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NURS 200 Nursing Informatics and the Future of Nursing – Flashcards

Sarah Taylor

7 July 2022

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CNA Statement on Nursing Information and Knowledge Management (taken from CARNA: The role of the registered nurse in health informatics)

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•Information management and ICT are integral to nursing practice •Registered nurses should advocate and lead in implementing the collection, storage, retrieval and use of nursing care data to generate information on patient outcomes •Registered nurses should advocate for data standards and promote adoption in Canada of one clinical care terminology with the capacity to represent client health data and the clinical practice of all health-care providers •Registered nurses should advocate for a client centered pan-Canadian electronic health record

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CARNA position on nursing informatics (taken from CARNA: The role of the registered nurse in health informatics)

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•Firmly supports the active engagement of registered nurses and the inclusion of nursing input in all stages of life cycle of nursing information and communication technology in health and nursing environments •Recognizes the importance of roles for registered nurses in nursing informatics and health informatics •Encourage active participation of registered nurses in all roles of information management within health care systems at the local, provincial and national levels •Endorses principles of access, competence and participation recommended in the CNA-e Nursing Strategy as guidance for registered nurses and employers

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CARNA believes formal education should in nursing should (taken from CARNA: The role of the registered nurse in health informatics)

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•Provide the appropriate information management competencies for knowledge based practice which are: o Using various data collection approaches appropriate to the situation to complete client assessment o Use information and other technology to support nursing practice •Provide a working knowledge of the International Classification of Nursing Practice •A working knowledge of health informatics encompassing nursing informatics

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CARNA believes registered nurses should (taken from CARNA: The role of the registered nurse in health informatics)

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•Seek opportunities to acquire basic information management concepts and skills i.e. computer skills •Develop working familiarity with standardized nursing technology and clinical terminology so that a common language can be used for describing nursing practice and enable comparison of nursing data across clinical populations, settings, geographical areas and time •Identify and address nursing information issues that affect the role of the registered nurse •Promote a positive integration of health information and communication technology into an organization's chosen nursing care delivery model •Seek access to staff development programs that permit registered nurses to acquire skills that enable them to use the information system specific to their organization •Actively participate in committees dealing with the development, implementation and maintenance of health information, and communication technology initiatives at the local, provincial and national levels

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Define health informatics (taken from CARNA: The role of the registered nurse in health informatics)

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•Coined by Mandil (1989) •Refers to the use of information and communication technology, including both hardware and software, in combination with information management concepts and methods to support the delivery of health care •Umbrella term encompassing medical informatics, nursing informatics, dental informatics and pharmacy informatics

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Health information systems/ health information and communication technology/ ICT (taken from CARNA: The role of the registered nurse in health informatics)

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Refers to those collected information and communication technologies that are used in support of the management and delivery of health services

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Bagely and Thompson's definition of nursing informatics (taken from CARNA: The role of the registered nurse in health informatics)

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•a specialty that integrates nursing science, computer science and information science to manage and communicate data, information and knowledge in nursing practice. •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 use of information structures, information processes and information technology.

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ICNP/International Classification for Nursing Practice (taken from CARNA: The role of the registered nurse in health informatics)

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•a unified nursing informatics system •compositional terminology for nursing practice that facilitates the development of and cross mapping among local terms and existing terminologies •used as a reference language to link all the disparate nursing terminologies and languages that have proliferated around the world particularly the United States •in 2003 CNA endorsed use of ICNP in Canada •AARN (alberta) first provincial nursing jurisdiction to endorse ICNP in 1997

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3 Key Elements identified by CNA for integration of ICT in nursing (taken from CARNA: The role of the registered nurse in health informatics)

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•Nurses' access-nurses must have access in the workplace to information and ICT •Nurse's competence- nurses must have the necessary skills and abilities to use information and ICT in their practice to support clinical judgment and decision making •Nurse's participation- nurse's insights are essential to ensure the right ICT tools are selected and implemented in health organizations to achieve maximum patient benefit

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SNOWMED-CT (taken from CARNA: The role of the registered nurse in health informatics and Potter and Perry Chapter 16)

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Systematized NOmenclature of MEDicine Clinical Terms •Preferred language of documentation of client information in the electronic health record clinical terminology standard

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Landmark Institute of Medicine dimensions of patient care relevant to nursing informatics (taken from Sensmeier, J. (2011). Transforming nursing practice through technology and informatics.)

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respect for patient's values, preferences, needs coordination of care physical comfort and emotional support involvement of family and friends information communication education

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The value of nursing informatics (Sensmeier, J. (2011). Transforming nursing practice through technology and informatics.)

