This paper examines the major issues shaping nursing informatics, a field integrating information technology, computer science, and nursing science to improve patient care. It traces the profession's dependence on informatics for clinical documentation, evidence-based practice, and patient empowerment, while identifying a significant gap between the demand for informatics competencies and the preparedness of nursing education programs. The paper also analyzes how informatics influences patient safety, workflow, and organizational culture, before looking ahead to emerging challenges such as data security, interoperability, and the integration of artificial intelligence. Throughout, the paper emphasizes that informatics literacy is no longer optional but essential to every nurse's professional practice.
Since as early as the 1980s, information technology, computer science, and nursing science have all been integrated under the rubric of nursing informatics, with the goal of improving patient care and quantifiable outcomes (Kaminski, 2015). Nursing informatics has also enabled the entrenchment of evidence-based practice in healthcare. Key issues in nursing informatics include the ongoing changes to hardware and software, the need to align various informatics systems and techniques across multiple care providers in a globally integrated healthcare system, and the need for core competencies to become mandatory for all nurses. Advancements in medical technologies and science, such as genetics, will also radically transform the role informatics plays in patient care.
Nursing informatics has radically transformed the nature of the nursing profession by expanding the requisite skills for professional practice and altering the roles nurses play in healthcare institutions. Even though there have been and will continue to be specialists whose sole role is to create and manage nursing information systems or to train nursing personnel in their use, all nurses now need informatics competencies to function in a dynamic healthcare environment. Nursing informatics is also continually affected by changes to healthcare legislation — such as the Health Insurance Portability and Accountability Act of 1996 — which mandate provisions for informatics data security. Nursing informatics also impacts organizational culture and structure within healthcare organizations, changing patterns of workflow and decision-making related to patient care. The increased diversity and complexity of nursing informatics systems presents unique challenges for healthcare professionals and systems designers alike.
The nursing profession depends on informatics for managing patient data, including health history and billing and other administrative duties (Farzandipour, Meidani, Riazi, et al., 2016). Informatics can streamline workflow, making the delivery of care more cost-effective and efficient. Nurses also use information systems to document patient care, offering other members of the healthcare team access to relevant information that improves quality of care and reduces error. In fact, informatics can help reduce medical errors as well as errors in cost accounting and billing. With automated documentation systems, nurses ensure that medications are input correctly, administered at the correct doses, and are not conflicting with other patient medications or conditions. Administrators can use informatics for value-based purchasing decisions or for matching their purchases with the specific or predicted needs of their patient population. Nurses can also offer patients various options for treatment interventions based on knowledge of insurance coverage provisions.
Nurses also rely on information systems for evidence-based practice. Having access to epidemiological data and databases of recent empirical studies, nurses can optimize service delivery. Nurses can also access big data and meta-analyses to glean the most accurate and reliable information related to the best options for treatment. Informatics includes the ability of nurses to quickly access and analyze big data systems to improve patient care — perhaps by using portable devices that allow for on-the-fly research. General practice nurses and specialists alike need informatics during all phases of clinical practice, from identifying patient information upon intake to managing complex conditions requiring the coordination of multiple care providers. Informatics can also help nurses make informed choices about patient referrals to specialists or offer alternatives to unavailable treatments or medications. Nurses can also contribute to the growing body of knowledge by adding information to electronic databases or documenting anomalies in care.
Informatics can also be used to empower patients with self-monitoring tools and methods of communicating regularly with healthcare staff regarding their condition, prognosis, or medications (McGonigle, Hunter, Sipes, et al., 2014). Nurses can offer patients access to their personal medical histories and to general knowledge about their conditions or treatment interventions through the use of informatics. Biometrics are already being integrated into patient self-care, with data such as blood sugar or heart rate linked to nurses' systems to help with remote monitoring of patients. Expanded use of patient-centric informatics systems may reduce healthcare burdens by improving preventative care options. Patients located in rural or remote regions have come to depend on informatics for non-emergency healthcare — such as via telehealth or telemedicine (McGonigle, Hunter, Sipes, et al., 2014) — and informatics has thereby improved service delivery to underserved communities.
