The document discusses the effects of the 1999 report "To Err is Human" on nursing practice in the United States. It highlights how the report's recommendations have guided significant changes in nursing practice through increased focus on patient safety. Nurses are asked to review the report's recommendations and consider how health information technology can help address patient safety concerns raised in the report. Specifically, they are asked to reflect on how their current organization has transitioned from outdated rules to new rules focused on patient safety and quality of care.

1. Transforming Nursing and Healthcare through Technology
(NURS - 6051N – 37)
DISCUSSION- 1
The Effects of “To Err Is Human” in Nursing Practice
The 1999 landmark study titled “To Err Is Human: Building a
Safer Health System” highlighted the unacceptably high
incidence of U.S. medical errors and put forth recommendations
to improve patient safety. Since its publication, the
recommendations in “To Err Is Human’ have guided significant
changes in nursing practice in the United States.
In this Discussion, you will review these recommendations and
consider the role of health information technology in helping
address concerns presented in the report.
To prepare:
Review the summary of “To Err Is Human” presented in the
Plawecki and Amrhein article found in this week’s Learning
Resources.
Consider the following statement:
“The most significant barrier to improving patient safety
identified in “To Err Is Human” is a “lack of awareness of the
extent to which errors occur daily in all health care settings and
organizations (Wakefield, 2008).”
Review “The Quality Chasm Series: Implications for Nursing”
focusing on Table 3: “Simple Rules for the 21st Century Health
Care System.” Consider your current organization or one with
which you are familiar. Reflect on one of the rules where the
“current rule” is still in operation in the organization and
consider another instance in which the organization has
effectively transitioned to the new rule.
Please Provide References
Learning Resources
Required Readings
American Nurses Association. (2015). Nursing informatics:
Scope & standards of practice (2nd ed.). Silver Springs, MD:

2. Author.
“Introduction”
This portion of the text introduces nursing informatics and
outlines the functions of the scope and standards.
McGonigle, D., & Mastrian, K. G. (2015). Nursing informatics
and the foundation of knowledge (3rd ed.). Burlington, MA:
Jones and Bartlett Learning.
Chapter 1, “Nursing Science and the Foundation of Knowledge”
This chapter defines nursing science and details its relation to
nursing roles and nursing informatics. The chapter also serves
as an introduction to the foundation of knowledge model used
throughout the text.
Chapter 2, “Introduction to Information, Information Science,
and Information Systems”
In this chapter, the authors highlight the importance of
information systems. The authors specify the qualities that
enable information systems to meet the needs of the health care
industry.
Wakefield, M. K. (2008). The Quality Chasm series:
Implications for nursing. In R. G. Hughes (Ed.), Patient safety
and quality: An evidence-based handbook for nurses (Vol. 1, pp.
47–66). Rockville, MD: U. S. Department of Health and Human
Services.
Pages 1–12
These 12 pages highlight the issues raised by the Quality Chasm
Series and examine their long-term implications for nursing.
The text reviews external drivers of safety and quality, design
principles for safe systems, and guidelines for health care
redesign.
Cipriano, P. F., & Murphy, J. (2011). Nursing informatics. The
future of nursing and health IT: The quality elixir. Nursing
Economic$, 29(5), 282, 286–289.
In this article, the authors focus on how nurses can use health
information technology to help transform health care using the
recommendations included in the 2010 Institute of Medicine

