THE NURSING SHORTAGEWithin 10 years, 40% of working registerednurses will be over 50 years or older. As thoseRNs retire, the supply of nurses will be 20%below requirements by the year 2000. Thisproblem is due to steep population growth andan ageing population; diminishing pipeline ofnew students in nursing; and an aging nursingworkforce. Unfortunately, there is not simplesolution to nursing shortage. Nursing mustapproach the problem in all angles.
• Patient safety is considered an international issue. In 2001, in Britain, there were more than 10,000 recorded medicine errors resulting in 1,100 deaths. In the US, there are 750,000 recorded medical errors with a death rate of between 44,000 to 90,000. According to international statistics, one in every 300 errors will result in a serious, and possible fatal, adverse effects.INCREASED DEMAND FOR PATIENT SAFETY
THE NEED FOR VISIBILITY• If nursing cannot establish its contribution to patient outcomes, nursing becomes invisible and in a fiscally tightened market, invisibility can mean expandability. Nursing must have a way to substantiate its role in the healthcare process and its vitality to outcomes.
The Future of Computerized Nursing Information Systems
Wireless Area Networking- Mobile electronic health tools such as cellphones and telemedicine technologies arerapidly transforming the face and context ofhealth care service delivery around the world.
LEVEL OF COMPETENCIES• Beginner / Entry / User level• Intermediate / Modifier level • Advanced / Innovator level of competency. 47
COMPETENCIES REQUIREDNurses must have a minimum of a "user" level in computer literacy and informatics theory. 48
TECHNICAL COMPETENCIES• psychomotor use of computers and other technological equipment.• Ability to use selected applications.• Confidence 49
COMPUTER APPLICATIONSAll three levels of competencies -• Word processing• Keyboarding• Spreadsheets• Presentation Graphics 50
COMPUTER APPLICATIONS• Databases (simple to complex)• Desktop Publishing• World Wide Web• E-mail programs• Expert data systems• Multimedia• Telecommunication devices• Nursing information systems• Hospital information systems• Peripherals (Printers, CD/DVD) 51
USER LEVEL TECHNICAL COMPETENCIES INCLUDE:• word processing applications• keyboarding skills• spreadsheet applications• telecommunication devices• e-mail systems• presentation applications 52
USER LEVEL TECHNICAL COMPETENCIES INCLUDE:• internet resources• sources of data• accesses, enters and retrieves data• database management programs• database 53
USER LEVEL TECHNICAL COMPETENCIES INCLUDE:• conducts online and database literature searches• uses decision support systems, expert systems and other aids for clinical decision making and care planning• uses computer applications to – document client care – plan client care – enter client data 54
USER LEVEL TECHNICAL COMPETENCIES INCLUDE:• uses information management systems for client education• uses technology based client monitoring systems• operates peripheral devices (bedside and hand held)• uses operating systems• uses computer peripheral devices (CD ROMs, DVD, zip drives) 55
USER LEVEL TECHNICAL COMPETENCIES INCLUDE:• navigates in FOSS/Windows environment effectively• demonstrates basic technology skills• uses computer technology safely 56
MODIFIER LEVEL TECHNICAL COMPETENCIES INCLUDE:• applies technology support to provide evidenced based practice• synthesizes data from more than one source and applies to practice• demonstrates awareness of and ability to access data and information from multiple sources• uses decision support systems in practice 57
MODIFIER LEVEL TECHNICAL COMPETENCIES INCLUDE:• Can access pertinent literature and resources and incorporates it into practice and professional development• Can access and create research and other documents electronically 58
INNOVATOR LEVEL TECHNICAL COMPETENCIES INCLUDE:• participates in the design and development of information systems for nursing practice• develops inventive ways to access data and interact with information systems• participates in the design and develop design and development of new applications for nursing practice• participates in developing new methods for data and information organization 59
INNOVATOR LEVEL TECHNICAL COMPETENCIES INCLUDE:• collaborates with information technology consultants and other members of information system development team• collaborates, negotiates with and directs information technology vendors• proficiency in diverse computer application programs• manipulates and enhances nursing data sets• organizes and directs applications of shared data sets 60
INNOVATOR LEVEL TECHNICAL COMPETENCIES INCLUDE:• develops data gathering tools and processes for literature search access for nurses• develop charting and documentation templates for use in nursing practice• design and development of evidenced based practice documentation and processing within practice area 61
CERTIFICATION AND EDUCATIONPrerequisites for certification:•baccalaureate or higher degree in nursing or relevantfield•an active registered nurse (RN) license in the UnitedStates•2 years of RN practice plus 2,000 hours of informaticsnursing practice within the previous 5 years or12 hours of academic credit in a graduate program innursing informatics and 1,000 hours of nursinginformatics practice within the previous 5 years. 65
SUMMARY• Informatics can make nursing practice visible in local, national, and international health care data sets, thus empowering nurses with information to influence policy. 66
SUMMARY• Information is a critical component of effective decision-making and high quality nursing practice.• The information and knowledge gained through nursing informatics can bring increased awareness and understanding of nursing and health care issues. 67
SUMMARY• Nursing Informatics is committed to maintaining a clinical perspective and promoting research that would bear directly on improving patient care.• Recognition of Nursing Informatics team value in support of clinical excellence is crucial to any healthcare organization’s success. 68
FRIENDLY ADVICE…• Work towards achieving the INNOVATOR LEVEL of technical competency• Keep abreast of “latest greatest” technology trends• Assess newest technology for “fit” and potential applicability in your nursing profession 69
NURSING INFORMATICS ORGANIZATIONSA short list of examples includes:• American Nursing Informatics Association (ANIA)• Australian Nursing Informatics Council (ANIC)• Brazilian Nursing Association Nursing Informatics Group• British Computer Society Nursing Specialist Group• European Nursing Informatics (ENI)• International Medical Informatics Association Nursing Informatics Special Interest Group (IMIA-NI)• NURSINFO: Hong Kong• Spanish Society of Nursing Informatics and Internet (SEEI)• Swiss Special Interest Group Nursing Informatics (SIG-NI) 70
The Principle ofInformation-Privacyand Disposition All persons have right to privacy, and to control over the collection, storage, access, use, communication, manipulation and disposition of data about themselves
The Principle of OpennessThe collection, storage, access, use, communication,manipulation and disposition of personal data must bedisclosed in an appropriate and timely fashion to thesubject of those data.
The Principle of SecurityData should be protected by all reasonable andappropriate measures against loss, degradation,unauthorized destruction, access, use,manipulation, modification or communication.
The Principle of AccessThe subject of an electronic record has theright of access to that record and the right tocorrect the record
The Principle of Legitimate Infringement•Control over the collection, storage, access, use,manipulation, communication and disposition ofpersonal data is conditioned only by the legitimate,appropriate and relevant data-needs.
The Principle of the Least Intrusive Alternative•Any infringement of the privacy rights may onlyoccur in the least intrusive fashion and with aminimum of interference with the rights of theaffected person.
The Principle of AccountabilityAny infringement of the privacy rights mustbe justified to the affected person in goodtime and in an appropriate fashion.