Nursing Informatics
Nursing
Midwifery
Public Health
Dr Afful Ekow Kelly
Course Description
This course deals with the use of Information
Technology systems and data standards based on
nursing informatics principles. It further deals
with the utilisation of clinical information systems
in the management and decision-making of
patient care
Dr Afful Ekow Kelly
Course objectives
a. Describe informatics as used in nursing and midwifery practice
b. Describe the historical roots of today’s Health and Nursing Information
Technology systems
c. Identify and use the various tools used in Information Technology
d. Develop proficiency in the use of electronic patient records in assessing
a patient, making a nursing diagnoses, designing and executing a care
plan
e. Assess solution in Information Technology by using web and other
research tools
f. Understand and also use nursing taxonomies and nursing and midwifery
informatics standards set for Ghana
Dr Afful Ekow Kelly
Course Evaluation
Assessment
A. Class Assessment (40 %)
Attendance - 10%
Participation - 5%
Assignment and Quizzes - 5%
Mid Semester -20%
B. End of Semester Examination (60%)
Dr Afful Ekow Kelly
What is Informatics?
Informatics is the study and application of
Information Technology to design, develop, and
implement systems that support human-centred
information processes.
Dr Afful Ekow Kelly
Subfields of
Informatics?
a. Health Informatics: Healthcare information systems
b. Nursing informatics: Nursing practice and patient
care
c. Medical informatics: medical research and education
d. Bioinformatics: Biological data analysis
e. Computational informatics: computational modelling
and simulation
Dr Afful Ekow Kelly
Nursing Informatics
Nursing Informatics (NI) is a speciality that integrates
nursing science, computer science, and information
science to design, develop, and implement information
systems that support nursing practice, education,
research, and administration.
Dr Afful Ekow Kelly
Nursing Informatics
ctn
Nursing Science:
Focuses on systematic study of nursing phenomena,
considering:
1. Human health and well-being
2. Nursing interventions and care
3. Health promotion and disease prevention
4. Healthcare system and policies
Dr Afful Ekow Kelly
General Definition
Nursing Informatics is the science and practice that facilitates the use of
information technology to:
1. Support nursing practice and patient care
2. Improve nursing productivity and efficiency
3. Enhance patient outcomes and safety
4. Advance nursing education and research
5. Inform healthcare policy and decision-making
Dr Afful Ekow Kelly
Definition ctn
American Nurses Association (ANA), 1994 defined nursing informatics as:
“The development and evaluation of applications, tools, processes, and
structures which assist nurses with the management of data in taking care of
patients or supporting the practice nursing”
Dr Afful Ekow Kelly
Framework for Nursing Informatics
The framework for nursing informatics relies on the central concepts of data,
information and knowledge:
a. Data: defined as discrete entities that are described objectively without
interpretation
b. Information as data that is interpreted, organised or structured
c. Knowledge: as information that has been synthesized so that
interrelationships are identified and formalised….. Resulting in decisions that
guide practice
Dr Afful Ekow Kelly
DATA
5 M 36.4
7 M 37
6 F 49.2
9 M 36.7
Dr Afful Ekow Kelly
DATA PROCESSING
AGE GENDER TEMP.
5 M 36.4
7 M 37
6 F 49.2
9 M 36.7
Dr Afful Ekow Kelly
DATA to
AGE INFORMATION
GENDER TEMP.
