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What Is Nursing Informatics and Why Is It So Important?

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What Is Nursing Informatics and Why Is It So Important? Number 11 September 2001 referred to as nursing informaticians. What is Nursing Increasingly, however, there is a need for all nurses to integrate nursing informat- ics competencies into their practices. Informatics and Why While there is no standard definition for the concept of nursing informatics, the is it so Important? following definition was proposed in the 1999 National Nursing Informatics 1 nformation is key to effective regarding the delivery of care by sup- Project (NNIP) discussion paper: decision-making and integral to plying access to health information Nursing Informatics (NI) is the application of quality nursing practice. Much of about clients, allowing data-entry, computer science and information science to Iwhat nurses do involves information – and offering electronic access to sci- nursing. NI promotes the generation, manage- from assessing the health care needs of entific knowledge. In Canada, much ment and processing of relevant data in order patients, to developing care plans, to work remains to be done to make the to use information and develop knowledge that communicating patient information to EHR a reality. supports nursing in all practice domains. other health professionals, to analyzing Advances in information technology Applications of nursing informatics are staffing and budget reports – in fact, have created new roles for nurses, and illustrated in figure 1. nurses work in an information-intensive environment. FIGURE 1. Advances in information technology SAMPLE APPLICATIONS OF NURSING INFORMATICS (i.e., computers and software) over the last 25 years have created significant Clinical Practice Administration opportunities for nurses to be aware of • Recording of patient assessment data • Analysis of MIS reports generated from current information when making deci- in an electronic health record a spreadsheet software application • Recording of workload and interven- • Review of outcome indicators using a sions. We have faster computers to tions as a by-product of electronic decision-support software application process data, more sophisticated soft- charting • Recording of workload and interventions ware to assist in the transformation of as a by-product of electronic charting Education data into useful information, and power- • Distance learning/teaching via the ful communication technologies such as internet Research the internet to enable the secure trans- • Recording of workload and interven- • Evaluation of nurse-sensitive outcome measures using a standard minimum mission of information among health tions as a by-product of electronic charting data set service organizations and professionals. • Use of knowledge bases via the internet • Recording of workload and interventions Advances in information technology as a by-product of electronic charting have accelerated efforts to implement information systems such as the electronic health record. The electronic health record (EHR) is a collection of all emphasized the need for all nurses to Building blocks of nursing of an individual’s interactions with communications the health care system that will be become more knowledgeable about The foundation of nursing informatics is available electronically (subject to health information concepts and the based on the concepts of data, informa- privacy, confidentiality and security technology that is designed to manage tion and knowledge. Because information guidelines and legislation) to health and process information. Many nurses and knowledge are essential for nurses care professionals anywhere in the recognize informatics, derived from the when interpreting data and making country. EHRs have the potential to French term informatique, as an area of decisions, it is important to know the enhance nurses’ decision-making nursing specialization. Nurses with expertise in informatics are often difference between these concepts. 50 DRIVEWAY, OTTAWA ON K2P 1E2 TEL: (613) 237-2133 1-800-361-8404 FAX: (613) 237-3520 WEB SITE: www.cna-nurses.ca E-MAIL: [email protected] Data are discrete observations that are All three concepts can be stored in across disciplines and across the con- not interpreted, organized or struc- computers and software programs can tinuum of health services need to be tured. Information is data that has been be developed to assist in the interpre- structured and defined in a standard or interpreted, organized or structured to tation of the data and the develop- common way – this means that not provide meaning to the data. And ment of new nursing knowledge. While only do we need standards for com- knowledge is the synthesis of informa- the concepts of data, information and mon concepts but we also need stan- tion to identify relationships that knowledge are different, the concepts dards that are compatible across infor- provide further insight to an issue or as a whole are typically referred to mation systems used by different subject area. When you think about it, generically as information. health professions, across the continu- these concepts are the building blocks um of health service delivery, and with- Common language for of all nursing communications. Nurses common concepts in and across provinces and territories. collect data when assessing and moni- Notwithstanding all the challenges, toring the health of clients and record The need for health information stan- there has been significant progress their observations in the client’s chart; dards has never been greater. The over the last decade in the develop- they exchange service requests to, and International Organization for 2 ment of health information stan- receive results from, the clinical labora- Standardization (ISO) defines stan- dards. Highlights of relevant work tory and radiology departments; they dards as: documented agreements containing are provided here. receive and review admission data and technical specifications or other precise criteria discharge summaries; they review infor- to be used consistently as rules, guidelines, or (a) Nursing Terminology mation on the results of clinical trials; definitions of characteristics to ensure that At the international level, the they communicate client information materials, products, processes, and services are International Council of Nurses (ICN) between service providers; they sum- fit for their purpose. Today, there are many is leading the development of a univer- marize, calculate and interpret work- different types of health information sal language for defining and describ- load indices for their nursing unit for standards including technical stan- ing nursing practice – the International monitoring and management purposes; dards for computer hardware and soft- Classification for Nursing Practice (ICNP®). and they consult evidence-based clini- ware, data standards to enable the The purpose of ICNP® is to provide a cal guidelines and protocols to guide development of quality and compara- tool for describing and documenting their practice. As knowledge workers, ble information, and information key elements that represent clinical nurses use sources such as these to exchange standards or protocols to nursing practice. ICNP® provides nurs- influence decision-making. facilitate the sharing of information. ing with a common framework that facilitates cross-mapping of existing Specific examples of data, information The development and implementa- nursing vocabularies and classifica- and knowledge relevant to nursing are tion of computer health information sys- tions to enable comparison of nursing provided below. tems or automated health information sys- tems requires some form of structured data across organizations, health sec- Data vocabulary or terminology with com- tors, and countries. The alpha version • Age mon definitions for common terms to of ICNP® was released in 1996 for • Number of home care visits enable the effective management and review and feedback. A significantly • Blood pressure processing of data. This may seem revised beta version was released in • Disease simple but is quite a challenge when 1999 and has been translated into • Weight you consider the complexity of issues more than 20 languages. • Number of workload units of service nurses have to deal with. In addition, (b) Health Information: Information nurses and other health professionals Nursing Components • Prevalence of patient falls by nursing unit, often use different terms and mea- In Canada, CNA’s HI: NC (Health by month – this year compared to last year surement instruments to describe the Information: Nursing Components) • Prevalence of stage 1-4 decubitus same thing. For example, functional ulcers, by quarter Working Group has continued to build status, decubitus ulcers, patient falls on the work started in the early 1990s • % distribution of workload units of ser- and patient self-care are often vice and intervention by activity catego- to develop a standardized minimum defined and measured differently. ry,by nursing unit, by month data set for nursing. There is now a Knowledge To complicate matters further, the national consensus that critical nursing • Effectiveness of hip pads in preventing advent of multidisciplinary health pro- care data elements include client status, hip fractures grams, regionalization and integrated nursing intervention and client outcome. • Decubitus ulcers treatment protocols health systems has increased the need While nurses have reached a consen- • Relationship between different nurse-staff for integrated health information sys- mix configurations,
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