Informatics in nursing practice.
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Humans↗
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Nursing intervention lexicon and taxonomy study: language and classification methods.
Research on nursing informatics to establish a Nursing Intervention Lexicon and Taxonomy is described. The rationale for using classification and language-based methods in establishing and validating a lexicon and taxonomy for use with automated systems is provided. The importance of designing automated systems with language-based analyses capabilities is emphasized.
Databases, Factual↗
Clinical decision support in critical care nursing.
A clinical decision support system (CDSS) is a computerized application that helps clinicians detect and prevent untoward clinical events such as drug interactions, errors of omission, and trends in symptomatology. A CDSS in healthcare usually is built around an alerting system based on rules of logic. The alerting system of a CDSS can notify clinicians immediately on clinical data entry, or it can generate alerts over time after relating data from multiple sources. A CDSS for nurses and patients offers immediate benefits for nurses and patients by detecting potential drug-laboratory and drug-drug combinations and impending pharmacologic complications, monitoring microbiology results, and helping nurses relate symptoms to pharmacology and medication side effects. Other benefits include savings in time and money and reductions in morbidity and mortality. A CDSS presents an opportunity for nursing informatics and critical care nursing to collaborate for the benefit of the patient and the profession.
Adverse Drug Reaction Reporting Systems↗
Web-based informatics education: lessons learned from five years in the trenches.
Duke University has a five-year history with high-quality and clinically oriented informatics web-based nursing informatics education. This paper highlights an overview of instructional methods used and pedagogical considerations for both students and faculty. To do the job well, faculty workload for web-based instruction has been more than double the time and effort required for teaching an on-campus course. Results suggest that virtual teamwork is difficult but possible for highly motivated students. Committed to excellence, Duke's program finds that most students do well in achieving their goals and achieving Duke's high standards of academic rigor, however some students are not successful with on-line courses.
Computer-Assisted Instruction↗
Nurses' perspectives on problems of hospitalized PCP patients: implications for the development of a nursing taxonomy.
The phenomena of interest in nursing informatics research are the data, information and knowledge related to nursing. This study presents nurses' perspectives on the problems of patients hospitalized for Pneumocystis carinii pneumonia from four data sources: nurse interview, intershift report, care plan, and nurses' notes. Even within this narrowly specified sample, patient problems showed variation across sources of data. The results of this study demonstrate the difficulties inherent in developing a nursing taxonomy when there is not consensus about the relevant data for nursing within a specific patient sample. Although existing information technology is capable of processing large volumes of nursing data, the lack of a common taxonomy limits the usefulness of the technology for documentation of care and decision support applications.
Acquired Immunodeficiency Syndrome↗
Interdisciplinary information design with an empowerment strategy.
An innovative research into a model for ICT enabled Empowerment. By deliberate use of ICT and a feedback-focused communication model in a prototyping process, e-health information based on an empowerment strategy is evaluated. Overall a risk-driven spiral model is applied for Progress and Complexity handling in order to ensure success. The process model devised has a proactive approach to interdisciplinary teamwork, organisational web maturity, and the post-modern user's interaction with ICT. The research is performed and evaluated in cooperation with an interdisciplinary team of health professionals, and voluntary groups of patients from an athletic clinic in a Danish University Hospital.Results are as follows: INDIVIDUAL LEVEL: Empowerment is evaluated as successful using Empiric reception analysis, based on social and humanistic sciences, and showing traces of Empowerment from the patient's perspective. ORGANIZATIONAL LEVEL: Nursing Informatics becomes a tool in the interdisciplinary understanding, allowing the nurses to take responsibility for core nursing themes regarding the healthy and the diseased phases of the patients' lives. Iterative modelling ensuring the results is evident and derived from the patient's perspective.
Denmark↗
The superhighway to nursing science and practice.
