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Nursing Informatics day 5 Nursing Informatics day 5.pptx
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- 2. Introduction to Standardized Terminologies •Accessibility: • Ubiquity: • Longevity: • Reusability:
- 3. Introduction to Standardized Terminologies •Accessibility: • Ubiquity: • Longevity: • Reusability:
- 4.
- 5.
- 6. Standardized Nursing Terminology isa nursing terminology that is in some way approved by an appropriate authority or by general consent
- 7. Enumerative Approach • words orphrases are represented in a list or a simple hierarchy
- 8. Ontological Approach • makesit well-suited to support the development of local terminologies.
- 9. Exploiting Commonality Among Nursing Terminologies •Scale • Scope • Structure • Intended use
- 10. Exploiting Commonality Among Nursing Terminologies •Scale • Scope • Structure • Intended use
- 11. Terminology or Ontology •describes how general entities are represented and how those representations relate to each other.
- 12. Thought Provoking Questions • Whatto you believe are the advantages and disadvantages of having a single shared consensus-driven model of terminology use? • How can a single agreed model of terminology use (with linkages to a single terminology) help to integrate knowledge into routine clinical practice?
- 13.
- 14. • derived fromthe French term informatique • which means to refer to the computer milieu What is Nursing Informatics?
- 15. • NI asa “combination of computer science, information science and nursing science Graves and Corcoran
- 16. • is basedon science, it is an applied science and not a basic science. • data, information, and knowledge are key components of NI practice. American Nurses Association (ANA)
- 17. • Data • Information •Knowledge • Core Sciences Foundation of NI Practice
- 18. • Healthcare beganto use computers in the 1950’s. • 1970’s, nursing began to realize the importance of computers History
- 19. • 1980’s, medicaland nursing informatics specialties emerged • 1995 saw the first certification exam for NI • 2000 explosion of both computer hardware and software. History
- 20. • 1990’s Telemedicine becamepossible and was recognized as specialty. • NI rapid growth in the last 40 years History
- 21. • nurses usedata and information • converted to knowledge. • initiating a plan of care Knowledge Worker
- 22. • the distillationof information that has been collected, classified, organized, integrated, abstracted, and value added Knowledge
- 23. • one thatworks especially at manual or industrial labor or with a particular material worker
- 24. • as onewho has advanced formal education and is able to apply theoretical and analytical knowledge. • must be a continuous learner and a specialist in a field. Knowledge Worker
- 25. • as onewho has advanced formal education and is able to apply theoretical and analytical knowledge. • must be a continuous learner and a specialist in a field. Knowledge Worker
- 26. • as onewho has advanced formal education and is able to apply theoretical and analytical knowledge. • must be a continuous learner and a specialist in a field. Knowledge Worker
- 27. • A well-functioningteam will consistently outperform an individual Knowledge Worker
- 28. • A well-functioningteam will consistently outperform an individual Knowledge Worker
- 29. • transition fromthe Industrial Age to the Information Age Knowledge Workers and Healthcare
- 30. • Nursing entailsa significant amount of knowledge and non- knowledge work. • Knowledge work would include such things as interpreting trends in labs and symptoms. • Non-knowledge work would include such items as calling the lab to check on lab results or making beds. Nurses as Knowledge Workers
- 31. • Nurses willtransition from knowledge users to knowledge builders Nurses as Knowledge Workers
- 32. • The information-userrole requires a system that can transform clinical data into a format that allows for easy recognition of patterns and trends. • The knowledge-user role is the least supported role and many systems are currently looking at ways to support the nurses in this role. Nurses as Knowledge Workers
- 33. • The knowledge-builderrole is typically seen in conjunction with the nurse researcher role and quality management roles. • The knowledge needs of nurses will continue to improve as the systems improve. Nurses as Knowledge Workers
- 34. • In orderfor nurses to be treated as a knowledge workers, nurses must first be recognized as knowledge workers Nursing Challenges
- 35. • Computers, technology, andthe informatics fields • Nurses deal with a vast amount of information and knowledge every day The Nurses Knowledge Needs
- 36. • Nurses relyon their own knowledge but there are times when this is not adequate and they must access information in order to provide safe patient care. The Nurses Knowledge Needs
- 37. • Decision supportsystems (DSSs) may be incorporated into the EHR. • One challenge, that healthcare is currently facing, is the vast differences in computer literacy and information management skills that healthcare workers possess The Nurses Knowledge Needs
- 38. • Staggers, Gassert,& Curran (2002) conducted a Delphi Study to validate the placement of the competencies into the correct skill level. • Of the 305 original competencies identified, 281 achieved an 80% approval rating for both importance as a competency and for placement in the correct practice level. The Nurses Knowledge Needs
- 39. • computers were introducedinto healthcare • Nursing has been involved in the purchase, design, and implementation of Information Systems Nursing Informatics Specialty Practice
- 40. • involved heavilyin the design of educational materials Nursing Informatics Specialty Practice
- 41. Computers have revolutionized • Patientsaccess information • Educational process Nursing Informatics Specialty Practice
- 42. • Nurses whoenter this field may have done so by accident because they were comfortable working with computers and their co-workers used them as a resource for computer related questions. • Assisting nurses to incorporate this new technology into their daily workflow is one of many challenges that the nurse informatics specialist (NIS) may tackle. Nursing Informatics Specialty Practice
- 43. The first twograduate NI programs • University of Maryland • University of Utah Nursing Informatics Specialty Practice
- 44. The first twograduate NI programs • University of Maryland • University of Utah Nursing Informatics Specialty Practice
- 45. The first twograduate NI programs • University of Maryland • University of Utah Nursing Informatics Specialty Practice
- 46. Thought Provoking Questions •Hospital C is looking to implement an EHR. It has been suggested that a NIS be hired. This position does not involve direct patient care and the administration is struggling with how to justify the position. How can this position be justified? • This chapter discusses the fact that nurses are knowledge workers. How does nursing move from measuring the tasks completed to measuring the final outcome of the patient?
