Health care informatics is one of the aspects a qualified nurse should consider in working toward evidence-based practice and quality improvement (American Association of Colleges of Nursing, 2006). The American Medical Informatics Association (n.d.) defines nursing informatics as the “science and practice (that) integrates nursing, its information, and knowledge, with information and communication technologies to promote the health of people, families, and communities worldwide” (pars. 1). Thus the major concern of nursing informaticians is the research and development of communication and information technologies. Nursing informaticians often occupy the positions of chief nursing officers, chief information officers, software engineers, implementation consultants, policy developers, and business owners who work for the advancement of healthcare (American Medical Informatics Association, n.d.). On the whole, informatics in nursing is the application of data to promote change in health care, the ultimate goals of which are increasing the quality of patient care, advancing patient care, and decreasing health care costs.
Nursing Informatics in Promoting Health Care Quality
Generally speaking, the major aim of informatics or information technology (IT) is information management (Rundio & Wilson, 2013). Informatics supports the development of clinical care, management and administration, research, and education. Although IT is considered to be a powerful tool in improving the quality of health care, there is no scientific proof of its efficiency. Ortiz and Clancy (2003) provide an overview of IT applications in clinical practice and research. The recent study by Darvish, Bahramenzhad, Keyhanian, and Navidhamidi (2014) finds the role of nursing informatics in promoting health care quality. The researchers state that information technology has many advantages for various spheres of nursing, including the clinical, managerial, educational, and research spheres. A nursing environment that is empowered through technology and the development of information services in hospitals favors the promotion of healthcare and an increase in its quality (Darvish et al., 2014). The Agency for Healthcare Research and Quality (AHRQ) funds many research projects aimed at increasing patient safety. Among the funded research directions are designing and testing of advanced practices aimed at the reduction of errors in diverse health care facilities; the development of scientific foundations to support these endeavors; the enhancement of care provider education aimed at the reduction of errors; taking advantage of progress in IT to translate efficient strategies into common practices; and facilitating further reduction of errors (Ortiz and Clancy, 2003). Thus the development of information systems that comprise different routine nursing processes reduces the number of errors, increases patient safety, and improves patient outcomes.
Another opportunity for informatics in nursing is the translation of research into practice (Ortiz and Clancy, 2003). A major problem for health care is the lack of scientific evidence for clinical practice. This problem is aggravated by the results of many studies being inaccessible to a broad nursing audience. IT applications allow the creation of research databases that contain information on various research findings and that open access to clinical evidence for health care practitioners, thus empowering them to translate theory into practice. The availability of knowledge allows medical practitioners to foresee patient outcomes based on the research evidence and thus improve patient care quality. One of the future trends of nursing informatics is the creation of a culture that promotes translational research (Discussion week 4). A DNP should develop professional opportunities for members of the health team and stakeholders to learn and understand the importance of EBP and translational research in improving the quality of health care and optimizing patient outcomes (Discussion week 4).
An additional opportunity for informatics that deals with patient safety are the electronic patient record. It has become “an important aspect in the information workflow and using information technology will result in improving patient outcome quality and efficiency” (Cassano, 2014). Documentation of patient history, condition, peculiarities of care, and treatment is vital for nursing staff working in shifts. Electronic patient records allow the safe transfer of patient information with minimal risk of misinterpretation or data loss. Moreover, the transition from paper to electronic documentation minimizes the time nurses spend recording patient information. It contributes to the promotion of safe, high-quality care and more time dedicated to patient care (Discussion week 1). Another advantage of electronic records is the possibility to share them among providers to improve the communication and coordination of care (Discussion week 1).
Informatics can be also used in the management of health care facilities. One of the possibilities for nursing is an internet-based nursing scheduling system (Darvish et al., 2014). Darvish et al. (2014) state that “several studies have confirmed the impact of careful shift planning and efficient management on nurse’s work and the quality of health care” (p. 16). It has been proved that thoughtful shift planning and time management for nurses decrease their burnout, fatigue, and job dissatisfaction, which has a positive impact on the quality of care, reduce the possibility of nursing errors, and, consequently, improves patient outcomes. Another way to reduce misunderstandings in health care is the integration of standardized nursing languages (SNL) and standardized nursing terminology (SNT) into patient records (Discussion week 2). It offers nurses an opportunity to delineate the focus of nursing practice through the identification of nursing diagnoses, interventions, and outcomes (Discussion week 2).
Nursing Informatics and Education
The rapid spread and development of technology stimulate education in this direction. It is particularly important in nursing. Nursing preparation is more concentrated on care, medical, and pharmacological issues. Thus there is not enough attention to nursing informatics. Darvish et al. (2014) state that “to effectively take advantage of information technology in nursing outcome and quality of health care, the educational arrangement is recommended to strengthen nurses at different levels for implementing information technology tools in all aspects of their profession” (p. 17). Consequently, a certain level of attention in nursing education should be given to technology and informatics. These tools provide great opportunities, but they should be used carefully and with corresponding knowledge.
