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The nurse informaticist in metropolitan Minnesota: Credentials, salary, perceived roles, and value to the organization.

UNLABELLED: The main objective of this study was to describe nurse informaticists' (NIs) current practice in a large metropolitan area. There is little literature that addresses the understanding of the roles of nurse informaticists from the perspective of the nurse executive. Even if nurse executives in Minnesota desired to find out how many nurse informaticists are practicing in the state, it would be difficult to obtain this data because it is not collected at the state level. The study sought to answer how many NIs ("computer nurses") were employed by various organizations, and what the roles, salary ranges, levels of power, respect, and value of these nurses were. Using a qualitative, exploratory design, nurse leaders who had responsibility for oversight of technical or clinical information systems staff were interviewed using a structured questionnaire. FINDINGS: NIs who were working in organizations with more evolved clinical information systems were performing more of the tasks listed in the Scope and Standards of Nursing Informatics Practice more often than were their counterparts who were involved with less evolved systems. More evolved systems also had higher NI per bed ratios and lower beds per NI ratios. Annual salaries ranged from 51,000 dollars-85,000 dollars, and credentials, including titles, educational preparation, and certification were highly variable. Nurse executives rated the value of NIs in their organizations as high (mean of 9.5 on a 10-point scale). Power and respect questions yielded rich information about the difficulty of transition from the bedside for the NIs studied.

Career Choice↗

Time-capsule thinking: the health care workforce, past and future.

The size and shape of the U.S. health care workforce are in constant evolution. Using the metaphorical device of a time capsule, this essay examines the past and future of the workforce. It traces the growth, specialization, and diversification of health care workers during the twentieth century, emphasizing the particular expansion of the nonmedical aspects of the workforce. Looking ahead, the paper examines technology, informatics, nursing, provider distribution, and the global migration of health care workers as pivotal issues for the future of the workforce.

Clinical Medicine↗

A study on new nursing information accessibility mechanism using the digital broadcasting network.

There have been efforts to add an interoperability function to TV systems. The digital technology has changed all our lifestyles. Now TV systems do indeed have interoperability functions. However, this means more than interoperable TV. It announces the birth of a digital broadcasting network (one-source and many-destination digital communication mechanism)--the new digital communication network as a broadcasting style. As a viewpoint of nursing informatics, this mechanism provides a new accessibility mechanism to structured and interoperable data. This paper introduces the technology and the basic scenarios on the data accessibility mechanism using the digital broadcasting network.

Access to Information↗

Evaluation of user interface satisfaction of a clinical outcomes database.

Interface design and usability testing are important skills for the informatics nurse. This study used the Questionnaire for User Interaction Satisfaction (QUIStrade mark) to evaluate a nurse practitioner outcomes database used to track client variables for evaluating clinical outcomes and for implementing a process improvement project. Five nursing faculty and students were instructed in the use of the database and subsequently evaluated the usability or "ease of use" of the interface (data entry screens). The mean on individual QUIS ratings ranging from 3.0 to 8.0 on a 9-point scale, although most mean ratings were moderately high. User comments identified specific areas for improvement in the interface. Discovering problem areas and modifying the screen design prior to deployment may increase the usability of the database and decrease user frustration.

Consumer Behavior↗

Information technology in maternal/child nursing: past, present, and future.

This issue commemorates the remarkable 25-year span of MCN, a journal born at the dawn of the microcomputer revolution. Key events in computer history and nursing informatics are chronicled, followed with visions of future technologies. A review of the technology literature published in MCN is summarized. Clinical implications include four nursing strategies for integrating electronic technology into practice and a list of online information resources.

Female↗

Important computer competencies for the nursing profession.

Nursing requires computer competencies. This study aimed at identifying those competencies required for the nursing profession in Taiwan. The Delphi technique was deployed in this study. In the Delphi questionnaires, computer competencies were sorted into seven domains: concepts of hardware, software, and networks; principles of computer applications; skills of computer usage; program design; limitations of the computer; personal and social issues; attitudes toward the computer. In three Delphi questionnaires, nursing informatics experts gave us their opinions on the importance of each computer competency for the nursing profession. The experts also designated when the competency should be cultivated. This study provides a comprehensive list for nursing professionals to check on their computer competence. The results of this study should also serve as good references for teachers and schools in designing related curriculums.

Adult↗

Nursing and the informatics revolution.

The Institute of Medicine's quality initiatives have collectively emphasized the importance of information technology to the transformation of health care. Not coincidentally, federal initiatives in 2004 have signaled the start of "the decade of health information technology." Building on those reports, this article describes the informatics revolution in process, and nursing's readiness to move in that direction. The promise of informatics in reshaping practice is sketched out in terms of seven aims for improvement, followed by a listing of some of the issues that must be addressed for nursing to realize those possibilities. In similar fashion, changes in academia are discussed both in terms of the promise of informatics applications and the barriers to achieving that preferred future. The article ends with some policy recommendations and reflections on opportunities at hand, particularly the growing emphasis on patient self-management support.

Informatics↗

Strategic planning for an information system.

