How Informatics links to Nursing/Midwifery Staff

7 November 2014

Discussion points

• Impact of health IT on patient centred care • Acceptance of health care technology by Nurses/Midwives • Future of health IT on care delivery models

2 Imperatives of health care

• Increased acuity and complexity in a cost constrained health environment • Transformation of care at the bedside/in patients homes • Patients and families fully integrated into the health care team as active partners • Immediacy of data • Evidence based practice

3

Philosophy of Human Caring (Jean Watson)

Caritas – the caring moment The Nurse and the patient interact in the delivery of Nursing & Midwifery care.

The Nurse/Midwife paying special attention to the patient and family member

Caritas – what it really means

Ten Caritas Processes™ • Embrace altruistic values and Practice loving kindness with self and others. • Instil faith and hope and honour others. • Be sensitive to self and others by nurturing individual beliefs and practices. • Develop helping – trusting- caring relationships. • Promote and accept positive and negative feelings as you authentically listen to another’s story. • Use creative scientific problem-solving methods for caring decision making. • Share teaching and learning that addresses the individual needs and comprehension styles. • Create a healing environment for the physical and spiritual self which respects human dignity. • Assist with basic physical, emotional, and spiritual human needs. • Open to mystery and Allow miracles to enter. \Caritas Processes refined from Inova Health Jean Watson 2007

5 Informatics – the confluence of 3 sciences

Bringing system information, nursing knowledge and data into the nursing field:

– A process of translation

Enhanced Needs of ICT productivity patients and Telehealh of nursing staff care

Health Informatics: computerised networking & communications

– Supporting Medicine, Nursing, Pharmacy and Dentistry – Involving collection, analysis and movement of health information and data – Including Telehealth: videoconferencing or website delivery of health information/care

6 The Essence of Informatics

Effective Communication via Nursing Science Documentation:

- Current - Timely - Accessible - Accurate Informatics

Information Computer Science Science Decision making points:

1. Opportunity Management: – Strategic positioning – Initial high investment balanced by well-coordinated, effective linking systems – Immediate access to real time data – Data collection and audits – Workflow and care process changes – The future: increased self-management interventions

2. Consumer Engagement: – Seamless approach across continuum – Patient Portals – Patient participation in patient-centric recording process

3. Considerations: – System integration is essential – a standalone system cannot survive without consideration of upstream and downstream impact on other technologies in place. – Emphasis placed on information literacy and informatics competencies – transferable skills

The Ideal

Record once, use many times

- Anne Casey, RCN Standards Officer

9 1. Saved patient lists

3. Containing simple screening tools with decision support and structured data collection forms

2. Provide access to protocols

10 What this means to Nursing….

finding ways to improve information management and communications in nursing to improve efficiency, reduce costs and enhance the quality of patient care.

Benefits Risks • Faster, more appropriate decisions. • Lack of integration/interoperability • Evidence for decision making at point of • Systems take time which might care otherwise be used in direct patient care. • Archived information is easily accessible • Any changes to the system can affect for patients with chronic conditions. other similar systems – care needs to be • EMR/Digital Medical Record –document taken and testing is important. at patient side – with the patient. • ICT drives work flow • Collection and analysis of healthcare • E-forms can be just as repetitive as workforce data from Health IT system paper based systems • Electronic reporting system – improves • ICT literacy – competency timeliness of reporting/feedback loops underdeveloped • Data can populate different subsets of • Nurses remain at PC not with patient information e.g. weight/dob/UMRN

Nursing focus

• Nursing informatics competency structure . Undergraduate . Post graduate . Nurse/Midwifery leadership competency • Informatics Nurse/Midwife workforce • Patient centred care – customisation of tools to support information and education

12

Informatics enhances Nursing and Midwifery practice when systems are interoperable, patient centric, user friendly and support work flows that deliver quality outcomes

13 References

Ahmad, N., Ellins, J., Krelle, H., & Lawrie, M. (2014). Person-centred care: from ideas to action. Health Foundation, London UK. Borycki, E. M., & Foster, J. (2014). A comparison of Australian and Canadian informatics competencies for undergraduate nurses. Studies in health technology and informatics, 201, 349-355. Carlson, E. A., Catrambone, C. D., Nauseda, S., Oder, K., Slaughter, W., & Brown Jr, F. M. (2013). Criteria for clinical information technology device selection: what do nurse executives need to know?. Journal of Nursing Administration, 43(12), 623-626. Dowding, D. (2013). Are nurses expected to have information technology skills? The NHS knowledge and skills framework requires staff to have communications and computer knowledge commensurate with their roles. Dawn Dowding reports on a study to identify whether employers are conforming to this standard. Nursing Management, 20(5), 31-37. Choi, J., & De Martinis, J. E. (2013). Nursing informatics competencies: assessment of undergraduate and graduate nursing students. Journal of clinical nursing, 22(13-14), 1970-1976. Choi, J., & Zucker, D. M. (2013). Self-Assessment of Nursing Informatics Competencies for Doctor of Nursing Practice Students. Journal of Professional Nursing, 29(6), 381-387. Eby, D., Henriks, G., Mojestig, M., Karlsson, S. O., & Gabow, P. (2006). Health Care Transformation. Institute for Healthcare Improvement 18th Annual National forum on Quality Improvement in Health care. Gocsik, T. K., & Barton, A. J. (2014). Why Clinical Change Leadership Is Essential for Project Success. Clinical Nurse Specialist, 28(2), 83-85. Gray, K., Dattakumar, A., Maeder, A., Butler-Henderson, K., & Chenery, H. (2014). Advancing Ehealth education for the clinical health professions. Hovenga, E. J., & Grain, H. (2013, August). Developing a common reference model for the health informatics discipline. In MedInfo (pp. 122-126). Johnston, M. J., King, D., Arora, S., Cooper, K., Panda, N. A., Gosling, R., ... & Darzi, A. (2014). Requirements of a new communication technology for handover and the escalation of patient care: a multi‐stakeholder analysis. Journal of Evaluation in Clinical Practice. Knight, E. P., & Shea, K. (2014). A Patient‐Focused Framework Integrating Self‐Management and Informatics. Journal of Nursing Scholarship, 46(2), 91-97. Rajalahti, E., Heinonen, J., & Saranto, K. (2014). Developing nurse educators' computer skills towards proficiency in nursing informatics. Informatics for Health and Social Care, 39(1), 47-66. Roberts, J. (2014). The Emerging Role of the Health Informatician as a Key Player on eHealth. Managing EHealth: From Vision to Reality, 106. Rojas, C. L., & Seckman, C. A. (2014). The Informatics Nurse Specialist Role in Electronic Health Record Usability Evaluation. Computers Informatics Nursing, 32(5), 214-220. Zadvinskis, I. M., Chipps, E., & Yen, P. Y. (2014). Exploring nurses’ confirmed expectations regarding health IT: A phenomenological study. International journal of medical informatics, 83(2), 89-98.