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. 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. 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. 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. 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. Deﬁni-on by AMIA
7. Health and Biomedical Informa-cs !
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. 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. 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) Digitalnurse.org
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. 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. 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. 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. 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. 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. Decision support • assist the clinician in making care decisions • error preven-on, and care coordina-on • Clinical ﬂows CIO CNIO CMIO
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. 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. 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. HIMSS Nursing Informa-cs 101 • Standardized Documenta2on ØThe collec-on tool for informa-on management • Informa2on Management ØKey role for Nursing Informa-cs ØKey to research and evidence collec-on • Process Re-‐engineering ØKey to successful implementa-on • Research and Evidence Collec2on ØKey to repeatable, standardized care and improved outcomes
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. 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. 21 June 1991 21 anniversary NIA-‐HISA
25. Health Informa-cs Society of Australia
26. Proceedings Book HIC 2012 IOS Press -‐178
27. NIA Conference @ HIC2012 NIA has 94 members in all states and territories.
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. 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. 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. • 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
33. www.the-gerini-a-ve.org TIGER
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