1. BACKGROUND. This strategic plan was developed by members of the Ontario Nursing Informatics Group (ONIG), an affiliated group of the Registered Nurses Association of Ontario (RNAO), in response to priorities set by its membership. This project management approach is an overview of the step-by-step approach described in the workbook Framework for Planning Nursing Information Systems [1]. 2. PLANNING PROCESS. The first phase, "Getting Ready," of the planning process emphasizes the importance of developing a strategic vision and preparing a business case. The objectives to be attained include a review of the current healthcare trends and state-of-the-art, the development of commitment from managers, and the establishment of a project structure. Secondly, one must "Analyze the Needs" of the health care facility. The current system is reviewed and future information requirements are defined. To facilitate this analysis, a detailed review of the current system is undertaken, the current system costs are identified, the technical and functional requirements are determined, and anticipated costs and benefits are outlined. Phase three, "Choosing a System," involves selecting system(s) that best meet the needs of the healthcare facility. A detailed system review is undertaken; it includes planning for the selection process, developing a request for information and/or a request for proposal, attending vendor demonstrations, attending site visits, and negotiating the contract. "Implementing the System" outlines the project plan for integrating the selected system in the work environment. The activities involved in managing the change process include the identification of the project team, defining the project plan, reviewing the budget, tailoring the system to meet the health care facility requirements, developing policies and procedures, outlining educational requirements, installing new hardware and software, piloting the system, and managing the transition. During the "Going Live" phase, the new system is integrated in the health care facility work activities. To manage this transition, an implementation checklist is developed, all staff that will be using some component of the system is educated, and the old system is converted to the new system. Following implementation of the system, a preventative "Maintenance" program must be developed to ensure the optimum level of functioning of the new system. This includes maintenance of the healthcare facility processes implemented during the conversion and maintenance of the application software and hardware. The last phase of the planning process is "Continuous Quality Improvement" (CQI). This phase stresses the importance of evaluating the system on an ongoing basis. A CQI program should be developed, on-going review must be scheduled, and the evaluation documented and communicated.

Information Systems↗

The barriers and benefits of nursing information systems.

Nursing informatics is a growing field with many opportunities for nursing involvement. Because nurses are involved increasingly in the design, installation, and use of nursing information systems (NIS) it is important that they are aware of the barriers to and benefits of nursing information systems. This article describes the evolution of nursing information systems and the design goals for current systems. The lack of a unified nursing language and individual and organizational factors such as characteristics of the nurse, the unit, the administrative philosophy, and workload issues are discussed as barriers to NIS development. Increased nurse involvement, education, research, and recognition of the benefits of computerization are suggested to overcome the barriers. A review of the literature provides the reader with evidence of improved efficiency, patient safety and satisfaction, and ability to measure quality as benefits of NIS. Areas for further research are identified: outcomes measurement using NIS, decision support and expert systems, point-of-care documentation, interagency and interdisciplinary communication, and further work on individual and organizational factors.

Diffusion of Innovation↗

Developing informatics as a discipline.

Informatics is developing in all of the disciplines related to healthcare. There are many aspects to informatics development which frequently appear to be unrelated and to lack cohesion. This paper builds on the development of a model for nursing informatics and proposes how the components of that model can interact to provide an outline for the development of informatics as a discipline. A understanding of the disciple allows us to organize the existing research and more importantly to understand the areas where research is lacking as the discipline is evolving.

Classification↗

Enabling technologies promise to revitalize the role of nursing in an era of patient safety.

The application of information technology (IT) in health care has the potential to transform the delivery of care, as well as the health care work environment, by streamlining processes, making procedures more accurate and efficient, and reducing the risk of human error. For nurses, a major aspect of this transformation is the refocusing of their work on direct patient care and away from being a conduit of information and communication among departments. Several of the technologies discussed, such as physician order entry and bar code technology, have existed for years as standalone systems. Many others are just being developed and are being integrated into complex clinical information systems (CISs) with clinical decision support at their core. While early evaluation of these systems shows positive outcome measurements, financial, technical, and organizational hurdles to widespread implementation still remain. One major issue is defining the role nurses, themselves, will play in the selection and implementation of these systems as they become more steeped in the knowledge of nursing informatics. Other challenges revolve around issues of job satisfaction and the attraction and retention of nursing staff in the midst of a serious nursing shortage. Despite these concerns, it is expected that, in the long run, the creation of an electronic work environment with systems that integrate all functions of the health care team will positively impact cost-effectiveness, productivity, and patient safety while helping to revitalize nursing practice.

Communication↗

Education of medical informatics in the medical curriculum on biomedical faculties in Sarajevo.

In this paper author discussed about experiences of implementing curriculum of education of Medical informatics on biomedical faculties in Sarajevo. Theoretical and practical part of education process, according to new curriculum, during 6 years period of studying at Faculty of medicine in Sarajevo, is hold within the second semester and consists of 30 hours. At Faculty of Dental Medicine in Sarajevo, education is hold in the fourth semester, and consists of 45 hours. At Higher Medical School in Sarajevo, education is also hold in the fourth semester, and consists of 30 hours of theoretical and 30 hours of practical hours as well. Curriculum of Medical Informatics is identical at all these three institutions. Faculty of Dental Medicine education process points out dental informatics, and Higher Medical School devotes more time in education on nursing informatics.

Bosnia and Herzegovina↗

Re-engineering intensive care: the role of informatics.

Managed care and quality improvement are two driving forces in the current health care environment. The pressure of capitation and the recent focus on outcomes of care have generated new incentives to restructure care delivery to control costs. Intensive care units, once revenue centers, are becoming cost centers. Re-engineering, or redesigning, the process of care entails examining premises for ability to provide services as well as considering how to do things more efficiently. The assumption is that all aspects of a process are legitimately subject to examination and restructuring. Information systems provide a powerful tool to support re-engineering. Nursing informatics, which pertains to nursing data, information, and knowledge has major implications for hospital information systems. This article explores possible changes in intensive care and the role of informatics in a changing health care environment.

Hospital Information Systems↗

Diffusion of technology innovation.

Within the context of nursing informatics as a field that addresses the use of information technology by nurses as they care for patients, carry out administrative tasks in health facilities, and educate others in the discipline, this article presents the theoretic perspectives of the adoption and implementation of such technologies. Research in the area of diffusion of innovations is reviewed from the perspective of classical diffusion theory and organizational theory. The state of the art and methodological issues of research in this area are addressed. Areas for future study are proposed.

Communication↗