Nursing Informatics (IT)

Course Description: This course deals with the use of information technology system and data standards based on nursing informatics principles/theories. It further deals with the utilization of clinical information systems in the management and decision-making of patient care. A laboratory session shall be provided for practice application. Course Objectives: At the end of the course and given relevant actual or simulated situations/conditions, the student will be able to: 1. Apply concepts, theories and principles of informatics in nursing and health care; 2. Discuss issues and trends in informatics relevant to nursing and health. Placement: Second Year, Summer Course Credit: 2 Units Lecture; 1 Unit Laboratory Contact Hours per Semester: 36 Lecture hours; 54 Laboratory hours

Textbook: Essentials of Nursing Informatics, International Edition, 4th Ed. by Virginia K. Saba and Kathleen A. McCormick Lecturers: CYGNETTE S. LUMBO, RN, MN (BSN 2A)

RUBY A. LECCIO, RN, MN (BSN 2B)

COURSE OUTLINE A. Computers and nursing 1. Computers and nursing a. Overview 2. Historical perspectives of nursing and the computer a. Six Time periods b. 4 major nursing areas c. Standards initiatives d. Significant landmark events 3. Electronic health record from a historical perspective a. The Davies Program B. Computer system 1. Computer hardware a. Definition b. Fundamentals - CPU - Memory: ROM, RAM - Input and Output Devices - Storage Media: Hard Drive, Diskette Drive, CD-ROM, USB Disk, Others - Bits and Bytes - Computer Speed c. Descriptive terms used in Computing d. History of Computers e. Types of Computers f. Common Hardware Peripherals - Keyboard - Monitor - Mouse and Trackball - Floppy Disks/ Diskettes and CD-ROMs - Touch pad and Mouse Button - Light Pen/ Touch Screen - Optical Character Recognition - Magnetic Ink character recognition - Voice synthesizer - Imaging - Digital Versatile Disk (DVD) - Printers - Modems g. Basics of Computer Network Hardware 2. Computer software and systems a. Definition b. Brief History of computer programming and software

c. Types of software d. Common software useful to nurses e. Computer programming f. Systems Theory; System Elements and Classifications g. Computer Systems h. Information Systems i. Hospital Information systems j. Network Systems 3. Open source and free software a. Introduction to OSS/FS b. OSS/FS Theory c. OSS Definition d. Open Source Licensing e. OSS/FS Applications f. OSS/FS Healthcare Applications - openEHR, FreeMed, OpenEMR, CARE2X, EU- Funded Projects g. Advocate organizations and resources of OSS/FS 4. Data processing a. Definition - Data, databases, information, Information systems b. Types of data c. Database Management Systems d. Fields, Records and Files e. Types of Files f. Database Models g. Conceptual Models h. Database Life Cycle i. Detailed Systems Design j. Data Warehouse - Development, purposes, functions, quality k. Data to Knowledge (D2K) l. The Nursing Context - The Nelson Data to Wisdom Continuum 5. The Internet: A Nursing Resource a. The history of the internet b. The internet technology - The Domain Name System (DNS) - Top-Level Domains (TLDs) - Scope and coverage - The internet Use- Then and Now c. E-mail - The anatomy of an E-mail Address - Using the E-mail : Emoticons, abbreviations, organizing received files, file attachments, etiquette, cautions and suggestions - Mailing list : List fundamentals, finding a list, etiquette

d. The World Wide Web (WWW) - Origins, functions, value e. The Internet as an Information source - Searching the web - Cookies - Evaluating Information from the web f. Getting on the information superhighway - Finding and evaluating an ISP - Creating a web page - Home page design - Links, Forms and maintenance g. Patient/ Consumer Use of the internet 6. PDA and wireless devices a. Continuum of Information technology for Personal Computing - Desktop Computer vs. Smartphone Physical Characteristics - Notebook/ laptop vs. tablet vs. PDA Physical Characteristics - Mobile Devices - Wireless Devices b. PDA (Personal Digital Assistant) - Usability - Functions and their applications to clinical practice c. Add-on Software for PDA 7. Incorporating evidence: Use of Computer-Based Clinical Decision Support System for health professionals a. DSS/ CDSS - Definition, expanded use, history b. Types and characteristics of DSS c. Key CDSS functions, d. Examples of CDSS Applications e. CDSS impact on Clinicians and Clinical decisions - Evidence-based practice, barriers to its use, evaluation f. Knowledge and Cognitive process g. Ethical and Legal responsibility of user h. Implications for future uses of CDSS in Nursing C. Issues in informatics 1. Nursing informatics and healthcare policy as a specialty - Differentiated and interdisciplinary practice - Patient Safety and Nursing Informatics - Nursing informatics initiatives and nursing informatics - National agenda and advocacy to nursing informatics 2. The role of technology in the medication-use process - Computerized prescriber Order Entry (CPOE) - Bar Code-Enabled Point-of-care technology - Automated Dispensing Cabinets - Smart infusion Pump Delivery Systems - Implementation of technology

