Nursing informatics Lecture


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Nursing informatics Lecture

  1. 1.     Masters  of  Nursing  Science   NURS90054  Nursing  and  the  Health  Care  System  2–  (5  Sept  2012)    Overview  of  Nursing  Informa2cs   (NI)     Prof.  Fernando  Mar-n-­‐Sanchez     Health  and  Biomedical  Informa-cs  Research  (HBIR)  Unit   Melbourne  Medical  School   FMDHS       The  University  of  Melbourne  
  2. 2. Outline  •  Health  and  Biomedical  Informa-cs   – Ra-onale   – Defini-on  •  Nursing  Informa-cs   – Defini-on  and  evolu-on   – Skills  and  roles   – Core  areas  of  work  •  Relevant  organiza-ons  and  ini-a-ves  in  NI  
  3. 3. Outline  •  Health  and  Biomedical  Informa-cs   – Ra-onale   – Defini-on  •  Nursing  Informa-cs   – Defini-on  and  evolu-on   – Skills  and  roles   – Core  areas  of  work  •  Relevant  organiza-ons  and  ini-a-ves  in  NI  
  4. 4. Ra-onale  •  Background   -  Health  care,  Biomedical  research  and  Public   Health  are  informa-on  intensive  ac-vi-es:   -  Medical  images  and  clinical  records   -  DNA  sequencing,  molecular  data   -  Literature  and  public  databases   -  Clinical  trials,  biobanks,...   -  New  data  types  (extremely  complex  and   heterogeneous)  are  being  generated  at  an   unprecedented  pace   -  Nurses  spend  roughly  15%  of  their  -me   with  pa-ents  whereas  50%  is  spent  on   documenta-on.  (Kenny  &  Androwich,   2009).   4  
  5. 5. Biomedical  Informa-cs  •  Informa-cs  is  the  science  of  informa-on  •  Informa-on  is  data  plus  meaning    •  Biomedical  informa-cs  is  the  science  of  informa-on  as   applied  to  or  studied  in  the  context  of  biomedicine.    •  Informa-cians  study  informa-on  (data  +  meaning,  in   contrast  to  focusing  exclusively  on  data).    •  Thus,  prac--oners  must  understand  the  context  or   domain  (biomedicine).     •  Bernstam EV, Smith JW, Johnson TE. (2010) What is Biomedical Informatics . Journal of Biomedical Informatics; 43 104-110. •  Hersh W. (2009). A Stimulus to define Informatics and Health Information Technology . BMC Medical Informatics and Decision Making. 9:24. •  Groth DP and MacKie-Mason JK. (2010) Why an Informatics degree? Communications of the 5   ACM. 53 (2) 26-28
  6. 6. Defini-on  by  AMIA  
  7. 7. Health  and  Biomedical  Informa-cs   !
  8. 8. New  scope  •  In  the  future  nursing  informa-cs  will  also  be  more   involved  with  other  biomedical  informa-cs  fields  such   bioinforma-cs  and  public  health  fields.    •  “Nursing  informa-cs  should  encompass  emergency   preparedness,  biodefense,  and  public  health  nursing… since  nurses  serve  as  gene-c  counselors  in  many   environments,  nurses  must  stay  informed  about   computa-onal  biology,  genomics  and  proteomic”                    (  McCormick  et  al.,  2007,  p.21).  
  9. 9. Outline  •  Health  and  Biomedical  Informa-cs   – Ra-onale   – Defini-on  •  Nursing  Informa-cs   – Defini-on  and  Evolu-on   – Catalogues   – Integrated  search  engines   – Main  databases    •  Relevant  organiza-ons  and  ini-a-ves  in  NI  
  10. 10. Nursing  Informa-cs  NI  is  the  "science  and  prac0ce  (that)  integrates  nursing,  its  informa0on  and  knowledge,  with  management  of  informa0on  and  communica0on  technologies  to  promote  the  health  of  people,  families,  and  communi0es  worldwide.”  (AMIA  NI  WG)  
  11. 11. Nursing  Informa-cs  •  Nursing  Informa-cs  (NI)  -­‐  clinical  specialty  in  the  1970’  •  In  1992,  the  American  Nurses  Associa-on  recognized  nursing   informa-cs  as  a  professional  specialty,  and  cer-fica-on  is  now   available.  •  The  first  two  graduate  NI  programs  were  introduced  at  the   University  of  Maryland  and  the  University  of  Utah  in  1989.    •  The  first  doctoral  program  was  offered  in  1991  at  the  University   of  Maryland.      •  The  job  market  for  nurses  in  informa-cs  is  growing  at  a  faster   pace  than  the  supply  of  nurses  qualified  to  fill  available   posi-ons.    •  Educa-on  programs  are  now  available  in  many  countries  •  In  1981  there  were  only  15  nurses  with  exper-se  in  informa-cs   in    USA.    In  2008  that  number  had  grown  to  almost  9,000.  (Saba   &  McCormick,  2006;  HRSA,  2010  )      
  12. 12. NI  –  essen-al  skill  set  for  nurses  •   The  American  Associa-on  of  College  of  Nursing  (AACN)  has  developed   informa-cs  studies  in  Bachelor,  Master’s,  and  Doctoral  programs.  •   QSEN:  The  has  developed  a  3  phase  project  funded  by  the  Robert  Wood   Johnson  founda-on  to  prepare  nurses  with  the  proper  Knowledge,  Skills,   Antude.   •   6  Core  competencies  of  QSEN  (Quality  and  Safety  Educa-on  of   Nurses)  :   •   Pa-ent  centered  care   •   Teamwork  and  collabora-on   •   Evidence  based  prac-ce   •   Quality  improvement     •   Informa-cs   •   Safety  