Nursing is evolving within a societal context of shifting paradigms and pervasive technology. Information technology offers untold possibilities to enhance the mechanisms of health care delivery. The capacity for comprehensive access to and integration of information and knowledge suggests a holistic approach that transcends time, settings, and providers. Moreover, the interface between nursing practice and nursing informatics provides an opportunity to create new science and to expand the boundaries of nursing knowledge.
Humans↗
Informing the nursing professions about IT.
In the United Kingdom, over two decades of activity by enthusiasts for nursing informatics appears to have failed to engage the active interest of fellow nurses, midwives, and health visitors. Conferences, journals, and articles in the professional journals have been used. Clinical computing has developed, with the Department of Health in England taking a lead. Changes have occurred in the organization of the health services and in nurse education. One possible model, drawn from general education, is proposed as an explanation and a source for solutions.
Curriculum↗
Readiness for evidence-based practice: information literacy needs of nurses in the United States.
In this paper U.S. nurses' readiness to provide Evidence-Based Practice (EBP) as measured by their information literacy knowledge and skills is described. The Institute of Medicine directed health care providers to use EBP as a means to improve patient safety, efficiency and effectiveness of health care services. Information literacy has been identified as a nursing informatics competency for the basic nurse. As such, information literacy is an essential component in the application of EBP. The importance of developing information literacy skills is enhancement of the nurse's ability to use current best available research literature in the conduct of EBP with subsequent improvement in nursing sensitive patient outcomes. This study describes the level of nurses' information literacy knowledge and gaps in their skills for identifying, accessing, retrieving, evaluating and utilizing research evidence to provide best care for patients. The value of this study is to increase awareness among nurse administrators, educators, and clinicians of the need for information literacy education to enable evidence-based nursing practice and to guide development of supportive curricula and professional continuing education.
Biomedical Research↗
Shaping the future. The marriage of nursing theory and informatics.
The link between nursing theory and computerized nursing information systems is explored. In particular, the use of Self-Care Deficit Nursing Theory in the development of an information processing model for use in a computerized nursing information system is described. This development is discussed with reference to the American Nurses' Association design criteria for computerized nursing information systems. There is some indication that the design criteria do not adequately address the relationships among nursing theory, nursing processes, and computerized nursing information systems.
American Nurses' Association↗
A Delphi study to determine informatics competencies for nurses at four levels of practice.
BACKGROUND: Despite its obvious need, a current, research-based list of informatics competencies for nurses is not available. OBJECTIVE: To produce a research-based master list of informatics competencies for nurses and differentiate these competencies by level of nursing practice. METHODS: After a comprehensive literature review and item consolidation, an expert panel defined initial competencies. Subsequently, a three round Delphi study was conducted to validate the items. Participants were expert informatics nurse specialists in the United States of America. RESULTS: Of the initial 305 competencies proposed, 281 competencies achieved an 80% or greater agreement for both importance as a competency and appropriateness for the correct practice level. Five competencies were rejected. Six competencies were considered valid competencies but the appropriate level of practice could not be agreed upon. Thirteen competencies did not reach any consensus after the three Delphi rounds. DISCUSSION: The Delphi study had a high rate of participation, demonstrating the great level of interest and need for a list of informatics competencies for nurses. Out of the initial 305 competencies, only 24 items were not validated. Respondents commented during each round about whether computer skills should be considered informatics competencies. The authors propose that computer skills, while not high level, are one set of tools within the larger category of informatics competencies. This sample of experts did not deem programming skills as necessary for informatics nurses. This research study is an initial effort to fill the void of valid and reliable informatics competencies. It is the first study to span four levels of nurses, create competencies for both entry-level and experienced informatics nurse specialists, and examine the categories of computer skills, informatics knowledge and informatics skills.
Attitude of Health Personnel↗
Using reengineering to improve "customer visit processes".
