1. Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved Professional Nursing Practice Concepts and Perspectives Seventh Edition Chapter 16 Technology and Informatics

2. Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved 16.1 Define nursing informatics and technology assessment. 16.2 Describe current issues related to technology and informatics. 16.3 Identify applications of information technology in health care. 16.4 Discuss the role of nursing and healthcare informatics. Learning Objectives

3. Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved Hallmark Features A focus on foundational knowledge related to professional nursing –Includes nursing history, nursing theory, ethics, and legal aspects, etc. An overview of professional nursing roles, issues, and changes in the profession –Discusses nurses as healthcare providers, learners and teachers, and leaders

4. Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved Challenges and Opportunities The design of technology must address confidentiality and security concerns Manage information technologies in a manner that supports quality nursing care Opportunities are vast, encompassing many aspects of nursing practice, education, research, and administration

5. Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved Learning Objective 16.1 Define nursing informatics and technology assessment.

6. Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved Nursing Informatics, Healthcare Informatics, and Technology Informatics describes all aspects of computers and information systems Nursing informatics integrates nursing information and knowledge with management of information and communication technologies to promote health

7. Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved Nursing Informatics, Healthcare Informatics, and Technology The core of informatics –Data –Information –Knowledge Nursing information systems are modules within larger integrated healthcare information systems

8. Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved Nursing Roles and Education Informatics nurse career opportunities in –Acute and ambulatory settings –Academic institutions –Application companies –Consulting firms One of the newest specialties in professional nursing, recognized in 1992 by ANA –Certification is now available –Requirements

9. Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved Nursing Roles and Education Nursing roles in informatics continue to evolve –Theory formulation –Design –Development –Marketing –Testing

10. Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved Nursing Roles and Education Nursing roles in informatics continue to evolve –Implementation –Training –Maintenance –Evaluation –Enhancement

11. Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved Nursing Roles and Education Top three job responsibilities are –Systems implementation –Systems optimization/utilization –Systems development All nurses need to be information- and computer-literate –Computer skills –Information literacy skills –Overall informatics competencies

12. Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved Technology and Informatics Telehealth technology –Use of electronic information and telecommunications technologies to support long-distance health care, health-related education, and health administration –Removal of access barriers –Web seminars (webinars) –Web meetings –Web conferences

13. Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved Informatics Frameworks Frameworks help clinicians understand how informatics concepts are structured and operationalized; four concepts –Data, information, and knowledge –Sciences underpinning nursing informatics –Concepts and tools from information science and computer science –Phenomena of nursing

14. Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved Informatics Frameworks Data transformed into information and information into knowledge –Data are discrete entities that are described objectively without interpretation –Information is data interpreted, organized, or structured –Knowledge is synthesized information; relationships are identified and formalized –Wisdom is the appropriate use of knowledge –Nurses are processors of information

15. Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved Informatics Frameworks Sciences underpinning nursing informatics –Nursing science –Information science –Computer science –Combination creates a unique blend to solve information management issues

16. Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved Informatics Frameworks Methods and tools from computer and information sciences –Information technology –Structures –Management –Communication

17. Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved Informatics Frameworks Information technology includes –Computer hardware/software –Communication –Network technologies

18. Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved Informatics Frameworks Fundamental concepts to the informatics nurse –Human-computer interaction –Ergonomics The metaconcepts of nursing –Nurse –Person –Health –Environment

19. Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved Learning Objective 16.2 Describe current issues related to technology and informatics.

20. Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved Issues Related to Information Technology Four issues addressing information technology –Ethics –Confidentiality –Data integrity –Caring in a highly technical environment

21. Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved Issues Related to Information Technology Ethical concerns –Confidentiality, security, and privacy –Precautions for unauthorized access –Ethical duty to protect patient confidentiality –Guidelines related to ethical concerns  Health on the Net Foundation (HON)

22. Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved Issues Related to Information Technology Confidentiality of medical records and data –Major medical privacy breaches are one of the perils of automation –Laws related to confidentiality  Health Insurance Portability and Accountability Act (HIPAA)  Gramm-Leach-Bliley Act

23. Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved Issues Related to Information Technology Data integrity –Healthcare providers should have confidence in accuracy and quality of data they access –Controls that prevent incomplete or inaccurate entry of data instill trust –Ensuring that data are entered correctly –Data quality-management procedures in place

24. Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved Issues Related to Information Technology Caring in a high-tech environment –Nurses use technology at point of care across all care settings; sophistication and amount of technology varies –Evidence that technology improves outcomes of patient care has been inconclusive –Informatics nurses challenged to continue research and apply appropriate codes and laws to protect patients and use information tools to improve quality of care

25. Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved The Technology Explosion Evolution of technology –Exponential growth of the Internet and information systems –Nurses asked to verify information found on the Internet –Patients expect healthcare information systems to provide same level of services set by other industries

26. Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved Learning Objective 16.3 Identify applications of information technology in health care.

27. Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved The Technology Explosion Evolution of technology –Development of healthcare systems has been slower than in other industries; traditional records difficult to automate –Electronic health records (EHRs) proposed to improve quality of care and control costs –Design of new patient care systems has affected staff workflow, efficiency, and effectiveness

28. Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved Computer Technology in Practice, Education, Research, and Administration Nursing practice in organization with integrated clinical information system may include using –Online Kardex –Care protocols –Bedside computers –Barcode technology for medication administration –Personal digital assistants (PDAs) –Orders-management systems –Medication administration records

29. Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved Computer Technology in Practice, Education, Research, and Administration Informatics nurse’s role in new technologies may involve –Examination and design of new workflow –Development of implementation plan –Training in and evaluation of new technologies Research and education –Online courses –Tools for research and information access  Cumulative Index for Nursing and Allied Health Literature (CINAHL)  MEDLINE

30. Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved Computer Technology in Practice, Education, Research, and Administration Nurse administrators use information technologies to –Guide their management when they are uncertain –Satisfy stakeholders –Build and retain passionate workforces –Manage budgets

31. Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved Computer Technology in Practice, Education, Research, and Administration Nurse administrators use information technologies to –Collect and evaluate staff and patient data –Anticipate quality management interventions –Forecast resource needs

32. Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved Computer Technology in Practice, Education, Research, and Administration Priorities for informatics research –Standardized language/vocabularies –Technology development to support practice and patient care –Database issues –Patient use –Telecommunications

33. Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved Computer Technology in Practice, Education, Research, and Administration Priorities for informatics research –Putting technology into practice –System evaluation issues –Information needs of nurses and other clinicians –Innovations for professional practice –Professional practice issues

34. Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved Learning Objective 16.4 Discuss the role of nursing and healthcare informatics.

35. Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved Current Applications of Information Technology in Practice Four nursing applications of information technology –Physician order entry  Enables providers to enter, edit, schedule, track, and discontinue treatment and diagnostic services electronically –Clinical information system  May include patient registration, orders, and departmental systems –Wireless and portable devices  Bedside computers and PDAs –Electronic health record (EHR)  Electronically maintained information about individual’s lifetime health status

36. Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved Evidence-Based Practice Evidence-based practice (EBP) integrates nursing experience, patient preferences, and current research to achieve best patient outcomes –Depends upon access to current professional literature in print and online

37. Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved Telehealth Telehealth is the wide range of health services delivered by telecommunications-ready tools Telenursing is the use of communication technology to deliver nursing care Issues related to telehealth –Lack of standards regulating interface among systems –Most geographically isolated regions have poorest technology infrastructure –Funding –Patient safety