Integrating Informatics Competencies and Digital Health in Nursing Education

WNRCASN, Victoria, B.C. Wednesday, February 15th, 2017

South Pender Island Room Hotel Grand Pacific, Victoria, B.C.

Elizabeth Borycki RN PhD Glynda Rees Doyle RN MSN Workshop Objectives

1.Participants will have a clear understanding of CASN’s digital health support tools for undergraduate nursing education 2.Participants will leave with a deeper understanding of where and how digital health intersects with nursing care 3.Participants will learn strategies for integrating this content into nursing programs.

2 TIME ITEM AGENDA PRESENTER(S) 1200 - 1230 LUNCH 1230 - 1245 1 Welcome and introductions Elizabeth Borycki, RN, PhD & Glynda Rees Doyle, RN, MSN

1245 - 1315 2 Project overview Elizabeth Borycki, RN, PhD & Glynda Rees Doyle, RN, MSN  Entry-to-practice informatics competencies

 Nursing informatics teaching toolkit  Consumer Health Solutions Resource

1315 - 1445 3 Case study activity Elizabeth Borycki, RN, PhD & Glynda Rees Doyle, RN, MSN  Whiteboard animation video with group discussion to explore the intersection of digital health and nursing care All participants

1445 – 1500 BREAK 1500 - 1600 4 Case study activity (continued) Elizabeth Borycki, RN, PhD & Glynda Rees Doyle, RN, MSN All participants

1600 – 1650 5 Discussion & networking All participants 1650 - 1700 6 Wrap-up and closing statements Elizabeth Borycki, RN, PhD & Glynda Rees Doyle, RN, MSN

3 Canadian Association of University Schools of Nursing The national voice for nursing education, research, and scholarship and represents baccalaureate and graduate nursing programs in Canada.

DIGITAL HEALTH NURSING INFORMATICS TRAINING PROJECT http://www.casn.ca/education/digital- healthnursing-informatics-casn-infoway- nurses-training-project/

Canada Health Infoway (Infoway) A not-for-profit corporation funded to…

With their partners, Infoway helps accelerate the development, adoption and effective use of digital health solutions across Canada

5 Project Background • Since 2011, CASN and Canada Health Infoway have partnered on a series of projects to enable the integration of digital health into nursing curricula

• They have developed a series of guideline documents and tools to support faculty through a Digital Health Nursing Faculty Peer Leader Network http://www.casn.ca/2014/12 http://casn.ca/wp- /casn-entry-practice-nursing- content/uploads/2014/12/in informatics-competencies/ fowaytoolkit.jpg

The Digital Health Nursing Faculty Peer Network

49 NURSING SCHOOLS 11 PROVINCES

8 Digital Health Nursing Faculty Network Peer Leaders

Lynn Nagle (Chair) University of Toronto Antonia Arnaert McGill University Richard Booth Western University Elizabeth Borycki University of Victoria Glynda Rees Doyle British Columbia Institute of Technology Craig Duncan Laurentian University Jodi Found Saskatchewan Polytechnic Karen Furlong University of New Brunswick Jessie Johnson St. Francis Xavier Manal Kleib University of Alberta Digital Health

“Digital health refers to the use of information technology/electronic communication tools, services and processes to deliver health care services or to facilitate better health. Infoway’s vision is healthier Canadians through innovative digital health solutions.” https://www.infoway-inforoute.ca

10 Nursing Informatics

“In all types of health care organizations, nursing is the hub of the information flow. Developing the science and technology of nursing informatics will enhance the information available to nurses for clinical practice, management, education, and research and will facilitate the role of nurses as communicators." (Brennan, 1996) Nursing Informatics is…

…the "science and practice (that) integrates nursing, its information and knowledge, with management of information and communication technologies to promote the health of people, families, and communities worldwide."

