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NURSING INFORMATICS

MODULECHAPTER 1- INTRODUCTION

The American Nurses Association (ANA) defned nursing in ormatics

as a specialty that integrates nursing science , computer science and

information science to manage and communicate data, information

and knowledge in nursing practice . It represents the transition o data

and data in ormation and knowledge into action. (V. Saba and .

!c"ormick#$ th %d.# &'' ). In ormatics (in ormatics comes rom the rench

word in ormati*ue which means computer science). In ormatics is defned

as computer science + in ormation science. ,sed in con-unction with the

name o a discipline# it denotes an application o computer science and

in ormation science to the management and processing o data# in ormation#

and knowledge in the named discipline. Thus we ha e# medical in ormatics#

nursing in ormatics# pharmac/ in ormatics and so on. 0ebda (1223 p. 4)#

defnes nursing in ormatics as 5the use o computers technolog/ to support.

6e can consider NI or nursing in ormatics as a multi aceted

interdisciplinar/ feld o nursing science. In ormation integrit/ and ensuring

the sa et/ o data transmission is an essential part# not onl/ in nursing# but

also# in the feld o in ormation and communications technolog/ (I"T). And

with the progressi e integration o I"T concepts and protocols in the practice

o nursing# whether in the clinical# academe or research# nurses should be

prepared to become globall/ competiti e healthcare pro essionals.

In the 7hilippines# the In ormatics Nurses Societ/ o the 7hilippines hasbeen leading in the de elopment and ad ancement o nursing in ormatics

through local and international linkages and collaboration.

Nurses and academicians currentl/ utili8ing se eral programs are

aware that there is a need to standardi8e the contents o the course being



implemented b/ nursing schools. Theoretical concepts and practical

applications should be aligned so that it ma/ be applicable to the 7hilippine

setting. In this regard# the concept o nursing in ormatics needs to be

concreti8ed in the Nursing curriculum so that trained acult/ members and

instructors in the "olleges o Nursing appropriatel/ handle both the lecture

and laborator/ component o the course. !ore so# nursing in ormatics need

to be integrated to the realms o nursing education# practice and research.

Thus# 7hilippine !edical In ormatics Societ/9Nursing In ormatics (7!IS9NI) is

created to translate these ideas into realit/. It en isions itsel to be the lead

organi8ation in promoting a culture o e:cellence among its members

through nursing in ormatics applied to nursing education# research and

practice dedicated towards pa/ing orward to the societ/.

Defnition- KEY TERMS

Buil in! "lo#$% 9 ;asic element or part o nursing in ormatics such as

in ormation science# computer science# cogniti e science and nursing

science.

Clini#&l D&t&"&%e% 9 A collection o related patient records stored in a

computer s/stem using so tware that permits a person or program to *uer/the data in order to e:tract patient in ormation

D&t& 9 <aw act= lacks meaning.

D&t& 'inin! 9 So tware that sorts thorough data in order to disco er

patterns and ascertain or establish relationships= so tware that disco ers or

unco ers pre iousl/ unidentifed relationships among the data in a database=

program that conducts e:plorator/ anal/sis looking or hidden patterns in

data.

E(i en#e 9 Arti acts# productions# attestations or other e:amples that

demonstrate what an indi idual>s knowledge# skills or alued attributes.

Fee "&#$ 9 Input in the orm o opinions about or reactions to something

such as shared knowledge= in an ISs# eedback re ers to in ormation rom the



s/stem that is used to make modifcations in the input# processing actions or

outputs .

In)o*'&tion 9 ?ata that are interpreted# organi8ed# or structured= data that

is processed using knowledge or data made unctional through the

application o knowledge.

Kno+le !e - The awareness and understanding o a set o in ormation and

wa/s that in ormation can be made use ul to support a specifc task or arri e

at a decision= abounds with others> thoughts and in ormation= in ormation

that is s/nthesi8ed so that relationships are identifed and ormali8ed

Kno+le !e &#,ui%ition 9 Act o ac*uiring or getting knowledge.

Kno+le !e i%%e'in&tion 9 ?istribution and sharing o knowledge.

Kno+le !e !ene*&tion 9 "reating new knowledge b/ changing and

e ol ing knowledge based on /our e:perience# education# and input rom

others.

Nu*%in! in)o*'&ti#% 9 This support is accomplished through the use o

in ormation structures# in ormation processes# and in ormation technolog/=

@a specialt/ that integrates nursing science# computer science# and

in ormation science to manage and communicate data# in ormation# and

knowledge (Staggers B Thompson# &''&# p. & ')Nu*%in! %#ien#e 9 The ethical application o knowledge ac*uired through

education# research and practice to pro ide ser ices and inter entions to

patients in order to maintain# enhance or restore their health= to ad ocate or

health# and to ac*uire# process# generate and disseminate nursing

knowledge to ad ance the nursing pro ession.

