How Technology and Informatics Has Influenced Nursing Practice

Madeline Gervase RN,MSN,CCRN,FNP Advanced Practice Nurse

Objectives:
Identify the role of informatics in nursing. Identify the current uses of technology and how
technology will affect clinical practice. Understand the advantages and disadvantages of using technology. Demonstrate an understanding to the techniques and tools used to protect client confidentiality in practice.

Informatics
The science of
information

Skills nurses need related to informatics & technology

Use information & communication technology
to document & evaluate patient care, advance patient education, & enhance the accessibility of care Use appropriate technology to assess & monitor patients Work on an interdisciplinary team to make ethical decisions regarding the application of technologies & the acquisition of data

Nursing Skills:
Adapt the use of technologies to meet patient
needs Teach patients about health care technologies Protect the safety & privacy of patients in relation to the use of health care & information technologies Use information technologies to enhance ones own knowledge base

International Medical Informatics Association

Forty-one
recommendations for using informatics in health care delivery Identified 313 competencies for nurses with various levels of education & practice responsibilities

IMIA
www.imia.org

Two specialized areas for development: Informatics and healthcare delivery Specialists design software & create
integrated information systems for health care delivery

IMIA Nursing Evaluation Novice Nurse Competency:

Novice nurse: use of administrative
application, telecommunication devices, e-mail, database management program, client care devices, & the Internet while being able to find resources to address ethical decision making related to computing

Seasoned Nurse Competency:

Experienced nurse: same as the beginner
with the addition of ability to use diagnostic coding application, evaluate computerized assisted instruction programs, integrate selected resources into client record, & evaluate accuracy of health care information found on the Internet

IMIA Competencies for the Nursing Informatics Specialist

Graduate education Able to integrate established technologies
into clinical practice

IMIA Competencies for the Nursing Informatics Innovator

Doctorate Degree Designs and develops new technological
systems, techniques, & conceptual models for databases Evaluates safety, effectiveness, cost, & social impacts of technological systems Researches & develops theoretical foundations for the specialty

Components of an Integrated Delivery System (IMIA, 1999)

Hyperlinks to the latest information for client

care Nursing care planning programs Specific client teaching materials On-line clinical practice manuals with evidencebased nursing care protocols Data collection for best health care practices Client billing systems Health care insurance reimbursement programs

Informatics & Technology in Client Care

Handheld monitors (e.g., pulse oximetry & peripheral blood
glucose monitors) Wireless technology with automatic nurse paging capability when client measurements fall outside of normal parameters

Technology & Informatics in Client Care :

Computerized clinical decision-making

programs Nurse personal digital assistants Care-planning software programs Handheld clinical resource information devices Intravenous pumps for medication delivery

Informatics & Technology in Record Keeping

Financial reimbursement applications for
services rendered Nursing documentation systems: CERNER Integrated health record systems to denote past medical history & allergies Electronic health records

Informatics & Technology in Communication

Wireless telephone systems Wireless paging systems Alphanumeric paging systems Handheld computers to record & receive client information E-mail

Components of a Health Information System Currently Used by Health Care Institutions

Current uses of Informatics Applications in Healthcare:

Admission, discharge, & transfer Patient Access Record Financial parameters Physician order entry Ancillary department Documentation

Informatics Applications in Healthcare:

Scheduling Pharmacy preparation Acuity criteria Specialty practice Decision support Communication Critical pathways

The Nursing Informatics Specialist Responsibilities

Create systems to maximize the efficiency
of information use & computer technology for clinical practice Develop software programs to support nurses as they deliver client care Keep software management updated & educate staff on its use & changes

Education for the Nursing Informatics Specialist

Thorough understanding of clinical
practice Detailed computer expertise ANA certification in nursing informatics Graduate nursing education programs in nursing informatics are available

Role of the Nursing Informatics Specialist in Technological & Health Care Development
Contribute specialized nursing knowledge to
systems Develop software programs & computer systems that facilitate nursing care delivery Field test software programs Verify that systems (hardware & software) address critical nursing considerations

Technological Influences to Health Care

In the late 1950s & early 1960s,
businesses used computers for financial record management Medicare & Medicaid require data for governmental reimbursement for rendered services

Technology Influences:
In 1968, Lawrence Weed developed the
Weed Problem Oriented Medical Record Information System, the first computerized system for client care at the University of Vermont Medical Center

Technological Changes to Nursing & Health Care

LifeView Care Station for virtual house

calls Telehealth Genetic advances in health promotion, disease prevention, & illness treatment Stem cell research On-line educational options

Challenges of Managing HealthRelated Informatics & Technology

Confidentiality of client health

information Ethics related to new therapies Evaluating the quality of information Information security Potential health & personal problems from too much technology

Our Future:
Technological advances are advantageous
only if nurses find them useful & learn how to use them Nurses may tend to focus on machinery rather than persons in the future Information overload

The Future of Healthcare:

Keeping institutional & personal systems
updated Impact of being dependent on electrical or other sources of power to run equipment Optical technology or other invasive methods to confirm identity

Computer Networks

Local area network (LAN) Wide area network (WAN) Internet Service Provider (ISP) Group e-mail or list servers (Listserv) Electronic publishing (e-books & on-line journals)

Access Information Requirements:

Accurate typing skills & knowledge of an

exact website or e-mail address Internet server provider A website is a series of pages posted on the Internet Website addresses denote the type of server Professional chat rooms

Thank you!