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Transcript of Nursing Informatics
What is nursing informatics?
Derived from the french term "informatique"
"A specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, knowledge, and wisdom in nursing practice. It supports consumers, patients, nurses, and other providers in their decision making in all roles and settings" (ANA, P1)
Many still wonder if informatics is even important for care or if it is getting in the way of it.
Ethics in Informatics
Ethics is a process of examining different viewpoints related to moral questions or right or wrong
Bioethics is defined as the study of healthcare ethics
Ethical dilemmas occur when moral issues raise questions that cannot be answered with a clearly defined rule or fact
Informatics theory and practice is growing at a rapid rate
Informatics practitioners are bridging continents and international organizations and committees are beginning to establish rules and standards for the implantation of informatics
What is HITECH ACT?
The Health Information Technology for Economic and Clinical Health Act
It was signed in 2009 by President Obama as part of the (ARRA) American Recovery and Reinvestment Act
It was created to encourage the adoption of the electronic health record (EHR) in the U.S
Advantages of Informatics
Nursing Informatics (Electronic health records) supports patients, nurses, and providers in the decision-making process and in the setting. It can reduce healthcare costs, improves quality of care and patient outcomes
4 most common benefits of nursing informatics
1) Increased delivery of guideline-based care
2) Enhanced capacity to perform monitoring for disease conditions
3) Reduction in medication errors
4) Decreased use of care
The Future of Nursing Informatics
In many counties, not just the U.S, much of the most recent focus of technology use in nursing and health care has been aimed at improving patient safety (ex: reducing medication errors).
The report of Feb 2007 Technology Informatics Guiding Education Reform (TIGER) Initiative summit, defined a 3 year action plan toward achieving a 10-year vision to enable practicing nurses and nursing students to engage fully in the unfolding digital era of health care, thereby enabling nurses to use information technology (IT) seamlessly to provide safe, higher quality patient care.
One study showed that the use of informatics have helped manage chronic illnesses by:
1) Guideline adherence
2) Less frequent doctor and ER visits
3) Helped provider documentation
4) Patients followed treatment plans better
5) For screening and tests
Other simple benefits include:
Not having to interpret poor handwriting
Not having to interpret written orders or prescriptions
Reduced turnaround time for lab results in the ER
Decreased time in administering first dose antibiotics in inpatient settings
Overall the biggest advantage of EHR is the significant reduction in medication errors because of barcode scanning alerts. There has been a $3 million decrease in medical record expenses due to going paperless, and a 5% reduction of duplicate lab orders by using computerized provider order entry alerts.
Patients have also benefited from the EHR. There has been a 13% decrease in adverse drug reactions because of computerized physician order entry. Also, there was a decrease from 9.8 per 10,000 discharged to 6.4 per 10,000 discharges in MRSA nonsocomial infections; This was due to EHR flagging. It is a function that makes physicians immediately aware of MRSA positive patients and flags for contact precautions.
Patients benefit too!
What is the goal of informatics?
"To improve the health of populations, communities, families, and individuals by optimizing information management and communication. This includes the use of information and technology in the direct provision of care, in establishing effective administration system, in managing and delivering educational experiences, in supporting lifelong learning, and in supporting nursing research."
How does informatics impact nursing?
Nurses spend 25-50% of their time managing, recording, and seeking information to aid in their practice and care.
BP, blood glucose, and other assessment findings.
Collective data to derive info:
using S/S to determine an impending problem.
lowering the HOB, suctioning a patient etc.
Clinical information systems (CIS)- like electronic documentations and decision support applications
Nurse can contribute to the advancement of knowledge and care
Capture nurses' own personal knowledge
Environment and social factors
Negatives of CIS
Less amount of time with patients
Increase in time needed to complete computer-related tasks
Insufficient computer literacy
Positives of CIS
Increase in patient safety
Facilitate interdisciplinary collaboration
Independent decision making
When informatics dilemmas are ethically examined, this international perspective, such as diverse political, social, and human factors, must be taking into consideration
Bioinformatics can gather, classify, manipulate, analyze, synthesize, retrieve, and maintain databases
These databases are related to different ethical cases, the reasoning applied to various ethical dilemmas, and the resulting ethical decision made in the dilemma
In the case of an ethical dilemma, clinicians would not only access these databases, but must also assess the patient's specific situation and needs, and make their ethical decision based on all the data and information they have at hand
To make ethical decisions about informatics technologies and patients healthcare information, one must be informatics competent
Healthcare professionals must be trained in the use of these tools
The ethical model for ethical decision making gives us the ability to analyze the dilemma and synthesize the information into a plan of actions
Each letter guides and encourages one to think critically through the situation presented
The HITECH Act & the HIPPA privacy/Security rules are intended to enhance the rights of individuals
These laws provide patients with greater access and control over their PHI.
They can control its uses, dissemination, & disclosures.
Covered entities must establish a required level of security for PHI
Over the next few years, international efforts will accelerate, enhancing international data exchange.
Purposes of HITECH ACT
Helps to improve healthcare quality by preventing medical errors & advancing the delivery of patient centered care
Reduces the costs of healthcare by addressing inefficiencies, such as duplications of services
Improves people's health by promoting prevention, early detection, & management of chronic diseases
Protects public health by fostering early detection & rapid response to infectious diseases, bio terrorism, & other situations.
HIPPA & HITECH
HITECH recognizes that due to the initiative taken up by ARRA there will be a substantial expansion in the number of healthcare facilities endorsing EHR. Based upon this consideration, HITECH stresses upon the privacy rulings of Patient Health Information (PHI)
It is known that new healthcare technologies will develop, most likely in genomic and nanotechnologic sciences, and they will lead to huge new volumes of data, with implications for what is captured and stored, for how long, and how it is used.
It is also known that computing power and storage capabilities will lead to faster, smaller, more mobile and more powerful devices with vastly greater capacities for storing data.
One can already see the integration of more functions into today's cell phones and newer, more portable tablet-sized devices such as the ipad, and this trend is likely to continue.
Both of these trends make the information processing power available to nurses more mobile, enabling nurses to spend more time with patients and delivering care in wide range of settings.
Another emerging medium is
, which is a model of online storage where data is held on, and possible distributed across, several virtual servers, rather than being hosted on dedicated servers.
This has many implications that are only beginning to be explored, especially in terms of legal and ethical issues if, for example, health data is stored on servers that may be located outside of the jurisdiction of the country where the hospital or other health facility is physically located.
They are also researching whether "apps" running on smart phones and other mobile devices will mean the decline of web-based internet use.
Finally, wearable computing may have more to offer in terms of capturing data from patients, there are many emerging tools that may mean the nurse will not be restricted to holding and handling physical devices, but may interact, through voice and other commands, with computing devices carried elseswhere on their persons.