Some of the most commonly used informatics tools in nursing include patient electronic health records detailing medication and health history. Lesser known but equally significant are informatics systems that allow healthcare workers to communicate and collaborate on decisions, technologies that aid with research on best practices, and databases for healthcare taxonomy. For example, different terms may be used to describe similar procedures in different countries; nursing informatics helps to eliminate such barriers to communication that could cause medical errors. Using informatics reflexively, nurses face reduced chances for miscommunication due to factors like similar-sounding terms or different terms used in different languages or cultures. Informatics also opens up the potential for accessing much larger and more reliable data sets pertinent to specific patient demographics. For instance, the effectiveness of treatment options may vary depending on gender or ethnicity.
As integral as nursing informatics is to the direct delivery of care, healthcare administrators also rely on informatics for budgeting, growth and marketing strategies, risk management, and streamlining workflow (McGonigle, Hunter, Sipes, et al., 2014). Informatics can help administrators assess risk and needs using quantitative and longitudinal data, or project future needs based on changes to local population demographics. Improving the efficiency and cost-effectiveness of hospitals and other healthcare institutions ultimately improves patient care through the more strategic use of funding and resources. Informatics allows nurses to coordinate care among various service providers and partners, which is becoming increasingly important in team-based healthcare decision-making.
Unfortunately, nursing education has not kept pace with the demand for improved core competencies in informatics. One study found that less than one third of all teaching faculty in nursing education programs were competent to teach nursing informatics, and that half of all nursing schools had "no future plans or did not know of any plans to offer nursing informatics" courses or programs of study (Madsen, Cummings, Borycki, et al., 2016, p. 783). Nagle, Crosby, Frisch, et al. (2014) also found that the majority of teaching faculty were not only unprepared to teach informatics but also "expressed a lack of support for gaining this knowledge" (p. 356). The lack of access to proper education throughout the course of a nurse's training could constitute a crisis in patient care, given the immense importance of informatics to safe, effective, and efficient healthcare service delivery. Attitudes and perceptions need to change if nursing informatics is to be properly integrated into nursing education. Nursing informatics is no longer ancillary to the profession but absolutely critical to service delivery.
To mitigate the current lack of informatics training in nursing education, professional development workshops and seminars may offer healthcare administrators the best option for improving their staff's competencies (Collins, 2016). Rather than focusing solely on theoretical issues related to nursing informatics, healthcare administrators may offer nursing staff targeted training in using specific informatics systems. In-service training and online courses can also offer healthcare administrators and nurses access to ongoing skills upgrades in informatics (Kaminski, 2015). Nagle, Crosby, Frisch, et al. (2014) also suggest that nursing education programs phase in informatics in a systematic way, guided by best practice mandates issued either by professional organizations governing the profession or via legislative action. Madsen, Cummings, Borycki, et al. (2016) further suggest coordinated training programs that prepare nurses for a globally integrated healthcare system that relies heavily on informatics for continuity of care.
Nursing informatics education should therefore be considered an ongoing challenge that is not limited to university programs but is continually integrated into job training and staff development. The future of nursing informatics may also entail the creation of specialist fields, with new nursing roles and positions that carry implications for nursing education programs and professional licensing. Specialists in nursing informatics need to keep abreast of changes to state and federal legislation, emerging technologies, and threats to data security. Informatics education may also need to become more highly specialized, with training offered in various information systems depending on the area or areas of specialization.
"Impact of informatics on safety and patient outcomes"
"AI, interoperability, and data security ahead"
McGonigle, D., & Mastrian, K. (2014). Nursing informatics and the foundation of knowledge. Jones & Bartlett.
Nagle, L. M., Crosby, K., Frisch, N., et al. (2014). Developing entry-to-practice nursing informatics competencies for registered nurses. In Saranto, Weaver, & Chang (Eds.), Nursing Informatics 2014. IOS Press.
You’re 53% through this paper. Sign up to read the remaining 2 sections.
Sign Up Now — Instant Access Already a member? Log inAlways verify citation format against your institution’s current style guide requirements.