1. BY: KRISTIAN C. DAKAY NURSING INFORMATICS IN CANADA

2. The Canadian Nurses Association CNA has taken the position that “registered nurses and other stakeholders in healthcare delivery require information on nursing practice and its relationship to client outcomes. CAN believes that registered should advocate and lead in implementing the collection, storage and retrieval of nursing data at national level.”

3. Focus of NIT in CANADA The role of nursing within healthcare organizations A long standing tradition that nurses have the role of custodians of information on behalf of other caregiver and users of patient information.

4. Pressures on health services delivery system

5. National Health Information Organizations CANADIAN INSTITUTE OF HEALTH INFORMATION The establishment of National Health Information Council in the late 1980’s lead to the National Task Force on Health Information, also known as the Wilk Task Force Wilk Task Force- presented comprehensive goals and a strong vision for nationwide health information system

6. CIHI Health Data Elements and Proposed Nursing Components Care Items Patient Demographics Service items

7. Canadian Institute for Health Information An independent, pan-Canadian not for profit organization, established jointly by federal and provincial/territorial ministers of health, with a mandate (CIHI,2002) Coordinate the development and maintenance of a comprehensive and integrated approach to health information for Canada. Provide and coordinate the provision of accurate and timely data and information required.

8. Canada Health Infoway Inc. Resulted in commitment in October 2000 by the federal government of $500 millino to support the development and coordination of pan-Canadian health information systems necessary to achieve an EHR Incorporated in January 2000 and began its 1 st year of operation in April 2001

9. The Federal/ Provincial/ Terriyorial Advisory Committee on Health Infostructure Set its top priority on the development of HER and telehealth

10. Standards Council of Canada The CAC has a dual role: To provide technical input to SCC on Health Informatics standards development in Canada To provide feedback about utility in Canada of ISO health informatics standards. The Goal of the CAC: Is to harmonize national with international health information standards, specifically those addressed by the ISO/TC 215 on Health Informatics.

11. Obstacles to Effective Nursing Management of Information in Canada Software and hardware for modern electronic communication networks are only two aspects of an information infrastructure Lacking in most hospitals and health services organizations: absence of appropriate infrastructure to facilitate information management- not limited to date management policies and procedures, methods for data stewardship and custodianship, user training and information management support staff,

12. Issues Related to Effective Nursing Management of Information Nursing issues lack of adequate educational programs in information management techniques, and strategies for nurse clinicians and nursing managers. Frequently uderrepresented in the selection and installation of patient care information systems and financial management systems in Canada Have been involved in the management of nursing information since the initial systems for gathering minimum uniform health data Canadian nurses must be able to manage and process nursing data, information and knowledge to support patient care delivery in diverse care delivery settings.

13. Initiatives Directed at the Development of Nursing Components of Health Information for use in Canada Client status is broadly defines as a label for the set of indicators that reflect the phenomena for which nurses provide care, relative to health status of clients Nursing interventions refers to purposeful and deliberate health affecting interventions (direct and indirect). Client outcome is defined Nursing intensity Primary nurse identifier is a single unique lifetime identification number for each individual nurse

14. Meeting the Challenge: CNIA (Canadian Nursing Informatics Association) Overall objectives: To provide nursing leadership for the development of nursing/health informatics in Canada To establish national networking opportunities for nurse informaticians To facilitate informatics educational opportunities for all nurses in Canada To as a nursing advisory group in matters of nursing and health informatics To expand awareness of nursing informatics to all nurses and healthcare community