How Technology and Informatics Has Influenced

Nursing Practice

Madeline Gervase RN,MSN,CCRN,FNP

Advanced Practice Nurse

Objectives:• Identify the role of informatics in nursing.

• Identify the current uses of technology and how technology will affect clinical practice.

• Understand the advantages and disadvantages of using technology.

• Demonstrate an understanding to the techniques and tools used to protect client confidentiality in practice.

Informatics

• The science of information

Skills nurses need related to informatics & technology

• Use information & communication technology to document & evaluate patient care, advance patient education, & enhance the accessibility of care

• Use appropriate technology to assess & monitor patients

• Work on an interdisciplinary team to make ethical decisions regarding the application of technologies & the acquisition of data

Nursing Skills:

• Adapt the use of technologies to meet patient needs

• Teach patients about health care technologies

• Protect the safety & privacy of patients in relation to the use of health care & information technologies

• Use information technologies to enhance one’s own knowledge base

International Medical Informatics Association

• Forty-one recommendations for using informatics in health care delivery

• Identified 313 competencies for nurses with various levels of education & practice responsibilities

IMIA

www.imia.org

• Two specialized areas for development:

• Informatics and healthcare delivery

• Specialists design software & create integrated information systems for health care delivery

IMIA Nursing Evaluation Novice Nurse Competency:

• Novice nurse: use of administrative application, telecommunication devices, e-mail, database management program, client care devices, & the Internet while being able to find resources to address ethical decision making related to computing

Seasoned Nurse Competency:

• Experienced nurse: same as the beginner with the addition of ability to use diagnostic coding application, evaluate computerized assisted instruction programs, integrate selected resources into client record, & evaluate accuracy of health care information found on the Internet

IMIA Competencies for the Nursing Informatics Specialist

• Graduate education

• Able to integrate established technologies into clinical practice

IMIA Competencies for the Nursing Informatics Innovator

• Doctorate Degree• Designs and develops new technological

systems, techniques, & conceptual models for databases

• Evaluates safety, effectiveness, cost, & social impacts of technological systems

• Researches & develops theoretical foundations for the specialty

Components of an Integrated Delivery System (IMIA, 1999)

• Hyperlinks to the latest information for client care

• Nursing care planning programs

• Specific client teaching materials

• On-line clinical practice manuals with evidence-based nursing care protocols

• Data collection for best health care practices

• Client billing systems

• Health care insurance reimbursement programs

Informatics & Technology in Client Care

• Handheld monitors

• (e.g., pulse oximetry & peripheral blood glucose monitors)

• Wireless technology with automatic nurse paging capability when client measurements fall outside of normal parameters

Technology & Informatics inClient Care :

• Computerized clinical decision-making programs

• Nurse personal digital assistants• Care-planning software programs• Handheld clinical resource information

devices• Intravenous pumps for medication

delivery

Informatics & Technology in Record Keeping

• Financial reimbursement applications for services rendered

• Nursing documentation systems: CERNER

• Integrated health record systems to denote past medical history & allergies

• Electronic health records

Informatics & Technology in Communication

• Wireless telephone systems

• Wireless paging systems

• Alphanumeric paging systems

• Handheld computers to record & receive client information

• E-mail

Components of a Health Information System Currently

Used by Health Care Institutions

Current uses of Informatics Applications in Healthcare:

• Admission, discharge, & transfer

• Patient Access Record

• Financial parameters

• Physician order entry

• Ancillary department

• Documentation

Informatics Applications in Healthcare:

• Scheduling

• Pharmacy preparation

• Acuity criteria

• Specialty practice

• Decision support

• Communication

• Critical pathways

The Nursing Informatics Specialist Responsibilities

• Create systems to maximize the efficiency of information use & computer technology for clinical practice

• Develop software programs to support nurses as they deliver client care

• Keep software management updated & educate staff on its use & changes

Education for the Nursing Informatics Specialist

• Thorough understanding of clinical practice

• Detailed computer expertise

• ANA certification in nursing informatics

• Graduate nursing education programs in nursing informatics are available

Role of the Nursing Informatics Specialist in Technological & Health

Care Development• Contribute specialized nursing knowledge to

systems

• Develop software programs & computer systems that facilitate nursing care delivery

• Field test software programs

• Verify that systems (hardware & software) address critical nursing considerations

Technological Influences to Health Care

• In the late 1950s & early 1960s, businesses used computers for financial record management

• Medicare & Medicaid require data for governmental reimbursement for rendered services

Technology Influences:

• In 1968, Lawrence Weed developed the Weed Problem Oriented Medical Record Information System, the first computerized system for client care at the University of Vermont Medical Center

Technological Changes to Nursing & Health Care

• LifeView Care Station for virtual house calls

• Telehealth• Genetic advances in health promotion,

disease prevention, & illness treatment• Stem cell research• On-line educational options

Challenges of Managing Health-Related Informatics & Technology

• Confidentiality of client health information

• Ethics related to new therapies

• Evaluating the quality of information

• Information security

• Potential health & personal problems from too much technology

Our Future:

• Technological advances are advantageous only if nurses find them useful & learn how to use them

• Nurses may tend to focus on machinery rather than persons in the future

• Information overload

The Future of Healthcare:

• Keeping institutional & personal systems updated

• Impact of being dependent on electrical or other sources of power to run equipment

• Optical technology or other invasive methods to confirm identity

Computer Networks

• Local area network (LAN)

• Wide area network (WAN)

• Internet Service Provider (ISP)

• Group e-mail or list servers (Listserv)

• Electronic publishing (e-books & on-line journals)

Access Information Requirements:

• Accurate typing skills & knowledge of an exact website or e-mail address

• Internet server provider• A website is a series of pages posted on

the Internet• Website addresses denote the type of

server• Professional chat rooms

Thank you!