CHAPTER 17

Nursing Informatics and Patient Safety /

Nursing Informatics and Patient Safety

Nursing Informatics and Patient Safety

Key Points
 Nursing informatics integrates nursing science with
multiple information and analytical sciences to
identify, define, manage, and communicate data,
information, knowledge, and wisdom in nursing
practice.
 Nurse informatics specialists provide networking,
education, and information resources that enrich and
strengthen the roles of nurses in the field of
informatics, including clinical information, education,
and administration decision support. They manage
and communicate nursing data and information to
improve decision-making by consumers, patients,
nurses, and other healthcare providers.
 Nurses are challenged by inconsistencies and
breakdowns in care communication, physical and
resource challenges, interruptions characteristic of
nursing work, and documentation challenges.
 Clinical information systems impact patient safety by:
o Providing easy access to patients’ records
o Highlighting abnormal findings
o Providing critical information
o Generating reminders
o Enabling legibility of data
 Clinical documentation in an electronic information
system improves communication and coordination
among providers.
 Bar-code patient identification systems increases
confirmation of patient identity before administration
and ensures the right patient gets the right
medication, in the correct dose, by the appropriate
route, and at the right time.
Quiz me now!
Safely Implementing Health Information
Technology
Key Points
 The successful implementation of technology requires
a shared responsibility and multifaceted approach,
looking at the people, processes, environment, and
technology involved.
 Nurses must work with their counterparts since
increased use of technologies and automation may
create opportunities for new types of errors and less
transparency. Relying too heavily on health
information technology for communication reduces
teamwork and negatively affects patient safety and
quality.
 Health information technology can result in value-
added activities for care providers. Value in nursing
care includes:
o Documenting vital signs of the patient
o Graphing the values across several days
o Reviewing the medication list
o Processing the data collected
o Sending communication order for monitoring
changes in the value or other symptoms
o Notifying the physician if the situation has not
changed
Quiz me now!
Previous

Lesson Assessment
Key Points
 Nursing informatics integrates nursing science with
multiple information and analytical sciences to
identify, define, manage, and communicate data,
information, knowledge, and wisdom in nursing
practice.
 Nurse informatics specialists provide networking,
education, and information resources that enrich and
 strengthen the roles of nurses in the field of
informatics, including clinical information, education,
and administration decision support. They manage
and communicate nursing data and information to
improve decision-making by consumers, patients,
nurses, and other healthcare providers.
 Nurses are challenged by inconsistencies and
breakdowns in care communication, physical and
resource challenges, interruptions characteristic of
nursing work, and documentation challenges.
 Clinical information systems impact patient safety by:
o Providing easy access to patients’ records
o Highlighting abnormal findings
o Providing critical information
o Generating reminders
o Enabling legibility of data
 Clinical documentation in an electronic information
system improves communication and coordination
among providers.
 Bar-code patient identification systems increases
confirmation of patient identity before administration
and ensures the right patient gets the right
medication, in the correct dose, by the appropriate
route, and at the right time.
 The successful implementation of technology requires
a shared responsibility and multifaceted approach,
looking at the people, processes, environment, and
technology involved.
 Nurses must work with their counterparts since
increased use of technologies and automation may
create opportunities for new types of errors and less
transparency. Relying too heavily on health
information technology for communication reduces
teamwork and negatively affects patient safety and
quality.
 Health information technology can result in value-
added activities for care providers. Value in nursing
care includes:
o Documenting vital signs of the patient
 Graphing the values across several days
o
o Reviewing the medication list
o Processing the data collected
o Sending communication order for monitoring
changes in the value or other symptoms
o Notifying the physician if the situation has not
changed
Quiz me now!