3. Healthcare data standards - Message Format Data Standards - Terminologies - Data content standards - The standards development process - Framework for strategic action - The business value of data standards 4. Electronic health record systems: U.S. federal initiatives and public/private Partnerships 5. Dependable systems for quality care - Guidelines for dependable systems 6. Nursing minimum data set systems - Clinical nursing visibility from national to international contexts - NMDS (Concept Nursing Minimum Data Set) - NMDS Relationship to International Nursing Minimum Data Set (iNMDS) D. Informatics theory 1. Theories, models and frameworks a. Foundational Documents Guide Nursing Informatics practice b. Informatics and healthcare Informatics c. Nursing informatics as a specialty d. Models for nursing informatics e. Data, information and knowledge f. Registered nurses as Knowledge Workers g. Competencies h. Electronic Health Record i. Terminologies - NANDA-I - NIC - NOC - CCC - Omaha System - PNDS - SNOMED CT - ABC codes - PCDS - LOINC - ICNP - NMMDS j. Organizations as Resources - AMIA, HIMSS, National League for Nursing, Society for Health Systems, ACM, ARMA international, American Society for Information Science and technology

2. Advanced terminology systems a. Background and definitions b. Components of advanced terminology systems c. Advantages of advanced terminology systems d. Advanced terminological approaches in nursing, summary and implications 3. Implementing and upgrading clinical information systems a. Clinical Information System - Planning phase - The key role of the Nurse Administrator - System Analysis Phase - System Design Phase - Testing Phase - Document system - Training phase - Implementation Phase - Evaluation phase b. Upgrading clinical information systems, workstations, system issues and future trends E. Practice application 1. Practice applications a. History and evolution b. Standards for practice - Problem solving as an organizing framework c. Information technology and the actual work of nurses - Nursing documentation, care planning, decision-making, outcomes management, discharge planning, healthcare collaboration 2. Critical care applications a. IT capabilities and applications in critical care settings b. Device Connectivity Infrastructure - Physiologic monitoring systems - Hemodynamic monitors - Arrhythmia monitors - Critical Care Information Systems - Coordination and Scheduling of Patient care activities 3. Community health applications a. Community health Nursing System Development b. Home health c. Public health challenges d. Data sets e. Vocabulary Languages - Clinical care Classification System f. Omaha System g. Community health Intensity Rating Scale

h. Community health Systems i. Home Health Information Systems j. Telemedicine, Community Health telemedicine Systems k. Community health Network Systems l. Home High-tech Monitoring Systems m. Educational Technology systems 4. Ambulatory care systems a. Applications necessary in the Ambulatory environment - Financial, administrative and clinical benefits; regulatory Requirements b. The Role of the nurse using informatics concepts in the ambulatory arena 5. Internet tools for advanced nursing practice a. Basic and advanced internet search methods b. Internet- available clinical practice tools 6. Informatics solutions for emergency preparedness and response 7. Vendor applications a. Current trends toward prime vendors, EHRs and systems integration b. Historical perspective c. New technologies and current situation - Care flow diagram d. Key clinical system nursing and multidisciplinary care components - Patient access, admission assessments, diagnosis, - Nursing and multidisciplinary orders and plans of care - Integrated plans of care, Kardex, Workplans - Clinical documentation and discharge summaries e. Standard Terminology provided with clinical applications F. Consumers use of informatics 1. Consumer and patient use of computers for health a. Consumer use of computers for health - Information seeking - Communication and support - Personal health records 2. Decision support for consumers - Disease management 3. Issues in consumer computing for health - Variability in quality of information available to consumers - Lack of security in internet-based transactions - Uneven Accessibility across age, ethnic and socioeconomic Groups - Educational and cultural barriers - Physical and cognitive disabilities - Impact on relationship with health care providers 4. The Nurse Informaticians role in consumer and patient computing - Areas of nursing expertise that can be applied to consumer/

patient computing G. International perspectives 1. Nursing informatics in Canada 2. Nursing informatics in Europe 3. Pacific Rim 4. Nursing informatics in Asia 5. Nursing informatics in South America H. The future of informatics 1. Future directions a. The New Twenty-first century scenario b. Trends toward 2030 - Demography, growth in chronic diseases, emerging infectious disease threats - Changes in health-seeking behavior on the internet - Security and biodefense - Genetic revolution - Nanotechnology - Nursing and the core competencies for the future c. Ethical, Social and Legal Issues ___________________________________________________________________________________ ___________________________________________________________________________________

Prepared by: CYGNETTE S. LUMBO, RN, MN Lecturer, Nursing Informatics

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