How Informatics Makes Nursing More Efficient

Impact of Nursing Informatics on Efficiency of Nursing and Improved Patient Outcomes
Although some critics charge that innovations in technology are having a negative effect on humankind, virtually none of them deny the positive effect of such innovations on the delivery and quality of medical and surgical services today. In fact, the introduction and uptake of so-called informatics closely parallels the Information Revolution itself, and most authorities today agree that computer-based applications are going to have an even greater positive impact in the future. This paper examines how informatics in general and nursing informatics in particular have affected the efficiency of nursing practice and improved patient outcomes in the process. A discussion concerning the role of nursing informatics is followed by a description of the historical evolution of the use of informatics in this area. In addition, a discussion concerning the need to more fully integrate nursing informatics with other nursing specialties and an analysis in support of this position are followed by a discussion concerning the future direction of the use of nursing informatics in this area. Finally, a summary of the research and key findings concerning the history, current applications and future directions for nursing informatics are presented in the conclusion.
Discussion of the role of informatics in nursing and impact on patient outcomes
The American Nurses Association (ANA) defines nursing informatics as “a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, and knowledge to support patients, nurses, and other providers in their decision-making in all roles and settings” (as cited in Forehand, 2013, p. 37). This broad-based definition underscores the utility of informatics in facilitating a wide range of nursing activities, including most especially those involving the administration of patient medical records and the management of scarce organizational resources. Indeed, there are few areas of practice in which informatics cannot improve nursing practice and clinical outcomes (Forehand, 2013). For instance, according to Bloch (2009), “Nursing informatics transcends all aspects of nursing practice, teaching, and research, including multiple aspects of health care policy” (p. 98). In reality, though, the introduction of nursing informatics is not a recent trend but rather dates back nearly a half century to the early 1970s as discussed further below.
History of the use of informatics in nursing
Introduced in 1971, the first commercial digital management information system developed specifically for use in health care setting was implemented at the El Camino Hospital in central California following close collaboration with its practitioners concerning what computer-based technological applications were needed to facilitate practice and improve patient outcomes (Thede, 2012). A nursing supervisor who was working at El Camino Hospital when it was first implemented describes the management information system as being “an inpatient-oriented, hospital-wide system” and suggests that the main factors that contributed to its early success and acceptance by health care practitioners were “its true integration, clinician workflow support, and ease of use” (as cited in Thebe, 2012, p. 7).
Other features that helped to facilitate the uptake of this newly implemented hospital-wide management information system included the use of conventional English words and phrases rather than computer codes which were commonly being used at the time, as well as the use of a light pen to help clinicians select on-screen resources and input patient data (Thebe, 2012). Indeed, these types of ease-of-use attributes have characterized the evolution of nursing informatics since that time, and these have combined to provide more efficient nursing care together with improved patient outcomes. Perhaps even more importantly, though, the system designers were also careful to collaborate with El Camino’s nursing staff concerning what features were regarded as most important to them. In this regard, Thebe points out that, “The collaborative culture and respect for the role of RNs was reflected in system design. MIS provided more functionality and better integration for nurses than we see in most systems today; requirements of the healthcare providers drove the technical innovations” (p. 4). The collaboration with the nursing staff at El Camino resulted in the identification of a number of features that remain fundamental to modern nursing informatics applications. For example, at the time, the nursing staff at El Camino was prescient in their visions of how these technologies could make them more efficient in ways that also contributed to improved clinical outcomes. In this regard, Thebe (2012) concludes that these nurses “envisioned such things as minimal time spent in documentation, working together with patients to document past history and care received, a lifetime healthcare record, and the use of aggregated data to improve nursing practice” (p. 4).
