LICEO DE CAGAYAN UNIVERSITY

BACHELOR OF SCIENCE IN NURSING

LEVEL 3

NURSING INFORMATICS
LECTURE
Midterm A.Y. 2023 - 2024
Clinical Instructor: Ma. Dolores Mercado
Transcribe by: MECTL8~ Term: 1ST SEMESTER

INFORMATICS APPLICATION
Trans Guide

MAIN TOPIC Goals Of Nursing Informatics

SUBTOPIC
• Improve the health of populations, communities, families, and
Additional Information/ Subtopic
individuals by optimizing information management and
Subtopic 2
communication
o Using technology in the direct provision of care
o Establishing administrative systems
TOPIC OUTLINE o Managing and delivering educational experiences
INFORMATICS APPLICATIONS IN EVIDENCE- BASED PRACTICE o Supporting life-long learning
Historical Perspective o Supporting nursing research
Evolution of Nursing Informatics
Essential elements of Nursing Informatics Key Tenets of Contemporary Nursing Informatics
Goals of Nursing Informatics
• Clinical and non-clinical aspects of practice
Key Tenets of Contemporary Nursing Informatics • Importance of human factors (human computer interaction,
General field of health informatics ergonomics and usability) in decision-making
Nursing health informatics • Focus on delivering the right information to the right person at the
Standards for practice right time.
• Concerns about and commitment to ensuring the confidentiality
Informatic competencies
and security of health care data and information and advocating
COMPUTER GENERATED NURSING CARE PLAN privacy.
E - journals • The central emphasis on the improvement of the quality of patient
Critical pathways care, welfare of the health care consumer, and patient outcomes
Care pathway • Importance of collaboration with other areas within healthcare
informatics
Clinical practice guidelines
Protocol General field of health informatics

• Identifying information to collect and process

INFORMATIC APPLICATIONS IN EVIDENCE- BASED PRACTICE
Historical perspective
• Florence Nightingale spoke about the clinical importance of
nursing informatics in patient care
• “Decision making must be based upon the use of accurate data”
(Ulrich,1992)
• She also spoke of difficulties of extracting such critical patient-
related data from hospital records
• “In attempting to arrive at the truth, I have applied everywhere for
information, but in scarcely an instance have I been able to obtain
hospital records for any purposes of comparison. If they could be
obtained they would enable us to decide many other questions
besides the ones alluded to.” (Nightingale, 1859)
• Creating databases
• Developing user-friendly data entry and retrieval screens
• Educating users to work with and maximize available information
resources
• Installing and maintaining hospital information systems
• Developing distance education and telehealth systems for
information exchange
Nursing Health Informatics
• Bringing specific values and beliefs
• Bringing a specific practice base that produces unique knowledge
• Focusing attention on specific phenomenon
• Providing a unique language and word context

Evolution of NI definition Standards For Practice

1992 a specialty that integrates nursing science, computer • Definition of nursing informatics
science, and information science in identifying • Role that information plays in the nursing practice
collecting, processing, and managing data and o Develop skills in managing and communicating
information to support nursing practice, administration, information.
education, and research • Differentiate the nurse who are not nursing informatics specialist
1994 Supports the practice of nursing specialties in all sites from those who are:
and settings whether at the basic or advance levels. o Not NI: information system, structure, applications &
The practice includes the development of applications, presentation of information
tools, processes and structure that assist nurses with o NI : optimize structures, applications and technology for
management of data in taking care of patients or in use in patient care setting
supporting their practice of nursing.
2001 Is a specialty that integrates nursing science, computer The Foci of Nursing VS Nursing Informatics – Metastructures, concepts & tools
science, and information science to manage and
communicate data, information, and knowledge in
nursing practice.
Nursing Facilitates the integration of data, information, and
Informatica knowledge to support patients, nurses, and other
providers in their decision making in all roles and
settings.

