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Nursing informatics practice in traditional hospital settings

Dieckhaus, Tina MSN, RN-BC, NE-BC, CPHIMS, FHIMSS

doi: 10.1097/01.NURSE.0000453708.50823.ec
Department: NEW TECH NOTES
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Practicing nursing informatics in hospital settings

Tina Dieckhaus is the director of Patient Care Services Informatics at St. Jude Children's Research Hospital in Memphis, Tenn.

The author has disclosed that she has no financial relationships related to this article.

WHEN EXPLORING THE SCOPE of nursing informatics (NI) practice, it helps to remember the definition of NI. The key concepts are that NI is based on science and focuses on using data to contribute to nursing knowledge with the goal of improving patient care.1 NI provides the information and tools healthcare professionals need to improve individual and population health. This article will review the scope of NI practice in a hospital setting.

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Defining NI nurses

In reviewing informatics nursing in the traditional hospital setting, it's important to note that the American Nurses Association (ANA) describes an Informatics Nurse (IN) as one who has traditionally received on-the-job training for his or her role or “a generalist who has had informatics experience, but does not have graduate level education on the subject.”1 The ANA describes an Informatics Nurse Specialist (INS) as “formally prepared at the graduate level in informatics or a related field.”

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What kind of factors predispose a nurse to pursue informatics roles? Often, these professionals are defined as “innovators” or “early adopters” based on the categories of Rogers' Diffusion of Innovation Theory.2 Rogers, in this model, indicates that all staff fall somewhere in the bell curve of propensity for adopting technology. Adoption ranges from those who are innovators in the use of technology to those who are “laggards” or will wait as long as possible before adopting technology into their workflow.2

The ANA describes functional areas for INSs that are very similar to other areas of nursing. These include administration/leadership, analysis, compliance/regulation, consultation, education/professional development, policy development, and advocacy/research.1 The ANA also lists some of the tenets of NI practice, which include supporting clinical and nonclinical efforts of nurses and other healthcare professionals to improve the quality of patient care.

Information or informatics methodologies alone don't improve patient care; data and information, driving knowledge and wisdom through nursing informatics practice, is used by clinicians and mangers to improve care and patient outcomes.1 NI focuses on efficient and effective delivery of complete and accurate information to achieve quality outcomes.1

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Looking for an INS

The most common place to find an INS in the traditional hospital setting is in the Information Technology (IT) or Information Sciences (IS) department. The Healthcare Informatics Management Systems Society Nursing Informatics Workforce survey released in February, 2014 found that 53% of survey respondents reported to the IS/IT department compared with 30% reporting to the nursing department.3 See NI roles in the information systems department and NI roles in the nursing department for details.

Besides the IS and nursing departments, an INS may work in institutional risk management or the quality improvement department, given his or her dual expertise in both clinical care and data analysis. The same qualities may help the INS find a niche in the nursing research department, too.

If a hospital has an NI team, its primary responsibility is to serve as the liaison between clinical care providers and the IS/IT departments. This team allows the IS/IT departments to concentrate on technical aspects of the role while the NI staff focuses on informatics support and user adoption. An NI team that exists in conjunction with other hospital informatics teams is typically made up of registered informatics nurses and/or INSs. The team augments the work of the other informatics groups in the hospital.

The primary advantage of this structure is that the members of the NI team reporting through the clinical arm of the institution have already developed strong relationships with the clinical team, spending a lot of time with the users/clinical nurses in order to understand the issues they're facing.

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Combining experiences

Given the national focus on evidence-based practice and quality outcomes, it's an exciting time to be an INS in the hospital setting. Many opportunities are available for those interested in combining their clinical and technological experience with a desire to assist nurses in making sound clinical and business decisions as well as providing the best care to their patients.

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REFERENCES

1. American Nurses Association. Nursing Informatics Scope & Standards of Practice. Silver Springs, MD: American Nurses Association; 2008:1, 17–18.
2. Boston University School of Public Health. Behavioral change models. Diffusion of Innovation Theory. 2013. http://sphweb.bumc.bu.edu/otlt/MPH-Modules/SB/SB721-Models/SB721-Models4.html.
3. Healthcare Information and Management Systems Society. HIMSS 2014 Nursing Informatics Workforce Survey: executive summary. 2014. http://himss.files.cms-plus.com/FileDownloads/2014-Nursing-Informatics-Workforce-Survey-Executive-Summary.pdf.
© 2014 by Wolters Kluwer Health | Lippincott Williams & Wilkins.