"hapter Cui8D

1. 0a e a flm iewing about nursing during lorence Nightingale>s time.

?escribe the health care deli er/ s/stem.

&. Visit a hospital in /our localit/. "ompare and contrast nursing practice

in the past and in the present.



C &.te* /-0 &t i% in)o*'&ti#%

The healthcare o our clients is largel/ dependant on in ormation. % er/

action taken depends on pre ious in ormation and knowledge. The deli er/

o health care re*uires in ormation aboutD• Science o t/pe o care (nursing) E 7rocess and s/stems or

deli er/ o care

• 7ro ider E Futcomes

• 7atient or client

The @science o care re ers to the scientifc oundations o the pro ession

that pro ides healthcare. In ormation on the client is re*uired or hisGher

indi idual care. The use o technolog/ can assist in collecting this

in ormation. It can be ound in the patient record# the patient>s histor/# lab

results. 6hat is important to note is# in ormation changes and grows o er

time.

In ormation about the process and s/stems or deli er/ o care assists in

deciding on the t/pe and the amount o care re*uired. In ormation about

each o these areas ha e an impact on the t/pe and the amount o care

gi en. In ormation must beD

accurate

timel/

accessible

understandable



6hat is ?ataD discrete entities ob-ecti el/ described# without interpretation

or conte:t. %:ampleD 11'

6hat is In ormationD data processed into a structured orm. ?ata that are

interpreted# organi8ed#

structured and gi en meaning are re erred to as in ormation. %:ampleD

6hen combining 11' with other data# it becomes in ormation. S/stolic

blood pressure o 11' mm0g and diastolic blood pressure o H' mm

0g. This in ormation can be captured in a orm# on a graph on in a

report.

6hat is nowledgeD s/nthesi8ed in ormation deri ed rom the interpretation

o data. It pro ides a

logical basis or making decisions. %ssential to decision9making and to

new disco eries. %:ampleD 6hen the blood pressure reading is

combined with in ormation about anatom/ and ph/siolog/#

pharmacolog/# pathoph/siolog/# knowledge is used to decide about

urther care and treatment.

?ecisions that guide practice result rom e ecti e data collection to

accumulate a bod/ o knowledge which is the oundation o di erent

disciplines.

The management and processing components ma/ be considered the

unctional components o in ormatics.

•

In)o*'&tion &% f(e *i! t%2

<ight in ormation

<ight person

<ight time



<ight place

<ight amount

6ith the knowledge o the importance o in ormation in healthcare#

healthcare in ormatics has become a specialt/. 0ealthcare in ormatics is a

combination o computer science # healthcare science # information

science and cognitive science .• Computer science D de elopment# confguration# architecture o

computer hardware and so tware.• Healthcare science D bod/ o knowledge on which healthcare

pro ession bases their practice. The sciences o anatom/# ph/siolog/

and knowledge specifc to each pro ession.• Information science D also includes in ormation technolog/ which

in ol es the process o sending and recei ing in ormation.• Cognitive science D the process o human thinking# understanding and

remembering.

@Nu*%in! In)o*'&ti#% 3NI4 is the application o computer science and

in ormation science to nursing. NI promotes the generation# management

and processing o rele ant data in order to use in ormation and de elopknowledge that supports nursing in all practice domains (0ebert# &''').

In ormatics enables nurses to use in ormation and communications

technologies in theD – collection o data# – use o in ormation – generation o knowledge to support nursing practice

"hallenges or in ormaticists include the ollowingD

Integration o dataJduplication o ten

Inabilit/ to access data or decision making



,ni*ue distinctions between roles has not been defned99

competencies

A..li#&tion o) Nu*%in! In)o*'&ti#%2

Nursing In ormatics can be applied to all areas o nursing practice# which

include= clinical practice# administration# education# and research. ;elow are

some e:amples o how nursing informatics, information technology and

computers # are used to support arious areas o nursing practice.

Nursing "linical 7ractice (7oint9o 9"are S/stems and "linical

In ormation S/stems)

• 6ork lists to remind sta o planned nursing inter entions

• "omputer generated client documentation

• %lectronic !edical <ecord (%!<) and "omputer9;ased 7atient <ecord

("7<)

• !onitoring de ices that record ital signs and other measurementsdirectl/ into the client record (electronic medical record)

• "omputer 9 generated nursing care plans and critical pathwa/s

• Automatic billing or supplies or procedures with nursing

documentation

• <eminders and prompts that appear during documentation to ensurecomprehensi e charting

Nursing Administration (0ealth "are In ormation S/stems)

• Automated sta scheduling



• %9mail or impro ed communication

• "ost anal/sis and fnding trends or budget purposes

• Cualit/ assurance and outcomes anal/sis

Nursing %ducation

• "omputeri8ed record9keeping

• "omputeri8ed9assisted instruction

•

Interacti e ideo technolog/

• ?istance Kearning96eb based courses and degree programs

• Internet resources9"%,Ls and ormal nursing courses and degree

programs

• 7resentation so tware or preparing slides and handouts97ower7oint

and !S 6ord

Nursing <esearch

• "omputeri8ed literature searching9"INA0K# !edline and 6eb sources

• The adoption o standardi8ed language related to nursing terms9

NAN?A# etc.

