NursingNursing InformaticsInformatics TeachingTeaching Toolkit:Toolkit: SupportingSupporting thethe IntegrationIntegration ofof thethe CASNCASN NursingNursing InformaticsInformatics CompetenciesCompetencies into NursingNursing CurriculaCurricula Production of this document was supported by the Canada Health Infoway Clinicians in Training program. Published by: Canadian Association of Schools of Nursing Association canadienne des écoles de sciences infirmières 99 Fifth Avenue, Suite 15 Ottawa ON K1S5T3 www.casn.ca © Canadian Association of Schools of Nursing, 2013 2 Nursing Informatics Teaching Toolkit NURSING INFORMATICS TEACHING TOOLKIT: SUPPORTING THE INTEGRATION OF THE CASN NURSING INFORMATICS COMPETENCIES INTO NURSING CURRICULA ACKNOWLEDGEMENTS The Canadian Association of Schools of Nursing (CASN) gratefully acknowledges Ella Mann, RN, MSc for developing this resource. CASN acknowledges the expertise, time, and contributions of the Generating Momentum to Prepare Nursing Graduates for the Electronic World of Health Care Delivery project Task Force: Noreen Frisch (Chair), RN, PhD, FAAN Professor and Director, School of Nursing, University of Victoria Irma Jean Bajnok, RN, PhD Director, International Affairs and Best Practice Guidelines Centre Co-Director, Nursing Best Practice Research Unit, Registered Nurses’ Association of Ontario Cynthia Baker, RN, PhD Executive Director, Canadian Association of Schools of Nursing Sandra Bassendowski, RN, EdD Professor, College of Nursing, University of Saskatchewan Elizabeth Borycki, RN, PhD Associate Professor, School of Health Information Science, University of Victoria Denise Bowen, RN, MN Chair, School of Health and Human Services, Aurora College Maureen M. Charlebois, CHE, MHSc, BScN RN Clinical Adoption, Chief Nursing Executive & Group Director Lorie Donelle, RN, PhD Assistant Professor, Arthur Labatt Family School of Nursing, Western University Kathryn Hannah, RN, PhD Hannah Education and Consulting Services Inc. Health Informatics Advisor, Canadian Nurses Association Professor (Adjunct), School of Nursing, University of Victoria PublishedProfessor by: (Adjunct), Department of Biomedical Informatics, University of Utah Alexandra Harris, RN, MN/MHScCanadian AssociationPhD of StudentSchools &of ResearchNursing Officer, University of Toronto Association canadienne des écoles de sciences infirmières Sylvie Jetté, RN, PhD 99 Fifth Avenue,Professor, Suite School 15 of Nursing, University of Sherbrooke Margot McNamee, RN, MHA OttawaSenior ON K1S5T3 Nurse Advisor, Member Engagement, www.casn.caCanadian Nurses Association Lynn Nagle, RN, PhD President, Nagle & Associates Inc. Assistant Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto Catherine Peirce, MA Project Manager, e-Learning, The Association of Faculties of Medicine of Canada Patricia Seaman, RN, PhD Assistant Dean UNB/Humber Collaboration Faculty of Nursing, University of New Brunswick Loretta Secco, RN, PhD Faculty of Nursing, University of New Brunswick Tracy Shaben, RN, MN Canadian Nursing Informatics Association Representative / Lead, Clinical Informatics, University of Alberta Hospitals sites, Alberta Health Services Anna Sherlock, RN, MBA Clinical Leader, Clinical Adoption, Canada Health Infoway Anne Tran Fazzalari, M.E.S National Project Manager, Clinical Adoption, Canada Health Infoway 4 Nursing Informatics Teaching Toolkit TABLE OF CONTENTSS PREAMBLE . 8 SECTION 1: INTRODUCTION TO THE NURSING INFORMATICS TEACHING TOOLKIT 9 1.0 TOOLKIT ORGANIZATION AND USE . .9 1.1 INTRODUCTION . .10 1.2 BACKGROUND AND RATIONALE . .11 1.3 GENERAL NURSING INFORMATICS RESOURCES . .12 SECTION 2: INFORMATION AND KNOWLEDGE MANAGEMENT . .15 2.0 INFORMATION AND KNOWLEDGE MANAGEMENT COMPETENCY AND INDICATORS . .15 2.1 CONTEXT . .15 2.2 KEY CONCEPTS . .16 2.3 KEY LEARNINGS . .17 2.3.0 Gathering, Assessing and Using Information and Knowledge for Evidence-Informed Nursing . .17 2.3.1 Assisting Patients/Clients in Using Information and Communication Technologies in Managing Their Health . 19 2.3.2 Nursing Data and the Advancement of Nursing Practice . 20 2.3.3 The Current State of Standardized Clinical Terminologies 20 2.3.3.0 International Classification for Nursing Practice (ICNP) . .21 2.3.3.1 Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) . .22 2.3.3.2 Canadian Health Outcomes for Better Information and Care (C-HOBIC) . .23 2.3.3.3 Other Standardized Nursing Terminologies . .23 2.3.4 Applying the Standardized Clinical Terminologies and Collecting Standardized Data in Nursing . .23 2.3.4.0 Canadian Health Outcomes for Better Information and Care (C-HOBIC) Project . .23 2.3.4.1 The Registered Nurses Association of Ontario (RNAO) Best Practice Guideline Nursing Order Sets . .24 2.3.4.2 SNOMED CT and pan-Canadian EHRs . .25 2.3.5 Benefits of Standardized Clinical Terminologies to Nursing . .25 Supporting the Integration of the CASN Nursing Informatics Competencies into Nursing Curricula 5 2.4 INFORMATION AND KNOWLEDGE MANAGEMENT CASE STUDY . .26 2.5 PRESENTATION ON INFORMATION AND KNOWLEDGE MANAGEMENT . 