3. report “The Future of Nursing, Leading Change, Advancing
Health.” The author also discusses the 2011 National Strategy
for Quality Improvement in Health Care.
Plawecki, L. H., & Amrhein, D. W. (2009). Clearing the err.
Journal of Gerontological Nursing, 35(11), 26–29.
This article presents a summary of the Institute of Medicine
report “To Err Is Human: Building a Safer Health System.” The
authors provide an overview of what has been accomplished in
the decade following the IOM report, focusing in particular on
health information technology.
Required Media
Laureate Education (Producer). (2012e). Introduction to nursing
informatics. Baltimore, MD: Author.
In this video, Doris Fischer, Richard Rodriguez, Carina Perez,
and Carmen Ferrell introduce the concept of nursing
informatics. These individuals provide insight into how
informatics is transforming the health care system by improving
efficiency and quality of care.
Optional Resources
Hilts, M. E. (2010). Up from the basement. Health Management
Technology, 31(9), 14–15.
Retrieved from the Walden Library databases.
Institute of Medicine. (1999). To err is human: Building a safer
health system. Retrieved from
http://web.archive.org/web/20141016134546/http://www.iom.ed
u/~/media/Files/Report%20Files/1999/To-Err-is-
Human/To%20Err%20is%20Human%201999%20%20report%20
brief.pdf
Kohn, L. T., Corrigan, J. M., & Donaldson, M.S. (Eds.).
(2000). To err is human: Building a safer health system.
Washington, D. C.: Institute of Medicine. Retrieved from the
National Academies Press website:
https://download.nap.edu/catalog.php?record_id=9728
DISCUSSION-2

4. Nursing Informatics Competencies
Today’s fast-paced health care environment demands nurses to
be skilled not only in their clinical practice or specialty area but
in the use of technology tools that improve practice and lead to
better patient care. Basic and advanced technology
competencies are required and expected as technology
increasingly touches and changes the job of every nurse.
Numerous organizations, including the American Nurses
Association (ANA), the American Medical Informatics
Association (AMIA), and Healthcare Information and
Management Systems Society (HIMSS), have developed nurse-
specific technology competencies. The challenge for nurses is to
identify both needs and training opportunities.
In this Discussion, you identify the role informatics plays in
your professional responsibilities. You pinpoint personal gaps
in skills and knowledge and then develop a plan for self-
improvement.
To prepare:
Review Nursing Informatics: Scope and Standards of Practice in
this week’s Learning Resources, focusing on the different
functional areas it describes. Consider which areas relate to
your current nursing responsibilities or to a position you held in
the past. For this Discussion, identify one or two of the most
relevant functional areas.
Review the list of competencies recommended by the TIGER
Initiative. Identify at least one skill in each of the main areas
(basic computer competencies, information literacy
competencies, and information management competencies) that
is pertinent to your functional area(s) and in which you need to
strengthen your abilities. Consider how you could improve your
skills in these areas and the resources within your organization
that might provide training and support.
Please Provide References
Learning Resources
Required Readings

5. American Nurses Association. (2015). Nursing informatics:
Scope & standards of practice (2nd ed.). Silver Springs, MD:
Author.
“Functional Areas for Nursing Informatics”
This chapter describes the key functional areas of nursing
informatics. It also clarifies the roles of informatics nurse
specialists and informatics nurses.
“Informatics Competencies: Spanning Careers and Roles”
This chapter details an informatics competencies matrix that has
been developed by reviewing research. It outlines best practices
for successful use of health information technology.
McGonigle, D., & Mastrian, K. G. (2015). Nursing informatics
and the foundation of knowledge (3rd ed.). Burlington, MA:
Jones and Bartlett Learning.
Chapter 7, “Informatics Roles and the Knowledge Work of
Nursing”
This chapter details the roles, competencies, and skills that
ensure effective nursing informatics practice. The text also
details the future of nursing informatics.
Chapter 8, “Information and Knowledge Needs of Nurses in the
21st Century”
In this chapter, the author emphasizes the need for embedding
the core concepts and competencies of informatics into the
practice of nurses. The chapter describes how this integration of
concepts and competencies is necessitated by the integration of
clinical information technologies into nursing practice.
Wakefield, M. K. (2008). The Quality Chasm series:
Implications for nursing. In R. G. Hughes (Ed.), Patient safety
and quality: An evidence-based handbook for nurses (Vol. 1, pp.
47–66). Rockville, MD: U. S. Department of Health and Human
Services. Retrieved from
http://www.ncbi.nlm.nih.gov/books/NBK2677/
Pages 12–19