Essential Elements of Nursing Informatics: Dynamic interactions

Page 1 of 5
 LICEO DE CAGAYAN UNIVERSITY
BACHELOR OF SCIENCE IN NURSING
LEVEL 3

NURSING INFORMATICS
LECTURE
Midterm A.Y. 2023 - 2024
Clinical Instructor: Ma. Dolores Mercado
Transcribe by: MECTL8~ Term: 1ST SEMESTER

Informatics Competencies Nursing Care Plan Checklist

Computer literacy skills o Basic computer skills :

o Use of word processor;
o Access a database
o Create spreadsheet;
o Communicate with e-mail;
Interact with clinical
documentation
General informatics o Identifying, collecting and
competencies recording data relevant to nursing
care of patients
o Analyzing and interpreting patient
and nursing Information
o Using applications of informatics
as an integral part of the nursing
process
o Implementing institutional and
public policies regarding privacy,
confidentiality and security of
information
Staggers, Curran & • The nurse should be able to see
Gassert (2001): relationships among data
elements, make judgments based
on trends and patterns with the
data, use current informatics
solutions, and also collaborate
with the informatics nurse
specialist.

Kerfoot (2000): • Not only knowing about specific E- Journals

functioning of technology, but
also the interrelatedness between
the technology people, and
system that interact with this
technology and how this
translates into outcomes.
COMPUTER GENERATED NURSING CARE PLAN
• Using data, information and knowledge; collecting data;
• An electronic journal is a periodical publication which is published
in electronic format, usually on the Internet.
Electronic Journals Advantages Over Traditional Printed Journals
1. You can search the contents pages and/or the full text of
journals to find articles on a certain subject.
2. You can read journal articles on your desktop, you don't have
to be in the Library.
3. You can e-mail articles to yourself or download them for
printing.
4. The article that you want to read will always be available, even
when the Library is closed.
5. Hypertext links allow you to move to different sections within
individual journals or articles and can link you to related
resources on the Internet.
6. Journals can include more images and audio-visual material.
7. Journals can be interactive - you can e-mail the author or
editor with your comments.

• Some journals are only available in electronic format and although

some of these journals are of a high "academic" quality,
• Be aware that not all of the journals have gone through the same
process of academic peer review as traditional print journals.

The Philippine E- Journals

• is an expanding online collection of academic publications of
different higher educational institutions and professional
organizations.
• its sophisticated database allows users to easily locate abstracts,
full journal articles, and links to related research materials.
• Promotes research done by Filipino scholars
• Improves online visibility and readership of the local academic
journals in the worldwide research community

