Nursing Informatics. Asieh Dervish Faculty of Nursing & Midwifery Tehran University of Medical Sciences

١

Nursing Informatics

g

Asieh Dervish

Faculty of Nursing & Midwifery Tehran University of Medical Sciences

sedarvish@yahoo.com

@f

adarvish@farabi.tums.ac.ir 2011

Objectives

• Introduce Nursing Informatics • Introduce Nursing Informatics • Managing medical knowledge • Nurse & Technology Interaction

• Conclusion

٢

z Late 1960’s first computer systems were

i l t d i h it l

Nursing Informatics

implemented in hospitals

z Nurses felt the need of new technologies

in hospitals

z Technically curious and willing to try new

things things

٣

NI as a specialty

Guenther & Peterz (2006)

z NI is seen as specialty in literatures in 1984 z Roles, titles and responsibilities varied

z Definitions similar, conceptual models

considered, research in varied directions

P l bl d t h l t t th i

z Panel assembled to help sort out the pieces

٣

z 1989- Graves and Corcoran defined

Nursing Informatics as

Nursing Informatics

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.”

۵

z 1996 -Turley defined Nursing

I f ti

Nursing Informatics

Informatics as

the intersection point with Nursing Science, Computer Science and

Information Science.

۴

American Nurses Association

Nursing Informatics

z Recognized as a specialty in 1992 z Defined NI, outlined roles and

responsibilities and developed standards for practice.

z Certification for generalist z Certification for generalist

٧

z 1994, Scope of Practice for Nursing I f ti

Nursing Informatics

Informatics

z “Nursing Informatics is the specialty that

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

۵

z 2001, Scope and Standards of Nursing Informatics Practice

Nursing Informatics

Informatics Practice

z NI is an evolving field - expect change in

definitions

z Three categories of definitions

zTechnology focused zConceptually focusedConceptually focused zRole-Orientated

٩

Certification

z The first computer technology lesson to

Nursing Informatics

z The first computer technology lesson to

nursing students in 1976

z During last 25 years, increased lesson

numbers & graduations levels

z Began in 1995 z Began in 1995

z Knowledge expected of a NI generalist

۶

Focus Areas S t A l i d D i

Nursing Informatics

z System Analysis and Design

z System Implementation and Support z System Testing and Evaluation z Human Factors

z Computer Technologyp gy

z Information/Database Management z Professional Practice/Trends and Issues

١١

Nursing Informatics

z The exercise of specialist knowledge and

competencies

z Emphasis on the knowledge which is

located in brains dialogue and symbols located in brains, dialogue and symbols

٧

Nursing Informatics

z Nursing is a Cognitive Discipline

z Nursing Actions To, With, and For the

Client are the Visible Manifestations of Nurses’ Thinking

z Knowledge Work Requires Data,

Information and Knowledge Information and Knowledge

١٣

Nursing Informatics

z Data - from the client; collected,

d d d b RN

recorded, managed by RNs

z Information - data analysis and

interpretation in context by RNs

z Knowledge - clinical information is used

to expand nursing and other health care to expand nursing and other health care sciences through research and other scholarly work

٨

Nursing Informatics

Nursing Informatics Education

z NI Specialist Preparation

z Registered Nurses already in practice z Continuous entry of students

١۵

Nursing Informatics

z Scope of Practice (ANA) z Standards of Practice (ANA) z Board Certification (ANCC) z Preparation

z Graduate Preparation (Masters) z PhD Programs

z Certificate Programs

٩

Competencies for NI practitioners

Nursing Informatics

z Data, Information, Knowledge z Atomic Level Data

z Knowledge Seeking

z Critical Analysis of D, I, K z Information Technologies

z Electronic Health Records & Systems z Internet

١٧

Competencies for NI practitioners

Nursing Informatics

z Computer Skills

z Informatics Knowledge z Informatics Skills

١٠ z Computer Skills

Nursing Informatics

Nursing Informatics

١١ z Informatics Skills

Nursing Informatics

z Decision Analysis & Evaluation z Scarcity and Conflict

z Collaboration and Team Work z Data Aggregation and Analysis

z Economics, History, Political Science

١٢

z Collection & preservation of nursing data

i iti l is critical

z Explanation of variances in client

outcomes

z Accurate cost of care: individual, groups

of clients community covered lives of clients, community, covered lives ...

z Knowing what works, what doesn’t &

why

٢٣

NI Education Issues

z Integration into curricula vs. separate

courses

z Inclusion of multi-disciplinary healthcare

informatics - how, when, where, what

z Informatics competencies for all z Informatics competencies for all

registered nurses

z Competencies for NI practitioners

١٣

z Data

Managing medical knowledge

z Information z knowledge z Wisdom z Skill z Specialty z Expert ٢۵

Managing medical knowledge

z Knowledge management features

Definition of KM:It Secures & distributes knowledge in

order to assure and optimise its availability

Aims of KM:

- Keeping knowledge up to date & correct - Providing knowledge in the right locationProviding knowledge in the right location - Applying knowledge of the most suitable type - Providing knowledge at the time of need