6. This chapter discusses four of the Institute of Medicine’s
reports on the quality and safety of health care. Specifically, the
chapter focuses on the issues, concepts, findings, and
recommendations of To Err Is Human, Crossing the Quality
Chasm, Health Professions Education: A Bridge to Quality, and
Quality Through Collaboration: The Future of Rural Health
Care.
Cheeseman, S. E. (2011). Are you prepared for the digital era?
Neonatal Network, 30(4), 263–266.
This article explores the application of health information
technology (HIT) in neonatal intensive care units. In addition,
the article highlights national initiatives advocating for the
implementation of HIT throughout the health care delivery
system.
AMIA. (2012). AMIA. Retrieved from
http://www.amia.org/
This homepage of AMIA (formerly known as the American
Medical Informatics Association) details the activities of the
AMIA, including its publications, programs, events, and
policies.
Healthcare Information and Management Systems Society.
(2012a). Healthcare Information and Management Systems
Society. Retrieved from
http://www.himss.org/
This homepage of the Healthcare Information and Management
Systems Society displays research conducted by HIMSS and
introduces various tools, events, and resources for professional
development.
Healthcare Information and Management Systems
Society.(2012b). Resources/reports. Retrieved from
https://web.archive.org/web/20151108084347/http://www.thetig
erinitiative.org/resources.aspx

7. This page of the TIGER website contains a list of resources and
reports related to the development and implementation of
technology informatics.
Healthcare Information and Management Systems
Society.(2012c). The TIGER initiative. Retrieved from
http://www.thetigerinitiative.org/
This site includes information on the phases of the TIGER
Initiative and includes related resources and reports,
opportunities for strategic partnerships, and general information
about TIGER.
Technology Informatics Guiding Educational Reform. (2009).
TIGER informatics competencies collaborative final report.
Retrieved from
http://tigercompetencies.pbworks.com/f/TICC_Final.pdf
This text details foundational informatics competencies that
nurses should possess in order to meet standards of providing
safe, quality, and competent care. In particular, this article
specifies requirements for nurses in the areas of basic computer
competencies, information literacy, and information
management.
The TIGER Initiative. (2009). Informatics competencies for
every practicing nurse: Recommendations from the TIGER
collaborative. Retrieved from
https://web.archive.org/web/20150323183938/http://thetigeriniti
ative.org/docs/TigerReport_InformaticsCompetencies_001.pdf
This report supplies the findings and recommendations of the
Informatics Competencies Collaborative Team. The text
describes the background, methodology, findings, and
recommendations for future work as stated by the team.
Quality and Safety Education for Nurses. (2012). Quality and
Safety Education for Nurses. Retrieved from
http://www.qsen.org/

8. This homepage supplies information on quality and safety
competencies, teaching strategies, faculty resources, pilot
schools, and QSEN Consultants.
Required Media
Laureate Education (Producer). (2012d). Health information
technology competencies. Baltimore, MD: Author.
Optional Resources
Schleyer, R. H., Burch, C. K., & Schoessler, M. T. (2011).
Defining and integrating informatics competencies into a
hospital nursing department. CIN: Computers, Informatics,
Nursing, 29(3), 167–173.
DISCUSSION-3
Standardized Coding Systems
As a result of the fragmented nature of the health care system,
professionals in various specialty areas of medicine have
developed their own unique sets of terminology to communicate
within that specialty. In the past, limited attention has been
given to codifying practices in order for them to be understood
and utilized across disciplines or through different information
technology systems. The implementation of a federally
mandated electronic medical records system, therefore, poses a
challenge to nursing professionals and others who must be
prepared to utilize standardized codes for the new system. Why
are coding standards important for promoting consistent, high-
quality care?
According to Rutherford (2008, para. 15), “Improved
communication with other nurses, health care professionals, and
administrators of the institution in which nurses work is a key
benefit of using a standardized nursing language.” In this
Discussion you consider the reasoning behind and the value of
standardized codification.
To prepare
Review the information in Nursing Informatics: Scope and
Standards of Practice. Determine which set of terminologies are
appropriate for your specialty or area of expertise.