5 M 36.4
7 M 37
6 F 49.2
9 M 36.7
I. There are children attending the facility ……
II. More male attend the facility as compared with females…..
III. The only female had an abnormal temperature of 49.2..
IV. All the male patients had relatively normal temperature ranging
from 36.1 to 37
Dr Afful Ekow Kelly
Application of Nursing Informatics
Nursing informatics can be applied to all areas of nursing
practice, which include; clinical practice, administration,
education, and research
Dr Afful Ekow Kelly
Application of Nursing Informatics
Clinical Practice: is the application of nursing knowledge, skills
and competencies in real world healthcare setting to provide
high-quality patient care
Dr Afful Ekow Kelly
Nursing Clinical Practice(Point-
of-Care systems and Clinical
Information Systems)
a. Work lists to remind staff of planned nursing interventions
b. Computer-generated client documentation
c. Electronic Medical Record(EMR) and Computer-Based Patient Record(CPR)
d. Monitoring devices that record vital signs and other measurement directly
into the client record (Electronic Medical Record)
e. Computer generated nursing care plans and critical pathways
f. Automatic billing for supplies or procedures with nursing documentation
g. Reminders and prompts that appear during documentation to endure
comprehensive charting
Dr Afful Ekow Kelly
Nursing Administration (Health
care Information Systems)
a. Automated staff scheduling
b. E-mail for improved communication
c. Cost analysis and finding trends for budget purposes
d. Quality assurance and outcomes analysis
Dr Afful Ekow Kelly
Nursing Education
a. Computerised record-keeping
b. Computerised–assisted instruction
c. Interactive video technology
d. Distance learning- web-based courses and degree programs
e. Internet resource- formal nursing courses and degree programs
f. Presentation software for preparing slides and handouts – PowerPoint and
MS-Word
Dr Afful Ekow Kelly
Nursing research
a. Computerised literature searching – CINAHL(cumulative index to nursing and
allied health literature), Medline and Web source
b. The adoption of standardized language related to nursing terms –NANDA(North
American Nursing Diagnosis Association)
c. The ability to find trends in aggregate data, that is data derived from large
population group, - Statistical software, SPSS
Dr Afful Ekow Kelly
Standard Initiatives
a. ANA – is considered as the official nursing organisation that contributed to
the development and recommendation of standards of nursing practice
worldwide
b. Joint Commission on Accreditation of Hospital Organisations (JCAHO) –
focuses on the need for adequate records on patients in hospitals and the
practice of standards in the documentation of care
Dr Afful Ekow Kelly
Significant Landmark of Event
a. 1961 – Healthcare Information and Management System Society was founded
b. 1965 – Development of one of the first hospital information systems in California
c. 1973 – First conference on Management Information Systems
d. 1981 - First National Conference on Computer Technology in Chicago
e. 1984 – First Nursing Computer Journal is published
f. 1989 – Graduate program in Nursing Informatics is introduced in Maryland
University
Dr Afful Ekow Kelly
Significant Landmark of Event ctn
g. 1993 – Establishment of electronic library
h. 1995 – First International Nursing Informatics Teleconference held in Australia
i. 2002 – JCAHO identified clinical information system as a way to improve safety
and recommends that hospitals adopt technology
j. 2003 - Health Insurance Portability and Accountability Act was enacted
k. 2004 – Establishment of the National Health Information Coordinator.
Dr Afful Ekow Kelly
Why Nursing Informatics
a. Improve patient care and safety
b. Enhance Nursing productivity and efficiency
c. Support evidence-based practice
d. Facilitate communication and collaboration
e. Advance nursing research and education
f. Improve healthcare policy and decision-making
g. Address healthcare disparities and inequalities
Dr Afful Ekow Kelly
Benefit of Nursing Informatics
a. Better data management and analysis
b. Enhanced clinical decision support
c. Improved medication management
d. Increased patient engagement
e. Streamlined workflow and documentation
f. Enhanced continuity of care
g. Reduced medical errors
Dr Afful Ekow Kelly
Historical Background of
Electronic Health Records
Dr Afful Ekow Kelly
Electronic Health Record (EHR)
a. An electronic record composed of health information regarding an individual
patient that exists as part of a complete system designed to provide access to,
and management of, such information.
b. The EHR is developed and managed by the health facility or provider. The
term Electronic Health Record has largely replace the older “Electronic
Medical Record”
Dr Afful Ekow Kelly
Electronic Health Record (EHR)
c. It is much more than an electronic replacement of an existing paper system.