Much of informatics has been concerned with computer systems. Informatics took a broader view during the Fifth International Nursing Informatics Symposium Post Conference in Austin (1994) as Henry et al, captured the essence of informatics as being "imperative for assessing the quality of care provided and analyzing effectiveness of nursing interventions across settings and population". At York Central Hospital (YCH), Ontario, we realized the need to work differently, to keep what's good about what we do and still meet the changed needs of health care. We also realized it's about getting everyone close to the patient. We used a reengineering process to help us achieve that goal. This paper describes how models and techniques commonly used in reengineering can be used for assessing and analyzing the quality and effectiveness of the service provided to the client.
Appointments and Schedules↗
Performance support concepts for Web-based informatics instruction.
Duke University first offered World Wide Web (WWW) based courses in Nursing Informatics in January of 1997. The first class enrolled 18 nurses who were completing either a Post-Master's Certificate Program or were near completion of their Master's degree. Courses were designed around principles of advanced nursing practice, performance support, mastery learning, and virtual learning communities. Extensive learning assessment included traditional papers, real-world application projects, and a variety of pre and post-test measurements.
Computer Communication Networks↗
The WISECARE Project and the impact of information technology on nursing knowledge.
The European Union retained the WISECARE project "Work flow Information Systems for European nursing CARE" for funding. The project focuses on the use of telematics technology for clinical and resource management in oncology care in hospitals. This paper outlines the impact of introducing this kind of advanced nursing informatics application on the management of nursing knowledge. Three shift in knowledge management that will get high attention in WISECARE, are identified. The first is the shift from knowledge dissemination to knowledge sharing. The second is the shift from individual knowledge to organisational knowledge. The third is the shift from deductive, prescriptive knowledge as seen in guidelines, protocols to more inductive, experience based knowledge. The paper emphasizes that the real impact of information technology is not in the automation of existing processes but on the discovery of new ways of organisation and living.
Diffusion of Innovation↗
Exploring the impact of health information technology on communication and collaboration in acute care nursing.
A focus group using nursing informatics experts as informants was conducted to guide development of a survey to explore the impact of health information technology on the role of nurses and interdisciplinary communication in acute care settings. Through analysis of focus group transcripts, five key themes emerged: information, communication, care coordination, interdisciplinary relationships, workflow, and practice effectiveness and efficiency. This served as the basis for development of a survey that will investigate perceptions of acute care providers across the United States regarding the impact of health information technology on the role of nurses and interdisciplinar communication in acute care settings. The purpose of this paper is to describe the process of survey development including analysis of transcripts, emergence of key themes, and the processes by which the themes will be employed to inform survey development.
Acute Disease↗
Creating a Web site for on-line social support Melanocyte.
This article focuses on the creation of an on-line social support web site, Melanocyte, for people who have been diagnosed with malignant melanoma, a deadly form of skin cancer. The web site was created, designed, and programmed by undergraduate baccalaureate nursing students at William Paterson University. The article includes discussion of rationales for a melanoma web site, support groups and the efficacy of on-line support, and the technical creation of the web site. The article also emphasizes the use of undergraduate nursing informatics and research to prepare future nurses, and the use of the Internet as an important nursing research tool.
Computer Communication Networks↗
Strategic plan for promoting ICNP in Romania.
Preparing Romanian nursing community for the newcoming health information systems is not an easy task and has to start with the structuring of nursing information. That means that the free text of nursing documentation has to be mould, in a first stage, into a nursing language. Then, using a classification system, it will be possible for it to be captured in an electronic health record. This paper is presenting the strategy proposed by the Working Group for Nursing Informatics of the Romanian Medical Informatics Society for developing the Romanian version of the International Classification for Nursing Practice(ICNP) and the dissemination actions associated.
Computer Literacy↗
[Reflections on the introduction of informatics into the nursing profession].
The paper is an analysis about the impact of introducing informative technology and its consequences in the society, in general professions and mainly, in nursing practice. The authors emphasize the need of major discussions about the insertion of this new technology in nursing profession.
Ethics, Nursing↗