Reflective Paper of Nursing Informatics

INTRODUCTION

Nursing Informatics can best be described “as the integration of data, information and knowledge to support patient’s and clinicians in decisions across role and setting, using information structures, process, and technology” (Knight & Shea,p.93). In todays dynamic health system, technology plays an important role in nursing education and practice.  Four nearly four decade’s nurse’s have been working in the field of informatics, the term “NI” has been considered a specialization in nursing resources since 1984 (Guenther & Peters,2006). Informatics tool such as technology and multimedia integrated in nursing curriculum can promote patient safety and practice. However, the integration of IT into existing health care systems has been challenging. This course is helping me to understand how health care workers and their organizations can better utilize health informatics, with the goal of improving patient outcomes and public health. The core competencies gained in this course from week 1-8 have been focused on theoretical and practical concerns related to informatics and IT. I learned about existing laws and regulations related to health informatics, coming to terms with issues like confidentiality, privacy, and data security and about the applicability of informatics tools and technologies to improve the evidence informed practice. Understand the CNO practice standards and guidelines in relation to IT, client centred care, professional practice and conclusion. Understand how technology has shaped, and will continue to shape nursing practice. Learned about the ethics linked to healthcare informatics and other medical technologies that need to be thoughtfully and carefully resolved, balancing the needs for an efficient and integrated health care system with the needs for protecting patient information, explored health care information systems and electronic health records and examine their use in the delivery of nursing care; also learned about the utility of media within the contexts of consumer health information, client education, and professional practice. Ultimately, IT have the potential to improve patient outcomes and reduce medical errors (Burwell,2015).

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KNOWLEDGE GAINED

HEALTH AND NURSING INFORMATICS (week 1): “Health informatics is changing the practice and delivery of health care by providing computer technology based solutions to bridge the knowledge and information gaps experienced within the health care system”. Nursing informatics play a vital role in the health care system. It encompasses the use of computer information systems such as standardize computer forms which enables documentation to be done accurately and precisely for enhancing the quality and practice of nurses. Allowing more time can be spent caring for the client. As Burwell(2015) also points out, healthcare information technology improves cost saving and create higher value case. The ongoing development of computer technology and telecommunication, provide education, improve patient safety, and create new IT jobs within industry. It is essential for nurses to be involved in the initial design of systems to improve the quality of health care and change their culture in this regard (Darvisn & Salsali,2010), (Jenkins et al.2007).

COMPUTER AND DIGITAL MEDIA LITERACY (week2): Digital literacy has been defined by HEE (2016), Drawing on work by JISC (2014;2015a;2015b), as: ‘Those abilities that fit someone for living, learning, working, participating and thriving in a digital society. Improved digital literacy of the workforce is vital to maximise the potential of technology to enhance patient care. The health and social workforce need both the digital skills and confidence across a range of domains. With the emergence and development of technology enhanced learning (TEL) and technology enhance care (TEC), digital literacy is fast becoming a core requirement for students, academics, patients and everyone working in health and social care. Effective development of digital capabilities is essential to personal and professional development, participation and wellbeing, in the delivery of contemporary health and social care. Nonetheless, digital capabilities need to be acknowledge and embedded with in curricula to ensure learners enter workforce with both the necessary skills and attitudes/behaviors. Non professionals also need to recruited for digital literacy and for inducted, oriented and developed going forward in digital literacy capabilities. Ultimately, it is in all our best interests to provide the best care we can for individuals.

EVIDENCE INFORMED PRACTICE AND INFORMATICS (week3): All health care workers require an ability to search for information and new knowledge, and to critically examine factors that impact on people and their environment and they must be prepared to critically explore ways in which they can ensure the provision of quality care that is based on the best evidence available to them. Evidence informed decision-making is an important element of quality care in all domains of nursing practice and is integral to effect changes across the health care system. Nursing informatics and many technological applications provide nurses with up-to-date practice knowledge as well as current client information, which leads to efficient and effective quality care while also promoting client safety. New and emerging technologies and advances in the electronic capture of clinical care information present opportunities for powering the evidence continuum. Combining informatics with evidence based practice (EBP) can  help improve the care we provide to our patients.

