Unit VII

NURSE INFORMATICIST ROLE

NURSE INFORMATICIST ROLE
• Technologies optimized for the nursing process organize and prioritize
patient care data against a complex backdrop of quality and patient
safety.
• Nurse executives' responsibility to evaluate, select, and deploy these
advanced technologies requires one of two things:
1) either a deep personal and nursing-centric knowledge of technology or
2) access to that knowledge, which is resident in a technology expert.
NURSE INFORMATICIST ROLE
• Technologies optimized for the nursing process organize and prioritize
patient care data against a complex backdrop of quality and patient
safety.
• Nurse executives' responsibility to evaluate, select, and deploy these
advanced technologies requires one of two things:
1) either a deep personal and nursing-centric knowledge of technology or
2) access to that knowledge, which is resident in a technology expert.
NURSE INFORMATICIST ROLE
• Considering the organizational and interdisciplinary demands on nurse
executives, a direct reporting structure to the technology expert offers the
most efficient and effective pathway to this highly specialized knowledge.
• Often, this direct reporting relationship with the technology-infused individual
leads to a Nurse Informaticist (NI).
• While some confusion over the preferred background of the graduate-
prepared NI exists, nursing experts agree that effective Nis command highly
specialized knowledge from three distinct disciplines:
• 1) clinical nursing,
2) information technology, and
3) research.
NURSE INFORMATICIST ROLE
• NIs use a rich, interdisciplinary perspective to analyze
patient care and outcome data, creating new knowledge
that advances the clinical practice of nursing.
• As a trusted advisor to the nurse executive, the NI
serves a "translator" of technology capabilities, options,
and alternatives to the nurse executive, who looks to the
NI to align technologies and systems under consideration
with organizational objectives.
NURSE INFORMATICIST ROLE
• The nurse executive must be able to converse, debate, and
champion specific technologies and clinical information
systems personally.
• They are the only one at the executive decision-making table
with the expertise, knowledge, or perspective to advance the
requirements and needs of patient care during technology-
related discussions and debates.
NURSE INFORMATICIST ROLE
Two Key Areas Of Expertise
• Nurse executives and NIs involved in technology
decision-making need to leverage two specific
type of IT expertise when they evaluate, select,
and implement clinical information systems:
1. process mapping and
2. workflow design.
NURSE INFORMATICIST ROLE
Two Key Areas Of Expertise
• Process mapping delineates the actual steps of
clinical practice as they occur during patient care,
• Workflow design spans the mechanical
arrangement of information, forms, and triggers
to document nursing practice.
NURSE INFORMATICIST ROLE
• The success of every HIT implementation hinges
on having a clear understanding of process
mapping and workflow design, as well as the
ability to chart these activities in a format
understandable by computers.
NURSE INFORMATICIST ROLE
• Vendor-resident engineers lack the site-specific
and nursing practice-specific knowledge required
to add the context of the lived experience to the
workflow creation process.
• While evidence in the standardization of processes
and practices is a universal application goal, site-
specific modifications are needed to have the
software accepted and used by nurses delivering
patient care.
NURSE INFORMATICIST ROLE
• From a nursing perspective, leaving this critical
foundational work to engineers and technologists who
lack the hands-on experience of delivering patient care at
the bed- side is pure folly.
• Delegating these two key foundational activities to non-
nurses resembles the potential disaster created by
allowing individual motorists to build their own roads—
with no regard for the needs of their fellow motorists and
no knowledge of construction, traffic flow, volume, or local
weather conditions.
NURSE INFORMATICIST ROLE
• Informatics Competencies and Roles
• Very few of today's nurses have worked in only one
role or even one specialty of nursing throughout
their careers, and this will likely hold true for
coming generations of nurses.
• The need for informatics competencies exists in all
nursing roles and specialties.
NURSE INFORMATICIST ROLE
Informatics Competencies and Roles
• The National Council of State Boards of Nursing
(NCSBN) has developed and is studying a Transition to
Practice (TTP) nursing preceptor model that includes
"five transition units consisting of “:
1. communication and teamwork,
2. patient-centered care,
3. evidence-based practice,
4. quality improvement and
5. informatics" .
NURSE INFORMATICIST ROLE
Informatics Competencies and Roles
• The model incorporates many key aspects from the
Institute of Medicine's report on The Future of Nursing:
Leading Change, Advancing Health related to
competencies for all nurses, and is an inclusive model,
which would take place in all health care settings that hire
newly graduated nurses and for all educational levels of
nurses, including practical nurse, associate degree,
diploma, baccalaureate and other entry-level graduates” 
NURSE INFORMATICIST ROLE
Informatics Competencies and Roles
• Because informatics and technology are now
integral tools used in all aspects of nursing
practice, from entry-level to advanced practice, it is
strongly recommended that the state boards of
nursing require that basic informatics
competencies be incorporated into all nursing
program curricula, ranging from licensed practical
nurse (LPN) to doctoral levels.
