The Leadership Initiatives of Nurse Informatics - Research Paper Example

Introduction Nursing is one of the most vital ingredients of healthcare industry. In the environment of advancing technology and rapid globalization, nurses need to coordinate and empower themselves with informed choices to make effective decision making (Chitty, 2007). In the current times, technology has greatly facilitated continuous improvement process within healthcare that has not only benefited the industry but also helped meet the needs of the patients with more efficiency. Performance measurement and improvement have increasingly become key issues in healthcare delivery. For competent nursing, coordination amongst different departments and effective communication becomes hugely important factor for optimising performance. Hence information technology and management has increasingly become critical factor for improving and improvising nursing care and competency (Sullivan & Decker, 2009). As such, the nurse informatics as evolved as important stream in nursing professional that exploits information system and communication to improve efficiency and quality of patient care. What is nursing informatics? American Nursing Association has defined nursing informatics as ‘a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, and knowledge in nursing practice’ (ANA, 2001, p. vii). It has emerged as important branch of nursing career that specializes in developing and utilizing the information technology and management system to integrate data, information and knowledge to enrich the scope of nursing care and significantly boost the patient welfare. The effective exploitation of information through technology helps to create linkages across the patients, nurses and other healthcare service providers, thereby helping them in decision making based on informed choices. Data, information and knowledge are the three major elements of the informed choices that are facilitated by well-defined and developed information system within a healthcare organization. The structure and process help the information to be coordinated into defined format to aid efficient delivery of patient care. Theoretical framework used in nurse informatics The theoretical framework of nurse informatics is based on the expanded system of life cycle model as defined by Staggers, Thompson, and Snyder-Halpern (2002). The nurses’ competencies are defined at four levels in nursing practice. The expanded system of life cycle is contextual within the clinical background that encompasses logical process of planning, implementing and managing life cycle activities for all types of healthcare settings. The expanded life cycle includes five steps: planning, analysis, design, implementation and maintenance (Thompson et al., 1999). These are important paradigms that help to formulate concrete strategy for optimizing performance outcome in clinical setting. The planning is ongoing process that helps initiate analysis of the requirement of the patient. The design phase develops appropriate strategic care plan which is then implemented efficiently and maintained till desired goals of patient’s recovery is met. The system life cycle has dynamic format that constantly monitors the contextual changes and appropriately adapts the same within its different processes for optimized results. The system outcome primarily describes the legible documentation that is easily understood and implemented. These become intrinsic part of desired competencies for four levels of nursing practice for nurse informatics as quality care depends on effective communication and dissemination of information across the various service providers. The healthcare providers mainly communicate through written notes written on patients’ chart, the coalition of information becomes critical input for effective communication amongst the different healthcare providers. The four levels as described by Staggers et al. (2002) for nurse informatics broadly refer to the various stages of competencies developed by them during their practice as nurse informatics. The four levels of competencies are: beginning nurse; experienced nurse; informatics specialist; and informatics innovator. Beginning nurse: This is the initial stage where the nurse learns to operate and use information stored in the computer. Data entry of patient data, retrieval of data, coordinate data with practice and understanding the ways to communicate the same across the service providers become important activities for beginning nurse. They become proficient in using computer and multimedia helping in efficient documentation of patient data and using the same for various purposes including education, monitoring and evaluating outcome and resources. They also learn the limitation of computers and ethical decision making based on informed choices. Experience nurse: This is the next stage where the nurses use their knowledge for advanced nursing functions vis-à-vis administrative work like forecasting, budgeting, scheduling task; extracting data from clinical set and nursing research for enhancing their knowledge base. They use their experience for furthering their career in informatics by using it as teaching and learning tool. Most importantly, they become well versed in exploiting its potential for advancing their knowledge, using internet and manipulating information to gain new knowledge and expertise in new areas of healthcare deliverables. They gain in-depth knowledge of data integrity and data security measures and its importance in patients’ care. Informatics specialist: Knowledge becomes the most important part of information specialist in organizational functioning. As the competencies of nurse increases, they are better equipped to integrate and categorize information in some systematic format so that it can be further used, modified or changed as per the need. The diversity in the area of knowledge is the most important aspect of nursing paradigm which informatics specialist is able exploit to improve performance outcome of the patient care and overall delivery of healthcare. Indeed, knowledge