Nursing Informatics

Presented by Edi Purwanto

University of Muhammadiyah
Malang
LO
– Menjelaskan konsep IT dan peranananya dalam bidang keperawatan
– Memahami dan memanfaatkan komponen sistem komputer
– Menggunakan aplikasi Microsoft Office (Word, Excel, PPT) sebagai penunjang sarana
pembelejaran keperawanan
– Teknik Penulisan Ilmiah (Indexing, Heading dan Referencing).
– Reference manager (Mendeley)
– Analisis data SPSS
– Menggunakan aplikasi online storage
– Mengoperasikan search engine/data base jurnal
– Mendemonstrasikan cara membuat dan menggunakan blog
– Menggunakan aplikasi social media dan chat
– Menjelaskan karakteristik dunia maya dan kejahatan di dunia maya
– Menggunakan aplikasi/media penunjang untuk membuat media interaktif pendidikan kesehatan

– Teknik Penulisan Proposal Kreativitas Mahasiswa 5 bidang (Indexing, Heading dan Referencing).
– Etika penggunaan sumber informasi/reference online
Objectives this Subject

– Define nursing informatics.

– Describe the goal of nursing informatics.
– Describe how clinical information
technologies are and will impact nursing
practice.
– Explore how nurses can create and derive
clinical knowledge from information systems.
– Speculate on the future of nursing in the
context of health informatics.
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Information Production and
Access

– The information and knowledge informing

21st century of healthcare delivery has been
growing at an unprecedented pace in recent
years.
– Extended and expanded access to clinical
research findings and decision support tools
has been significantly influenced by the
advent of computerization and the internet.
Need for Quality
Information

– Working in environments of increasingly complex clinical

care and contending with the management of large
volumes of information, nurses need to avail themselves of
the technological tools that can support quality practice
that is optimally safe, informed and knowledge-based.
Global Definition of Nursing
Informatics

– Nursing informatics science and practice integrates nursing,

its information and knowledge and their management with
information and communication technologies to promote
the health of people, families and communities world wide.

IMIA-NI definition, adopted July 2009, Helsinki, Finland

www.ssk.med.uni-erlangen.de
Informatics Nursing Roles

Nurses in identified informatics roles typically focus their

efforts on:
• articulating meaningful clinical nursing data and information
structures that can be codified and processed
• identifying the information processes associated with nurses’
work
• determining ways in which information and communication
technologies can be most effectively utilized to support the
capture, retrieval, and use of data, information, and knowledge.
Informatics Needs

– More timely access to data and information, clinical and

financial, has been identified as a necessity in the climate of
21st century healthcare delivery (Hannah, 1995).
– Health service organizations, societies, and governments
throughout the industrialized world are charged with assuring
that healthcare delivery is:
• safer
• knowledge-based
• cost-effective
• seamless
• timely
Informatics to engage
consumers

– With the evolving emphasis on issues such as chronic

disease management and aging at home informatics can
encompass the use of technologies to empower citizens to
more effectively manage their own health and wellness.
Informatics and Nursing
Resources

– An additional challenge within the nursing profession is the

pending human resource crisis and dire projections of
imminent shortages.
– Nursing’s focus on IT has been elevated as a central means by
which nurses can be sufficiently supported in their work
environments.
– IT has the potential to reduce the waste of valuable nursing
resources by reducing the time spent in the “care and feeding”
of patient records. Having more time for direct client care that
is supported by ready access to information and knowledge
translates into the provision of safer, quality care.
Nurse as Knowledge Worker

– Nurses definitely fall into the category of knowledge

workers.
– Studies have identified that depending upon the setting,
nurses spend anywhere between 25-50% of their day
managing and recording clinical information and seeking
knowledge to inform their practice (Gugerty et al, 2007).
Nurse as Knowledge Worker

– With the advent of clinical information systems (CIS),

specifically electronic documentation and clinical decision
support (CDS) applications, every nurse has the capacity to
be contributing to the advancement of nursing knowledge
on many different levels.
Creating Clinical Knowledge

– Graves and Corcoran (1989) suggest that nursing

knowledge is “simultaneously the laws and relationships
that exist between the elements that describe the
phenomena of concern in nursing (factual knowledge) and
the laws or rules that the nurse uses to combine the facts
to make clinical nursing decisions” (p. 230).
Creating Clinical Knowledge

– New technologies have made the capture of multi-faceted

data and information possible through the use of
technologies like digital imaging (e.g., photography to
support wound management).
• Now part of the clinical record, such images add a new
dimension to the assessment, monitoring and treatment of
illness and the maintenance of wellness.
Creating Clinical Knowledge

– These are but a few of the emerging capabilities that will

allow for numerous data inputs to be transposed --
combined, analyzed, and displayed to provide information
and views of clinical situations currently not possible in a
world dominated by hard copy documentation.
Creating Clinical Knowledge

– Empirics – access to factual knowledge derived from

repositories of aggregated clinical research findings and
integrated with the CIS.
– Esthetics – access to multicultural practices and beliefs.
– Personal – access to a personal repository of clinical
experiences and reactions.
Creating Clinical Knowledge

– Ethics – access to standards of ethical practice, but also

access to experts in the field of moral reasoning to guide
interaction.
– In each and every instance of interacting with the CIS, a
nurse will add further to these repositories of knowledge
on the basis of their daily clinical challenges and queries.
Using Clinical Knowledge