29 2.6 RESOURCES RELATED TO THE INFORMATION AND KNOWLEDGE MANAGEMENT COMPETENCY . .42 SECTION 3: PROFESSIONAL AND REGULATORY ACCOUNTABILITY . .45 3.0 PROFESSIONAL AND REGULATORY ACCOUNTABILITY COMPETENCIES AND INDICATORS . .45 3.1 CONTEXT . .45 3.2 KEY CONCEPTS: . .46 3.3 KEY LEARNINGS: . .47 3.3.0 Awareness of Legislation and Policies that Regulate the Use of ICT in Nursing Practice . .47 3.3.0.1 Federal and Provincial Health Privacy Policies and Standards . .47 3.3.0.2 Nursing Health Privacy Policies and Standards . .48 3.3.0.3 Organizational Policies . .48 3.3.1 Information and Communication Technologies and Patient Safety . .48 3.3.2 Information and Communication Technologies and the Nurse’s Clinical Judgement . .49 3.3.3 Nurses as Advocates for Health Information and Communication Technologies . .49 3.4 PROFESSIONAL AND REGULATORY ACCOUNTABILITY CASE STUDY . .51 3.5 PRESENTATION ON PROFESSIONAL AND REGULATORY ACCOUNTABILITY . .53 3.6 RESOURCES RELATED TO THE PROFESSIONAL AND REGULATORY ACCOUNTABILITY COMPETENCY . .62 SECTION 4: USE OF INFORMATION AND COMMUNICATION TECHNOLOGIES . .64 4.0 USE OF INFORMATION AND COMMUNICATION TECHNOLOGIES COMPETENCIES AND INDICATORS . .64 4.1 CONTEXT . .64 4.2 KEY CONCEPTS . .65 4.3 KEY LEARNINGS . .66 4.3.0 The Introduction of Electronic Health Records in Canada . .66 4.3.0.0 Point-of-care Systems . .66 4.3.0.1 Functionality . .66 4.3.0.2 Interoperability . .67 6 Nursing Informatics Teaching Toolkit 4.3.1 Nursing and Electronic Health Records . .68 4.3.2 Comparing the Electronic Health Records, Electronic Medical Records, and Personal Health Records . .68 4.3.2.0 Electronic Health Records (EHRs) . .68 4.3.2.1 Electronic Medical Records (EMRs) and Other Point-of-Care Systems . .68 4.3.2.2 Personal Health Records (PHRs) . .69 4.3.3 Optimizing the Delivery of Patient Care . .69 4.3.3.0 Harnessing Information and Communication Technologies for the Delivery of Care . .69 4.3.3.1 Improved Documentation . .70 4.3.3.2 Decision Support at the Point-of-Care . .71 4.3.3.3 Preventing Gaps in Patient Care . .71 4.3.3.4 Improvements to Inter-professional Patient Care . .72 4.3.4 Ensuring that Information and Communication Technologies Support the Nurse-Patient Relationship . .73 4.4 USE OF INFORMATION AND COMMUNICATION TECHNOLOGIES CASE STUDY . .74 4.5 PRESENTATION ON THE USE OF INFORMATION AND COMMUNICATION TECHNOLOGIES . .76 4.6 RESOURCES RELATED TO THE USE OF INFORMATION AND COMMUNICATION TECHNOLOGIES COMPETENCY . .88 SECTION 5: GLOSSARY OF TERMS . .91 SECTION 6: REFERENCES . .94 Supporting the Integration of the CASN Nursing Informatics Competencies into Nursing Curricula 7 PREAMBLE In 2011, the Canadian Association of Schools of Nursing (CASN) embarked on a mission to engage nursing faculty, students, and other key stakeholders in developing nursing informat- ics outcome objectives for undergraduate nursing curricula, and in building capacity among Canadian nurse educators to teach nursing informatics. The project was funded by Canada Health Infoway, a not-for-profit organization formed in 2001 to promote the transformation of healthcare through health information technology by developing a blueprint for electronic health records, fostering the adoption of electronic records for all Canadians, creating standards for technology and communication, and promoting clinician facility with health information technology. For an informatics transformation of health care to take root, new nurses and other health professionals entering the workforce must be prepared to use health information and communication technology in practice. To this end, Infoway created the Clinicians-in-Training Initiative, to support the preparation of future nurses who graduate and enter the workforce with the ability to practice in modern, technology-enabled clinical environments. As a first step, CASN created Nursing Informatics Entry-to-Practice Competencies for Reg- istered Nurses. Three national consensus based competencies and indicators were developed using an extensive consultation process involving key stakeholders across Canada. The competencies detail the core nursing informatics knowledge and skills that nursing students should possess upon completion of a baccalaureate nursing program in Canada. In order to assist faculty to integrate the competencies into undergraduate curricula, CASN conducted an environmental scan of nursing informatics resources to develop a Nursing Informatics Inven- tory of