CONSUMER HEALTH INFORMATICS (week4): Consumer health informatics(CHI) is the field that helps to connect the gap between patients and health resources. “As a consumer of health care I know what I want out from it, and how I want it to be provided”. Owen(2009) notes the movement of consumer driven health care, and the importance of preserving clients choice upon their own health. Consumers have to be literate about health in order for health care to be on a more consumer directed basis. In order to educate clients a literacy level must be established for full understanding to be applied (Booth & Donelle,2014). The world is becoming increasingly connected through internet related technologies (Booth & Donelle,2014). Patient are taking more responsibility for managing their health information. People use online communities, or support within health concerns. Several measures have been introduced to address the quality of health information on the internet, including programmes to educate consumers, encourage self labelling, and self regulation of providers, to evaluate and rate information or enforce compliance with criteria to equalise relationships between health professionals and lay people. Consumer health informatics not only use computers and telecommunications but also includes delivery of information to patient through other media. The emphasis on information structures and processes that empower consumers to manage their own health for example; personal health records, consumer friendly language, health information literacy, internet based strategies, and resource. For stakeholders who have an interest in providing health resources online (such as health portals, academics, and public health experts) a professional code of ethics have been drafted for quality control. Therefore, health professionals should not only understand consumer health applications but also ensure that these application are developed, applied, and evaluated properly.

SOCIAL MEDIA AND PRIVACY AND ETHICAL PROFESSIONAL PRACTICE (week5&6):

According to Fergusan, ”Social media allow an open dialogue between health care consumer and providers, allowing for continuous feedback and engagement”. Many types of social networking tool, such as Facebook, Instagram and twitter, focus on communicating with an established group of people. Other tools like Youtube allow users to upload video and Linkedin helps to expand professional contacts. Each of these tools in presently being used in health care for example; health care provider can use twitter to monitor epidemics. Social media can act as a platform for nurses and nursing students to communicate. Nurses can collaborate and form professional groups to carry out research work, to find vacant positions. Its use by innovative nursing professional has debatable advantages and disadvantages. It is important to consider the legal and ethical standards before incorporating social media into nursing practice. It should be used appropriately, respectfully, and safely. RN’s must reflect on the CNA’s code of ethics for RN (2017). Nurses must be aware of any applicable federal and provincial legislation such as right to privacy and confidentiality of personal and health information (Sewell,2016). Nurses need to respect professional boundaries and adhere to the guidelines and online etiquettes while using social media. It can be said that social media will continue to play larger role in health care information and “Nurses play an important role in helping patient evaluate the veracity of online information and introducing them to reliable internet resources”. Potential recruiters always tend to hire decent and qualified staff. They try to find out the reputation of their employees prior to recruiting them from their contacts or even searching them on the internet. For instance, content on facebook can be viewed by patients, colleagues, or employers. Therefore, it is now becoming necessity to build a good online reputation. To prevent risk of ruining image of nursing professional and breaching confidentiality in professional environment, nurses and student nurses should use common sense and caution while communicating on social media.

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E HEALTH RECORDS (week 7&8): Digital health enables Canadian access better quality care efficiently through solutions and services such as; Electronic health record (EHR) which allows doctors to see patient’s complete health information, Electronic medical record (EMR) allows doctors to manage patient’s problem more effectively and with more efficiency, Patient portals are designed for the convenience of patients to access their personal health information. Similarly, virtual visits allow patients to connect with their health care providers with ease, Tele-homecare allows patients and clinicians to collaborate in monitoring health conditions, and by means of telecommunication technology Telehealth provides quality care for patients in remote, rural and first nations communities, and on the rise for patients in urban areas. Telemedicine is also,”a key strategy for making health care more cost effective,” (Kvedar, Coye & Everett,2014). This allows clinicians to access pertinent patient information when needed and make informed decisions. For patients, digital health means the convenience of getting their own lab results and health information online. In addition, the ability to gain timely access to lab test results and personal engagement has given a sense of empowerment, which is directly linked to improved chronic disease management. The nation is entering a new era of health care where providers can use HER to improve patient health and the way health care is delivered in this country. In the past, health history was tracked on paper only, but that’s no longer the care. Overall, EHRs are expected to reduce costs and improve quality of care.