9. Reflect on the importance of continuity in terminology and
coding systems.
In the article, “Standardized Nursing Language: What Does It
Mean for Nursing Practice?” the author recounts a visit to a
local hospital to view its implementation of a new coding
system. One of the nurses commented to her, “We document our
care using standardized nursing languages but we don’t fully
understand why we do” (Rutherford, 2008, para. 1). Consider
how you would inform this nurse (and others like her) of the
importance of standardized nursing terminologies.
Reflect on the value of using a standard language in nursing
practice. Consider if standardization can be limited to a
specialty area or if one standard language is needed across all
nursing practice. Then, identify examples of standardization in
your own specialty or area of expertise. Conduct additional
research using the Walden Library that supports your thoughts
on standardization of nursing terminology.
Please Provide References
Learning Resources
Required Readings
American Nurses Association. (2015). Nursing informatics:
Scope & standards of practice (2nd ed.). Silver Springs, MD:
Author.
“Metastructures, Concepts, and Tools of Nursing Informatics”
This chapter explores the connections between data,
information, knowledge, and wisdom and how they work
together in nursing informatics. It also covers the influence that
concepts and tools have on the field of nursing.
McGonigle, D., & Mastrian, K. G. (2015). Nursing informatics
and the foundation of knowledge (3rd ed.). Burlington, MA:
Jones and Bartlett Learning.
Chapter 6, “Overview of Nursing Informatics”
This chapter defines the foundations of nursing informatics
(NI). The authors specify the disciplines that are integrated to
form nursing informatics, along with major NI concepts.

10. Brokel, J. (2010). Moving forward with NANDA-I nursing
diagnoses with Health Information Technology for Economic
and Clinical Health (HITECH) Act Legislation: News updates.
International Journal of Nursing Terminologies &
Classifications, 21(4), 182–185.
In this news brief, the author describes the initiatives that
NANDA-I will implement to remain abreast of the HITECH
legislation of 2009. The author explains two recommendations
for the federal government’s role in managing vocabularies,
value sets, and code sets throughout the health care system.
Matney, S., Brewster, P. J., Sward, K. A., Cloyes, K. G., &
Staggers, N. (2011). Philosophical approaches to the nursing
informatics data-information-knowledge-wisdom framework.
Advances in Nursing Science, 34(1), 6–18.
This article proposes a philosophical foundation for nursing
informatics in which data, information, and knowledge can be
synthesized by computer systems to support wisdom
development. The authors describe how wisdom can add value
to nursing informatics and to the nursing profession as a whole.
Rutherford, M. A. (2008). Standardized nursing language: What
does it mean for nursing practice? OJIN: The Online Journal of
Issues in Nursing, 13(1). Retrieved from
http://www.nursingworld.org/MainMenuCategories/ANAMarket
place/ANAPeriodicals/OJIN/TableofContents/vol132008/No1Ja
n08/ArticlePreviousTopic/StandardizedNursingLanguage.html
The author of this article provides justification for the use of a
standardized nursing language, which will be necessary for
incorporating electronic documentation into the health care
field. The author defines standardized language in nursing,
describes how such a language can be applied in a practice
setting, and discusses the benefits of using a standardized
language.

11. Westra, B. L., Subramanian, A., Hart, C. M., Matney, S. A.,
Wilson, P. S., Huff, S. M., … Delaney, C. W. (2010). Achieving
“meaningful use” of electronic health records through the
integration of the Nursing Management Minimum Data Set. The
Journal of Nursing Administration, 40(7–8), 336–343.
This article explains the nursing management minimum data set
(NMMDS), which is a research-based minimum set of standard
data for nursing management and administration. The article
describes how the NMMDS can be used to minimize the burden
on health care administrators and increase the value of
electronic health records within the health care system.
Required Media
Laureate Education (Producer). (2012a). Data, information,
knowledge, and wisdom continuum. Baltimore, MD: Author.
McGonigle, D., & Mastrian, K. G. (2012). Nursing informatics
and the foundation of knowledge (2nd ed.). Burlington, MA:
Jones & Bartlett Learning. (p. 98, Chapter 6, Figure 6)
The continuum of data, information, knowledge, and wisdom is
used in the health care field to describe discrete levels of
understanding related to patient care and decision making. This
video provides an overview of the continuum from data to
wisdom.
Optional Resources
Truran, D., Saad, P., Zhang, M., & Innes, K. (2010). SNOMED
CT and its place in health information management practice.
Health Information Management Journal, 39(2), 37–39.
Brown, B. (2011). ICD-10-CM: What is it, and why are we
switching? Journal of Health Care Compliance, 13(3), 51–79.
Discussion:-4
Current Information and Communication Technologies
With so much attention focused on health care reform, it is

