NURSING

INFORMATICS
(Week 3)
Information Technology System Applicable
in Nursing Practice
Practice
application Critical
Care
Telehealth Practice Application
Application
Community
Administrative Health
Assistive Devices &
Workplace
Application
Technologies

Emergency Ambulatory
Preparedness Care System
& Response
o More than 150 years ago, Florence Nightingale
spoke about the critical importance of nursing
informatics in patient care. “Decision making must
be based upon the use of accurate data”, she said
(Ulrich, 1992, p.68)
o The nursing pioneer also spoke of
frustration from difficulties of exacting
such critical patient- related data from
hospital record.
o It was more than a century after Florence
Nightingale’s era that computer made their
appearance on the hospital landscape.

o The first hospital information system

arrived in the late 1950’s to the mid-
1960, although these systems
focused primarily on processing
financial and administrative
information
 Nursing Informatics as Evolving Definition

Since 1980, nursing informatics has been defined

broadly either with a focus on the technologic
aspects, on the concept of nurses interacting with
technology to produce greater knowledge, or on the
role of nurses who specialized in developing
applications of technology to nursing practice - ANA,
2001…
Nursing Informatics as Evolving Definition

A specialty that integrates

in identifying collecting,
processing and
Nursing Computer managing data and
Science Science information to support
nursing practice,
Information
administration,
Science education and
research; and to
expand nursing
knowledge.
 THE PURPOSE OF NURSING INFORMATICS

o analyze information, requirements design,

o implement and evaluate information systems
and data structures that support nursing…
o identify and apply computer technologies to
nursing. (ANA, 1992)
GOAL OF NURSING INFORMATICS (ANA)

 Improve the health of populations,

communities, families, and individuals by
optimizing information management and
communication. This includes:
o Use of technology in the direct
provision of care;
o Establishing administrative systems;
o Managing and delivering educational
experiences;
o Supporting life-long learning, and
o Supporting nursing research.
INFORMATICS COMPETENCIES:
INFORMATION LITERACY SKILLS

These are the basic computer skills

needed to use a word processor;

o access a database;
o create a spreadsheet;
o communicate with the e-mail; and
o interact with clinical documentation
systems.
 GENERAL INFORMATICS COMPETENCIES

 These basic skills are required for all nurses but are not
sufficient for specialists:

 identifying, collecting and recording data relevant to the

nursing care of patient;
 analyzing and interpreting patient and nursing
information;
 using applications of informatics as an integral part of
the nursing process; and
 implementing institutional and public policies regarding
privacy, confidentiality and security of information. (ANA,
2011, p.26)
 NURSING INFORMATICS: SCOPE
AND STANDARDS OF PRACTICE

• Nursing informatics (NI) integrates nursing science,

computer and information science, and cognitive
science to manage, communicate, and expand the data,
information, knowledge, and wisdom of nursing practice.

• Nurses trained in NI support improved patient outcomes

through their expertise in information processes,
structures, and technologies, thus helping nurses and
other care providers to create and record the evidence
of their practice.
 CRITICAL CARE APPLICATION

Critical Care Critical Care

Critical Care Nurse – Is Applications Areas
– where patients
Nursing – Is an responsible to
require complex
area of expertise ensure that
critically ill patients assessment, high-
within nursing intensity medication,
that focuses are seriously
conditioned continuous therapy
specifically with and interventions,
individuals. Ensure
human that families of the and unrelenting
responses to life- medically ill nursing attention and
threatening patients should continuous
watchfulness.
problems receive optimal
care.
CRITICAL CARE INFORMATION SYSTEM

