Nursing Informatics Present and Future Trends Research Paper
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Nursing Informatics Field
Definition of informatics nurses
Example of nursing informatics in practice (software applications)
Nursing shortage and its impact
Need for automated processes over manual processes
Need for increased patient safety in terms of medication, care and records
Need for data security and compliance with HIPPA rules
Need for increased healthcare coordination between nurses and others
Phases of Nursing Informatics Implementation
Design and Analysis Phases
a) Request for Proposal (RFP) process
b) Need for collaboration with other stakeholders
Final implementation Phase
Importance of nursing informatics
Benefits of nursing informatics
Impact to information management
Increased nursing satisfaction
Continued evolution of the field
Future direction and precaution for organizations
End benefit to patients
Current Trends and the Future of Nursing Informatics
Nursing informatics is a specialized area of healthcare information technology (HIT) that involves the design, testing, implementation and training associated with technical solutions that support nursing practice (Kumar & Aldrich, 2010). This may include nursing work being carried out in hospitals, geriatric or pediatric centers, public health clinics and other medical settings. Nursing informatics most commonly involves specific computer applications that aid nurses in collecting and analyzing patient data. Software applications in nursing often allow for real time data transfers for doctors and other healthcare practitioners. The end result is greater speed, efficiency and improved overall care for patients.
Nursing informatics was first recognized as a specialty by the American Nursing Association in 1992 (Sensmeier, 2011). Informatics nurses are expert clinicians who have a great understanding of patient care delivery, workflows and implementation of the nursing process. In particular, they have additional education and experience in technology and information systems, making them excellent project managers.
Nursing informatics as a field impacts professional practice by helping nurses communicate and coordinate care with all other clinical disciplines. It enables nurses to better coordinate discharge planning, education and training and primary care transitions. When technology is successfully incorporated into professional nursing practice, patient care delivery is enhanced. This paper discusses nursing informatics as a unique field within the nursing profession and also defines it as a systematic approach to using technology to improve healthcare outcomes. It concludes with a summary of the benefits and future promise of nursing informatics.
There are a number of events that have sparked new trends and increased investment in nursing informatics in recent years. For starters, there is a nursing shortage taking place in America (Mayer, 2009). In the early to mid-20th century, many women who worked professionally were teachers or nurses. Today, there is a wider array of professional career options for women. In addition, working in nursing environments is often viewed as demanding and difficult. These factors, along with an aging nursing workforce, have created a steady dip in nurse numbers. Technology has been helpful in terms of offsetting the work that used to require many nurses. The expertise of one nurse or a few nurses can be shared work across a healthcare network in a more efficient and streamlined way through technology.
Another reason for a more intense focus on nursing informatics is the modern day concern for patient safety (Sensmeier, 2011). HIT solutions eliminate the need for peel-and-stick labels, faxes, handwritten documentation and manual processes. Records are kept more accurately and can be archived for longer periods of time. Automated healthcare processes ultimately help improve workflows. Huge paper trails are condensed into electronic form making a patient's entire medical history digitally available to all who need it. The records can then be easily retrieved by others, enabling patients to navigate through healthcare and pharmaceutical systems in a safer and more effective manner. Nursing informatics allows for the quick and seamless creation of patient-centered care plans. Improved care coordination within and across medical settings means better service for patients, especially those facing chronic and acute conditions (Childs, Alexander & Duong, 2012). This helps prevent adverse events such as readmissions.
Finally, nursing informatics is critical to success in healthcare because it offers a higher level of standardization, security and improved privacy for patient information (Mayer, 2009). It allows differentiation among staff, giving select personnel access to confidential information. Systems can be set up to fully comply not only with Health Insurance Portability and Accountability Act (HIPPA) which applies to
both paper and electronic patient files, but also to HIPAA Security Rules, which apply to electronic patient files only. This ensures that the confidentiality, security and integrity of records are safeguarded properly (Kumar & Aldrich, 2010).
