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  1. 1. Chapter 6 Nursing and Health Care Informatics
  2. 2. Objectives <ul><li>Upon completion of this chapter, the reader should be able to: </li></ul><ul><ul><li>List the components that define a nursing specialty and discuss how nursing informatics meets these requirements </li></ul></ul><ul><ul><li>Discuss educational opportunities for nurses interested in pursuing a career in nursing informatics </li></ul></ul><ul><ul><li>Describe current challenges for health information applications </li></ul></ul>
  3. 3. Objectives <ul><ul><li>Describe current challenges for health information technology applications </li></ul></ul><ul><ul><li>Discuss how ubiquitous computing and virtual reality have the potential to influence nursing education and practice </li></ul></ul><ul><ul><li>Used established criteria to evaluate the content of health-related sites found on the World Wide Web </li></ul></ul><ul><ul><li>Identify the role of informatics in evidence- based practice and patient safety </li></ul></ul>
  4. 4. Nursing Informatics <ul><li>Recognized specialty group who function to integrate nursing, its information, and information management with information processing and communication technology to support the health of people worldwide </li></ul><ul><li>The use of information technology by nurses carrying out their duties in relation to any function in the purview of nursing </li></ul>
  5. 5. Focus of Nursing Informatics <ul><li>Technology focused </li></ul><ul><li>Conceptually focused </li></ul><ul><li>Role oriented </li></ul>
  6. 6. E-health <ul><li>Multiple functions </li></ul><ul><ul><li>Health care and information delivered or enhanced through the Internet </li></ul></ul><ul><ul><li>Involves medical informatics, public health, and business </li></ul></ul><ul><ul><li>Commitment for networked, global thinking to improve health care locally, regionally, and worldwide </li></ul></ul>
  7. 7. Telehealth <ul><li>Delivery of health-related services and information via telecommunications technology </li></ul><ul><li>May be simple or complex </li></ul>
  8. 8. Elements of Nursing Informatics <ul><li>Computerized order entry </li></ul><ul><li>Electronic health record </li></ul><ul><li>Patient decision tools </li></ul><ul><li>Laboratory and x-ray results </li></ul><ul><li>Electronic prescribing and order entry including barcoding </li></ul><ul><li>Community and population health management and information </li></ul>
  9. 9. Elements of Nursing Informatics <ul><li>Communication, staffing, and administrative systems </li></ul><ul><li>Evidenced-based knowledge and information retrieval systems </li></ul><ul><li>Quality improvement data collection/data summary systems </li></ul><ul><li>Documentation and care planning </li></ul><ul><li>Patient monitoring and problem alerts </li></ul>
  10. 10. Implementation of Health Information Technologies <ul><li>Standards needed so all health care providers can share patient information which is timely, patient-centered, and portable </li></ul><ul><li>Office of the National Coordinator for Health Information Technology (ONC) established 2004 </li></ul><ul><li>The Joint Commission established National Patient Safety Goals </li></ul>
  11. 11. Recommended Changes <ul><li>Care based on continuous healing relationships </li></ul><ul><li>Customized care based on patient needs and values </li></ul><ul><li>The patient as the source of control </li></ul><ul><li>Shared knowledge and the free flow of information </li></ul><ul><li>Evidenced-based decision making </li></ul><ul><li>Safety as a system property </li></ul><ul><li>The need for transparency </li></ul><ul><li>Anticipation of needs </li></ul><ul><li>Continuous decrease in waste </li></ul>
  12. 12. Core Competencies <ul><li>Provide patient-centered care  </li></ul><ul><li>Work in interdisciplinary teams </li></ul><ul><li>Employ evidenced-based practice </li></ul><ul><li>Apply quality improvement </li></ul><ul><li>Utilize informatics </li></ul>