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•Integral part of healthcare delivery and a differentiating factor in the selection, manipulation and evaluation of health Information technology that supports safe high quality, patient centric care •Nursing informaticists use technology and knowledge of patient care to contribute to care of individual and transformation of healthcare

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Landmark Institute of Medicine dimensions of patient care relevant to nursing informatics (Sensmeier, J. (2011). Transforming nursing practice through technology and informatics.)

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respect for patient's values, preferences, needs coordination of care physical comfort and emotional support involvement of family and friends information communication education Overall make the care respond to the person not the person respond to the care

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Implications of nursing informatics for time and place of care (Sensmeier, J. (2011). Transforming nursing practice through technology and informatics.)

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•promote continuum of care regardless of time and place in addition to wellness and maintenance activities •examples are virtual office visits, online appointment scheduling, mobile labs, electronic medication prescribing and patient portals connected with EHRs •able to share and compare data across health care organizations •systems must be able to exchange data to achieve these goals

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HIMSS position on Nursing informatics (Sensmeier, J. (2011). Transforming nursing practice through technology and informatics.)

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•Leadership Partner with nurse executives to lead technology changes that advance health and the delivery of healthcare Support the development of informatics departments Foster the evolution of chief nursing informatics officer role •Education Transform nursing education to include informatics competencies and demonstrateable behaviours at all levels of academic preparation Promote the continuing education of all levels of nursing, particularly in the areas of EHR and health IT. •Practice Ensure that data information, knowledge and wisdom form the basis of 21st century nursing practice by incorporating informatics competencies into practice standards at all health care settings Facilitate the collection and analysis of interprofessional healthcare workforce data by ensuring data can be collected from existing health IT systems

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Nursing informatics leadership (Sensmeier, J. (2011). Transforming nursing practice through technology and informatics.)

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•nursing informations executive is a new type of leader •critical to engage in necessary transformational activities and bridge new care delivery models into clinical practice with the right technology solutions •changes management efforts to shape behaviour and thinking beyond current models(physician and acute care centered ) to evolve them into coordinated care models

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Call to action (Sensmeier, J. (2011). Transforming nursing practice through technology and informatics.)

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* Vendor organizations that develop electronic systems for clinician use should employ nurse informaticists in analyst, leadership, and officer roles. * Provider organizations should develop informatics departments that include nurse informaticists. * Provider organizations should employ nurse informaticists in leadership roles, such as a nursing informatics executive, chief nursing informatics officer, chief clinical information officer, or vice president of nursing informatics. * Nursing informatics leaders should be knowledgeable and current in public policy initiatives. * Government agencies should recognize that regulations and reimbursement policies that remain exclusively physician-focused won't achieve the goals of healthcare transformation in the United States. * Academic organizations should integrate informatics content throughout the nursing undergraduate and graduate curriculum

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Electronic Health Record (Potter and Perry Chapter 16)

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a longitudinal record of an individual's health status (including diagnosed comorbid conditions), diagnostic tests, treatments and results.

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Current applications of information communications technology (ICT) in health care (Potter and Perry Chapter 16)

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patient scheduling and transfer billing and financial management diagnostic imaging lab reporting order entry applications pharmacy patient documentation systems clinical support tools remote consultation triage clinical resource management applications

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What is a consistent obstacle to the collection of nursing data? (Potter and Perry Chapter 16)

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the persistent absence of universally accepted methods for defining and coding nursing contributions to health outcomes

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Canadian Institute for Health information (CIHI)

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the national, independent, and not-for-profit body that records, analyzes and disseminates essential data and analysis on Canada's health system and the health of Canadians •Not initially geared to nursing data, but became more important to several issues directly influencing nursing •Nursing workforce recruitment and retention

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Canada Health Infoway (Potter and Perry Chapter 16)

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a key outcome of the federal, provincial and territorial partnership has a national mandate to generate consensus on health information standards, to drive the national agenda of creating an EHR system, and to act as the liason to international standards development organizations partners with jurisdictions as a strategic investor to share costs of implementing health information management projects and provides additional project benefits analysis

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Standards Collaborative (Potter and Perry Chapter 16)

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launched by Infoway in 2006 is a Canada wide coordination function created to support and sustain health information standards in Canada to coordinate support for development, implementation, testing and maintenance of standards and education for both general and specific user groups also incorporates nine Standards Collaborative Working Groups (SCWGs) in which clinicians, IT experts, academics, researchers and policymakers collaborate to address standards development for health information and information systems in Canada

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Health Informatics Nursing components 5 categories of elements (Potter and Perry Chapter 16)

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patient status nursing interventions patient outcomes nursing resource intensity primary nurse identifier

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patient status

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a label for the set of indicators that reflect the phenomena for which nurses provide care, relative to the health status of patients, represents a broader spectrum of health and illness; inclusive input from all disciplines; the phenomena for which nurses provide care are merely one aspect for a patient status at a point in time, in the same way as a medical diagnosis