١۴

Managing medical knowledge

Motivations for implementing KM strategy within an organisation:

an organisation:

- To keep track of an expert’s know-how, even if s/he moves or retires

- To enable an intelligent consultation in order to exploit successes & mistakes experienced

- To keep histories for new staffs and not decrease quality of work by changes in staffs

- To improve knowledge communication

- To improve learning of inexpert and new personnel ٢٧

Managing medical knowledge

Advantages of KM:

- A proper KM strategy allows for a continuous quality - A proper KM strategy allows for a continuous quality

improvement based on performance measurement and data analysis

- A careful data analysis may be a very effective way to identify problems in routine work and to provide directions to recognise medical services

M ti t f th i ti ti th l t d

- Motivate further investigations on the neglected or unobserved variables

-Invaluable source for planning organisational interventions

١۵

Managing medical knowledge

z Knowledge management in the medical domain: the nature of medical knowledgeg Features of implicit KM:

- Very useful for sharing other clinicians’ experiences - Needs individual ability of making inferences and of

coping with the problem

U h i i ’ l f i i th

- Uses physician’s personal way of organising the reasoning process

٢٩

Managing medical knowledge

Features of explicit KM:

- Formulating a hypothesis about the correct diagnosis or therapy

- Then in proving on the basis of additional observations - Rely on data & prior domain knowledge to make the

possible diagnostic explanation or therapeutic advice

١۶

Managing medical knowledge

An efficient KM approach An efficient KM approach

is

a valuable way for helping exploiting all the available knowledge sources

٣١

z CBR- case based reasoning

Managing medical knowledge

- for implicit type

z RBR- rule based reasoning

- for explicit type

z MMR- multi modal reasoning z MMR multi modal reasoning

- integrates CBR and RBR

١٧

Reasoning Paradigm

Managing medical knowledge

٣٣

Conclusion

z MMR methodology seems to be a valuable way for exploiting all the knowledge available within the organisation for:

the organisation for:

- Mining and intelligently retrieving it

- Distributing it among different health care providers -To optimise the processes of patients management and

therapy revision

z DSS cannot be conceived as an independent z DSS cannot be conceived as an independent

tool. It should be optimised by integrating with KM

١٨

Nurse & Technology Interaction

Computer Technology Acceptation

z Practice

z Management z Education z Research

٣۵

z in the medical domain, different knowledge types are typically available:

Nurse & Technology Interaction

are typically available: - Operative knowledge - Formalized knowledge

z Since 30 years ago, expert systems has been defined to help physicians solve particularly critical decision problemsp

z On field exploitation of ES were poor, due to: - poor usability, accessibility & organizational factors - stand alone situation

١٩

Nurse & Technology Interaction

z Today the trend in definition of DSS is

integration of HIS with different methodologies integration of HIS with different methodologies & technologies

z This goal is achieved by integrating the decision support functionality with the knowledge management (KM) task z IT allows to face simple, but large scale

problems

٣٧

Nurse & Technology Interaction

Interactive transfer of expertise nurse & computer program guide knowledge acquisition process

٢٠

z Nursing Information Systems

Nurse & Technology Interaction

z Electronic Health Report Systems

z Patient Digital Assistant

z Medical Diagnosis Systems

٣٩

Honeywell HomMed Products

٢١

H

Nurse & Technology Interaction

z Home care z Tele-Nursing z Database z E-Learning Ed ti l PDA z Educational-PDA z E-Shift Scheduling ۴١

Conclusion

Nursing informatics implementation depends on three factors:

Individual

depends on three factors:

٢٢

Conclusion

Information Management Framework

Computer Skills Informatics Knowledge Informatics Competencies H Information Management Competencies Informatics Skills Human Information processing Skills Competencies ۴٣

Conclusion

z Reasons for IT adoption failures

z Factors influencing IT adoption

z Nurses are integrated to Technology in

its all aspects

٢٣

references

Guenther JT, Peters M, .Mapping the literature of nursing informatics, Medical Library Association, 2006: 94(2) 92–98.

Staggers N Gassert CA Curran C A Delphi Study to Determine Informatics Staggers N, Gassert CA, Curran C, A Delphi Study to Determine Informatics

Competencies for Nurses at Four Levels of Practice, NURSING RESEARCH, 2002: 51(6)383-390

lee TT, Nursing administrators' experiences in managing PDA use for inpatient units, CIN, 2006:24(5) 280-287

Bangert AW, Easterby L, Designing and delivering effective online nursing courses with the evolve electronic classroom, CIN, 2008:26(2)99-105 Darvish A, Salsali M, "A review on information technology development and the

necessity of -nursing informatics specialty", INTED2010 (International Technology, Education and Development Conference) , 8-10 March 2010, Valencia, Spain. Virtual Presentation

Ammenwerth E, Iller C, Mahler C, IT-adaption and the interaction of task, technology and individuals: a fit framework and a case study, BMC Med Inform Decis Mak, 2006: 6(3)

۴۵

Next session

effective internet search: key points

effective internet search: key points