Provide real-time resource utilization data and

management of information and access critical
care areas through the integration of the medical
facilities in the critical to an intelligent computer
system which is capable of processing all data.
Enables the electronic collection of hospital and
patient-specific critical care data of the entire
patient in the critical care areas which can be
processed to create a patient profile which
generate real time and historical report . . .
Automated collection and management
of medical information will become the
important task of the critical care
information system
ADVANTAGE OF CRITICAL CARE INFORMATON
SYSTEM (CCIS)
Providing feedback and quick evaluation of the patient
condition and provides alert.
Intelligently integrates and process physiologic and
diagnostic information and store it to secured clinical
repository.
Creates trends analysis with graphical representation of
results.
Offline stimulation can be performed to test the condition of
the patients.
Provide access to vital patient information
Provide clinical decision support system
MEDICAL INFORMATION BUS (MIB)

The Medical Information Bus

(MIB) is an application of
networking and information
technology for healthcare
This is a way of gathering and
compiling data from medical
devices at bedside and
hospital host computers
 MEDICAL INFORMATION BUS (MIB)

 Provides a generalized method of attaching patient

monitoring devices to a common interface.
 This interface converts the unique manufacturer data
communications protocol into a standardized
hardware and software system
 It eliminates the need for custom connector and
software presently needed to interface such device
 Has the ability to filter, store and select information
sent for inclusion into the clinical medical record on
the clinical computer system
 for acquiring data from bedside devices such as
bedside monitors, IV pumps, ventilators, etc. for
multiple purposes
GOAL OF MEDICAL INFORMATION BUS (MIB)

 To communicate accurate, useful information to

clinician that will be used in decision-making.
 To provide care to critically-ill patients that
requires processing information collected from
multiple sources.
 To provide enough time to collect information and
to communicate it to many health care providers.
 To accurately monitor rapid changes in patient
condition and the therapy provided in response to
these changes
 To evaluate outcome of intervention in order to
measure cost effectiveness and describe quality
of patient care
Fulfills a unique role
in the community, Collective term for
promoting and the methodical
protecting the application of
health of the information
community at the science and
same time Community
technology to
maintaining Health community and
sustainability and Application public health
integrity of health
process.
data and
information.
•Focuses on the
•Emphasizes the health information
prevention of the system of the
disease, medical community, it is
intervention and centered on the
public awareness majority part of the
public.
Goal of community Goal of community
health informatics health nursing

Effective and timely Comprehensive

assessment that directed
involves monitoring
and tracking the towards the
health status of majority of
populations including individuals,
identifying and families, and
controlling disease
outbreaks and
the community
epidemics. at large.
COMMUNITY HEALTH INFORMATION SYSTEM

Encourages optimal application

of computer system, computer
programs and communication
system for the benefit of majority
of individuals, families and
community.
PRIMARY FOCUS OF COMMUNITY HEALTH
INFORMATION SYSTEM

• Preventing, identifying, investigating and

eliminating communicable health problems.
• Accessibility of data and information, through
communication
• Educating and empowering individuals to adopt
healthy life style
• Facilitate the retrieval of data
• Effective transformation of data into
information
• Effective integration of information to other
disciplined to concretized knowledge and
creates better understanding.
COMPUTER BASED HEALTH
SURVEY SYSTEM STATISTICAL
SURVEYS

 Are used to collect quantitative

information about items in a
population to establish certain
information from the obtained
data.
 Focused on opinions or factual
information depending on it’s
purpose and many surveys
involves administering
questions to individuals.
 Consistent
Building strong
communication exchange of
response

Control of Disease
spread tracking
ADVANTAGES
of disease
OF COMMUNITY
HEALTH SYSTEM

Synchronization
of the Building
decisions strategies
National
alertness and
preparedness
 Ambulatory Care System
Ambulatory care or outpatient care is medical
care provided on an outpatient basis. It
includes:
•diagnosis, observation,


•consultation, treatment,


•intervention, rehabilitation services



 This care can include advanced medical

technology and procedures even when
provided outside of hospitals.
 AMBULATORY CARE SYSTEM

• These services are performed at outpatient clinics,

urgent care centers, emergency rooms, ambulatory or
same-day surgery centers, diagnostic and imaging
AMBULATORY centers, primary care centers, community health centers,
CARE occupational health centers, mental health clinics, and
group practices.