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nursing interventions

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purposeful and deliberate health-affecting interventions (direct and indirect) based on assessment of patient status, which are designed to bring about results that benefit patients

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patient outcomes

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the "client's" status at a defined point following healthcare affecting intervention; influenced to varying degrees by the interventions of all health care providers

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nursing resource intensity

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refers to the amount and type of nursing resource used to provide care

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primary nurse identifier

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a single, unique, lifetime identification number for each individual nurse; independent of geographic location, practice sector (eg. Acute care, community care, public health) or employer

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Six core components that make up an EHR (Potter and Perry Chapter 16)

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patient registry provider registry diagnostic images labratory results drugs dispensed clinical reports/immunization

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standards in health care data management (Potter and Perry chapter 16)

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refer to nationally or internationally agreed on protocol for representing all types of health information, including types of care provided, location of care provision, pharmacy ordering and dispensing, and billing messages. ensure data is consistently represented and exchanged and thus consistently understood by practitioners and health information systems ensure interoperablity by supporting information exchange are a critical foundation for the interoperable health record

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Benefits of standards in health care data for patients (Potter and Perry chapter 16)

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reduced repetition of health information accessible personal health history improved coordination of care reduced duplication of tests and procedures improved health outcomes

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Benefits of standards in health care data for providers (Potter and Perry chapter 16)

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timely access to health data availability of more reliable health information reduced duplication of efforts shorter response time between assessment and treatment improved quality and consistency of care resulting from enhanced information access enhanced patient outcomes

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Benefits of standards in health care data for service delivery organizations (Potter and Perry chapter 16)

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reuse of solutions, benefiting from lessons learned and change management strategies greater breadth of data to use for evaluating outcomes enhanced ability to work collaboratively with other organizations or jurisdictions increased confidence in products when determining suitability for use

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Benefits of standards in health care data for educators (Potter and Perry chapter 16)

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support for curriculum design that is aligned with accreditation process increased value of data for educational purposes enabling of educators and students to understand health informatics environment at early stages of education enhanced ability to extract data such as best practice guidelines, from published sources

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Benefits of standards in health care data for researchers (Potter and Perry chapter 16)

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availability of higher-quality data reduced time to prepare data for use comprehensive data sets improved ability to monitor and assess health outcomes and determinants

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PIPEDA (Potter and Perry chapter 16)

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federal legislation governing the disclosure of personal health information in an electronic environment by addressing specific risks associated with electronic data collection, storage, retrieval, and communication; affects Canadian jurisdictions unless federal government acknowledges exception

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CNA's 7 Key Outcomes that are projected to emerge from the e-Nursing Strategy (Potter and Perry chapter 16)

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1.Nurses will integrate ICT into their practice to achieve desirable patient outcomes 2.Nurses will have the required information and knowledge to support their practice 3.Human resources planning will also be facilitated 4.New models of nursing practice and health services delivery will be supported 5.Nursing groups will be well connected 6.ICT will improve the quality of nurse's work 7.Canadian nurses will contribute to the global community of nursing

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3 fundamental directions for CNA's e-Nursing strategies (Potter and Perry chapter 16)

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access- health care organizations have a responsibility to ensure that nurses have connectivity—tools such as computers, mobile technology, as well as resource databases and Internet sources to support professional practice competencies- encourage nurses to develop competencies in the application of ICT and recommended that such competencies be part of both undergraduate and graduate-level nursing programs participation-including strategic partnerships with nurses in clinical practice; with employers and administrators; with federal, provincial ad territorial ministries; with nursing organizations (professional associations, regulatory bodies, educational groups and unions) and with educators and researchers. Effective partnership allows nurses to contribute to selection and design of electronic documentation systems

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NurseONE (potter and perry chapter 16)

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A key component of the e-Nursing strategy A nursing portal that enables you to register, create a personal profile, and customize the use of the site's tools and resources

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Services provided by NurseONE (Potter and Perry chapter 16)

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•Professional links (resources with clinical or professional orientation) •Professional development (including resources for continuing competence, online and continuing education, and career development) •Library (access to numerous article and publications) •NurseConnect (use of the portal to create discussion groups among individual subscribers)

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Canadian Nursing Informatics Association (CNIA) (Potter and Perry chapter 16)

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The national special interests group dedicated to the advancement of nursing informatics in Canada

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Mandates of the CNIA (Potter and Perry chapter 16)

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•To provide nursing leadership for the development of nursing and health informatics in Canada •To establish national networking opportunities for nurse infomaticians •To facilitate informatics educational opportunities for all nurses in Canada •To engage in international nursing informatics initiatives •To act as a nursing advisory group in matters of nursing and health informatics

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COACH (Potter and Perry Chapter 16)

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Canadian Organization for Advancement of Computers in Health Care Another organization dedicated to promoting health informatics within the Canadian health system through education, information, networking and communication Formed in 1975 by software developers and health care clinicians Focus is to support effective use of information technology and systems among Canadian health institutions by sharing ideas and efforts; includes the effective use of health information for decision making Multidisciplinary membership includes health care executives, physician's nurses, and allied health professionals, researchers, educators, chief information officers, information managers, technical experts, consultants, information technology members

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Current definition of nursing informatics (narrated powerpoint)

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"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."

