NURS FPX 4040 Assessment 4 Informatics and Nursing Sensitive Quality Indicators GC Assessment 04: Script Greetings all, Today, we will…
NURS FPX 4040 Assessment 1 Nursing Informatics in Health Care
Nursing Informatics and the Nurse Informaticist
According to the Healthcare Information and Management Systems Society (HIMSS), nursing informatics is a field that integrates computer science, information science, and nursing science to communicate and manage wisdom, data, data, and knowledge in the nursing field (Peltonen et al., 2018). Nursing informatics is the driving force behind the design and development, implementation, and optimization of electronic medical records, computerized practitioner order entry, nursing clinical documentation, and point-of-care clinical decision support.
The role of nurse informatics is a technical one. The nurse Informaticist use technology and data routinely to monitor patient care initiatives, systems, and program. They analyze data to check what is and what is not working. Nurse informaticist uses the findings to implement change, suggest improvements, and lead projects (All Nursing Schools, 2020). More so, nurse Informaticists research, develop and implement new technology. They are charged with training nursing staff to make good use of technology, respond to their questions, and monitor outcomes. Nursing informaticists receive feedback from the nursing staff and use the data to determine if the technology has enhanced patient outcomes (All Nursing Schools, 2020). Routine tasks handled by nurse informaticists as reported by HIMSS include resource management, establishing system-related policies and procedures, analyzing and optimizing performance, project management, system development, quality initiative planning and reporting, as well as supporting and training the nursing staff (All Nursing Schools, 2020).
Nurse Informatics and Other Health Care Organizations
Many healthcare organizations and systems have benefited from nursing informatics. For instance, Carolinas Healthcare System (CHS) went live with a 3-year optimization project in 2016 to simplify the Electronic Health Records in acute care. The system has been using Cerner tech for over a decade and wanted to upgrade the systems to help nurses use the technology and make things easier. The goal of this move was to organize tech in a user-friendly system, reduce documentation, and alleviate duplicate records. By leveraging nursing informatics, CHS saw a 14% improvement in on-time medication administration, 20% reduction in documentation time for head-to-toe assessment, and improved the quality of each assessment with 10 new screening tools that generated annual cost savings of $60K for third parties (Davis, 2018).
Nurse informaticists at John Peter Smith Hospital in Fort Worth, Texas, designed and operationalized an algorithm for recognizing domestic violence and red flags for human trafficking (Nelson & Parker, 2019). This system fits well into the emergency department nurse workflow, includes a narrative to use if the patient screens as positive, and offer step-by-step instructions to the nurse. Patients get immediate help. Informatics nurses at Texas Health Resources in Dallas-Fort Worth have uncovered how sending vital signs from the machine directly into the electronic medical records on surgical/medical and telemetry units save manual documentation time daily (Nelson & Parker, 2019). In a survey done to show how informatics support quality nursing care, Sendir et al (2019) found that 70% of nurse informaticists have helped organizations improve their medical device integration programs and those organizations that employ informaticists believe that it has improved patient safety and reduced near-miss adverse events.
To deliver better quality care, nursing informaticists must work in the same direction as nurses and other professionals. Informatics nurses facilitate communication between IT and clinical staff. They speak dual languages, health care and technology, and pay attention to designing strategies for IT procurement, optimization, implementation, and maintenance in collaboration with other operational and clinical leaders. They watch how providers are utilizing the technology so they can identify gaps or problems and create solutions. Besides, they support identifying trends and correlations as well as support data analysis that allow for decision-making.
Impact of Full Nurse Engagement in Health Care Technology
Nurse informaticists play a major role in patient care, clinical workflow, and patient data management. Nurses are using health informatics to enhance patient care through improved documentation. Through electronic documentation and sharing of patient information, nurses can manage care and thus enhance the quality of that care. Also by looking at the patient’s documented condition over time, caregivers can make good choices about how to provide care and when adjustments or changes should be made (Carroll, 2018). More so, nurse informaticists provide valuable data that can help reduce medical errors, misdiagnoses, and falls. For example, electronic medical records can offer information about a possible allergy or adverse drug interaction that goes unnoticed thus allowing nurses to make decisions to keep their clients safe. Also, nurse informatics help improves coordination of care. Without getting necessary information from billing, doctors, pharmacies, and therapists, patient care can be comprised. Nurse informaticists enhance coordination of this information thus allowing nurses to provide their clients with the much-needed information hence improving patient satisfaction and outcomes (Carroll, 2018).