Editor's Notes
- #3 Accessibility: It should be easy to access the information and knowledge needed to deliver care or manage a health service. Ubiquity: With changing models of healthcare delivery, information and knowledge should be available anywhere. Longevity: Information should be usable beyond the immediate clinical encounter. Reusability: Information should be useful for a range of purposes.
- #4 Without a standardized nursing terminology it would remain difficult to quantify nursing, the unique contribution and impact of nursing would go unrecognized and the nursing component of electronic health record systems would remain at best rudimentary. The current and future landscape of information and communication technologies and their inevitable infiltration into healthcare will only serve to reinforce the need for a standardized nursing terminology, while providing an additional sense of urgency.
- #5 A nursing terminology is a body of the terms used in nursing. There may be many nursing terminologies, formal or informal. Nursing terminologies allow us to capture, represent, access and communicate nursing data, information and knowledge.
- #6 A nursing terminology is a body of the terms used in nursing. There may be many nursing terminologies, formal or informal. Nursing terminologies allow us to capture, represent, access and communicate nursing data, information and knowledge. Nursing terminologies have evolved significantly over the past several decades in line with best practices in terminology work, from simple lists of words or phrases to large complex so-called ‘ontologies’.
- #7 A standardized nursing terminology is a nursing terminology that is in some way approved by an appropriate authority or by general consent. The data element sets provide a framework for the uniform collection and management of nursing data. The use of a standardized nursing terminology to represent that data serves to further enhance consistency.
- #8 With the enumerative approach, words or phrases are represented in a list or a simple hierarchy. In NANDA, a nursing diagnosis has an associated name or label and a textual definition (NANDA International, 2005). Each nursing diagnosis may have a set of defining characteristics and related or risk factors.
- #9 The ontological approach is compositional in nature and a partial representation of the entities within a domain and the relationships that hold between them. ICNP® is described as a ‘unified nursing language system’. The compositional nature of the ICNP® ontology makes it well-suited to support the development of local terminologies; the rich hierarchy (and the opportunity for automated reasoning) make it well-suited to support cross-mapping between terminologies.
- #10 There are many differences between the broader set of standardized nursing terminologies in terms of scale, scope, structure and intended use. At the heart of the standard are in fact two models – a model for nursing diagnosis and a model for nursing action.
- #11 As standardized nursing terminologies increase in complexity they become more difficult to implement; they may be computer-based but they are far from ‘plug and play’. Terminologies help us to convey our understanding of the world. Models of terminology use help us to structure information for particular purposes.
- #12 A terminology or ontology describes how general entities are represented and how those representations relate to each other. A model of terminology use seeks to organize data items in a way that fits with that context at that time. The nursing terminologies were standardized but not the models of terminology use – these were often embedded within applications and it would not be possible to share the valuable clinical and pragmatic knowledge they contained.
- #14 Nurses have historically gathered and interpreted data. Nurses are able to access information quickly and easily. Accessing the information via the internet or the electronic health record (EHR) allows the nurse to provide the best possible patient care. Nursing recognized early on that computers would change healthcare and became actively involved in shaping how computers were used in healthcare. The American Nurses Association (ANA) first recognized Nursing Informatics (NI) as a specialty in 1992 (Saba & McCormick, 2006; American Nurses Association [ANA], 2001).
- #15 The term informatics was derived from the French term informatique, which means to refer to the computer milieu (Saba, 2001).
- #16 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).
- #17 The ANA points out that even though NI is based on science, it is an applied science and not a basic science. Graves and Corcoran (1989) and the ANA (2001) both believe that data, information, and knowledge are key components of NI practice.
- #18 Data, information, knowledge, and the core sciences, when combined, represent the foundation of NI practice.
- #19 Healthcare began to use computers in the 1950’s. Computers, in this era, were typically used in the business office (Saba & McCormick, 2006). In the 1970’s, 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).
