preparation
Acuity criteria
Specialty practice
Decision support
Communication
Critical pathways
 The Nursing Informatics
Specialist Responsibilities
Create systems to maximize the efficiency
of information use & computer
technology for clinical practice
Develop software programs to support
nurses as they deliver client care
Keep software management updated &
educate staff on its use & changes
 Education for the Nursing
Informatics Specialist
Thorough understanding of clinical
practice
Detailed computer expertise
ANA certification in nursing informatics
Graduate nursing education programs in
nursing informatics are available
 Role of the Nursing Informatics
Specialist in Technological & Health
Care Development
Contribute specialized nursing knowledge to
systems
Develop software programs & computer
systems that facilitate nursing care delivery
Field test software programs
Verify that systems (hardware & software)
address critical nursing considerations
 Technological Influences to
Health Care
In the late 1950s & early 1960s,
businesses used computers for financial
record management
Medicare & Medicaid require data for
governmental reimbursement for
rendered services
 Technology Influences:
In 1968, Lawrence Weed developed the
Weed Problem Oriented Medical Record
Information System, the first
computerized system for client care at the
University of Vermont Medical Center
 Technological Changes to
Nursing & Health Care
LifeView Care Station for virtual house
calls
Telehealth
Genetic advances in health promotion,
disease prevention, & illness treatment
Stem cell research
On-line educational options
 Challenges of Managing Health-
Related Informatics & Technology

Confidentiality of client health

information
Ethics related to new therapies
Evaluating the quality of information
Information security
Potential health & personal problems
from too much technology
 Our Future:
Technological advances are advantageous
only if nurses find them useful & learn
how to use them
Nurses may tend to focus on machinery
rather than persons in the future
Information overload
 The Future of Healthcare:
Keeping institutional & personal systems
updated
Impact of being dependent on electrical
or other sources of power to run
equipment
Optical technology or other invasive
methods to confirm identity
 Computer Networks
Local area network (LAN)
Wide area network (WAN)
Internet Service Provider (ISP)
Group e-mail or list servers (Listserv)
Electronic publishing (e-books & on-line
journals)
 Access Information
Requirements:
Accurate typing skills & knowledge of an
exact website or e-mail address
Internet server provider
A website is a series of pages posted on
the Internet
Website addresses denote the type of
server
Professional chat rooms
Thank you!