NURSE INFORMATICIST ROLE
Informatics Competencies and Roles
• Because informatics and technology are now
integral tools used in all aspects of nursing
practice, from entry-level to advanced practice, it is
strongly recommended that the state boards of
nursing require that basic informatics
competencies be incorporated into all nursing
program curricula, ranging from licensed practical
nurse (LPN) to doctoral levels.
NURSE INFORMATICIST ROLE
• Informatics Competencies and Roles
• As noted previously, the American Association of Colleges of
Nursing (2008) provided guidance on the educational
requirements for the baccalaureate education for professional
nursing practice.
• "Essential IV: Information Management and Application of
Patient Care Technology identified informatics competencies
that all BSN graduates should possess.
• For nurses prepared at the graduate level, the AACN provided
foundational informatics competencies in The Essentials of
Master's Education in Nursing, "Essential V: Informatics and
Healthcare Technologies."
NURSE INFORMATICIST ROLE
• Informatics Competencies and Roles
• Nurses who hold a master's degree in something
other than nursing can gain a postmaster's
certificate in nursing informatics.
• Many of the numerous programs available have
similar competencies, but in general the curricula
focus on gaining specific knowledge and skills in
nursing and healthcare informatics, thereby
supporting evidence-based practice and the
improvement of healthcare outcomes.
NURSE INFORMATICIST ROLE
• Informatics Competencies and Roles
• AACN's Essentials of Doctoral Education for
Advanced Nursing Practice  lists informatics-based
competencies in "Essentials III: Clinical
Scholarship and Analytical Methods for
Evidence-Based Practice."
• Although only the Doctor of Nursing Practice (DNP)
is specifically addressed by the AACN, this does
not imply that informatics education is not
important in PhD programs.
NURSE INFORMATICIST ROLE
• Informatics Competencies and Roles
• In many PhD programs, computer science and biomedical
informatics are required courses. However, because the DNP is
considered a "practice doctorate and the PhD a "nursing
research doctorate," the emphasis on informatics and clinical
practice impact is reduced, though these areas are not
considered unimportant .
• Thus, it is strongly recommended that PhD curriculum writers
incorporate courses that examine the tenets of nursing
informatics and focus on the methods of data entry, data
storage, data retrieval, and data analysis from EHRs, report
writing programs, and database management systems.
NURSE INFORMATICIST ROLE

Informatics Competencies for Informatics

Nurses and Informatics Nurse Specialists
Informatics Competencies for Informatics
Nurses and Informatics Nurse Specialists
• are found in the "Standards of Nursing Informatics Practice"
• As part of its preparation for the new nursing informatics
certification exam test form, the American Nurses Credentialing
Center (ANCC) completed its Role Delineation Study: Nursing
Informatics--National Survey Results which reported the
collected information on the work activities that informatics
nurses perform in practice. The final report listed 8 domains
and 71 separate tasks, as well as calling out the 20 task
statements with the highest and lowest values of initial risk.
Informatics Competencies for Informatics
Nurses and Informatics Nurse Specialists
• are found in the "Standards of Nursing Informatics Practice"
• As part of its preparation for the new nursing informatics
certification exam test form, the American Nurses Credentialing
Center (ANCC) completed its Role Delineation Study: Nursing
Informatics--National Survey Results which reported the
collected information on the work activities that informatics
nurses perform in practice. The final report listed 8 domains
and 71 separate tasks, as well as calling out the 20 task
statements with the highest and lowest values of initial risk.
Informatics Competencies for Informatics
Nurses and Informatics Nurse Specialists
• The McGonigle, Hunter, Hebda, and Hill online
assessment of nursing informatics competencies can
assist faculty and management to develop curricula or
continuing education that best meets the needs of their
students or employees.
• While there are obvious concrete informatics
competencies that every nurse must have, there are
many other, more progressive, processes that will likely
never be part of an educational curriculum or added to a
formal list of competencies.
Informatics Competencies for Informatics
Nurses and Informatics Nurse Specialists
• An example is the ever-changing landscape of
meaningful use criteria. Another example is the
numerous ways in which technologies are enhancing
practitioners' ability to monitor patients and coordinate
care remotely via telehealth methodologies.
• All of these areas require informatics nurses and
informatics nurse specialists to be involved in defining
benefit versus impact, although it may be difficult to
predict how the evolving technologies will be used in the
future.