The EHR can start actively supporting clinical care by providing a wide variety of
information services. However, it is hard to understand what information is
important to clinical care and what is occasionally desirable.
Dr Afful Ekow Kelly
Electronic Health Record (EHR)
c. The EHR brings uncountable advantages in primary health care detaching
such as faster access to information, and updated information.
d. It allows having a clinical process with all the patient clinical information and
easier access to information (ex. Allows simultaneous access from different
locations)
e. Recognizable efforts in the development of EHR are distinguished by the
Nicholas E. Davis Awards of Excellence Program whose history describe the
improvement of EHR in different settings
Dr Afful Ekow Kelly
Benefits of Computer Automation
in Health Care
Many of these benefits have come about with the
development of the Electronic Medical Record(EMR), which
is the electronic version of the client data found in the
traditional paper record.
Dr Afful Ekow Kelly
EHR benefits include
a. Improved access to the medical record
b. Decreased redundancy of data entry
c. Decreased time spent in documentation
d. Increased time for client care
e. Facilitation of data collection for research
f. Improved communication and decreased potential for error
g. Creation of a lifetime clinical record facilitated by information systems
Dr Afful Ekow Kelly
EHR benefits include
a. Improved access to the medical record
The EMR can be accessed from several different locations simultaneously as
well as by different levels of providers
b. Decreased redundancy of data entry
For example, allergies and vital signs need only be entered once
c. Decreased time spent on documentation
Automation allows direct entry from monitoring equipment, as well as point-of-
care data entry
Dr Afful Ekow Kelly
EHR benefits include ctn
d. Increased time for client care
More time is available for client care because less time is required for documentation and
transcription of physician orders
e. Facilitation of data collection for research
Electronically stored client records provide quick access to clinical data for a large number of client
f. Improved communication and decreased potential for error
Improved legibility of clinician documentation and orders is seen with a computerised information
system
g. Creation of a lifetime clinical record facilitated by information systems
Dr Afful Ekow Kelly
Benefits of automation and computerization are related to the use of decision-
support software, computer software programs that organised information to aid
in decision-making for client care or administrative issues. These include:
a. decision-support tools as well as alerts and reminders notify the clinician of
possible concerns
Dr Afful Ekow Kelly
b. Decision-support tools as well as alerts and reminders notify the clinician of possible
concerns or omissions
c. Effective data management and trend-finding include the ability to provide historical or
current data errors
d. Extensive financial information can be collected and analyzed for trends. An extremely
important benefit in this era of managed care and cost-cutting
e. Data related to treatment such as inpatient length of stay and the lowest level of care
provider required can be used to decrease costs
Dr Afful Ekow Kelly
Class assignment
a. Describe the differences between EMR and EHR
b. Discuss the benefit of EHR to healthcare providers
c. Describe the benefit of EHR to the Patients
d. Discuss the justification of the use of EHR as a health practitioner in your
facility
Dr Afful Ekow Kelly
Computer Systems
“Computers are incredibly fast,
accurate and stupid.
Human beings are incredibly
slow, inaccurate and brilliant”
Albert
Einstein
Dr Afful Ekow Kelly
Dr Afful Ekow Kelly
Dr Afful Ekow Kelly
Major Components of Computers
Dr Afful Ekow Kelly
The Basic System Components
a. The basic operational design of a computer system is called its architecture
b. John Von Neumann, a pioneer in computer design, is given credit for the
architecture of most computers in use today
c. A typical Von Neumann system has three major components
i. The central processing unit (CPU)
ii. Memory, and
iii. Input/output (I/O)
Dr Afful Ekow Kelly
Hardware Devices
a. Hardware is the physical part of the computer and its associated equipment.
b. Computer hardware can comprise many different parts, these include:
i. Input Devices: used to enter data:
Example:
Keyboard, mouse, trackball, touch screen, light pen, microphone, bar code
reader, joysticks, and scanner
[Link] Devices: used to view and hear processed data:
Example:
Video monitor screens, printers, speakers and fax
Dr Afful Ekow Kelly
Central Processing Unit (CPU)
“Brain” of the computer
Three Components:
a. Arithmetic Logic Unit(ALU) - number “crunching”
b. Registers: Similar to memory but has special purposes
c. Control Unit: Manages instructions to other part of the computer, including
input and output devices “traffic cop”
Dr Afful Ekow Kelly
Primary Memory
The storage is in which program instruction (code) reside during execution
a. Read-only memory (ROM) is permanent; it remains when the power is off.
