Nursing

Informatics
Candra Panji Asmoro
Taken from : Ann Shepard, RNC, MSN
Director, Customer Support Services
Information Technology
Mercy Medical Center-Des Moines

Objectives
Introduce

Nursing Informatics
Certification for Nursing Informatics
Application of Nursing Informatics
Future of NI

How it all began.

Late

1960s first computer systems were

implemented in hospitals
Computer nurses began to appear in hospitals

Excellent clinicians
Technically curious and willing to try new
things

or did it?
The
First
Informatics
Nurse?

In attempting to arrive at the truth, I have

applied everywhere for information, but scarcely
an instance have I been able to obtain hospital
records for any purposes of comparison. If they
could be obtained, they would enable us to decide
many other questions besides the one alluded to.
They would show subscribers how their money
was spent, what amount of good was really being
done with it, or whether the money was not doing
mischief rather than good.

NI as a specialty
Disconnected

parts
Roles, titles, and responsibilities varied
Definitions similar, conceptual models
considered, research in varied directions, all
goodstandard languages
Panel assembled to help sort out the pieces

1. Definitions
1989Graves

and Corcoran defined Nursing

Informatics as

Computer science, information science, and

nursing science combined to assist in the
management and processing of nursing data,
information and knowledge to support the
practice of nursing and the delivery of nursing
care.
Image, p. 227

 1996Turley

defined Nursing Informatics as

the intersection point with Nursing Science,
Computer Science and Information Science.
1995Graves et al, began to incorporate
knowledge as a product of the sciences into
the definition.

National Center for Nursing

Research
Began

Noted scholars met to discuss priorities for nursing

research

in 1988

Dr. Gloria Bulechek, Dr. Judith Graves, Dr. Susan Grobe

Dr. Kathryn Hannah, Dr. Norma Lang, Dr. Judy Ozbolt, Dr.
Wm Paisley, Elliott Roberts, Dr. Samuel Schultz, and Rita
Zielstorff

Determined Criteria for Promising Dimensions

Group discussed early needs for standardization of
data sets, taxonomy to classify and allow for use of a
common language
Developed seven focus areas for Nursing Informatics

NCNR 1993
Reference available on line:
http://www.nih.gov/ninr/research/vol4/Overview.html

American Nurses Association

Recognized

as a specialty in 1992
Defined NI, outlined roles and responsibilities
and developed standards for practice.
Certification for generalist

www.ana.org
ANCC (American Nurses Credentialing Center)

American Nurses Association

1994,

Scope of Practice for Nursing

Informatics

Nursing Informatics is the specialty that

integrates nursing science, computer
science, and information science in
identifying, collecting, processing, and
managing data and information to support
nursing practice, administration,
education, research, and the expansion
of nursing knowledge.

ANA today
2001,

Scope and Standards of Nursing

Informatics Practice

NI is an evolving fieldexpect change in

definitions
Three categories of definitions
Technology

focused
Conceptually focused
Role-Orientated
To order or for additional info on the booklet:
www.nursebooks.org (part of the ANA web site)

New Definition -- ANA

Nursing Informatics is a specialty that integrates

nursing science, computer science, and information
science to manage and communicate date, information,
and knowledge in nursing practice. Nursing
informatics facilitates the integration of data,
information, and knowledge to support patients,
nurses, and other providers in their decision-making in
all roles and settings. This support is accomplished
through the use of information structures, information
processes,and information technology.

ANA (2001)p. 17

2. Certification
Began

in 1995
First computer based examable to take at
any time at any approved testing location
Knowledge expected of a NI generalist
Focus areas of knowledgefrom the NCNR
recommendations for focus

Exam Focus Areas

System

Analysis and Design

System Implementation and Support
System Testing and Evaluation
Human Factors
Computer Technology
Information/Database Management
Professional Practice/Trends and Issues
Theories

System Analysis and Design

Conducting

need and feasibility assessments

Process flow charting
Understanding requirements
Quality management and customer
satisfaction concepts

System Implementation and

Support
Project

management strategies
Policies and procedures
Education and training
Communication

Vendor management
Customer expectations

System Testing and Evaluation

Will

it do what we hoped it would for the costs

we thought in the time frame we planned?
This is our strength--assessment

Design process
Testing the system
Reviewing output of the systemreports
Measurement of pre-system goals
Less

time, more efficiently, legibility, accurate

data, single entry, etc

Human Factors
Ergonomics
Right

tool for the location, the care delivered,

the care provider
Screen flow, use of data for decisions

Computer Technology
Understanding

of the actual technology

Networks
Personal computers
Portable devices
Operating systems
Software

Information/Database
Management
Understand

database architecturehow data

is stored and accessed
Nursing structure

Nomenclature/vocabulary
Taxonomies and Coding Schemes
ICD-P,

CPT

Nursing Minimum Data Sets

NIC,NOC,

NANDA,

Theories
Nursing

Communication
Management Systems
Information
Computer
Behavioral

Change theory
Organizational behavior
Learning

Professional Practice/Trends and

Issues
Ethics
Privacy
Roles

of NI

Project Manager
Researcher
Educator
Consultant
Advocate/Policy Developer
Product Developer
Decision Support / Outcomes Manager

4. Future of Nursing Informatics

Emerging

roles

Entrepreneurs, Product Developers, Web

design, Independent Consultants

Challenges

Integration of dataduplication often

Inability to access data for decision making
Unique distinctions between roles has not been
defined--competencies

Thanks

References
American

Nurses Association (ANA). (1996).

The scope of practice for nursing informatics.
Washington, DC: Author
American Nurses Association (ANA). (2001).
Scope and standards of nursing informatics
practice. Washington, DC: Author.
Graves, J.R. & Corcoran, S. (1989). The study of
nursing informatics. Image, 21(4), 227-231.
Graves, J.R., Amos. L.K., Huether, S., Lange, L.,
and Thompson, C.B. (1995). Description of a
graduate program in clinic nursing informatics.
Computers in Nursing,13, 60-70.

 National

Center for Nursing Research

(NCNR). (1993). Nursing informatics:
Enhancing patient care: A report to the NCNR
priority expert panel on nursing
informatics/national center for nursing
research. NIH Publication No. 93-2419.
Bethesda, MD: U.S. Department of Health
and Human Services.
Turley, J.P. (1996). Toward a model for
nursing informatics, Image, 28(4), 309-313.