(IMIA Special Interest Group on Nursing Informatics, 2009) Bernstein, Jay H. (2009). The Data-Information-Knowledge-Wisdom Hierarchy and its Antithesis. Proceedings North American Symposium on Knowledge Organization Vol2. Available at: http://dlist.sir.arizona.edu/2633

Health Informatics has the potential to: 1.Improve patient safety and quality of care • Improves communication among health care team and patients • Makes medical records accessible to health care providers and patients (in real-time) 2.Improve the health of populations • Predictive modeling to identify patients at risk • Bio-surveillance tools • Genomics • Teleheath 3.Reduce the cost of health care https://cnia.ca/

CASN Competencies Framework

16 CASN Over-Arching Nursing Informatics Competency

• Students use information and communication technologies to support information synthesis in accordance with professional and regulatory standards in the delivery of patient/client care.

http://www.casn.ca/en/Whats_new_at_CASN_108/items/123.html

CASN Nursing Informatics Competencies • Foundational – hardware (PCs, tablets, mobiles, modems, blue-tooth, flashdrives) – application (email, texting, podcasts, blogs, social networks, word, excel, D2L) • Competency 1: Information and Knowledge Management – Uses relevant information and knowledge to support the delivery of evidence- informed patient care. • Competency 2: Professional and Regulatory Accountability – Uses ICTs in accordance with professional and regulatory standards and workplace policies. • Competency 3: Information and Communication Technologies – Uses information and communication technologies in the delivery of patient/ client care.

http://www.casn.ca/en/Whats_new_at_CASN_108/items/123.html Information and Knowledge Management • Lit reviews, scholarly articles, evidence-informed decision making • Uses patient data to support decision making • Assist patients and families to use ICTs to manage their health • Understands EHRs • Understands importance of using standardized nursing data to advance knowledge and articulate nursing • Evaluates data from multiple sources to inform practice

Professional and Regulatory Accountability • Privacy and confidentiality • Advocates for ICTs to deliver safe quality patient care • IDs and reports system failures/problems • Functions appropriately if system unavailable • Uses professional judgment with ICTs • Recognizes need for nurse input into systems Information and Communication Technologies

• Identifies and uses variety of ICTs (hemodynamic monitoring, CBGs, EHRs, point of care) • Uses decision support tools to assist judgment and deliver safe quality care • Uses ICTs to support not interfere with nurse- patient relationships

Information and Communication Technologies (cont.)

• Describes variety of information systems (CPOE, clinical documentation, MARs) • Knows difference between EHR, PHR, EMR • Describes benefit of informatics to improve health systems and quality of interprofessional patient care

23 Teaching Digital Health

http://www.casn.ca/wp-content/uploads/2015/03/file0002120440786.jpg

Consumer Health Solutions

Integration of digital and consumer health solutions (CHS) content in nursing education • Increased faculty knowledge about CHS • Readiness to integrate digital health/CHS into courses/curriculum

• Presence of learning http://www.casn.ca/wp- content/uploads/2015/03/file000212044078 25 opportunities 6.jpg

Consumer Health Solutions Resource

Detailed exploration of 6 bourgeoning areas of consumer health solutions and accompanying learning activities for curricular integration.

http://www.casn.ca/wp- content/uploads/2015/03/file0002120440786.jpg Sample Learning Activity

27 Whiteboard Animation: Classroom Learning Activity

http://www.casn.ca/2016/03/whiteboard-animation-student- nurses-story-social-media-use/

DISCUSSION TIME https://www.youtube.com/watch?v=5U7FZB-Z9Mk&feature=youtu.be 30

COFFEE BREAK ADDITIONAL RESOURCES The Canadian Nursing Informatics Association

• To provide nursing leadership for the development of Nursing/Health informatics in Canada. • To establish national networking opportunities for nurse informaticians. • 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. • To expand awareness of Nursing Informatics to all nurses and the healthcare community.

https://cnia.ca/education/resource-documents/

Canadian Nurses Association

• “CNA believes that information management and communications technology are integral to nursing practice. • Competencies in information management and the use of communications technology are no longer add-ons to traditional methods of health-care delivery. Rather, these competencies are an integral part of health care and nursing practice.”

http://cna-aiic.ca/en/on-the-issues/best-nursing/nursing-informatics

Canada Health Infoway

A national, federally-funded, not-for-profit organization created in 2001 to foster the development and adoption of electronic health records across Canada.

https://www.infoway-inforoute.ca/en/

COACH • founded in 1975, has actively initiated professional protocols for using computer systems in Canadian health care. • Canada's Health Informatics Association provides access to a diverse community of accomplished, influential professionals who work passionately to make a difference in advancing healthcare through information technology.