  13. 13. Specialty of Nursing Informatics <ul><li>Use decision-making systems or artificial intelligence to support the nursing process </li></ul><ul><li>Use software application to support health care organizations </li></ul><ul><li>Integrate IT into patient education </li></ul><ul><li>Use computer-aided learning for nursing education </li></ul><ul><li>Develop and use nursing databases </li></ul><ul><li>Use research related to nurses’ information management and communication </li></ul>
  14. 14. Clinical Information System <ul><li>A computer-based system </li></ul><ul><ul><li>Used to inform clinicians about tests, procedures, and treatment </li></ul></ul><ul><ul><li>Used to improve the quality of care through real-time assistance in decision making </li></ul></ul><ul><ul><li>Used to increase the efficiency and effectiveness of care delivery </li></ul></ul><ul><ul><li>Can be patient focused or department focused </li></ul></ul>
  15. 15. Computerized Patient Records <ul><li>Replacement for the paper record </li></ul><ul><li>Permits health information to be used to support the generation and communication of knowledge </li></ul><ul><li>Multiple functions and requirements </li></ul><ul><ul><li>Capture data </li></ul></ul><ul><ul><li>Store data </li></ul></ul><ul><ul><li>Process and retrieve data </li></ul></ul>
  16. 16. Information Communication <ul><li>Interoperability of systems and linkages for exchange of data across disparate systems </li></ul><ul><li>Must be secure </li></ul><ul><li>Security functions must be designed to ensure compliance with applicable laws, regulations, and standards </li></ul>
  17. 17. Security <ul><li>Privacy </li></ul><ul><ul><li>The right of individuals to keep information about themselves from being disclosed to anyone </li></ul></ul><ul><li>Confidentiality </li></ul><ul><ul><li>Limiting disclosure of private matters </li></ul></ul><ul><li>Security </li></ul><ul><ul><li>The means to control access and protect information from accidental or intentional disclosure to unauthorized persons </li></ul></ul>
  18. 18. Trends in Computing <ul><li>Computer literacy </li></ul><ul><ul><li>The knowledge and understanding of computers combined with the ability to use them effectively </li></ul></ul><ul><li>Information literacy </li></ul><ul><ul><li>The understanding of the architecture of information </li></ul></ul><ul><ul><li>The ability to navigate among print and electronic tools </li></ul></ul>
  19. 19. Virtual Reality <ul><li>Allows a person to see, move through, and react to computer-simulated items or environments </li></ul><ul><li>Has allowed surgeons to develop minimally invasive surgical techniques </li></ul><ul><li>PDA software has the potential to bring evidence-based care to the bedside </li></ul>
  20. 20. Using the Internet for Clinical Practice <ul><li>Information can be presented in different forms and different languages </li></ul><ul><li>Provides different organization structures for information storage and access to accommodate user’s preference and need </li></ul>
  21. 21. The P-F-A Assessment <ul><li>Purpose-Focus-Approach </li></ul><ul><li>Determine your purpose (why are you doing the search?) </li></ul><ul><li>Focus of the search may be: </li></ul><ul><ul><li>Broad or general </li></ul></ul><ul><ul><li>Lay oriented </li></ul></ul><ul><ul><li>Narrow and technical </li></ul></ul><ul><li>The purpose combined with the focus will determine the approach to the search </li></ul>
  22. 22. Strategies for Internet Searches <ul><li>Use Web sites published by governmental or professional organization </li></ul><ul><li>Use consumer health sites organized by medical librarians </li></ul><ul><li>Use precise terms </li></ul><ul><li>Draw on search engines </li></ul><ul><li>Refine your Internet searches with filters </li></ul>
  23. 23. Evaluating Internet Material <ul><li>Use critical-thinking skills </li></ul><ul><li>Evaluate with PLEASED </li></ul><ul><ul><li>Purpose </li></ul></ul><ul><ul><li>Links </li></ul></ul><ul><ul><li>Editorial </li></ul></ul><ul><ul><li>Author </li></ul></ul><ul><ul><li>Site navigation </li></ul></ul><ul><ul><li>Ethical Disclosure </li></ul></ul><ul><ul><li>Date last updated </li></ul></ul>