Select and discuss a current issue within that topic area related to the use of informatics
Although all of these eventualities have come to fruition in varying degrees in a wide array of health care settings, Thebe (2012) concedes that more needs to be done to promote the acceptance of nursing informatics by older practitioners who may lack the computer skills needed to use these systems or who lack an understanding concerning their purpose and utility in improving patient outcomes. These points are also made by Greenwood (2017) who emphasizes, “Integrating the work of the nurse informaticist with other nurses and various health care disciplines presents an ongoing challenge. Some older nurses and physicians, for example, may have limited computer skills and be reluctant to change their work habits” (para. 3).
While the reluctance to change longstanding work habits is certainly not limited to older nurses and physicians, of course, these empirical observations underscore the potentially significant differences in the skill sets and respective levels of expertise possessed by various generational cohorts. In fact, there are currently four generations (some authorities suggest there are even five) working together for the first time in American history (Bleedorn, 2013), and it is reasonable to suggest that each generational cohort has different views about informatics and how it can be used in health care settings to make their jobs more efficient and promote improved patient outcomes. Consequently, the future success of nursing informatics will depend in part on the ability of nurse informaticists to identify these types of constraints to acceptance in order to develop strategies that will increase the integration of these computer-based systems into all aspects of patient care and these issues are discussed further below.
Take a stand and defend that stand on the topic issue
Health care practitioners from the millennial generation (also known as generation Y) born since 1980 or so have a veritable lifetime of experience with computer-based technologies. Although practitioners from the baby boomer cohort who are nearing retirement age may also possess extensive experience with computer-based applications, they may be less amenable to learning the “next big thing,” especially if it means leaving their comfort zones and unlearning what has taken them decades to learn. Notwithstanding this constraint, however, nurse informaticists are well situated to educate all health care practitioners concerning the multidisciplinary benefits of informatics. Consequently, nurse informaticists must assume a leadership position in their health care organizations to promote the integration of informatics and provide the opportunities for education and training that will facilitate the process (Greenwood, 2017). In reality, this need is going to become even more pronounced for the foreseeable future as increasing numbers of health care organizations implement informatics and these issues are discussed further below.
Discuss the future direction of the use of informatics in the topic area.
Despite the challenges that are involved in increasing acceptance levels and use of nursing informatics today, a growing body of evidence confirms that the expanded use of these technologies is inexorable, and everyone better get used to the idea or get left behind in the dustbin of history. For instance, Forehand (2013) points out that, “There is a greater drive than ever before for healthcare institutions to adopt electronic health records including the passing of the American Recovery and Reinvestment Act which supports their use and provides financial incentives to adopt the required technology” (p. 7). A concomitant of this trend will be an even greater demand for nursing informaticists in order to help implement and administer these technologies to their best effect in ways that will make nursing practice more efficient and improve clinical outcomes (Forehand, 2013).
Conclusion
Fifty years ago when computers were still the size of warehouses, the tricorder diagnostic tool used by “Star Trek’s” Dr. McCoy seemed like just so much far-fetched science fiction, but these technologies are already being used in modern health care settings today. Looking ahead another 50 years, it is reasonable to posit that the state-of-the-art nursing informatics systems that are being lauded as the optimal solution to improving nursing efficiency and promoting improving patient outcomes at present will be regarded as the iron lungs of technology then, but even the iron lung save countless lives that would otherwise have been lost Similarly, it is vitally important for nurse informaticists today to fully integrate these technologies and help their organizations realize their full potential until the “next big thing” replaces them.

References
Bleedorn, G. (2013, January-February). Say hello to the Millennial generation: Millennials love to spend money and use mobile banking but winning their loyalty is not easy. ABA Bank Marketing, 45(1), 24-26.
Bloch, J. R. (2009, March/April). Essentials of nursing informatics. Nursing Education Perspectives, 28(2), 98.
Forehand, J. W. (2013, February). Consider a career in nursing informatics. American Nurse Today, 8(2), 7.
Greenwood, B. (2017). Problems with nursing informatics. Chron. Retrieved from http://work. chron.com/problems-nursing-informatics-27523.html.
Thede, L. (January 23, 2012). Informatics: Where is it? OJIN: The Online Journal of Issues in Nursing, 17(1), 3-5.