Part 1

Q1. Discuss the importance of nursing informatics to upgrade the efficiency and effectiveness
of nursing care in your country.
The term “nursing informatics” (NI) was initially noted in literature in the 1980s,
including a definition of combining nursing, information, and computer sciences for managing
and processing data into knowledge for using in nursing practice (Murphy, 2010). In 1994, The
American Nurses Association (ANA) began developing a statement to describe and define the
scope of nursing informatics (Baker, 2012). The meaning of nursing informatics has evolved and
been refined, with the American Nurses Association (2008) definition stated as “a specialty that
integrates nursing science, computer science, and information science to manage and
communicate data, information, knowledge, and wisdom in nursing practice” (p. 65). Nursing
informatics assists nurses, consumers, patients, the inter professional healthcare team, and other
stakeholders in achieving desired outcomes in all roles and settings. Information architecture,
information processes, and information technologies are used to provide this support (Baker J.,
2012 and Cummings E.,et al.,2015). Nursing informatics (NI) assists patients, nurses, and other
healthcare practitioners in all roles and situations in making decisions. Informatics nurses have a
lot of clinical experience, are considered specialists in the nursing process, and have a lot of
technology experience and education. As a result, the nurse is in charge of maintaining a current
product and keeping up with new advancements in the industry. They create software including
as decision support systems, nurse staffing systems, scheduling systems, and bedside
applications.
To eliminate errors and to provide better medical records, nursing informatics collect and
use aggregated data. Informatics, on the other hand, improve documentation and, when
effectively implemented, can reduce the amount of time spent on documentation and redundant
data entry, such as entering vital signs in both nursing notes and a flow sheet, which wastes time
and encourages errors. Furthermore, as per Baker, J. (2012), in a well-designed clinical
documentation system, these data will be input once, then retrieved and displayed in a variety of
ways to fit the user's needs. Nursing Informatics’ skills are more expected of healthcare
professionals and nursing leadership, according to McGonigle, et al., (2014), but there is still a
lack of knowledge of what they are and how they are a fundamental component of NI.

Impact of nursing informatics on the nursing profession

1. Computer information systems minimize or avoid nurses from making medication
errors.
2. Help nurses easily interpret orders from physician in the management of a patient.
3. There is better collaboration and sharing of patient information with other health
care providers.
 4. Nurses perform better assessments and monitoring of patients diseases and
ailments.
5. Helps nurses utilize research to provide evidence Nurses' Involvement in New
Technology
6. There is an increase in the use of technology such as mobile computers and
wireless solutions, and automated exchanges between providers and patients.
7. Nurses are at the center of this advancement as the professionals with the greatest
amount of direct patient care.
8. Healthcare environments now incorporate virtual office visits, online appointment
scheduling and payment, mobile laboratories, and electronic medication prescribing.
9. Nurses are also essential in helping patients set up their own personal health
records (PHRs), or explaining to patients how to use a patient portal.
10. The use of telehealth exchanges is increasing, particularly with underserved rural
populations. New technologies offer access and opportunities to provide quality care to
patients in remote settings. The challenge for these technologies with healthcare is
ensuring that the automated solutions completely interact with one another, as well as
with the healthcare professionals (American Medical Informatics Association, 2009).

Apart from above reasons, following major reasons were identified as major reasons
which makes Nursing Informatics important.

Simplicity and improve communication

Use of computerized data entry and recording will create simplicity in handling of
patients and their records. Once a patient is reported to the hospital for a treatment, the
preliminary information provided by the patient is to be submitted to the admission location and
then those details are to be included for the computerized system. The computerized system can
be made in a simple way that front table nurse has to enter only the most essential details about
the patient as per the standard format available on the system. When these details are fed to the
system, the nurse who is attending for this task will be skilled for that job and then nurse can
enter the details within very short time period. This creates simplicity in handling the patient
details.
Then the next nurse/ doctor examining the patient have the record of preliminary
information to access about the patient once the patient reported to the respective location.
Further, when same patient report to the hospital another occasion, he or she doesn’t require
producing historical data to the hospital again as same data already available in the system. This
creates simplicity in viewing and diagnosing the patients’ present health status.
 Further availability of data on computerized system reduce data searching time period
and will always provide accurate data for the doctors/ nurses reference. This will improve
communication between all levels when handling the patients and hence minimize / avoid
creating errors. In addition, nursing informatics system maintains the accessibility and legality,
so nurses will easily get information about the patient with full responsibility (Hariyati, Yani,
Eryando, Hasibuan & Milanti, 2016)