– Evidence-based practice (EBP) and research utilization (RU)

are concepts which have been widely addressed in the
nursing literature.
– Best practice guidelines hold much promise for the future,
but again in their typical form of paper volumes and oft
unsearchable online versions, these resources will not
realize significant adoption by an already stressed and
stretched nursing workforce.
Using Clinical Knowledge

– The profession has been steadily moving towards

consensus on the adoption of data standards and recent
work suggests that we are achieving significant strides
(Bickford & Hunter, 2006; Delaney, 2006).
– Consider that as CIS are widely implemented, as standards
for nursing documentation and reporting are adopted, and
as healthcare IT solutions continue to evolve, the potential
to synthesize findings from a variety of methods and
world-views becomes much more probable.
Clinical Decision Support

– Clinical decision support (CDS) tools have evolved beyond

the previously prevailing notion of accessible reference
texts and written resource materials like policies and
procedures.
– Most available clinical decision support (CDS) for nursing
practice, although promising, are simplistic and in early
development.
CDS Tools

– Computerized alerts and reminders (e.g., medication due,

patient has an allergy, potassium level abnormal);
– Clinical guidelines (e.g., best practice for prevention of
skin breakdown);
– Online information retrieval (e.g., CINAHL, drug
information);
– Clinical order sets and protocols; and
– Online access to organizational policies and procedures.
In the future, these tools will be possibly expanded to
include applications with embedded case-based
reasoning.
CIS Data Input Devices

– Biometrics (facial recognition, security)

– Voice and video recordings (client interviews and
observations, diagnostic procedures, ultrasounds)
– Voice-to-text files (voice recognition for documentation)
– Medical devices (infusion pumps, ventilators, hemodynamic
monitors)
– Bar-code technologies (for medication administration)
– Telehomecare monitoring (for use in diabetes and other
chronic disease management)
Leadership Challenge

– The field of nurse leaders in health informatics has

markedly grown in the past two decades.
– For several years, nurse informaticians have advocated for
the need for all nursing leaders to become knowledgeable
and engaged in setting the direction for informatics in the
profession (Nagle, 2005; Simpson, 2000).
Strategies for Leadership

– Identify the informatics education needs of nurse leaders.

– Develop mentorship programs for the acquisition of
informatics leadership skills.
– Assure enrollment of nurse leaders as sponsors for
electronic health records initiatives.
Clinical Practice Challenge

– Despite many valiant efforts to implement comprehensive

CIS throughout North American healthcare settings, there
are still many provider organizations with limited online
functionality available to nurses.
– Over the years, nurses have been on the receiving end of
systems which either did not add value to their work or by
virtue of poor design, created additional work.
Clinical Practice Challenges,
Con’t.

– The opportunity to avoid future installations of IT solutions

that do nothing to benefit and support the clinical practice
of nurses and healthcare teams is upon us now.
– It behooves nurses to be engaged in the acquisition,
design, implementation and evaluation of CIS to assure the
realization of benefits for clinical care and outcomes.
Strategies for Clinical
Practice Challenges

Nurses should:
– Be encouraged and supported to participate in the
acquisition, design, implementation, and evaluation phases
of CIS.
– Demand the adoption of IT solutions that support the
delivery of safe, quality care.
– Be provided with material and people resources to support
their acquisition of informatics competencies.
Challenges for Education

– Over the years, numerous efforts have been undertaken to

identify the core informatics competencies needed by
nurses.
– In recognizing nursing informatics as a specialty, the
American Nurses Association (2001) has articulated “scope
and standards of nursing informatics practice”.
Education Challenges, con’t.

– Recent studies of schools of nursing indicate that few basic

nursing education programs have embedded the concepts
and processes associated with informatics within the core
curricula (Carty & Rosenfeld, 1998; Nagle & Clarke, 2004).
– The core concepts and competencies of informatics are
particularly well suited to a model of inter-professional
education.
Education Challenges, con’t.

– A presumption is often made that future graduates will be

more computer literate than nurses currently in practice.
– Although likely true, computer comfort does not equate to
an understanding of the facilitative and transformative role
that IT will have in the future.
Strategies for Education

– Need to share prototypes of informatics integration among

schools of nursing.
– Consider interprofessional education opportunities in
addressing informatics concepts and competencies.
– Nursing faculty need to be obligated and supported in the
attainment of basic informatics competencies.
Strategies for Education,
cont.

– Seek and allocate funding for the development of

innovative curricular models and associated technological
support.
– Incorporate accreditation criteria that necessitate an
integration of informatics core concepts and competencies
in all basic nursing programs (See current NLN AC and CCNE
standards)
A View of the Future

– Overall, it is fair to say that a majority of nurses have yet to

embrace the notion of “informatics” and understand its
meaning and relevance to their work.
– The future holds a landscape yet to be understood as
technology evolves with a rapidity and unfolding that is rich
with promise and potential peril.
A View of the Future

With the availability of rich data repositories, there will be

opportunities to:
• Further enhance the training of health professionals;
• Advance the design and application of CDS;
• Deliver care that is informed by the most current evidence and
• Engage with individuals and families in ways yet unimagined.
A View of the Future

– The future of healthcare will be highly dependent upon the

use of CIS and CDS to achieve the systems’ global
aspirations of safer, quality care for all citizens.
– The core concepts and competencies associated with
informatics will be embedded in the practice of every
nurse, whether administrator, researcher, educator, or
practitioner.
Nursing Apps
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