Nursing Informatics
- integrates nursing, computer, and information sciences
- Enhances patient care, workflow efficiency, and evidence-based practice
- Ensures data security and compliance
Computer Systems in Healthcare
A. Computer Hardware
- Input: keyboard, mouse, barcode scanners
- Output: monitors, printers, speakers
- Storage: hard drives, cloud storage
- Networking: routers, servers for telemedicine
B. Computer Software Systems
- Electronic Health Record (EHR) is an electronic version of a patients medical history, that is maintained by
the provider over time, (e.g., Epic, Cerner)
-Clinical Decision Support System (CDSS) is an application that analyzes data to help healthcare providers
make decisions and improve patient care.
Telehealth is the use of digital information and communication technologies to access health care services
remotely and manage your health care.
Medication Administration Software (Barcode medication administration BCMA ) technology is a health
information technology credited for preventing medication errors and promoting patient safety when used
accurately.
Open Source and Free Software
Open Source Software is something that you can modify as per your needs, and share with others without
any licensing violation burden. When we say Open Source, the source code of the software is available
publicly with Open Source licenses like GNU (GPL) which allows you to edit the source code and
distribute it. Free software means software that respects users’ freedom and community. Roughly, it
means that the users have the freedom to run, copy, distribute, study, change, and improve the software.
- Examples:
OpenMRS is an enterprise EMR framework. Extensible and scalable EMR based on Java.
GNU Health is a centralized, highly scalable health and hospital information system
FreeMED is a practice management and electronic and computer records system. It allows the tracking of
medical data, in detail, with preservation not just of the diagnosis but the reasons for medical encounters.
FreeMED is released under the GPL
- Benefits: Cost-effective, customizable, improved accessibility
- Challenges: Requires technical expertise, cybersecurity risks
Data Assessment in Nursing Informatics
Collection: patient history, lab results, vital signs
- Analysis: predictive analytics, risk assessment tools
- Security: HIPAA compliance, encryption techniques
Conclusion and Future Trends
- AI, Blockchain, Big Data in Nursing Informatics
- Ethical Considerations: Privacy, patient consent
- Informatics enhances efficiency, accuracy, and patient outcomes
Nursing Information System
1. Support data exchange with internal and external systems.
2. Capture costs for billing, costing, & accounting purposes.
3. Support clinical decision-making.
4. Provide the legal record of care.
NIS : Obstacles
- It takes time to become nurse informatics.
- Lack of integration in computer systems and software.
- Some nurse informatics, followed by inadequate financial resources.
- Some nurses may be more comfortable with paper documentation than computers.
- Other issues were lack of administrative support, staffing issues, user acceptance, the organization’s
strategic plan problems, etc.
NIS : Advantages
- Enhanced regulatory compliance
- Improve access to information
- Better documentation
- Improve the quality of care
- Improve productivity & communications
- Tracking capability
NIS: Areas
- School health
- Including public health & community care
- NIS, particularly the maintenance of the nursing record.
- Occupational & home care.
- The management of health problems at all levels of complexity.
- Clinical care of individual patients to the administration of health services.
NIS: Online Application
-Enhancing communication, documentation, and patient care.
Personal Digital Assistant (PDA) & Wireless Devices
- Instant access to medical references and patient records.
- Supports electronic charting and scheduling.
- Example: Tablets used for bedside documentation.
Emails and Bookmarks
- Essential for professional communication and coordination.
- Helps in quickly accessing medical references and EHRs.
- Example: Receiving updates on patient care protocols via email.
Wireless Phones
- Improves communication between healthcare teams.
- Supports secure messaging and real-time updates.
- Example: Mobile apps like Voalte and TigerConnect?
Two-Way Video Conferencing
- Enables real-time remote consultations.
- Supports telehealth services and medical education.
- Example: Platforms like Zoom, Microsoft Teams, Doxy.me.
FaceTime and Video Calling
- Direct communication with patients and families.
- Enhances virtual visits and emotional support.
- Example: FaceTime used for remote patient monitoring.
Text Messaging
- Quick and efficient for urgent updates and reminders
- Ensures secure communication with HIPAA-compliant apps
- Example: Secure texting platforms like Spok Mobile
Twitter, Google, Internet, Facebook
- Social media for networking, education, and advocacy
- Quick access to research and guidelines
- Example: Nurses using Twitter for health updates
Web 2.0: Vlogs, Wikis, Collaborative Platforms
- Interactive learning and knowledge sharing
- Vlogs for educational nursing content
- Wikis for collaborative documentation
- Example: YouTube tutorials for nursing procedures
- Internet applications enhance nursing practice
- Improves efficiency, accessibility, and patient care
- Staying updated with technology for professional growth
Concepts, Principles and Theories in Nursing Informatics
Why Study Nursing Informatics?
Nurses are major stakeholders in healthcare.
Nurses can translate data to information, information to knowledge, and knowledge to wisdom.
Background of Informatics
First coined in 1957 by German computer scientist, Karl Steinbuch, as “Informatik”, followed by Phillippe
Dreyfus in 1962 as “Informatique”, and further translated into “Informatics” by Walter F. Bauer, the term
informatics combined the terms “information” and “automation” to name automatic information processing.