• Provides automated processing of data and

information such as allergies and medical alerts,
AMBULATORY patients accounting system such as charging, billing,
CARE
SYSTEM
discounts and concessions, diagnostics imaging
treatments, and etc
 ISSUES OF
ADVANTAGES OF AMBULATORY
AMBULATORY CARE INFORMATION CARE
INFORMATION SYSTEM SYSTEM
 Real-time and easy access to  Increased
patient’s medical records by accountability
healthcare providers.  The need for
 Improved workflow, which allows continuous support
more time for comprehensive
 Privacy and
patient counseling and review.
 Reduced errors with the availability
confidentiality of
of various automation engines – information
drug interaction engine; medical  Accessibility and
alert engine; patient billing engine, security of data and
etc. information
 Improved clinical outcome analysis  Integration and
 Improvement in hospital inventory support to the other
management. system
 Emergency Preparedness And Response
Early informatics planning has help focused mainly on threat detection.
Informatics can help increase the effectiveness in responding to
disasters as well as giving a tele-presence for remote medical
personnel. Some of the contributions that informatics can play during
disasters are electronic health records, tracking of victims and supply
inventory.

New threats to health include:

• Mass trauma – ex. explosions and blast injuries
• Biologic and biochemical warfare agents – ex. Anthrax, plague,
smallpox
• Emerging infectious disease – ex. SARS
• Other outbreaks/incidents – wildfire, storms
Primary care and emergency department practitioners need readily
accessible information to facilitate diagnosis
Administrative Assistive Devices
and Workplace Technologies
 TELEHEALTH
Use of telecommunication technologies to
provide health care services to clients and
provide access to health related information
for both the clients and healthcare providers.
 Telehealth Applications
1. Telephone – 911 for emergency and health
assistance; Teleconferencing to healthcare
community; Call centers dealing with healthcare
communication services
2. Computer systems – monitoring and diagnostic
equipment
 Advanced wireless applications
 Computerized home health care system (CHHCS)
 Computerized Home Health Care System (CHHCS)

Non invasive sensors are applied directly to patient:

• Monitor vital signs
• Oxygen Saturation
• Breath/ heart sounds
• Body postures & movements
• ECG leads and scanners

Interactive communication accessories:

• Microphone, speaker, monitor display, camera
 Computerized Home Health Care System (CHHCS)
Significance/Advantage
• Enables patient to look for themselves in their homes which
will help improve patients compliance.
• Reduces incidence of unnecessary readmission which is
cost-effective.
• Patients are assured that they are monitored daily in their
homes.
• Early detection of disease & complications, thus allowing the
nurse to respond immediately to the patient’s status
• Enables the nurse to be more autonomous and create more
collaborative roles
 Issues in Telehealth
• Legal Issues- Regulation and authority on
healthcare practice regarding telehealth.
• Safety Standards- there is a need to certify care
providers who engaged in telehealth as a new
medium of delivery.
• Security- question of privacy, confidentiality and
data security. Data should be in secure lines.
• Budget Constraints –cost of infrastructure,
installation, connection, training and
maintenance is high
 THE ROLE OF NURSE USING INFORMATION
SYSTEM IN THE AMBULATORY CARE SYSTEM

• The very basic objective of the automated

ambulatory care information system is to
easily integrate the data to the other data
and easily translate these data into
information.
• The effective transformation of data can be
integrated to the other processes to
transform it into knowledge.
• The ambulatory care nurse and other health
care provider should be capable enough to
implement the process effectively.
 The value of technology in automating and
improving patient care

• Nursing is what nurses do, and what nurses do is

coordinate and deliver care. The context, technology, and
health needs of our populations have changed, nurses
remain the foremost providers and coordinators of care.

• Showcasing the caring aspects of nursing in a

technologically dominated world is challenging.

• Technology enables care and enhances safety by

automating functions both simple and complex. It doesn’t
replace nurses.
End of slide