Future Trends and Professional Issues in Nursing Practice

With Telehealth and New Technologies

Box 17.5 Contents of Smart Cards

 Patient demographics and photo identification
 ICE—in case of emergency—contact and other key
information
 Patient medical history: for example, allergies,
medications, immunizations, laboratory results
 Past care encounter summaries, including surgical
procedures
 Patient record locations and electronic address
information
 Ability to upload or download patient information

Future Trends and Professional

Issues
Key Points

 Devices that can be used for continuous monitoring from the home
environment include glucose monitoring devices, implantable cardiac
arrhythmia devices, smartphones.
 Data standards are at the foundation of integrated, interoperable
information systems. They facilitate transfer of data from an emergency
department or operating room to inpatient hospital units and enable
electronic patient health information exchange between hospitals and
physician offices in different parent organizations.
 Smart cards store a limited number of pages of data on a computer
chip. They serves as a bridge between the clinician terminal and the
central repository, making patient information available to the
caregiver quickly and cheaply at the point of service because the
patients bring it with them.
 Patients’ rights to privacy of their data must be maintained whether
recorded in a manual or automated system. A firewall is a network
security system keeping electronic intruders from accessing an
organization’s data on its private network while allowing members of
the organization to reach the Internet.

 Telehealth
Key Points

 Telehealth visits protected health professionals and patients from

COVID-19 exposure.
o ECGs and radiographs can be viewed and transmitted.
o Sophisticated electronic stethoscopes and dermoscopes help to
look closely at wounds, eyes, ears, and skin.
o Ready access to expert advice and patient information is
available.
 The cardiac high-acuity monitoring program (CHAMP) is an in-home
monitoring system for patients with single-ventricle (SV) cardiac
disease. Home monitoring is completed using a tablet to input data.
 Nurses are required to use the informatics skills of consultation, systems
analysis and design, and policy development.
 Computer systems must collect good clinical data to promote ongoing
knowledge development for nursing care of patients and families. They
translate nursing knowledge into reference materials that can be
accessed at the point of care.

Quiz me now!
Future Trends and Professional Issues in Nursing Practice With Telehealth
and New Technologies

Lesson Assessment
Key Points

 Devices that can be used for continuous monitoring from the home
environment include glucose monitoring devices, implantable cardiac
arrhythmia devices, smartphones.
 Data standards are at the foundation of integrated, interoperable
information systems. They facilitate transfer of data from an emergency
department or operating room to inpatient hospital units and enable
electronic patient health information exchange between hospitals and
physician offices in different parent organizations.
 Smart cards store a limited number of pages of data on a computer
chip. They serves as a bridge between the clinician terminal and the
central repository, making patient information available to the
caregiver quickly and cheaply at the point of service because the
patients bring it with them.
 Patients’ rights to privacy of their data must be maintained whether
recorded in a manual or automated system. A firewall is a network
security system keeping electronic intruders from accessing an
organization’s data on its private network while allowing members of
the organization to reach the Internet.
 Telehealth visits protected health professionals and patients from
COVID-19 exposure.
o ECGs and radiographs can be viewed and transmitted.
o Sophisticated electronic stethoscopes and dermoscopes help to
look closely at wounds, eyes, ears, and skin.
o Ready access to expert advice and patient information is
available.
 The cardiac high-acuity monitoring program (CHAMP) is an in-home
monitoring system for patients with single-ventricle (SV) cardiac
disease. Home monitoring is completed using a tablet to input data.
 Nurses are required to use the informatics skills of consultation, systems
analysis and design, and policy development.
 Computer systems must collect good clinical data to promote ongoing
knowledge development for nursing care of patients and families. They
 translate nursing knowledge into reference materials that can be
accessed at the point of care.
 Patient advocacy remains an important function of the professional
nurse. Nurses are concerned with individual patient welfare and the
effects of technological intervention on the immediate and long-term
quality of life for patients and their families.
 Nurses must never share the passwords that allow them access to
information in computerized clinical information systems. Each
password:
o Identifies a user to the system by name and title
o Gives approval to carry out certain functions
o Provides access to data appropriate to the user
 Nurses have the responsibility to manage data to effectively lead change
through documentation audit tools and system compliance reports.