1. Eye of the TIGER:
Changes and Challenges in
Education
Jessica M. LiBassi, RNC-NIC

2. The TIGER Initiative
T: Technology
I: Informatics
G: Guiding
E: Education
R: Reform

3. What does this mean?
The TIGER Initiative:
 Seeks to educate nurses in informatics
competencies (Hinton-Walker, 2010)
 Responds to a call for safer, more efficient
care through the use of technology (Hinton-
Walker, 2010)
 Aims to improve information literacy among
nurses (Hinton-Walker, 2010)

4. Why did I choose this topic?
 Education Reform interests me, especially with regards
to technology and the implementation of the electronic
health record (EHR)
 I had never heard of TIGER, and I wanted to learn
more about it
 I have an interest in nursing education

5. Change #1: Electronic
Medical Record
The electronic medical record has impacted health care in
many ways:
 Uses Standard Terms – this enhances communication
through the use of standard abbreviations (Kunz, 2010)
 Accessibility – records are immediately available, no
time wasted searching, charts may be accessed
remotely (Kunz, 2010)
 Reduction in chart time – More time for patient care
(Kunz, 2010)

6. What does the EMR have to
do with TIGER?
 TIGER aims to ensure all nursing students have basic
computer literacy skills (TIGER, Leadership Imperative)
 TIGER offers a Virtual Learning Environment (VLE) for
Health IT (TIGER, VLE)
 In the VLE, the school has the opportunity to download
EMR demo software (TIGER, VLE)
 Health IT modules and resources are also available for
nursing curricula (TIGER, VLE)

7. Change #2: Medication
Administration
 Gone are the days of the Paper Medication Administration
Record (MAR) (Kunz, 2010)
 To administer a medication to a patient, the nurse scans the
patient’s barcode on his wrist (Kunz, 2010)
 This pulls up the MAR to the current hour on the computer
 The computer shows the nurse what medications are due
 Alert flags are built in so a nurse is alerted when a
medication is due/overdue

8. Change #3: “Smart”
Equipment
 Most common piece of “Smart” equipment is the smart
pump (Hebda & Calderone, 2010)
 Aids the nurse in giving the correct medication over the
correct amount of time
 Checks are built in such as patient weight and double
nurse sign-off
 Smart pumps should be available in nursing simulation
labs

9. Change #4: Bedside
Monitoring
 Bedside Monitors continuously display the patient’s
vitals
 Monitors are linked to patient’s chart, so data flow
seamlessly into the chart
 Nurses verify this information, but do not have to enter
it saving time and allowing for more time for patient
care
 This can be taught in TIGER’s Virtual Learning
Environment (TIGER, VLE)

10. Challenge #1:Different Levels
of Computer Literacy
 Some nursing students do not have basic computer skills
 Others are proficient
Suggestions to Overcome This:
 Have “Super Users” available
 Offer basic computer and typing classes
 Make one-on-one tutoring available (Kunz, 2010)
*TIGER recommends certification in basic computer skills be
required by all nurses and nursing students (TIGER, Revolutionary
Leadership)

11. Challenge #2:
“The IT trend dehumanizes care”
Solutions for this barrier:
 Encourage bedside charting
 Position computer so nurse is close to patient, not
computer
 Familiarize self with screens so navigation is easy
 Encourage personal touch when giving care (Kunz,
2010)

12. Challenge #3: Limited Access
and Knowledge
 Nursing students have limited access to health IT and
limited knowledge of how to navigate it (Hinton-Walker,
2010)
 Nurse Leaders responded to this by prioritizing the
development of the Virtual Demonstration Center on
www.tigerinitiative.org (Hinton-Walker, 2010)
 TIGER VLE is a partnership between industry,
universities, nursing and interdisciplinary associations,
community colleges, specialty organizations and health
care systems, and government entities (Hinton- Walker,
2010)

13. Challenge #4: Information
Illiteracy
The information literate nurse can:
 Determine the quality and significance of research and apply
to patient care
 Improve care with evidence-based practice (EBP)
However, many nurses:
 Are not aware of the importance of EBP
 Do not have consistent role models by nurse leaders and
mentors
 Are not comfortable with database searches (Hebda &
Calderone, 2010)

14. Challenge #4 (cont’d):
Information Illiteracy
TIGER Initiative aims to improve information literacy
among all nurses
HOW?

15. Conclusion

16. References
 Hebda, T., & Calderone, T. (2010, March/April). What nurse educators need to
know about the TIGER initiative. Nurse Educator, 35(2), 56-60.
http://dx.doi.org/10.1097/NNE.0b013e3181ced83d
 Hinton-Walker, P. (2010, September-October). The TIGER initiative: A call to
accept and pass the baton. Nursing Economics, 28, 352-355. Retrieved from
www.nursingeconomics.net
 Revloutionary leadership driving healthcare innovation: The TIGER leadership
development collaborative report. (n.d.). Retrieved from
http://www.thetigerinitiative.org/docs/TigerReport_Leadership_Collaborative.p
df
 The TIGER initiative foundation, the leadership imperative: TIGER’s
recommendations for integrating technology into practice and education.
(n.d.). Retrieved from
http://www.thetigerinitiative.org/docs/TIGERReportTheLeadershipImperative.p
df