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Current technological information of nursing informatics (narrated powerpoint)

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•Patient scheduling and transfer •Billing and financial management •Diagnostic imaging •Lab reporting •Order-entry applications for supplies to the units •Pharmacy •Patient documentation systems •Clinical support tools •Resource management applications

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What is the goal of nursing informatics? (narrated powerpoint)

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To improve the health of populations, communities, families, and individuals by optimizing information management and communication. (CNIA, 2003, p. 1).

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How do we meet the goal of nursing informatics? (narrated powerpoint)

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•by using information and technology in the direct provision of care •establishing effective administrative systems, in managing and delivering educational experiences •supporting lifelong learning •supporting nursing research

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3 types of electronic systems (narrated powerpoint)

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1. Point-of-care systems (e.g. EMR) •Patient's chart within a single organization or system •allow entry and viewing of data within an organization 2.Electronic Health Records •Much broader •allow data entry and viewing across multiple services and across a lifetime •is interorganizational and interprofessional 3.Consumer health solutions (e.g. PHR) •Engages patient as a member of the health care team enables the patient/client to enter, review, and share personal health information

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Basic Electronic Health Record Components (narrated powerpoint)

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•Point-of-care system for data entry and retrieval •Functionality •Client registry (e.g. personal information) •Provider registry (e.g. home care nurse) •Diagnostic imaging system (e.g. x-ray) •Drug information system (e.g. current meds) •Laboratory information system (e.g. blood-work) •Medication profiles •Clinical reports (e.g. discharge summary) •Interoperability •All the health care professionals can communicate with one another

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Advantages of Electronic Health Records (narrated powerpoint)

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•Legibility •Availability •Ease of updating •Storage •Improved patient safety

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Challenges of Electronic Health Records (narrated powerpoint)

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•Upfront costs •Collaboration of expertise of health professional and IT people •Protecting privacy is hard because firewalls need to be put up for workers accessing information from outside the building

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What types of information would you expect to see in an example of a basic health record? (narrated powerpoint)

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Patient Details-sex, date of birth, next of kin,phone,address, alerts Patient Record-lab results, diagnostics, images, details, notes, diagnosis (date and status) GP Details-name,phone, address, Other Health Care Providers- name,specialty, contact, access medications-name,started, last filled encounter history- name, specialty, facility, reason

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Benefits of Electronic Health Records for a patient (narrated powerpoint)

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•care during medical emergencies •monitoring and management of chronic diseases •wait times for diagnostic, screening or treatment procedures •use of diagnostic or screening results with reduced unnecessary repetition •diagnosis and treatment with information sharing •access for rural groups

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What is a personal health record? (narrated powerpoint)

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•Includes information added by the individual •Less comprehensive than an EHR, similar in scope to an EMR but includes different health information •May be an isolated document, but ideally is integrated and overlaps with an EHR

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Benefits of personal health records? (narrated powerpoint)

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•Supporting self-management •Improves communication between a patient/client and health care professionals •Allows for personalized health teaching

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C-HOIBC/ Canadian Health Outcomes for Better Information and Care Project (narrated powerpoint)

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•Multi-provincial project Launched by CNA in 2007 in collaboration with Ontario, Saskatchewan, Manitoba and Prince Edward Island with financial contributions from Canada Health Infoway •Focused on collecting information reflecting evidence informed, nursing sensitive client outcomes •Addresses health information gaps in health information related to the contributions of nursing care to client outcomes and addresses the need for standardized nursing data to be included in client admission and discharge summaries a systematic approach to gathering nursing content that is documented from a standard clinical terminology, the ICNP

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Four SRNA technology comeptencies (narrated powerpoint)

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11. Demonstrates critical inquiry in relation to new knowledge and technologies as it relates to nursing practice. 29. Demonstrates and utilizes nursing informatics and other information communications technology in promoting and providing safe nursing care. 40. Uses existing health and nursing information systems to manage nursing and health care data during client care. 61. Uses technology appropriately, ensuring client safety.

NURS 200 Nursing Informatics and the Future of Nursing – Flashcards

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