The American Association of Colleges of Nursing (2006) provides the context for graduate education in nursing in The essentials of doctoral education for advanced nursing practice. The Institute of Medicine and the National Research Council of the National Academies (as cited in American Association of Colleges of Nursing, 2006, p. 5) “have called for nursing education that prepares individuals for practice with interdisciplinary, information systems, quality improvement, and patient safety expertise.” Consequently, one of the essentials of nursing education is the use of information systems and technology for the improvement and transformation of health care. The ability to use them is a distinguishing feature of Doctors of Nursing Practice. According to the American Association of Colleges of Nursing (2006), “knowledge and skills related to information systems/technology and patient care technology prepare the DNP graduate to apply new knowledge, manage individual and aggregate level information, and assess the efficacy of patient care technology appropriate to a specialized area of practice” (p. 12). DNP graduates are able to develop, choose, and apply information systems and technology in order to assess programs of care and possible outcomes of care. Information systems and technology provide a mechanism “to apply budget and productivity tools, practice information systems and decision supports, and web-based learning or intervention tools to support and improve patient care” (American Association of Colleges of Nursing, 2006, p. 12). Thus these skills are essential for professional nurses. Nevertheless, nursing education is not limited to colleges or universities. Continuing education is crucial for a professional nurse to improve skills and theoretical knowledge and become more aware of contemporary approaches in nursing practice. Web-based learning is one of the opportunities for continuing education without leaving work. Web courses through an instructor can offer distance e-learning to an interprofessional group of health care providers in order to facilitate the exchange of experiences and the search for answers (Discussion week 7). Additional opportunities to learn new care techniques are video or web conferences. They are particularly useful for the education of professionals in rural areas (Discussion week 7). Moreover, web conferences may become a future trend for facilitating international communication among nursing professionals and thus developing an environment for advanced nursing practice.
Ethics and Data Safety
Data security is one of the contemporary trends. With the increased role of IT in nursing, the issue of data safety and the ethics of utilizing patient data gain particular importance. Patients need to be sure that their data will not be misused or given to a third party. Therefore healthcare facilities should be able to guarantee the safety of data and minimize the number of people who have access. Moreover, patient confidentiality is likely to improve patient outcomes. The environment of trust has a positive influence on patient outcomes. However, confidentiality maintenance is becoming more complicated (American College of Healthcare Executives, 2016). Although information technology encourages the increase of care quality by providing for constant availability of information through many devices, the risk of unauthorized access or misuse of patient data is growing. Thus it is the duty of healthcare providers to ensure the safety and confidentiality of patient data and prevent their illegal use. This can be done by limiting access to patient information, developing institutional policies and practices with a focus on confidentiality, education of personnel about data security requirements, development of security systems, etc. (American College of Healthcare Executives, 2016). Nevertheless, it is important to balance the need for access to patient information and patient data security.
Conclusions
Informatics is an integral part of contemporary nursing. It is present in every sphere of nursing and has many purposes. The primary concern of nursing informatics is improving the quality of patient care. It can be executed by promoting the translation of research into practice, providing opportunities for increasing the efficiency of nursing staff through better scheduling, lowering the probability of errors, and simplifying access to information through electronic patient records, etc. However, there are some aspects of nursing informatics that need more attention. First, nursing education should include preparation to work with information and technology so that professional nurses can apply all the achievements of technological progress to healthcare. Second, healthcare providers should be concerned about information safety. Patients should be assured of confidentiality and the security of their personal data so that they can concentrate on treatment and not worry about safety issues. On the whole, informatics is a powerful and multi-functional tool that has many benefits for nursing but should be used carefully and with corresponding knowledge.
References
American Association of Colleges of Nursing. (2006). The essentials of doctoral education for advanced nursing practice. Web.
American College of Healthcare Executives. (2016). Health information confidentiality. Web.
American Medical Informatics Association. (n.d.) Working groups: Nursing informatics. Web.
Cassano, C. (2014). The right balance –Technology and patient care. Online Journal of Nursing Informatics, 18(3). Web.
Darvish, A., Bahramenzhad, F., Keyhanian, S., & Navidhamidi, M. (2014). The role of nursing informatics on promoting quality of health care and the need for appropriate education. Global Journal of Health Science, 6(6), 11-18. Web.
Ortiz, E., & Clancy, C.M. (2003). Use of information technology to Improve the quality of health care in the United States. Health Services Research, 38, xi–xxii. Web.
Rundio, A., & Wilson, V. (2013). Nurse executive review and resource manual (2nd ed.). Silver Spring, MD: Nursing Knowledge Centre.