• Offers electronic publishing as an alternative, cost- efficient

method of supporting and promoting academic publications

Page 2 of 5

NURSING INFORMATICS
LECTURE
Clinical Instructor: Ma. Dolores Mercado
Transcribe by: MECTL8~
Critical pathways Care Pathway
• Healthcare • Is a
management multidisciplinary
plans that specify • Healthcare
patient goals and management tool
the sequence and • Based on
timing of actions healthcare plans
necessary to for a specific
achieve these group of patients
goals with optimal • With a predictable
efficiency. clinical course
• Care plans that • Different tasks or
detail the essential interventions by
steps in patient the professionals
care with a view involved in the
to describing the patient care
• Expected progress
of the patient.
• The use of critical • Aim is to enhance
• Pathways reduces the quality of care
the cost of care across the
and the length of continuum
patient By improving:
• Stay in hospital. o Risk-adjusted
patient
o Outcomes,
o Promoting
patient safety,
o Increasing
patient
satisfaction,
o Optimizing the
use of
resources
Care Pathway Versus Care Plan
Care Pathway
• represents the ideal way
to manage a patient
population with a specific
• problem or long-term
condition.
• provides
recommendations which
should be included a care
plan.
LICEO DE CAGAYAN UNIVERSITY
BACHELOR OF SCIENCE IN NURSING
LEVEL 3
Midterm A.Y. 2023 - 2024
Term: 1ST SEMESTER
Clinical practice
guidelines Critical Pathways
• Statements that
• Include
recommendations inte
nded to optimize
patient care.
• Informed by a
systematic review of
evidence, and an
• assessment of the
benefits and harms of
alternative care
• options.
• “systematically
developed statements
to assist practitioner
decisions about
appropriate health
• care for specific
clinical
• circumstances.”
• Reduce inappropriate
variations in practice
and
• Promote the delivery
of high quality,
evidence-based
health
• care.
Clinical Practice Guidelines
• Developed by multi- • Reflect broad statements of best practice with little operational
disciplinary detail.
subcommittees using
an evidence-based
approach, combining
the best research
• available with expert
consensus on best
practice.
Care plan
• For an individual.
• Care pathway
enacted within a
care plan
Protocol
• Offer information that is adapted to local contexts
• Reflects the agreed- upon approach for a specific practice.
Page 3 of 5
 LICEO DE CAGAYAN UNIVERSITY
BACHELOR OF SCIENCE IN NURSING
LEVEL 3
NURSING INFORMATICS
LECTURE
Clinical Instructor: Ma. Dolores Mercado
Transcribe by: MECTL8~
ELECTRONIC HEALTH RECORDS AND NMDS
Improved Population Health
TOPIC OUTLINE
ELECTRONIC HEALTH RECORD SYSTEM
Electronic Health records
Goals of EHR
DEPENDABLE SYSTEM FOR QUALITY CARE
Attributes and Guidelines of Dependable system
8 Administrative Safeguards: Important Operational
Practices
Physical Safeguard
NURSING MINIMUM DATA SET SYSTEM
Benefits of the NMDS
i-NMDS purposes
ELECTRONIC HEALTH RECORD SYSTEM
Electronic Health records
• Often used interchangeably with computerized patient record,
clinical information system, electronic medical record, and many
others
• Reflects the broader focus on the health of the consumer or
patient
• Used by all participants in the process of achieving health,
including all disciplines of clinicians, family caregivers and the
patient
HER-s by IOM • The set of component that form the
(Dick, Steen, & mechanism by which the patient record
Detmer, 1991) are created, used, stored, and retrieved.
• A patient record system is usually located
within a healthcare provider setting.
• It includes people, data, rules and
procedures, processing and storage
devices (e.g. paper and pen, hardware
and software) support facilities
HER-s 2003 • Longitudinal collection of electronic health
information for and about persons, where
health information is defined as
information pertaining to the health of an
individual or healthcare provided to an
individual
• Immediate electronic access to person-
and population level information by
authorized, and only authorized, users
• Provision of knowledge and decision
support that enhances the quality, safety,
and efficiency of patient care
• Support of efficient processes for
healthcare delivery
Goals of EHR- s
Inform Clinical Practice
• Informing clinical practice is fundamental to improving care and
making health care delivery more efficient
• This goal centers largely around efforts to bring EHRs directly into
clinical practice
• This will reduce medical errors and duplicate works, and enable
clinicians to focus their efforts more directly on improved patient
care
Interconnecting Clinicians
• Will allow information to be portable and to move with consumers
from one point of care to another
• Will require an interoperable infrastructure to help clinicians get
access to critical healthcare information when their clinical and/or
treatment decisions are being made
Personalized Care
• Consumer-centric information helps individual manage their own
wellness and assists with their personal healthcare decisions
• The ability to personalized care is a critical component of using
healthcare information in a meaningful manner
Midterm A.Y. 2023 - 2024
Term: 1ST SEMESTER
• Population health improvement requires the collection of timely,
accurate, and detailed clinical information to allow for the
evaluation of health care delivery and reporting of critical findings
to public officials, clinical trials, and other research and feedback
to clinicians
DEPENDABLE SYSTEM FOR QUALITY CARE
• Dramatic transformation ---- from inefficient, costly, manually
intensive, crisis-driven model of care delivery to ---- more efficient,
consumer-centric, science-based model that proactively focus on
health management
• Driven by ---- skyrocketing cost of healthcare; exposure of patient
safety problems, aging population --- IT
• ICN Code of ethics for nurses affirms that the nurses “holds in
confidence personal information” and “ensures that use of
technology...(is) compatible with safety, dignity, and rights of
people”
• Fulfilling these ethical obligations is the individual responsibility of
the nurse, who has the ability and authority to ensure that ---
personal information is protected and technology is safe
Dependability
• Is a measure of the extent in which a system can justifiably be relied
in to deliver the services expected from it
Attributes of Dependability
System Reliability consistently behaves in the same way
Service Availability requires services are present and usable when
they are needed
Confidentiality sensitive information is disclosed only to those
authorized to see it
Data Integrity data are not corrupted or destroyed
Responsiveness the system responds to user input within an
expected and acceptable time period
Safety the system does not cause harm
Guidelines for Dependable System
Architect for An enterprise system should be developed from
dependability the bottom up so that no critical component is
dependent on a component less trustworthy than
itself.
Anticipate failures Features that are transparent to software
applications should be implemented to detect
faults, to fail over to redundant components when
faults are detected and to recover from failures
before they become catastrophic
Anticipate success Should anticipate business success – and the
consequential need for larger networks, more
systems, new applications and additional
integration
Hire meticulous Individuals who knows that failures will occur and
managers accept that failures are most likely to occur when
they are less expected
Don’t be One should use only proven methods, tools,
adventurous technologies, and products that have been in
production, under conditions, and at a scale
similar to the intended environment
8 Administrative Safeguards: Important Operational Practices
1. Security management, including security analysis and risk
management
2. Assigned security responsibility
3. Information access management, including isolation of
clearinghouse functions from other clinical functions
4. Security awareness and training
5. Security incident procedures, including response and
reporting
6. Contingency planning, including data back- up planning,
disaster recovery planning, and planning for emergency
mode operations
7. Evaluation
8. Business associate contracts that lock in the obligations of
business partners in protecting health information to which
they may have access
Page 4 of 5
 LICEO DE CAGAYAN UNIVERSITY
BACHELOR OF SCIENCE IN NURSING
LEVEL 3