Phases of Implementation
Currently, nursing informatics implementation in healthcare settings follows specific phases. Most projects begin with design and analysis. Head nurses or nursing informatics analysts thoroughly consider ways to improve current workflows, processes, and fill service delivery gaps (Thacker, 2010). Beyond the immediate work of the nurses, consideration must also be given to needs of different departments or members of the facility. A gap analysis helps nurses determine the full scope of what technical solutions would work best and have a positive impact on the organization and patients (Lynn, 2011). It is the difference between where the organization is at the moment and where it hopes to be in the future.
An example of design and analysis in nursing informatics would be a solution to support nurses working in a large geriatric center. If the center wishes to roll out a new application for all nurses, there would first need to be as series of meetings to uncover needs, determine unique requirements, and develop a request for a proposal (RFP) for vendors to respond to with solutions and demonstrations (Thacker, 2010). From there, all participants would discuss ways that some of the options they have been presented with would serve the center. Because there are so many healthcare technology providers in the marketplace with varying capabilities and support packages, a chief nurse or nursing informatics analyst would guide the design and analysis phase and work with others throughout the center to make a final vendor selection.
It is worth noting that allowing all departments to have a voice in RFP design makes them full partners in redesigning health care necessities. This increases the likelihood that everyone in the organization will adopt the new technology and not undermine the process (Childs et. al., 2012). It is better to have representation from all stakeholders upfront than to attempt to rework a solution later. For example, the move to new technical platform may result in a positive impact for one department that needs real-time access to certain information. At the same time, however, this may potentially create a negative impact in another department with fewer, less technical workers. Collaboration during the design and analysis phase helps informatics nurses anticipate unintended consequences that may inadvertently create ripple effects for others (Kumar & Aldrich, 2010).
The configuration phase involves the actual build out of the solution which allows new processes to be defined. This can improve workflows by tailoring a new application to the needs of different departments (Sensmeier, 2011). This type of customization is one of the benefits of incorporating nursing informatics. For instance, a system can be configured so that nurses on each shift can access care plans, nutritionists can access diet plans, doctors can access prescription information and other caregivers can access needed health assessments. Data entry and the actual work within the system can be carried out by one individual person or many people.
Prior to final implementation, testing is required so that issues can be identified and errors remedied before the technology is put into everyday use. Testing helps ensure that those who need clearance to select data have it, that key pieces of information can be retrieved correctly, that all parts of the application are functioning with little downtime or disruption, and that all elements of the overall technical solution work in harmony with no surprises (Mayer, 2009). At this point, end users can be properly trained.
Training, like testing, can also help identify potential problems that need to be addressed before final implementation. This phase also allows a chief nurse or nursing informatics analyst to determine if the new processes and workflows that were designed make sense in everyday practice (Sensmeier, 2011). If not, there is still time to fine tune the configuration of the system and avoid problems down the road. Final implementation (or going live) is the full rollout of the new solution across the organization (Thacker, 2010). The chief nurse or informatics nurse or analyst usually continues to serve as a major touch point for end-users, addressing issues as they arise.
Nursing informatics is the marriage of nursing practice and computer technology to create processes that improve patient safety, patient-centered outcomes, and efficiency. Benefits are numerous -- real-time access to information; more accurate dispensing of medication in more appropriate dosages; fewer errors and liability risks; increased staff productivity; decreased administrative time and costs; and more standardized training (Sensmeier, 2011). All of these help ensure improved care coordination.
The other often overlooked benefit to…
Sources Used in Documents:
Childs, L., Alexander, E., & Duong, M. (2012). Risk evaluation and mitigation strategies: Assessment of a medical center's policies and procedures. American Journal of Health-System Pharmacy, 69(10), 885-889. doi:10.2146/ajhp110356.
Kumar, S., & Aldrich, K. (2010). Overcoming barriers to electronic medical record (EMR) implementation in the U.S. healthcare system: A comparative study. Health Informatics Journal, 16(4), 306-318. doi:10.1177/1460458210380523.
Lynn, K. (2011). What's the "buzz" on labs and EMRs? MLO: Medical Laboratory Observer, 43(4), 42-47.
Mayer, B. (2009). Wary, But Prepared. Health Management Technology, 30(3), 12-29.
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