- #20 In the 1980’s, medical and nursing informatics specialties emerged. 1995 saw the first certification exam for NI (Saba & McCormick). The post-2000 era saw an unprecedented explosion in the number and sophistication of both computer hardware and software.
- #21 Telemedicine became possible and was recognized as a specialty in the late 1990’s (Saba & McCormick). NI has experienced rapid growth in the last 40 years which does not appear to be slowing.
- #22 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.
- #23 Knowledge can be defined as “the distillation of information that has been collected, classified, organized, integrated, abstracted, and value added” (HIMSS, 2006, p. 49).
- #24 A worker is “one that works especially at manual or industrial labor or with a particular material” (Merriam-Webster, 2007).
- #25 Drucker (1994) describes a knowledge worker as one who has advanced formal education and is able to apply theoretical and analytical knowledge. The knowledge worker must be a continuous learner and a specialist in a field.
- #26 Many industrial workers are finding it more and more difficult to obtain jobs as they do not have the educational base or mind set required of knowledge workers (Drucker). The technologist is no longer trained on the job as were the industrial workers which can cause significant problems for the industrial worker who does not have the education required to transition to a knowledge worker position (Drucker; Sorrels-Jones & Weaver, 1999a).
- #27 Knowledge workers are innovators and the work they produce is the foundation for organizational sustainability and growth. Knowledge workers are most efficient when they are working in a multi-disciplinary team. Leadership will shift and change as the team tackles different parts of the project, with the topic expert taking the lead.
- #28 A well-functioning team will consistently outperform an individual (Sorrells-Jones & Weaver, 1999b). A key impediment to an effective team is a lack of understanding between team members as well as a lack of respect for each other’s knowledge and experience (Sorrells-Jones & Weaver, 1999a).
- #29 Companies that employ knowledge workers have had to change their management structure to support the knowledge workers. Loyalty is no longer purchased with a paycheck but is earned by giving the knowledge workers the ability to use their knowledge effectively and innovatively (Drucker, 1992).
- #30 Management needs to understand and support the knowledge work and non-knowledge work that is performed daily in healthcare. Organizations must switch from measuring the number of tasks completed to measuring the outcomes obtained by knowledge workers (Sorrells-Jones & Weaver, 1999b).
- #31 Nursing entails a significant amount of knowledge and non-knowledge work. Knowledge work would include such things as interpreting trends in labs and symptoms. Non-knowledge work would include such items as calling the lab to check on lab results or making beds.
- #32 Nurses will transition from knowledge users to knowledge builders when they examine clinical data and trends across groups of patients. The data gatherer requires a system that will capture and store data accurately and reliably and allow the data to be readily accessed.
- #33 The information-user role requires a system that can transform clinical data into a format that allows for easy recognition of patterns and trends. The knowledge-user role is the least supported role and many systems are currently looking at ways to support the nurses in this role.
- #34 The knowledge-builder role is typically seen in conjunction with the nurse researcher role and quality management roles. The knowledge needs of nurses will continue to improve as the systems improve.
- #35 In order for nurses to be treated as a knowledge workers, nurses must first be recognized as knowledge workers (Snyder-Halpern, et al., 2001). Nursing still has a long way to go before being accepted as an equal participant in the interdisciplinary knowledge team.
- #36 Computers, technology, and the informatics fields are assisting healthcare workers in dealing with this information explosion. Nurses deal with a vast amount of information and knowledge every day which they use to care for their patients.
- #37 Computers, technology, and the informatics fields are assisting healthcare workers in dealing with this information explosion. Nurses deal with a vast amount of information and knowledge every day which they use to care for their patients. 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.
- #38 Decision support systems (DSSs) may be incorporated into the EHR. One challenge, that healthcare is currently facing, is the vast differences in computer literacy and information management skills that healthcare workers possess (McNeil, Elfrink, Beyea, Pierce, & Bickford, 2006).
- #40 NI is an established and ever evolving profession which began when computers were introduced into healthcare (Belanger, 2006). Nursing has been involved in the purchase, design, and implementation of Information Systems (IS) since the 1970’s (Saba & McCormick, 2006).
- #41 Nursing is involved heavily in the design of educational materials for practicing nurses, student nurses, other healthcare workers, and patients. Computers have revolutionized the way patients access information as well as revolutionized the educational process (Saba).
- #42 Computers have revolutionized the way patients access information as well as revolutionized the educational process (Saba).
- #43 Nurses who enter this field may have done so by accident because they were comfortable working with computers and their co-workers used them as a resource for computer related questions. Assisting nurses to incorporate this new technology into their daily workflow is one of many challenges that the nurse informatics specialist (NIS) may tackle.
- #44 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). 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 (Duke University School of Nursing, 2007).
- #45 Local colleges and universities should be researched to see which may have added informatics programs. NI is a nursing specialty that does not focus on direct patient care but instead focuses on how to improve patient care and safety as well as improving the workflow and work processes of nurses and other healthcare workers utilizing technology.
- #46 Continuing education allows the NIS to improve a process or workflow within the hospital or to change the way a system upgrade is rolled out.