Nursing informatics is a nursing specialty that applies computer and information science to support nurses. It aims to improve health by optimizing information management. As technology has advanced, the role of nurses as knowledge workers has evolved, requiring informatics competencies. Nursing informatics roles and specialization help nurses access and utilize necessary information to provide safe patient care.

1. Chapter 7
Nursing Informatics
Roles,
Competencies, and
Skills

2. Objectives
• Provide an overview of nursing informatics’
historical development.
• Explore the concept of nurses as knowledge
workers.
• Discuss the evolving roles and competencies
of nursing informatics practice.

3. Introduction
• The world has witnessed an unprecedented number of
technological advances during the last 100 years.
• The early 20th century witnessed the invention of the
car and the airplane. These modes of transportation
drastically changed how people work and play.
• The entertainment world was dramatically altered by
the invention of radio and television.
• The introduction of the computer altered the way data
and information were viewed and utilized and changed
the way business was conducted.
• The computer is changing nursing and health care.

4. WHAT IS NURSING INFORMATICS?
• The term informatics was derived from the
French term informatique, which means to
refer to the computer milieu (Saba, 2001).
• The Health Information and Management
Systems Society (HIMSS) defines informatics
as “the discipline concerned with the study of
information and manipulation of information
via computer-based tools” (2006, p. 44).

5. History
• Health care began to use computers in the 1950s.
• Computers, in this era, were typically used in the business office
to track financial aspects of health care (Saba & McCormick,
2006).
• In the 1970s, nursing began to realize the importance of
computers to the nursing profession and became involved in the
design, purchase, and implementation of information systems
(Saba & McCormick, 2006).
• In the 1980s, medical and nursing informatics specialties
emerged. The personal computer was introduced, which allowed
for flexibility in how these clinical systems were used. It also
brought to everyone’s attention that not just NI specialists, but
all healthcare personnel, would need to know about these
systems (Hannah et al., 2006; Saba & McCormick, 2006).

6. History (con’t)
• The first certification exam for NI was taken in 1995
(Saba & McCormick). The post-2000 era saw an
unprecedented explosion in the number and
sophistication of both computer hardware and
software. Electronic patient records became an integral
part of clinical information systems.
• Telemedicine became possible and was recognized as a
specialty in the late 1990s (Saba & McCormick,2006).
• NI has experienced rapid growth in the last 40 years,
and it does not appear to be slowing. It will be
interesting to see what will happen over the next 40
years.

7. Goal of Nursing Informatics
• In 2008, ANA updated the Scope and
Standards of Nursing Informatics Practice.
ANA lists the goal of NI as: “The goal of NI is to
improve the health of populations,
communities, families, and individuals by
optimizing information management and
communication (p.1)”.

8. The Nurse as a Knowledge Worker
• It has been established that nurses use data and
information. This information is then converted to
knowledge. The nurse then acts upon this knowledge
by initiating a plan of care, updating an existing one
or maintaining status quo.
• Knowledge can be defined as “the distillation of
information that has been collected, classified,
organized, integrated, abstracted, and value added”
(HIMSS, 2006, p. 49).

9. The Nurse as a Knowledge Worker
• The term knowledge worker was first coined by Peter
Drucker in his 1959 book, Landmarks of Tomorrow
(Drucker, 1994).
• Knowledge work is defined as nonrepetitive,
nonroutine work that entails a significant amount of
cognitive activity (Sorrells-Jones & Weaver, 1999a).
• Drucker (1994) describes a knowledge worker as one
who has advanced formal education and is able to
apply theoretical and analytical knowledge.

10. The Knowledge Needs and
Competencies of Nurses
• The amount of information available is vast
and expanding exponentially, which makes the
healthcare industry the most knowledge-
intense environment (Snyder-Halpern,
Corcoran-Perry, & Narayan, 2001).
• Computers, technology, and the informatics
fields are assisting healthcare workers in
dealing with this information explosion.

11. Knowledge Needs
• Nurses rely on an extensive amount of clinical
information and specialized knowledge in order to
evaluate the processes they have implemented and
measure the corresponding outcomes (Snyder-Halpern,
Corcoran-Perry, & Narayan, 2001).
• Nurses rely on their own knowledge, but there are
times when this is not adequate and they must access
information in order to provide safe patient care. A
national survey was conducted and found that
consulting a peer was the most frequent way that
information was obtained.

12. Nursing Informatics Competencies
• One challenge that health care is currently
facing is the vast differences in computer
literacy and information management skills
that healthcare workers possess (McNeil,
Elfrink, Beyea, Pierce, & Bickford, 2006).
• Staggers, Gassert, & Curran (2001) believe
that nursing students and practicing nurses
should be educated on core NI competencies.

13. What Is Nursing Informatics
Specialty Practice?
• NI is an established and ever-evolving
profession that began when computers were
introduced into health care.
• Nursing Contributes to Healthcare Informatics
• Scopes and Standards: NI is important to
nursing and health care as it focuses on
representing nursing data, information, and
knowledge.

14. Nursing Informatics Roles
• The roles that the INS may engage in are
numerous. One position that nurses do quite
well in is the role of the project manager,
which is a result of their ability to manage
multiple complex situations at one time
(HIMSS Nursing Informatics Awareness Task
Force).

15. Specialty Education and Certification
• Nurses who choose to specialize in nursing informatics have
two certifications available to them.
• The first is through the American Nurses Credentialing
Center (ANCC). The ANCC exam is specific for the
informatics nurse. The applicant must be a licensed
registered nurse (RN) with at least 2 years of recent
experience and have a baccalaureate degree in nursing
(BS/BSN). The applicant must have completed 30 contact
hours of continuing education in informatics.
• The second certification exam is sponsored by HIMSS.
Candidates who successfully pass this exam will carry the
designation of certified professional in healthcare
information and management systems (CPHIMS).

16. Rewards of NI Practice
• The INS participates in informatics
organizations that allow INSs to network and
share experiences with each other. This allows
them to bring these new solutions back to
their respective organizations and improve
informatics issues.

17. Summary
• Nursing informatics is an emerging relatively nursing
specialty that combines nursing science, information
science, and computer science.
• Informatics practices support nurses to effectively and
safely care for their patients as the information that
they need is made more readily available.
• Nurses have been actively involved in this field since
computers were introduced to health care.
• With the advent of EHRs, it became apparent that
nursing needed to develop its own terminology and NI
has been instrumental in this process..