12. important that nurses be given the opportunity to use high-
quality technology tools. These tools can increase access to
vital medical information, promote effective communication
among health care professionals, and improve the patient
experience. By actively seeking out and adopting these tools,
nurses can greatly enhance the quality and safety of care that
they provide.
This Discussion focuses on identifying quality technology tools
that increase the ability of nurses to provide safe, effective care.
To prepare:
Review the various technology tools described in this week’s
Learning Resources.
Identify a recently adopted information, education, or
communication technology tool in your specialty area. Reflect
on how it is used and how its use impacts the quality of care.
Consider how your identified technology tool might impact
nursing practice if it were more widely used. What are some
barriers preventing increased usage? How could wider
implementation be facilitated?
Please Provide References
Learning Objectives
Students will:
Evaluate the effectiveness of a technology tool in your specialty
area
Appraise the barriers and facilitators of implementing an
information technology tool in your specialty area
Learning Resources
Required Readings
American Nurses Association. (2015). Nursing informatics:
Scope & standards of practice (2nd ed.). Silver Springs, MD:
Author.
“The Future of Nursing Informatics”
McGonigle, D., & Mastrian, K. G. (2015). Nursing informatics
and the foundation of knowledge (3rd ed.). Burlington, MA:
Jones and Bartlett Learning.
Chapter 12, “The Human-Technology Interface”

13. This chapter describes the human-technology interface and
explores some of the problems that result from its usage. The
author also reflects on methods for improving the interface.
Chapter 19, “Telenursing and Remote Access Telehealth”
This chapter explores the usage of telehealth in nursing
practice. The authors examine the role of telehealth, along with
potential issues that may arise in its usage.
Brewer, E. P. (2011). Successful techniques for using human
patient simulation in nursing education. Journal of Nursing
Scholarship, 43(3), 311–317.
This article identifies studies that have used human simulation
as an effective instructional tool in nursing education. The
article describes different strategies for incorporating human
simulation into nursing education, and it also offers insight on
improvements that could be made to current practices.
Guarascio-Howard, L. (2011). Examination of wireless
technology to improve nurse communication, response time to
bed alarms, and patient safety. Herd, 4(2), 109–120.
The author explains the results of a study on the outcomes of
using wireless communication devices to improve patient safety
by allowing nurses to communicate more quickly and easily
with other nurses. The results indicate that this technology can
increase the value of team nursing, improve response time, and
increase patient safety, although there are some drawbacks and
challenges associated with the devices.
Simpson, R. L. (2012). Technology enables value-based nursing
care. Nursing Administration Quarterly, 36(1), 85–87.
This article describes how technology can be used to address
problems in the U.S. health care system, such as lack of
consistency and lack of effective treatment. The article explains
the use of value-based care initiatives and outlines how nurses
can use these initiatives to improve outcomes in treatment and
research.

14. Vinson, M. H., McCallum, R., Thornlow, D. K., & Champagne,
M. T. (2011). Design, implementation, and evaluation of
population-specific telehealth nursing services. Nursing
Economic$, 29(5), 265–272, 277.
Telehealth is defined as health services that integrate electronic
information and telecommunications to improve health care
access, outcomes, and costs. This article describes how a
telehealth implementation project was designed, enacted, and
evaluated, and it analyzes the results of that project.
Required Media
Laureate Education (Producer). (2012c). Health care
technologies. Baltimore, MD: Author.
This video features Katie Skelton, Doris Fischer, Carina Perez,
Shannon Mori, Carmen Ferrell, and Lynn Tamanaha as they
discuss current technologies and innovations in health care.
They also describe a specific bed management-system that has
improved their hospitals’ efficiency.