management through effective use of information system becomes important part of workplace (Saba & McCormick, 2006). The informatics specialist through one’s expertise in the defined area becomes an intrinsic part of developing processes within and outside the organizational capabilities. Informatics innovator: It is the last but not the least important level of competency of nurse informatics. The scope of nurse informatics is widened to encompasses creativity within the system and explore new avenues of growth and opportunities within the healthcare. They develop patient based simulation for nursing to assess their clinical abilities and improve and improvise their nursing competencies as per the quality of end of life care (Alinier et al., 2003). They become proficient in exploiting technology and design creative techniques in clinical area, education, administration and research. They are huge asset for expanding the scope in nursing practice and improving healthcare. Importance of the nurse informatics Nursing informatics has emerged as very important part of healthcare industry as it integrates and correlates myriad information to give state of the art patient care. Using computer and technology, it has considerably simplified communication and helps document the notes and patients’ chart information so that they are accessible to different service providers for delivering optimal patient care. Indeed, the basic objective of nurse informatics is to develop an effective information system that would improve documentation accuracy and facilitate analysis of clinical data. They use handheld devices, voice recorder etc. to input patients’ health related information and physicians’ notes. This not only delineates the errors in the onerous task of manually feeding information in the computer but also increases the accuracy of the same. Thus, unnecessary tasks are reduced and at the same time, information is more accurate, efficient and timely. Nurse informatics also promotes affiliations and networking and ensures that theoretical knowledge is backed by practical experience. It provides the nurses with constant learning environment and helps to expand their knowledge base and improve their professional competency (Alexander, 2011). It encourages synergistic approach that excels in coordination and integration of information from different sources so that nurses are able to widen their area of knowledge and incorporate the changing environment and promote synergistic relationship with others. Thus, it not only optimizes patients’ care but also creates stimulating environment of constant learning that keeps one abreast with the advancing knowledge in the field. Review of literature Nurse documentation is dynamic process that is complex in its content and requires high degree of efficiency and expertise. ANA supports skilled information management and had established the role of informatics nurse specialist for encouraging use of information technology within nursing practice for optimized care. HIMSS (2007) has redefined the role of nurses as expected outcome of information technology. It has far-reaching consequences as it foresees the future implications of information technology in furthering the causes of nursing practice. It emphasizes that documentation of evidence based practice would help the practicing nurses to not only track their care and patient outcome but also allow others to learn from their experience. Langowski (2005) believes that information technology is important aspect of healthcare delivery as it enables access to critical patient’s data by different healthcare providers from different location. The point of care clinical system used by nurse informatics is hugely important not only for healthcare administrators, nurses and other service providers but is intrinsically linked to advancing one’s knowledge and career prospects (Gruber et al., 2009). Indeed, the system relies on the proficiency of the key users to exploit information and the contextual environment of clinical setting. Pare & Ellam (1998) assert that implementation might be difficult as different situations require different implementation design and practice. He further claims that though computer system offers huge opportunities to widen one’s clinical knowledge but different clinical settings could considerably increase risk of implementation which therefore requires more research to mitigate the same. But these are minor hurdles that can be overcome through judicious decision making based on informed choices. Major issues Nurse informatics career option fundamentally relies on the exploitation of information through the use of technology within the healthcare industry by the nurses who are primary carer of the patients. The leadership initiatives of nurse informatics promotes change and advocates networking in the work environment to boost patient care and create a constant learning environment for health professionals. Thus, the major issue that confronts nurse informatics is resistance to change. The importance of IT/IS system needs to disseminated amongst the various users and health workers so that they are able to understand the vast potential of computer and how it would improve and improvise their performance outcome. Nurses need to feel comfortable with the computers and associated technology to understand, evaluate and analyse data and information to enhance their efficiency in the patient care delivery. Thus, nurses need to undergo formal training in developing computer skills and use technology to improve their performance. The second important issue is redefining the role of nurses and nurse practicing informatics within the core of their profession. The role of nurse informatics is crucial for disseminating critical information about patient data and collating them for more efficient patient care. While most of the nurse informatics focus on training other nurses into the use of computers and developing, improving and testing new methods of improving patient care through exploitation of information, some of the nurse informatics also use it in clinical