Save Nurse’s Time

Nursing officers engaged in daily patient care and the most of their work load will be
based on maintaining books and BHT. Data entry on computerized system will minimize paper
works at first instance. At the same time, computerized systems minimize use of papers and
hence avoid loosing of records due to misplace or physical damages. When papers are used for
the recording, those papers need to be carried from one location to another for other nurses’ or
doctors’ reference. There must be a delivering mechanism for that purpose. Sometime, nurse
need to carry those records from one location to another. When the computerized system used for
data recording, there will not be a physical delivery mechanism and other persons can access
data through the computerized system once the data is input to the system. This save time for the
other essential works and patient care.

Save more time of Patients

Nursing management information system based on information technology also help
nurses to improve nursing care because it reduces human error, improve human behavior,
improve patient safety and enhance the role of nurses so that nurses can improve care with high
competency supported which by high technology (Yu, 2006). Further, patients have to wait long
time in queues in order to appear for the doctors or in the pharmacies to meet doctors or to obtain
drugs. If the data recording system is automated, it does not take much time for the consultancy
as well as for other treatments as all required details are already available on line. Waiting time
in the queue mainly takes place due to poor handling of records and inefficient transfer of
relevant records from one place to another. If the computerized system is established, the data
uploading will be fast and patients do not require more time to be in queues for them to be
appeared in front of the Doctors.

Rapid retrieval of Patient’s Information

Nurse Informatics plays a vital role in evaluating healthcare data and identifying areas of
opportunity within the clinical settings for improvement. Their primary focus is to look for ways
to reduce the strain on nursing and management teams while also increasing patient care and
satisfaction. In nurse informatics, you’ll leverage the latest technology to help create workflow
efficiencies, including data-driven tools, apps, and systems. You’ll continually analyze the data
and put the findings back into the workflow allowing the staff leads to better manage their teams
and resources. As new systems and processes go live, nurse informatics help train the clinical
staff and educate the team on how to take advantage of the features and functionality of the new
tools.

A longitudinal electronic record of patient health information generated by one or more

encounters in any care delivery setting. Included in this information are patient demographics,
progress notes, problems, medications, vital signs, past medical history, immunizations,
laboratory data and radiology reports.

The impact of COVID-19 on the healthcare system has intensified the need for
excellence in resource management and puts a spotlight on the critical role of nurse informatics.
There has never been a greater need for nursing leadership skilled in data collection, analysis,
and interpretation to lessen the strain on nurses and hospital staff

Reduction of human errors

Documentation can be standardized and unnecessary documents can be avoided via data-
sharing technologies, resulting in improved interdepartmental and cross-organizational
collaboration. Modern integrated databases also make it simple to access a variety of patient
data, such as medical history, treatment plans, lab and test results, imaging, and team notes. This
allows doctors, nurses, and hospital personnel to make more accurate and informed decisions
more quickly, resulting in better patient care.
In reading as well as writing human error is an unstoppable thing. With the work load and
duties nurses can’t maintain good hand writing or always write in block capital letters. Some
instances the drugs can be miss read or the order can be miss communicated or the procedure can
be documented wrong. These errors can be minimized by using informatics.

Conclusion
Of course the combining health with information technology lends a great economical
advantage to the health sector as health sector is currently spends significant amount of its
budget for the paper works. Not only nursing documents but also cost for printed CT, X rays will
be saved. The digital x rays, CT and MRI gives a greater detail than the printed version. In long
term reducing physical material gives a greater environmental support. It reduces waste
accumulation and protection of trees.
 Nursing Informatics Play a great support/ role in Nursing during in present scenario.
Hence, application of these facilities for the hospital sector in Sri Lanka will greatly benefited by
the people of the country and risk of lives will be minimized up to a greater extent.