NURSING INFORMATICS
LECTURE
Midterm A.Y. 2023 - 2024
Clinical Instructor: Ma. Dolores Mercado
Transcribe by: MECTL8~ Term: 1ST SEMESTER

Physical Safeguard

• Access control, including unique user identification and an

emergency access procedure
• Audit control
• Data integrity protection
• Person or entity authentication
• Transmission security

NURSING MINIMUM DATA SET SYSTEM

• A standardize approach that facilitates the abstraction of these

minimum, common, essential core data elements to describe
nursing practice from both paper and electronic records
• Intended for use in all settings where nurse provides care

NMDS Data Element

Nursing Care element

• Nursing diagnosis
• Nursing intervention
• Nursing outcome
• Intensity if nursing care

Patient or client demographic elements

• Personal identification
• Date of birth
• Sex
• Race and ethnicity
• Residence

Service Elements
• Unique facility or service agency number
• Unique health record number or patient or client
• Episode admission or encounter date
• Discharge or termination date
• Disposition of patient or client
• Expected payer for most of this bill

Benefits of the NMDs

1. Access to comparable, minimum nursing care and resource data

on local, regional, national and international level
2. Enhanced documentation of nursing care provided
3. Identification of trends related to patient or client problems and
nursing care provided
4. Impetus to improved costing of nursing services
5. Impetus to further development and refinement of NISs
6. Comparative research on nursing care, including research on
nursing diagnoses, nursing interventions, nursing outcomes, intensity
of nursing care and referral for further nursing services
7. Contribution toward advancing nursing as a research-based
discipline

i-NMDS
• Internationally relevant, essential, minimum data elements to be
collected in the course of providing nursing care
• These information can be utilize to describe , compare, and
examine nursing practice around the globe
• Composed of (1) representative of the National Nurses Association
(ICN) (2) International Medical Informatics Association Nursing
Informatics Special Interest groups (3) Informatics experts

i-NMDS Purposes

1. Describing the human phenomena, nursing interventions, care

outcomes, and resource consumption related to nursing services
2. Improving the performance of health care systems and the nurses
working within these systems worldwide
3. Enhancing the capacity of nursing and midwifery services
4. Addressing the nursing shortage, inadequate working conditions,
poor distribution and inappropriate utilization of nursing personnel,
and the challenges as well as opportunities of global technological
innovations
5. Testing evidence-based practice improvement
6. Empowering the public internationally

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