practice to enhance their efficiency and performance. The myriad functions of nurse informatics has become complex in its area and therefore needs to be redefined in terms of nursing practice and core nursing functions. The third major issue is the integration of information from various departments as information from nurses, physicians, administrators, clinicians, dieticians and pharmacists are needed to be collated for ensuring best care plan for the patient. Thus they not only need to be included while developing effective information system but also need to be trained to utilize the same to improve their performance in the respective field of healthcare. The inclusion of hospital administrators is required because they would be better able to understand and disseminate information regarding the best practices and approached that can contribute towards improved performance. Clinicians and dieticians provide critical service vis-à-vis medical and aftercare services, correct diets and lifestyle skills that promote self-help and preventive care. Inclusion of pharmacist is mainly to emphasize the need to create linkages with outside agencies that facilitate in the recovery of patients. The nurse informatics becomes vital as they integrate and use the information to improve patient care. Analysis and scope of nurse informatics Nurse informatics has huge significance in the overall delivery of patient care. They are well trained to create comprehensive database of patient information and their related healthcare needs which can be used by various service providers for implementing best practices within the broader precinct of ethical considerations. The success of system could only realized when the people who are directly involved with the various aspects of the information, ensure that small effort from them would significantly impact the outcome of the necessary outcome. Thus, resistance needs to be overcome through dissemination of information about the technology and its use within the nursing practice for efficient healthcare delivery. Indeed, the field empowers nurses and healthcare providers with crucial information that helps in the patient care and their treatment plan. Moreover, nurse informatics facilitates higher learning and encourages the professionals to widen their area of knowledge through the use of information technology. The advantages of information regarding evidence based practices and outcomes are myriad and serve as learning and teaching tools for the students and practicing professionals. Nurse informatics also serves as change agent as they are proficient in adapting to changes and use change management to influence others in the healthcare field. Nurses are always facing new challenges and in terms of attitude and behaviour of pluralistic society. They also need to be updated about new medications and best practices within the field so that they can meet the challenges of time with higher degree of confidence and skills to use new techniques and methods. The nurse informatics provides facilitating environment of learning which equips the nurses and other service providers with knowledge and information which can be implemented in the patient care. Implications of the nurse informatics The wider implications of nurse informatics necessitate creating an open environment of shared learning. The role of nurse informative is very positive and proactive that understands the importance of information system. It coordinates and supports the rest of the functions and user requirements in order to help the healthcare professionals to achieve all their strategic goals and objectives. They also identify the areas where the creative inputs of the healthcare professional would impact on the performance. Through training of staff on new skills, they enable health workers to keep up with the on-going changes within and outside the organization. Thus, nurse informatics have long term goals and ability to visualize future changes so that they can be adapted within the system and institute a process of continuous improvement in their performance. Conclusion The leadership initiatives of nurse informatics become key factors that motivate people to accept change. The huge potential of nurse informatics in improving the healthcare deliverables is the key enabling element of best practices that are adopted by the healthcare industry for optimizing patient care and treatment. The major challenge faced by nurse informatics is in ensuring the integration of information system with the existing system of the hospital so that various departments and healthcare professionals function smoothly and with high degree of efficiency. The integration of processes and activities are designed to improve and improvise the care outcome. The scope and rationale behind nurse informatics is to provide the healthcare system with accurate and updated data regarding patients’ care and treatment so that it can be efficiently used by various health professionals. It facilitates communication which can be accessed from any locations by authorised professionals to give timely medical treatment or financial benefits to the patient. Thus, emerging role of nurse informatics is hugely important and needs to be constantly monitored and developed to meet new challenges. Reference Alexander, Rinda. Understanding the needs and roles of today’s nursing leaders. 1 February, 2011. http://www.phoenix.edu/profiles/faculty/rinda-alexander/articles/understanding-the-needs-roles-of-todays-nursing-leaders.html 14 March, 2013 Alinier, G.; Hunt,W. & Gordon, R. Determining value of simulation in nurse education: Study design and initial results. Nurse Education in Practice 4 (2003): 200–207. American Nurses Association. Scope and Standards of Nursing Informatics Practice, Washington, DC: American Nurses Publishing, 2001. Chitty, K. Kittrell. Conceptual and Philosophical Bases of Nursing, University of Phoenix: Elsevier Inc., 2007. Gruber, Dianne et al. Factors Influencing Outcomes of Clinical Systems Implementation. CIN, 27.3 (2009):151-163. 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