  13. 13. Roles  •  Roles  include:   –  systems  analyst,     –  project  manager     –  developers  of  communica-on  and  informa-on   technologies,     –  informa-on  systems  trainer  and  educators,     –  researchers,     –  chief  nursing  officers,     –  chief  informa-on  officers,     –  sopware  engineers,     –  implementa-on  consultants,     –  policy  developers,     –  business  owners  
  14. 14. Core  areas  of  work  •  Concept  representa-on  and  standards  to  support  evidence-­‐ based  prac-ce,  research,  and  educa-on  •  Data  and  communica-on  standards  to  build  an  interoperable   na-onal  data  infrastructure  •  Research  methodologies  to  disseminate  new  knowledge  into   prac-ce  •  Informa-on  presenta-on  and  retrieval  approaches  to  support   safe  pa-ent  centered  care  •  Informa-on  and  communica-on  technologies  to  address  inter-­‐ professional  work  flow  needs  across  all  care  venues  •  Vision  and  management  for  the  development,  design,  and   implementa-on  of  communica-on  and  informa-on  technology  •  Defini-on  of  healthcare  policy  to  advance  the  public’s  health…  
  15. 15. Standardized  terminologies  for  nursing  •  Since  the  early  1970s  there  has  been  a  concerted  effort  to   develop  standardized  terminologies  for  nursing.    §   The  American  Nursing  Associa-on  (ANA)  currently  recognizes   12  standardized  languages.  §   Several  prominent  standard  nursing  language  include:   §   North  American  Nursing  Diagnosis  Associa-on  (NANDA)   §   Clinical  Care  Classifica-on  (CCC)   §   Omaha  System     §   Interna-onal  Classifica-on  of  Nursing  Prac-ce  (ICNP)   §   Nursing  Interven-on  Classifica-on  (NIC)   §   Nursing  Outcome  Classifica-on  (NOC)  
  16. 16. Safety,  Efficiency  &  Quality  Improvement    –  Computer  technologies  can  place  safety  barriers  within   high  risk  processes  to  improve  pa-ent  safety  –  Moving  away  from  paper  records  –  improves  access  to   the  data  you  need  without  flipping  through  a  bulky   pa-ent  record  –  Easier  retrieval  of  data  associated  with  a  par-cular   process  –  Data  sharing  -­‐  Measurement  of  performance  against   standards  of  prac-ce  to  iden-fy  systems  issues  and   opportuni-es  for  improvement   (VA  eHealth  University,  2010)  
  17. 17. Decision  support  •  assist  the  clinician  in  making  care   decisions    •  error  preven-on,  and  care  coordina-on  •  Clinical  flows     CIO   CNIO   CMIO  
  18. 18. Evidence  Based  Nursing  Prac-ce    •   In  Evidence  Based  Prac-ce,  a  nurse  is  able  to  formulate  a  ques-on  that  is   relevant  to  a  pa-ent’s  care,  conduct  research  and  evaluate  how  the   evidence  relates  to  the  pa-ent’s  specific  situa-on  and  apply  the  best   op-on  to  the  pa-ent’s  care.    •  There  are  many  posi-ve  benefits  for  evidence  based  nursing  including:   •  Helping  improve  pa-ent  care   •  Ability  to  implement  the  most  current  and  innova-ve  treatments   •  Allows  nurses  to  stay  up  to  date  on  new  research  and  increase  their   exper-se   •  Promotes  the  opportunity  for  collabora-on  between  nurses,  their   pa-ents  and  other  medical  staff   (Kelly,  Mallon,  Musi-ef,  Paton,  2011)  
  19. 19. Telehealth  -­‐  Telenursing  •  Telehealth ,  referring  to  a  wide  range  of   health  services  that  are  delivered  by   telecommunica-ons-­‐ready  tools,  such  as  the   telephone,  videophone,  and  computer.    •  NBN  /  IBES  §  The  prac-ce  of  nursing  over  a    distance  using  telecommunica-on  technology    (Na-onal  Council  of  State  Boards  of  Nursing  NCSBN,  1997)  
  20. 20. Par-cipatory  Health      • à  Pa-ents  empowered,  informed  and  involved  in   decision  making,  preven-on  and  learning   self  tracking  devices     Social  web      games   Participatory Health mobile     Internet  of  things     sensors     PCEHR  
  21. 21. HIMSS  Nursing  Informa-cs  101  •  Standardized  Documenta2on     ØThe  collec-on  tool  for  informa-on  management    •  Informa2on  Management     ØKey  role  for  Nursing  Informa-cs     ØKey  to  research  and  evidence  collec-on    •  Process  Re-­‐engineering     ØKey  to  successful  implementa-on    •  Research  and  Evidence  Collec2on     ØKey  to  repeatable,  standardized  care  and  improved  outcomes    
  22. 22. Respondents  were  asked  to  iden-fy  their  base  salary  as  of  Dec  1,  2010.      The  average  salary  of  the  respondents  in  the  survey  was  $98,703.      This  is  substan-ally  higher  than  the  average  salary  iden-fied  in  the  2007  ($83,675)  and  2004  surveys  ($69,500).  