References.
Simplicity and Completeness of Nursing Process Satisfaction Using Nursing Management Information
System at the Public Health Service "X" Indonesia. Available from:
https://www.researchgate.net/publication/327679863_Simplicity_and_Completeness_of_Nursing_Proc
ess_Satisfaction_Using_Nursing_Management_Information_System_at_the_Public_Health_Service_X_I
ndonesia
Part 2
Project Proposal on Hospital Information System

Objective
To design a hospital Information System for your unit to automate the nursing care process for
better quality service delivery.
Scope
The Hospital Information Systems helps all investigations are to be documented in timely
order and it is much easier to take an idea about patient’s progress. As an example, simply
without turning multiple pages to look at a total bilirubin level of a neonate can simply look at a
chart and tell. Change in vital signs of a bad patient in ICU this can predict the prognosis of the
patient. This is effective than traditional paperwork system. Hence, main scope of this
information system is to develop a system which will support closely monitoring of the Patients
to ensure their safety and fast recovery.
In an emergency, the speed is the most important aspect. The trop I is not important after
the golden hour in a MI patient. FAST scan is pointless if the patient gone in to shock. So the
rapid transferring of investigation results and information has a greater importance. Furthermore,
up keeping the stocks of drug store and ordering of drugs are main duties of nursing officers. In
stock keeping there are number of books to be maintain. With the informatics system it will be
easy. Can easily detect drugs with high demand and can preorder those drugs. It can be a safety
mechanism to regulate the harmful drugs.

WBS
In order to design a Hospital Informatics System, following work breakdown structure is
designed.
At first stage, the patient is reported to hospital to obtain treatments. So it is the
responsibility of front desk registrar (Nursing officer) to enter the details of the patient to the
computerized system. While entering the details to the computerized system, the Identity card
(ID) number can be used as the key word for the patient identification as ID is unique number for
each individual.
When the details are entered to the computerized system, the patient can be issued with
the token (Symbol with a number) in order to direct to the doctor. This token can be withdrawn
from an automated system and issued to the patient. This token can be incorporated with the
number as per the order of reporting to the hospital and same number can be able to visualize at
the OPD to present in front of doctor. However, the nursing officer at front desk can decide
whether patient to be directed to emergency treatment or for the Non-emergency treatment.

Patient
Admission

Triage nurse

Non- emergency
emergency

OPD ETU

Initial management and

Initial management and stabilization
stabilization

Admit to
Home care Admit to
specialized
specialized
wards
wards

When the patient is directed to the non-emergency treatment, the patient has to wait for
appearing to the Doctor and the system has to display the number issued to patient at token in
order to appear in front of the patient.
When doctor examined the patient, doctor can include his observations and
recommendations in to the computerized system. These details will be stored in the system and
when the patient report next time, the doctor can retrieve this information based on the ID
number of the patient.
The Doctor can decide whether the patient require to be admitted in order to provide
special treatments by admitting to the wards or patient can be released by providing drugs in
order to get home care.
 When doctor recommends that the patient can be released up on issuing drugs, then the
drugs requirement can be included to computerized system. When the patient is informed to
obtain drugs from the Pharmacy, the patient can go to the pharmacy. At this time, the staff at
pharmacy can observe the drugs requirement need to be issued to the patient based on the ID.
Hence, patient can be issued with required drugs and can be released to home care.
When doctor recommends that the patient needs to be admitted in order to provide
medical treatments, the ward in which patient to be admitted will be able to select by the doctor.
At that instance, when the relevant ward is selected, same details need to be displayed on
respective ward and the front desk nursing officer can register and make required bed allocations
prior patient report to the ward. When the ward beds are filled, that details also need to be
displayed to OPD doctor in order to select the correct ward where patient can to be admitted
based on space availability. Once the patient is admitted to the ward, the doctor at the ward can
inspect the patient and pre- examination details of the OPD doctor has to be able to observe from
the computerized system. Then ward doctor may decide that the patient need any other special
observations such as ECGs, X rays, blood or urine testing etc. once required examinations
require to be done are selected, then those information must be able to display on relevant
sections in order for them to plan and prepare for such examinations. Once these examinations
are done, respective technicians can included those reports to the computerized system. Then the
ward doctor must be able to visualize those reports through the computerized system and has to
be able to decide on patient’s treatment plan.
Same procedure can be applied once a patient is directed to emergency treatment and
after that when directed to respective wards too.
This system can be inter-connected to the drugs inventory also. When the drugs
inventory is included to the system, the doctor can decide the drugs which can be issued to the
patient based on the availability of the relevant drugs, If some drugs are not available, the
alternative drugs can be decided by the doctor during initial recommendation stage and
accordingly drugs can be issued to the patient. This would help nursing officers also to know
about the stock availability of respective drugs and accordingly reorder stage can be decided.
In such manner, computerized nursing informatics system can be effectively used at
hospital level for effective and efficient functioning of the hospital related works.