• The abilit/ to fnd trends in aggregate data# that is data deri ed rom

large population groups9Statistical So tware# S7SS

Beneft% o) Co'.ute* Auto'&tion in He&lt C&*e2



!an/ o these benefts ha e came about with the de elopment o

the ele#t*oni# 'e i#&l *e#o* # which is the electronic ersion o the client

data ound in the traditional paper record.

%!< benefts includeD

Improved access to the medical record. The %!< can be accessed rom

se eral di erent locations simultaneousl/# as well as b/ di erent le els o

pro iders.

Decreased redundancy of data entry. or e:ample# allergies and ital signs

need onl/ be entered once.

Decreased time spent in documentation. Automation allows direct entr/ rom

monitoring e*uipment# as well as point9o 9care data entr/.

Increased time for client care. !ore time is a ailable or client care because

less time is re*uired or documentation and transcription o ph/sician orders.

Facilitation of data collection for research. %lectronicall/ stored client records

pro ide *uick access to clinical data or a large number o clients.

Improved communication and decreased potential for error. Impro ed

legibilit/ o clinician documentation and orders is seen with computeri8ed

in ormation s/stems.

Creation of a lifetime clinical record facilitated by information systems.

Fther benefts o automation and computeri8ation are related to the use

o e#i%ion-%u..o*t %o)t+&*e5 computer so tware programs that organi8e

in ormation to aid in decision making or client care or administrati e issues=

these includeD



• Decision-support tools as well as alerts and reminders noti / the

clinician o possible concerns or omissions. An e:ample o this# is the

documentation o patient allergies in the computer s/stem. The health

care pro iders would be alerted to an/ discrepancies in the patient

medication orders.

• E ective data management and trend- nding include the abilit/ to

pro ide historical or current data reports.

• E tensive nancial information can be collected and anal/8ed or

trends. An e:tremel/ important beneft in this era o managed care and

cost cutting.

• Data related to treatment such as inpatient length o sta/ and the

lowest le el o care pro ider re*uired can be used to decrease costs.

T e Role o) t e Nu*%in! In)o*'&ti#% S.e#i&li%t 3NIS42

;ecause o the increased importance o computers and in ormation

technolog/ in the practice o pro essional nursing= a new role has emerged#

the nu*%in! in)o*'&ti#% %.e#i&li%t 3NIS46 The NIS is a nurse who has

ormal education# certifcation and practical e:perience in using computers in

patient care settings. The American Nurses Association (ANA# 122$)# lists

se eral unctions o the NISD

!heory development. The NIS contributes to the scientifc knowledge base o

nursing in ormatics.

"nalysis of information needs. The identifcation o in ormation that nursesL

need to in order to accomplish their work= client care# education#

administration# and research



#election of computer systems. The NIS# guides the user in making in ormed

decisions related to the purchase o computer s/stems.

Design of computer systems and customi$ations. The NIS collaborates with

users and computer programmers to make decisions about how data will be

displa/ed and accessed.

!esting of computer systems. S/stems must be checked or proper

unctioning be ore the/ are made a ailable or use in patient care.

!raining users of computer systems. ,sers need to be trained in how the

s/stem works# the importance o accurate data entr/# and how the s/stem

will beneft them# and more importantl/ how it will impro e patient outcomes

Evaluation of the e ectiveness of computer systems. The uni*ue role o the

NIS makes them the ideal person to e aluate the e ecti eness o computer

s/stems.

%ngoing maintenance and enhancements. The NIS makes sure the

computeri8ed s/stem unctions properl/ and e:plores possible

enhancements to the s/stem that will better ser e the users and the

patients.

Identi cation of computer technologies that can bene t nursing. The NIS

must keep abreast o the changes in the felds o computers and in ormation

technolog/# including new hardware and so tware that will beneft the nurse

and patient. ( httpDGGwww.csulb.eduGMdkumrowGin ormaticsGlec&.html # &'1$)

http://www.csulb.edu/~dkumrow/informatics/lec2.html

http://www.csulb.edu/~dkumrow/informatics/lec2.html



Seatwork No. &D ?raw a model o /our defnition o in ormatics in /our

discipline. i e a brie description o /our diagram. "heck out these 6eb

sites or some e:amplesD

A. An F er iew o Nursing In ormatics

;. A !athematical !odel o "ommunication (p. &)

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