Informatics Competencies for Informatics
Nurses and Informatics Nurse Specialists
• In addition to numerous researchers, academics, and
employers, many professional organizations are actively
working toward validating, creating resources, and providing
education in nursing informatics. These include the:
• American Nurses Association (ANA)
• American Medical Informatics Association (AMIA)
• American Nursing Informatics Association (ANIA)
• Health Information and Management Systems Society
(HIMSS) Nursing Informatics Working Group
Informatics Competencies for Nurse
Educators
• Today's nursing educators are challenged to
include information on informatics in a basic
nursing education curriculum that is already full.
• A second challenge is that many nurse educators
themselves lack informatics competencies
(AACN, 2013; Flood, Gasiewicz, & Delpier, 2010).
Informatics Competencies for Nurse
Educators
• The Gordon and Betty Moore Foundation
funded a pilot conference to teach faculty how
to teach 110informatics. The "QSEN Nursing
Informatics Deep Dive Workshop" was co-
sponsored by the American Association of
Colleges of Nursing and the Schools of Nursing at
the Universities of Minnesota and Maryland.
Informatics Competencies for Nurse
Educators
• The presentations and resources are available to
anyone, without charge, on the AACN website
(http://www.aacn.nche.edu/qsen-
informatics/2012-workshop).
Informatics Competencies for Nurse
Educators
Additional challenges include:
1) continuing to enhance and disseminate resources and
teaching strategies for all faculties across the country;
2) the lack of requirements for PhD programs in nursing to
include informatics (researchers are going to need advanced
informatics skills); and
3) the need for methods required for "big data” research to be
integrated into curricula for future faculty and nurse
researchers.
Informatics Nurse (IN) and Informatics
Nurse Specialist (INS) in the
Philippines
Informatics Nurse (IN) and Informatics
Nurse Specialist (INS) in the Philippines
• Hebda, Hunter and Czar (2019) describe the role
of the Informatics Nurse (IN) and the Informatics
Nurse Specialist (INS) in relation to their distinct
roles as stated in the Scope of Nursing
Informatics Practice statement revised by the
American Nurses Association (ANA) in 2008.
Informatics Nurse (IN) and Informatics
Nurse Specialist (INS) in the Philippines
• "The IN refers to the RN who works in the
area of informatics. She has experience or
an interest in the area but no formal
informatics preparation.
• the INS has advanced, graduate education
in nursing informatics or a related field and
may hold ANCC certification."
Issues and Challenges of Nursing
Informatics in the Philippines:
Informatics Nurse (IN) and Informatics
Nurse Specialist (INS) in the Philippines
• Nursing informatics face many challenges while
in its infancy stage.
• The inclusion of informatics as an integral part of
the undergraduate curriculum has been one of
the most influential factors for the increased
awareness and interest in this field of nursing.
• However, the contents of the curriculum was
adapted from international materials which
does not match the local needs."
Informatics Nurse (IN) and Informatics
Nurse Specialist (INS) in the Philippines
• A community-centered approach to the use of
information, communication and technology in nursing
practice must be adapted to ensure the impact of the
program in the local healthcare system.
• Lack of certification and credentialing programs in
post-graduate levels are also absent with the scarcity
of local nursing informatics experts. This new field has
yet to gain acceptance and recognition in the nursing
community as a sub-specialty.
Informatics Nurse (IN) and Informatics
Nurse Specialist (INS) in the Philippines
• A community-centered approach to the use of
information, communication and technology in nursing
practice must be adapted to ensure the impact of the
program in the local healthcare system.
• Lack of certification and credentialing programs in
post-graduate levels are also absent with the scarcity
of local nursing informatics experts. This new field has
yet to gain acceptance and recognition in the nursing
community as a sub-specialty.
Future Direction of Nursing Informatics in
the Philippines:
Future Direction of Nursing
Informatics in the Philippines:
• Development of training, certification and credentialing
programs are in the pipeline for the Philippine Nursing
Informatics Association (PNIA).
• Future partnerships with local and international nursing and
health informatics organizations have started as well.
• Other programs are expected to be slowly delivered with PNIA's
CORE X strategic platform which stands for Competency,
Organization, Recognition, Experience and Expertise.
• It is also a major thrust to support the use of health information
standards in the Philippines and to have nursing informatics
specialists in every hospital in the country.
IN in the Philippines will include the
following roles:
1. Ensure proper record or documentation with the use of
technology whether in clinical practice, administration, or the
academe
2. Utilize information and technology responsibly in health education
3. Collaborate with other health professionals with the use of
hospital information system (clinical) or educational information
system (academe
4. Use of simulation learning in education or continuing education
5. Educate students about nursing informatics and facilitate learning
through the use of Information Communication Technology (ICT)
Tools
For INS in the Philippines, the following would
be some of the roles:
1. Research and theory development
2. Design information systems that work well in the
Philippines
3. Test human-computer interfaces
4. Contribute to Health Informatics Policy
5. Champion or advocate for nursing informatics in
the country
6. Help develop standardized nursing terminology in
the Philippines