http://www.coachorg.com/en/index.asp

Technology Informatics Guiding Education Reform

http://www.thetigerinitiative.org

Clinical and Systems Transformation Project

A join undertaking between Vancouver Coastal Health, Provincial Health Services Authority and Providence Health Care to complete a significant transformation of clinical practices and systems. http://www.providencehealthcare.org/careers /clinical-and-systems-transformations-cst-0

Position Statements & Guidelines on Social Media

Nurses Association of New Brunswick. (2012). Practice http://www.nanb.nb.ca/media/resource/NANB- Guidelines: Ethical and responsible use of social media PracticeGuideline-SocialMedia-E.pdf technologies. Fredericton, NB: Author.

Canadian Nurses Association. (2012). When Private Becomes https://www.cna-aiic.ca/~/media/cna/page-content/pdf- Public: The ethical challenges and opportunities of social en/ethics_in_practice_feb_2012_e.pdf?la=en media. Ottawa, ON: Author.

Canadian Nurses Protective Society. (July 2012). Social http://www.cnps.ca/upload- Media. infoLAW, 19(3), 1‐2. files/pdf_english/social_media.pdf

College of Registered Nurses of British Columbia. (2012). https://www.crnbc.ca/Standards/Confidentiality/Pages/Soci Social Media: Professionalism, nurses and social media. alMedia.aspx

College of Registered Nurses of Nova Scotia. (2012). Position https://crnns.ca/wp- Statement: Social Media. Halifax, NS: Author. content/uploads/2015/02/PositionStatement_SocialMedia.p df

College & Association of Registered Nurses of Alberta. http://www.nurses.ab.ca/Carna- (2011). CARNA Social Media Guidelines. Calgary. Admin/Uploads/Social_Media_Guidelines.pdf

Association of Registered Nurses of Newfoundland and http://www.arnnl.ca/documents/publications/Position_Stat Labrador. (2012). Position Statement: Social Media. St ement_on_Social_Media_2013.pdf John’s. 39 Social Media NurseONE : “Teaching Health Information Science for Health Care Instructors Handbook activity topic 1 to 4”, by Pasquale Fiore (2013) http://www.nurseone.ca/~/media/nurseone/files/en/health_s ciences_information_course%20announcement_en.pdf

Evaluating healthcare websites

“HEALTH ON THE NET FOUNDATION”…. to guide the growing community of healthcare consumers and providers on the World Wide Web to sound, reliable medical information and expertise. In this way, HON seeks to contribute to better, more accessible and cost-effective health care.

https://www.healthonnet.org Standardized Terminologies C-HOBIC: • Suite of standardized clinical outcomes reflective of nursing practice that can be captured to understand how nursing practice impacts patient outcomes in Canada. • Currently in multi-provincial use in Canada, • Additionally, the CHOBIC set of data elements is expressed in the International Classification for Nursing Practice (ICNP®) and is currently being mapped to SNOMED CT.

• http://c-hobic.cna-aiic.ca/about/default_e.aspx • https://www.nlm.nih.gov/research/umls/Snomed/nursing _terminology_resources.html 42

SNOMED CT

• In 1999 the American Nurses Association acknowledged the Systematised Nomenclature of Medicine, Clinical Terms (SNOMED CT®) as "the clinical reference terminology to support the integrated electronic health record for nursing." SNOMED CT® was developed by the College of American Pathologists as a reference terminology representing a broad array of health care concepts.

43 ICNP

• The International Classification for Nursing Practice (ICNP®), developed by the International Council of Nurses, is a classification of nursing phenomena, actions, and outcomes that provides a unifying framework into which regional nursing languages, vocabularies, and classifications can be crossed mapped. In a collaborative effort NANDA International & ICNP® are in the process of identifying how NANDA® diagnoses are represented in ICNP®. • http://www.icn.ch/images/stories/documents/pillars /Practice/icnp/ICNP_FAQs.pdf

44 Thank You!

Elizabeth Borycki [email protected]

Glynda Rees Doyle [email protected] www.healthedtech.net http://opentextbc.ca/clinicalskills/