  23. 23. Outline  •  Health  and  Biomedical  Informa-cs   – Ra-onale   – Defini-on   – Main  areas  of  work  •  Nursing  informa-cs   – Defini-on  and  evolu-on   – Skills  and  roles   – Core  areas  of  work  •  Relevant  organiza-ons  and  ini-a-ves  in  NI  
  24. 24. 21  June  1991   21  anniversary   NIA-­‐HISA  
  25. 25. Health  Informa-cs  Society  of  Australia  
  26. 26. Proceedings  Book   HIC  2012   IOS  Press  -­‐178      
  27. 27. NIA  Conference  @  HIC2012  NIA  has  94  members  in  all  states  and  territories.  
  28. 28. NIA  Conference  @  HIC2012  Nurses  are  the  largest  group  of  healthcare  professionals  with  over  300,000  registered  nurses  who  collect,  maintain  and  use  health  informa-on  more  than  any  other  health  professional.    The  implementa-on  of  health  informa-on  technology  over  the  past  few  years  and  the  government’s  commitment  to  e-­‐health  now  and  in  the  future  requires  nurses  to  have  more  input  into  any  future  developments  and  to  be  poli-cally  ac-ve  in  pursuing  the  needs  of  the  profession  to  ensure  that  healthcare  consumers  get  the  best  possible  health  outcomes.    The  change  in  focus  to  primary  healthcare  and  telehealth,  digital  smart  homes  and  ageing  in  place  are  all  changing  how  we  prac-ce.  We  must  have  input  and  control  over  how  we  see  nursing’s  future.  
  29. 29. NIA   Chair   Lis  Herbert     CommiKee  Member   Donna  Barton     CommiKee  Member   Sharon  Downman     CommiKee  Member   Trevor  Hoare     CommiKee  Member   Marian  Linnane     CommiKee  Member   Ping  Yu     Secretary   Joanne  Foster     Treasurer   Susan  McIndoe    
  30. 30. IMIA  –  NI  SIG  –  Working  Groups  •  Consumer/Client  Health  Informa2cs   Co-­‐Chair:  Strachan,  Heather     Co-­‐Chair:  Bürkle,  Thomas    •  NI-­‐Educa2on   Chair:  Skiba,  Diane   Co-­‐Chair:  Honey,  Michelle        •  NI-­‐Evidence  Based  Prac2ce     Chair:  Weaver,  Charlote     Co-­‐Chair:  Cook,  Robyn          •  NI-­‐Health  Informa2cs  Standards   Chair:  Bakken,  Suzanne   Co-­‐Chair:  Hardiker,  Nicholas     –  NI-­‐Nursing  Concept  Representa2on   merged  into  NI  Health  Informa-cs  Standards       –  Process  Driven  Implementa2on  Strategies   merged  into  NI  Health  Informa-cs  Standards      
  31. 31. •  Preparing  nurses  to  use   technology  &  informa-cs  to   improve  pa-ent  care  •  I.  Define  and  publish  the   10-­‐year  vision  and  3-­‐year   ac-on  plan  to  raise   awareness  of  the  need  for   informa-cs  competencies   for  all  nurses    
  32. 32. TIGER  
  33. 33.     TIGER  
  34. 34. Opportuni-es  for  engagement  •  History  of  MI  project  –  HISA,  IMIA  •  HBIR  subjects   –  eHealth  and  Biomedical  Informa-cs  Systems   (basic)  -­‐  2013   –  eHealth  and  Biomedical  Informa-cs  Methods   (advanced)  –  30  October  –  30  Nov  2012   –  Master  of  IT  (Health)  –  2013  •  HBIR  Research  supervision  •  Links  with  TIGER…  IMIA,  AMIA,  HISA  
  35. 35. Thank  you  for  your  aten-on!  ©  Copyright  The  University  of  Melbourne  2011  
  36. 36. Comments,questions?