Nurse informaticists also help align nursing best practices with clinical workflows. The goal of nurse informatics is to apply the overall process and best practices to maximize patient care. As such, nurse informaticists often take an active role in the process design, new diagnostics and treatment plans, and clinical workflow reviews. They consider different options for delivering care and use objective facts and analysis to figure out the measures that will result in patient-oriented, value-based care (Carroll, 2018). Besides, nurse informaticists can help reduce medical errors in the healthcare organization and its associated costs. Best practice, staff training, and process improvement in combination can limit patient risks and improve the quality of care. In a healthcare setting, medical errors are driven by lack of communication, unclear messages, incorrect or incomplete information, and sharing of information with wrong persons. Nurse informaticists can monitor how the organization collaborates and communicate patient information. They can audit each case, pinpoint gaps, and recommend how to avoid future medical errors. According to Betsy Lehman Center for Patient Safety (2019) identified about 62k medical errors and computed excess claim costs resulting from medical errors to be over $617 million annually. Nurse informatics can help nurses avoid errors and automate tasks that improve productivity and prevent some of these costs.
Privacy, confidentiality, and security concerns over protected health information are the major barriers to adoption of health information technology. It is important for nurse informatics to identify evidenced-based techniques to secure electronic medical records. Kruse et al (2017) identified various security techniques, including the use of firewalls, cryptography, cloud computing, and antivirus software. Firewalls have proven to be very successful in securing the network on healthcare organization and the protected health information that dwells on the network. Cryptography has also been shown to guarantee the security of protected health information in EMRs; particularly encryption improves the security of electronic records during exchange of patient information. When viewed by patients, decryption ensures security of health information technology. The use of passwords and usernames can eventually stop security breaches by incorporating individual privacy concerning passwords and needing users to change their personal passwords often (Kruise et al. 2017). The infrastructures created by cloud computing facilitate electronic transfer and sharing of information via the computing power, renting of storage, and software. Via this site, organizations can integrate cryptography techniques to makes sure access to the cloud is secured. Antivirus software is the commonly used defensive security measure; it is in the top ten listed strategies for avoiding security violations (Kruise et al., 2017).
Challenges and Opportunities
The field of nurse informatics is still young and nurse informaticists are often the pioneers and end up facing challenges with their organization roles, hardware or software problems, and interactions with other professionals. First, integrating the role of nurse informaticist with that of other healthcare specialists, including nurses, presents a major challenge. For example, some older doctors and nurses may lack computer skills and be reluctant to change their mode of working. Besides, nurse informaticists must communicate and translate for IT fields integral to the design of EHR and nursing documentation systems (Peltonen et al., 2019). Another challenge is that it takes a substantial amount of time for one to become a nurse informaticist. Newly hired nurses should practice and refine their clinical skills to understand the complexity of what nurses do and how to document activities.
Referencing a 2011 study that was carried out on nursing informatics by Murphy (2011), Greenwood (2020) found that 66% of informaticists had 11-16 years of clinical experience prior to transitioning into informatics, and more than 50% had graduate degrees implying that informaticists went back to school. Another challenge relates to averting destruction and fragmentation. Greenwood (2020) observed that nurses are ill-prepared to assume their roles in a highly technological environment where documentation is done electronically. Because of this, nurse informaticists must step in to teach and persuade nurses of the value of electronic documentation systems to prevent tech from fragmenting patient care and creating destructive elements. Shapland (2022) identified barriers to successful implementation of nurse informatics as physician orders taking long to be entered, cyber security and patient confidentiality, fear of technology and learning new ways of working, high investment of time of doctors and medical staff to be trained, poor communication between programs for inpatient-outpatient and inter-facility, inadequate financial services, staffing issues, and lack of integration in computer systems and software.