Start-up instructions for the computer is an example of ROM
b. Random access memory (RAM), is a temporary storage area for program
instructions and data that is being processed, it is only active while the
computer is turned on
Dr Afful Ekow Kelly
Secondary Storage
Provides space to retain data in an area separate from the computer’s memory
after the computer is turned off, these include:
hard disk drives, floppy disk, tape, optical drives, flash memory, CD-ROM drives
Dr Afful Ekow Kelly
Networks
A network is “ a combination of hardware and software that allows
communication and electronic transfer of information between
computers”
This allows the sharing of computer and software resources, through
the use of the network
Dr Afful Ekow Kelly
Computer Categories
a. Supercomputers: the largest and most expensive, can perform billions of
instructions every second
b. Mainframes: large computer capable of processing several millions
instructions per second. They support organisational functions, therefore
have been the traditional equipment in hospitals. Customised software
results in high-cost
c. Minicomputer: A scaled-down version of the mainframe, since they are now
becoming more powerful they can now be found in hospitals
d. Microcomputers (PCs): inexpensive processing power for an individual user
e. Laptop or Notebook, handheld, and personal digital assistants(PDAs):
Portable devices which can be used almost anywhere
Dr Afful Ekow Kelly
Nursing Informatics Specialist
Because of the increased importance of computers and information
technology in the practice of professional nursing; a new role has
emerged, the Nursing Informatics Specialist (NIS)
The NIS is a nurse who has formal education, certification and
practical experience in using computer in patient care settings
Dr Afful Ekow Kelly
The role of the Nursing
Informatics Specialist
(NIS)
Dr Afful Ekow Kelly
The American Nurses
Association(ANA, 1994)
ANA list several functions of the NIS:
a. Theory development
b. Analysis of information needs
c. Selection of computer systems
d. Design of computer systems and customizations
e. Testing of computer systems
f. Training users of computer systems
g. Evaluation of the effectiveness of computer systems
h. Ongoing maintenance and enhancements
i. Identification of computer technologies that can benefit nursing
Dr Afful Ekow Kelly
The American Nurses
Association(ANA, 1994)
ANA list several functions of the NIS:
a. Theory development
The NIS contributes to the scientific knowledge base of nursing informatics
b. Analysis of information needs
The identification of information that nurses need to accomplish their work;
client care, education, administration, and research
c. Selection of computer systems
The NIS guides the user in making informed decisions related to the purchase
of computer systems
d. Design of computer systems and customizations
The NIS collaborates with users and computer programmers to make
decisions about how data will be displayed and accessed
Dr Afful Ekow Kelly
The American Nurses
Association(ANA, 1994)
e. Testing of computer systems
Systems must be checked for proper functioning before they are made available for use in
patient care
f. Training users of computer systems
Users need to be trained in how the system works, the importance of accurate data entry, how
the system will benefit them, and more importantly how it will improve patient outcomes
g. Evaluation of the effectiveness of computer systems
The unique role of the NIS makes them the ideal person to evaluate the effectiveness of
computer systems
h. Ongoing maintenance and enhancements
The NIS makes sure the computerised system functions properly and explores possible
enhancements to the system that will better serve the users and the patients
i. Identification of computer technologies that can benefit nursing
The NIS must keep abreast of the changes in the fields of computers and Information
Technology, including new hardware and software that will benefit the nurse and patient
Dr Afful Ekow Kelly