The combination of “informat” with the suffix “ics” broadened the definition to address the actual science
and inherent theories of information and information processing. As information technology began to be
applied within various disciplines and social arenas, the term “informatics” was linked to the specific field in
question, for instance, medical informatics, health informatics, business informatics, and so on.
In 1980, Scholes and Barber applied this new term to the art and science of nursing, coining the term,
“nursing informatics”, which they defined as “...the application of computer technology to all fields of
nursing-- nursing services, nurse education, and nursing research”
ANA 2008
Nursing Informatics integrates nursing science, computer science, and information science to manage and
communicate data, information, knowledge, and wisdom in nursing practice.
MURPHY 2010
Nursing Informatics integrates nursing science, information science, and computer science to manage and
communicate data, information, and knowledge in nursing practice. This supports decision-making through
information structures, processes, and technology.
AMIA
Nursing Informatics integrates nursing, its information, and information management with communication
technologies to promote the health of people, families, and communities worldwide.
Landmark Events in Nursing and Computers
1. 1961: Healthcare Information and Management Systems Society (HIMSS) Founded
• Establishment of HIMSS, an organization dedicated to advancing healthcare information and management
systems.
2. 1965: Development of One of the First Hospital Information Systems in California
• Introduction of one of the earliest hospital information systems, marking a significant milestone in
healthcare informatics.
3. 1973: First Conference on Management Information Systems
•Inauguration of the first conference focusing on management information systems, laying the groundwork
for further advancements in healthcare technology.
4. 1981: First National Conference on Computer Technology in Chicago
• The convening of the inaugural national conference dedicated to computer technology, showcasing its
growing importance in various industries, including healthcare.
5. 1984: Publication of the First Nursing Computer Journal
• Launch of the first nursing journal specifically dedicated to computer-related topics, reflecting the
increasing integration of technology into nursing practice.
6. 1989: Introduction of Graduate Program in Nursing Informatics at Maryland University
• Establishment of a graduate program in nursing informatics, signaling the recognition of informatics as a
specialized field within nursing education.
7. 1993: Establishment of Electronic Library
• Creation of an electronic library, providing healthcare professionals with access to a wealth of information
and resources.
8. 1995: First International Nursing Informatics Teleconference in Australia
• Hosting of the inaugural international teleconference focused on nursing informatics, fostering
collaboration and knowledge exchange among professionals worldwide.
9. 2002: JCAHO Identifies Clinical Information Systems for Safety Improvement
• Joint Commission on Accreditation of Healthcare Organizations (JCAHO) identifies clinical information
systems as instrumental in enhancing patient safety, advocating for their adoption in hospitals.
10. 2003: Enactment of Health Insurance Portability and Accountability Act (HIPAA)
• Implementation of HIPAA, which aims to safeguard patient privacy and improve the security of healthcare
information.
11. 2004: Establishment of the National Health Information Coordinator
• Establishment of a national coordinator role for health information, highlighting the growing importance of
information management in healthcare policy and practice.
Theories, Models, and Frameworks
Graves and Corcoran’s Model (1989)
Nursing informatics as the linear progression - from data into information and knowledge Management
processing is integrated within each elements, depicting nursing informatics as the proper management of
knowledge - from data as it is converted into information and knowledge
Schiwirian’s Model 1986
Nursing informatics involves identification of information needs, resolution of the needs, and attainment of
nursing goals/objectives Patricia Schwirian - proposed a model intended to stimulate and guide systematic
research in nursing informatics Model/framework that enables identification of significant information needs,
that can foster research (some what similar to Maslow's hierarchy of needs)
Turleys Model 1996
Nursing informatics is the intersection between the discipline-specific science (nursing) and the area of
informatics.
Core components of informatics:
- Cognitive science is the study of the human mind and brain, focusing on how the mind represents and
manipulates knowledge and how mental representations and processes are realized in the brain.
- Information science is the study of how information is created, stored, and used. It's an interdisciplinary
field that combines aspects of computer science, library science and information management.
- Computer science is the study of computers and computing, including their theory and applications. It
uses principles from mathematics, engineering, and logic.
Benner’s Level of Expertise Model:
Every nurse must be able to continuously exhibit the capability to acquire skills (in this case, computer
literacy skills parallel with nursing knowledge), and then demonstrate specific skills beginning with the very
first student experience.
Levels of Expertise (Benner):
Novice - individuals with no experience of situations and related content in those situations where they are
expected to perform tasks
Advanced Beginner - marginally demonstrate acceptable performance having built on lessons learned in
their expanding experience base;
needs supervision
Competent - enhanced mastery and the ability to cope with and manage many contingencies
Proficient - evolution through continuous practice of skills, combined with professional experience and
knowledge; individual who appreciates standards of practice as they apply in nursing informatics.
Expert - individual with mastery of the concept and capacity to intuitively understand the situation and
immediately target the problem with minimal effort or problem solving.
Data-Information-Knowledge Wisdom Model (ANA):
NI is a specialty that integrates nursing science, computer science and information science to manage and
communicate data, information, knowledge and wisdom into nursing practice (ANA) (American Nurses
Association)
Nursing informatics is an evolving, dynamic process involving the conversion of data into information, and
subsequently knowledge.