Even with these challenges, nurse informatics presents numerous opportunities for transforming and enhancing healthcare. These include facilitating care coordination, tracking data over time, reducing human errors, improving practice efficiencies, and improving clinical outcomes (Alotaibi & Federico, 2017).
There is a need to implement informatics in the organization to improve patient outcomes. With their competencies in computer skills, informatics skills, and information knowledge, nurse informaticists can improve patient monitoring, help in the preparation of charts for process information flow, information flow interpretation, and the design of the database and standard structures to improve clinical care, research, and administration (Bowles, 2017). They can add value to the organization by improving information technology integration in the nursing profession. Secondly, healthcare organizations have shifted from profit models to delivering value-based care. Informatics can help in these efforts to provide research and evidence-based treatment that prevents costly procedures. One way to harness data from electronic medical records and ubiquitous health devices to eliminate waste and standardize care is through decision support systems (Bowes, 2017). Informaticists can help implement such software programs to analyze client data and provide important insights such as clinical guidelines. With a functional decision support system, the organization can make diagnoses and elicit timely reminders and prompts during treatment.
Lastly, delivering quality patient care requires collaboration among medical professionals working in different organizations, departments, or facilities. Effective communication and coordinated care can allow people involved in diagnoses and treatment to organize their efforts and share details. Informatics is important in leveraging these efforts. When healthcare professionals easily access information about their needs, they can make informed choices and prioritize patient safety. With well robust privacy and security measures, caregivers can share important medical records thus avoiding redundant procedures and delivering the best treatment (Bowles, 2017).
All Nursing Schools. (2020, November 25). What You’ll do as a nurse informaticist. https://www.allnursingschools.com/nursing-informatics/job-description/
Alotaibi, Y. K., & Federico, F. (2017). The impact of health information technology on patient safety. Saudi medical journal, 38(12), 1173.
Betsy Lehman Center for Patient Safety. (2019, June 19). The financial and human cost of medical error… and how Massachusetts can lead the way on patient safety. https://psnet.ahrq.gov/issue/financial-and-human-cost-medical-error-and-how-massachusetts-can-lead-way-patient-safety
Bowles, K. H. (2017). The barriers and benefits of nursing information systems. Computers in Nursing, 15(4), 191-6.
Carroll, W. (2018). Artificial intelligence, nurses and the quadruple aim. Online Journal of Nursing Informatics, 22(2).
Davis, J. (2018, February 23). How nursing informatics helped Carolinas healthcare eliminate 18 million clicks. Healthcare IT News. https://www.healthcareitnews.com/news/how-nursing-informatics-helped-carolinas-healthcare-eliminate-400000-clicks
Greenwood, B. (2020). Problems with nursing informatics. Work – Chron.com. https://work.chron.com/problems-nursing-informatics-27523.html
Kruse, C. S., Smith, B., Vanderlinden, H., & Nealand, A. (2017). Security techniques for the electronic health records. Journal of medical systems, 41(8), 1-9.
Murphy, J. (2011). The nursing informatics workforce: who are they and what do they do?. Nursing Economics, 29(3), 150-154.
Nelson, T. L., & Parker, C. D. (2019, October 4). Nursing informatics: The EHR and beyond. American Nurse. https://www.myamericannurse.com/nursing-informatics-ehr-beyond/
Peltonen, L. M., Nibber, R., Lewis, A., Block, L., Pruinelli, L., Topaz, M., … & Ronquillo, C. (2019). Emerging professionals’ observations of opportunities and challenges in nursing informatics. Nurs Leadersh (Tor Ont), 32(2), 8-18.
Peltonen, L. M., Sensmeier, J., Saranto, K., Newbold, S. K., & Ramírez, C. (2018). Supporting Nursing Informatics in Practice–Lessons Learned by Nursing Informatics Pioneers. In Nursing Informatics 2018 (pp. 62-64). IOS Press.
ŞENDİR, M., KIZIL, H., & AÇIKSÖZ, S. (2019). The Reflection of Healthcare Informatics Systems on Nursing Practices. Sakarya Üniversitesi Holistik Sağlık Dergisi, 2(1), 2-9.
Shapland, M. (2022, January 13). Challenges in Implementing Health Informatics. https://study.com/academy/lesson/challenges-in-implementing-health-informatics.html/
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