Nursing Informatics (Acknowledgments)
Introduction
Increasingly, the world of nursing is being impacted by technological
change. As one commentator put it, "In today's Information Age, nurses
are expected to keep pace with the rapidly advancing technology."(1)
In discussing how nursing education is being influenced by "rapidly changing technologies and dramatically expanding knowledge," and how "students must learn to acquire, apply, and evaluate new knowledge," the American Association of College of Nursing's Nursing Education's Agenda for the 21st Century recognizes the importance of information skills, listing "information seeking, sorting and selection" as third among nine essential cognitive curricula areas.
Nurses are seen as being at "the hub of the information flow between patients and the health care system."(2) Charting is being automated, as are patient care plans. Work is proceeding on developing a Nursing Minimum Data Set (NMDS). There is a new emphasis in health care on evidence-based, cost-effective practice, which puts a premium on nurses being information savvy. While critical thinking is key to evidence-based nursing practice, it is also true that information access and information technology skills are also essential.
Nursing informatics(3) is the term that is used to describe the cross-functional interrelationship between nursing concepts, and information resources and technology. The Web site Nursing Informatics from Columbia University provides good background information.
Informatics Curricula
Over the last 5 years or so, the term has evolved to have two basic
meanings. One refers to the broad needs that all nurses have to be information
savvy -- to be able to use information access tools, information technology
resources, and computerized systems on the job. This is the most common
meaning. As with other occupational programs, nursing faculty are scrambling
to incorporate nursing informatics into regular coursework. As an example,
the Nursing
Program at Front Range Community College (Colorado) offers 30 contact
hours of nursing informatics content. Case Western Reserve's Frances
Payne Bolton School of Nursing has developed a series of courses for
their nursing students to cover informatics. One of them is NURS 120
which is described as a course that focuses on identifying content,
flow, and the processing of patient information in the hospital. The
context is the nursing process, and the role of the nurse as the gateway
for patient information. Students see the ways in which information
technology influences and facilitates collecting, processing and communicating
information.
The second meaning refers to nursing informatics as a
nursing specialty. For example, there is a Nursing
Informatics program at the University of Maryland, and Duke
University . Nursing informatics is recognized as a specialty by
the American Nurses Association (ANA); those actively involved in the
practice of nursing informatics can be certified
by examination.
What Nurses Say about the Impacts of the Information Age
on Their Jobs
Using nursing chatrooms and other avenues, I have directly asked practicing
nurses about the impact of the Information Age on their activities.(4)
Here is a selection of the responses I received:
Speaking from 21 years of experience, I would definitely recommend that you know how to use an Internet Web browser proficiently. It is also good to have a general notion as to how a network works...not the technical aspects, but a general familiarity with the concepts is very helpful. All modern healthcare computer systems are networked.
Usually in my experience (I'm an RN), you are trained by your institution in using its proprietary computer systems. However, if you temp at a variety of hospitals, you are going to have to have the broader concepts firmly in mind, since the proprietary systems will vary.
You take the knowledge explosion, the growth of the Internet, and the public's increased awareness of and participation in their own health decisions, and you can see that nurses must stay current. It's becoming more and more the nurse's responsibility to know how to advise patients on how to access information that is credible and relevant for them.
If you're already a nurse, you have to have on-the-job training; and be sure to go to all those workshops and seminars that get offered in your area. Technology moves so fast that it is hard for older nurses who have been on the job for a while.
Nursing is affected greatly by the Information Age. Computers are at bedsides in many hospitals. A basic understanding of search tools is imperative. Much of nursing charting is now done electronically.
If you're thinking of becoming a nurse, it's very important to take courses in Windows, Word, Excel, and Internet searching. These are now basic skills for nursing personnel.
I've worked in intensive care nursing for the last 7 years and couldn't live without computer charting (or computerized information management, as we prefer to call it) anymore! There is hardly any paperwork (decoding bad handwriting is history!). Of course, it takes time to use the pc, but as it is situated right next to the patient's bed, I'm always there for him/her.
At my hospital, patients' rights are posted in the lobby. One of the rights is to receive information about your illness, course of treatment, and prospects for recovery in terms the patient can understand. As a nurse, that often comes down to being your responsibility. In today's world, you need to be comfortable doing Internet searches for information that patients can read and understand.
In my facility, we use the Meditech system. In my opinion, not only would we be lost without it, but we would also become less efficient. These systems have helped our profession in caring for our patients. We are able to do nursing care plans, nurse notes, get lab, X-rays and other test results returned much faster than if they were done manually like they used to be.
This is a COMPUTER WORLD we live in. Like other professions, nursing is using more and more technology. Oftentimes, it comes down to how good are you at finding the online information you need -- when you need it?
With the move toward paperless medical facilities, today's nurse simply must be computer-literate; and people around here talk about being information-literate, so that, too!! So much communication among and between departments is done through hospital-wide networks. More often than you might think, there you are using a browser and a search tool on the Internet looking for information to help your patient understand their condition. (I think there's going to be more of this in the future, frankly.) If they're already on the job, nurses often have to educate themselves. For some, this can cause a lot of anguish.
Nurses themselves realize that the Information Age has brought massive changes
to their work environments. And the impacts will probably increase in the
years ahead.
Resources
A variety of computer-assisted (including Internet-accessible) programs
exist in the nursing field. Examples
Painless Pain Management
Simulation; from CSU
TLC Medical Center
Healthcare students become familiar with using computers in a clinical setting
Virtual
Hospital Patient Simulations/Virtual Patients
Online courses and courses that include Internet assignments
for nursing may be accessed at
World Lecture Hall:
Nursing
Professional associations directly concerned with informatics include the American Medical Informatics Association and the American Nursing Informatics Association
(1) Jo Ann Klein, Nursing Informatics Education: Past, Present, and Future, 24 May 2000 <http://nursingnetwork.com/education.htm>
(2) B. Sibbald, "Nursing Informatics for Beginners." Canadian Nurse, vol. 94, no. 4, April 1998, p. 22.
(3) The term originated in the 1980s (see Overview of Nursing Informatics, 24 May 2000, <http://www.nih.gov/ninr/vol4/Overview.html>); increased attention was focused on informatics as computerization and interactive technologies became more widespread in the 1990s.
(4) The question asked was the following (or very similar): The electronic Information Age has had considerable impact on medical environments. Many nurses now routinely use computers, electronic devices, and the Internet on the job. My question is: what computer and information access/management skills are critical for success in nursing today?
Acknowledgments Many
thanks to legions of nursing students, and to nursing faculty at Cabrillo
College (especially Sally Miller, Patsy Paul, Debora Bone, and Marjorie
Miller) for allowing me to tag along with them in their clinical work
at area hospitals. Also, to Candace Walker, librarian at Dominican Hospital,
for sharing her time and expertise in an interview.
last rev. 4/13/01
Investigating
Information Age Realities in the World of Work
