воскресенье, 16 сентября 2012 г.

Nursing informatics: an evolving specialty. (Information Systems & Technology). - Nursing Economics

AS CLINICAL INFORMATION SYSTEMS have become more commonly used in clinical practice, a specialty in nursing has emerged--nursing informatics. The informatics nurse combines his or her knowledge of nursing practice with information management; not a small task considering the amount of information generated in the process of nursing practice. It has been estimated that nurses spend as much as 50% of their time gathering, coordinating, and documenting information. That's why it is essential that some kind of structure and discipline be maintained in managing all of this clinical data in order to realize the full potential and benefit of these systems. Nursing informatics provides the support for that information management for all other nursing specialties.

What Is Nursing Informatics?

As defined by Craves and Corcoran in 1989, nursing informatics is a 'combination of computer science, information science and nursing science designed to assist in the management and process of nursing data, information and knowledge to support the practice of nursing and the delivery of nursing care.' As one of the newest specialties recognized by the American Nurses Association (ANA) in 1992, nursing informatics supports the nursing process by helping to integrate the data, information, and knowledge required for clinical decision making. The ANA (2001) further defined nursing informatics in its scope and standards of nursing informatics practice as the following: 'Nursing informatics is a specialty that integrates nursing science, computer science and information science to manage and communicate data, information and knowledge in nursing practice. Nursing informatics facilitates the integration of data, information and knowledge to support patients, nurses and other providers in their decision-making in all roles and settings. This support is accomplished through the use of information structures, information processes, and information technology' (p. vii).

Utilizing clinical information systems, an informatics nurse can help other nurses explore and understand the informational and cognitive foundations of their profession. The ability to electronically record, integrate, and analyze data and information enables nurses to quickly move to the synthesis of nursing knowledge and the development of nursing wisdom, which they can then apply to affect patient care.

What Are the Roles of an Informatics Nurse?

Although the role of the informatics nurse has only recently been defined as a nursing specialty, many nurses have functioned in similar roles for a number of years. The typical career path of these nurses began when the hospital at which they were employed decided to implement a clinical information system. Recognizing the need for nursing input, a nurse was hired to help during system implementation. Additional career options became available as his or her skills and knowledge grew. Some of these nurses may have gone on to work with an information systems vendor or with a consulting firm helping other health care organizations in their clinical system implementations. As the specialty of informatics became more defined, many of these nurses decided to further their education in this field.

As more health care organizations implement clinical information systems, the role of an informatics nurse cannot be underestimated in the potential success of the implementation and ongoing use of the system. The informatics nurse can play a key role in clinical staff education; project management; system selection, testing, and implementation; and research, maintenance, and ongoing system evaluation (Rosen & Routon, 1998).

Outside of the health care organization, an informatics nurse may be employed by an information systems vendor to work in areas such as product design and development, customer consulting, education, or other clinical areas that take advantage of the unique knowledge and experience that a nurse familiar with the practice of informatics can bring (Rosen & Routon, 1998).

Educational Options

Until the last decade, there were few formal education programs for nursing informatics. As discussed previously, many informatics nurses started working in information systems with little or no specific informatics education, but learned 'on the job.' There are now many more traditional educational programs in the field of nursing informatics. Most of these programs offer either a master of science in nursing informatics, a post-master's certificate in nursing informatics, or a doctoral program.

The University of Maryland School of Nursing in Baltimore offered the first master's of science degree in nursing informatics in 1989 and followed with a doctoral program in 1992 (University of Maryland, 2002). Additional programs are now available throughout the United States at other schools of nursing. The American Medical Informatics Association has a full listing of different types of nursing informatics programs on their Web site at www.amia.org/working/ni/education/education.html.

For nurses actively working in an informatics position, certification as an informatics nurse is available through the American Nurses Credentialing Center (ANCC). The ANCC organization reports that 420 nurses were certified as informatics nurses from November 1, 1995 through May 31, 2001. (The American Nursing Informatics Association Web site address is www.ania.org.) Pre-requisites and eligibility requirements are established by the ANCC and can be found on the ANCC Web site at www.nursingworld.org/ancc.

Continuing education programs are also offered through various organizations and facilities. One of the more popular programs is the Weekend Immersion in Nursing Informatics, offered at various locations during the year in the United States and in Canada. (For more information, visit their Web site at http://nursing.umaryland.edu/~snewbold/wini.htm.)

Summary

Health care organizations will continue to invest heavily in clinical information systems to help improve patient safety, reduce variability of care, and increase the efficiency of their staff. These clinical information systems can assist in reducing medication errors through sophisticated medication management solutions and provide clinical decision support to aid in the decision making of all clinicians. They can also help offset the effects of a growing worker shortage, especially hard-felt in nursing, by reducing redundant tasks, improving communication, and streamlining clinical data collection. As these clinical systems are implemented, there is an increased need for information management of all of this complex data. By bringing both clinical and information systems expertise to bear, the informatics nurse plays a crucial role in ensuring that these goals are met to help the organization maximize its use of clinical information technology.

REFERENCES

American Nurses Association. (2001). Scope and standards of nursing informatics practice. Washington, DC: ANA.

Graves, J.R., & Corcoran, S. (1989). The study of nursing informatics. Image: Journal of Nursing Scholarship, 21,227-231.

Rosen, E.L., & Routon, C.M. (1998, May/June). American Nursing Informatics Association role survey. Computers in Nursing.

University of Maryland. (2002). Weekend Immersion in Nursing Informatics program. [On-line]. Retrieved October 14, 2002 from http://nursing.umaryland.edu/~snewbold/wini.htm

GINNY MEADOWS, RN, is Director, Clinical Product Marketing, McKesson Information Solutions.