 PAST EXPERIENCE

Through out my career, I have had technological opportunities offered to me. Some of these include computerized nursing documentation, medicine indents from pharmacy through computer, an IV infusion pump, monitors, ventilators. In my previous clinical experience, I came across with an elderly client of 80years of age with the diagnosis of osteoarthritis. She was suffering from severe pain and lack of mobility. After complete assessment and collaboration with the team members doctor recommended her knee replacement surgery. I saw her that she was very upset and asked for her cause of concern. She expressed her worries and fear to me and said she does not want this surgery to be done. As a client advocate it was my responsibility to respect her decision. I talked to the health care team providers and asked them to give her informed choices regarding her disease condition, so she can opt what is best for her. Client was told other options after discussion and her choices were documented electronically. A new plan was made for her. We did research by using some health websites. We found lot of information about some natural remedies and other measures to decrease pain and some other symptoms related to arthritis. We recommended her those websites and also, some support communities for example; Arthritis foundation and Centers for disease control and prevention. By the use of digital media, we were able to helped her by giving her other options as well like; loosing weight, eating supplements, topical ointments, proper diet, acupuncture, chiro practitioner and consulting physical therapist. Through evidence based practice, clinical expertise and best research quality care was provided to the client by keeping in mind clients beliefs, values, culture and preferences. Informatics and technologies played a very vital role in getting and delivering her information.

CONCLUSION

I believe, what I learned will only impact my practice in positive ways. I will be more thorough in my gathering, relaying and retrieving of information. I will be even more self sufficient in completing tasks and take initiative in helping others who may be as technically savvy. What I learned will also help to keep me motivated on learning about the new technological advances that I may came across in the future. In regard to this course, I would say I have a better understanding of what nursing informatics is. I explored health care technology and the impact it has on individuals in the health care field.  I think informatics should be discussed and promoted more in clinical field training of all health care personnel; IT must be implemented for smooth transition. As Information and technology is becoming more advanced and most commonly used globally today, it will indeed have a positive impact on the evolution of nursing and with this course laying the groundwork for such an venture.

References

• American Nurses Association. The standards of practice for nursing informatics. Washington, DC: American Nurses Publishing, 1995. (Pub.no. NP-100). [Google Scholar]
• Canadian Association of schools of Nursing (CASN). (2012). CASN-entry-to-practice nursing informatics competencies for registered nurses. Retrieved from http://www.casn.ca/2014/12/casn-entry-practice-nursing-informatics-competencies/
• Canadian Nurses Association. (2006a). E-nursing strategy for Canada. Retrieved from http://www.cna-aiic.ca/~/media/cna/page-content/pdf-en/e-nursing-strategy-for-canada.pdf?la=en
• Canadian Nurses Association, & Canada Health Infoway. (2014). National survey of Canadian nurses: use of digital health technologies in practice. Retrieved from http://www.infoway-inforoute.ca/en/component/edocman/1913-national-survey-of-canadian-nurses-use-of-digital-health-technologies-in-practice/view-document;
• Healthcare Information and Management Systems Society. (2015). 2015 HIMSS impact of the informatics nurse survey. Retrieved from http://www.himss.org/ni-impact-survey
• HIMSS Nursing Informatics Awareness Task Force. (2007). An emerging giant nursing informatics. Nursing management, 38(3), 38-42 5p. doi:10.1097/01.NUMA.0000262926.85304.a6
• http://www.himss.org/ResourceLibrary/genResourceDetailWebinar.aspx?ItemNumber=29.
• http://www.researchgate.net