Nursing Informatics

Required Readings
McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.
Chapter 25, “The Art of Caring in Technology-Laden Environments” (pp. 525–535)
Chapter 26, “Nursing Informatics and the Foundation of Knowledge” (pp. 537–551)
American Nurses Association. (2018). Inclusion of recognized terminologies supporting nursing practice within electronic health records and other health information technology solutions. Retrieved from https://www.nursingworld.org/practice-policy/nursing-excellence/official-position-statements/id/Inclusion-of-Recognized-Terminologies-Supporting-Nursing-Practice-within-Electronic-Health-Records/
Macieria, T. G. R., Smith, M. B., Davis, N., Yao, Y., Wilkie, D. J., Lopez, K. D., & Keenan, G. (2017). Evidence of progress in making nursing practice visible using standardized nursing data: A systematic review. AMIA Annual Symposium Proceedings, 2017, 1205–1214. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5977718/
Office of the National Coordinator for Health Information Technology. (2017). Standard nursing terminologies: A landscape analysis. Retrieved from https://www.healthit.gov/sites/default/files/snt_final_05302017.pdf
Rutherford, M. A. (2008). Standardized nursing language: What does it mean for nursing practice? Online Journal of Issues in Nursing, 13(1), 1–12. doi:10.3912/OJIN.Vol13No01PPT05.
Note: You will access this article from the Walden Library databases.
Thew, J. (2016, April 19). Big data means big potential, challenges for nurse execs. Retrieved from https://www.healthleadersmedia.com/nursing/big-data-means-big-potential-challenges-nurse-execs
Topaz, M. (2013). The hitchhiker’s guide to nursing theory: Using the Data-Knowledge-Information-Wisdom framework to guide informatics research. Online Journal of Nursing Informatics, 17(3).
Note: You will access this article from the Walden Library databases.
Wang, Y. Kung, L., & Byrd, T. A. (2018). Big data analytics: Understanding its capabilities and potential benefits for healthcare organizations. Technological Forecasting and Social Change, 126(1), 3–13. doi:10.1016/j.techfore.2015.12.019.
Note: You will access this article from the Walden Library databases. Nursing Informatics And The Foundation Of Knowledge Essay
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Discussion: Big Data Risks and Rewards

When you wake in the morning, you may reach for your cell phone to reply to a few text or email messages that you missed overnight. On your drive to work, you may stop to refuel your car. Upon your arrival, you might swipe a key card at the door to gain entrance to the facility. And before finally reaching your workstation, you may stop by the cafeteria to purchase a coffee. From the moment you wake, you are in fact a data-generation machine. Each use of your phone, every transaction you make using a debit or credit card, even your entrance to your place of work, creates data. It begs the question: How much data do you generate each day? Many studies have been conducted on this, and the numbers are staggering: Estimates suggest that nearly 1 million bytes of data are generated every second for every person on earth.

As the volume of data increases, information professionals have looked for ways to use big data—large, complex sets of data that require specialized approaches to use effectively. Big data has the potential for significant rewards—and significant risks—to healthcare. In this Discussion, you will consider these risks and rewards.

To Prepare:

Review the Resources and reflect on the web article Big Data Means Big Potential, Challenges for Nurse Execs.
Reflect on your own experience with complex health information access and management and consider potential challenges and risks you may have experienced or observed. Nursing Informatics And The Foundation Of Knowledge Essay

1-Post a description of at least one potential benefit of using big data as part of a clinical system and explain why.

2-Then, describe at least one potential challenge or risk of using big data as part of a clinical system and explain why.

3-Propose at least one strategy you have experienced, observed, or researched that may effectively mitigate the challenges or risks of using big data you described.

4-Be specific and provide examples.

Introduction:
“Nursing informatics is defined as the combination of nursing science, information science, and computer science”. (McGonigle& Mastrian, p.5, 2012) Nursing Informatics centers on concepts of data, information, knowledge and wisdom in efforts to improve health of population as whole and individuals by optimizing communication. We can picture these components of nursing informatics in form of a pyramid. Data being the base of the structure provides basic maximum information. Followed by information and knowledge, wisdom takes the top spot of the pyramid. Data is a set of distinct objective facts/entries about an episode or a process, which has little or no worth unless converted into meaningful information. It can be present in a quantitative and qualitative form. Vital signs, respirations and patient’s complaints are some of the example of data. Information is a collection of data that is enriched with applicability and purpose. Information is associated with explanations and analysis concerning a particular event, and requires organization and interpretation of the collected data in order to apply. For example: routine blood test (BUN, Creatnine) over a period of time helps keep track of patient’s kidney function in a patient with acute kidney disease. Nursing Informatics And The Foundation Of Knowledge Essay Knowledge is basically a blend of an individual’s experience, moral values, information provided and judgment. It is derived from organization of summarized information, which augments understanding of the scenario that further enables an individual to take action or take decisions upon. A good example of knowledge can be monitoring patient’s urinary output each shift and identifying potential problems and complications while formulating interventions with knowledge and experience that is acquired and learned. Wisdom is a human’s ability to identify right from wrong, and apply applicable knowledge to reach a concrete solution. In short, it’s an appropriate application of collective information and knowledge into action. Information attained from subjective and objective data helps generate knowledge, while wisdom helps us make beneficiary decisions for our patients.
A male 69-year-old patient named Bill Jo was admitted to orthopedic rehab with aphasia secondary to stroke and minimal difficult swallowing. Patient is a full code, diabetic and have unsteady gait. Patient is on novolog subcutaneous five units prior to meals (TID). Post admission day one; while making my rounds around 5 pm, I noted Bill was confused but able to make verbal ques. Visual assessment showed diaphoresis and cold/clammy skin to touch while vital signs showed a pulse of 107bpm. Quick Accucheck readings showed the blood sugar level of 42mg/dl. As per facility protocol, I gave patient 8 oz glass thickened orange juice STAT. Bill was unable to swallow the juice and became unconscious. Meanwhile, MD was notified; I kept close communication with my coworkers and gave patient Glucagon IM while continuing to monitor Bill at the bedside. Patient subsequent blood sugar readings showed 52, 67, 81 and 124 mg/dl within 20 minutes of glucagon administration. Bill could verbalize he is ok in his normal yet slurred speech R/T aphasia. The physician ordered STAT glucagon, hourly blood sugar readings X24 hour and A1C test in AM. 5 pm dose of novolog was held. Data in this scenario was the facts I acquired from shift report and patient chart like: code status, diagnosis and history. Information is what I acquired during quick assessment of my patient, for example; diaphoresis, increased pulse and change in mental status. Knowledge is what I applied while looking at the scenario, as I decided to administer 8oz glass of thickened orange juice. Though the patient is not on any aspiration precaution, administering thickened liquid was my choice because patients had mild aphasia, and is experiencing… Nursing Informatics And The Foundation Of Knowledge Essay

The field of nursing informatics offers a number of opportunities to share and communicate data effectively and efficiently. This reflects the importance of shaping an environment that is based upon the discovery of knowledge that is generated once a research question has been identified. Within the practice setting, it is important to determine if nursing informatics may play an important role in determining the impact of pre-appointment phone calls on whether or not patients show up to their appointments as scheduled. Pre-appointment calling is a complex issue that involves many key variables and which influences the continuum of data, information, knowledge, and wisdom in different ways. Within this context, there must be a greater emphasis on understanding the data that is associated with pre-appointment calling, including whether or not it is related to an improvement by patients in keeping their appointments. In addition, developing information regarding this practice, imparting knowledge to others, and addressing wisdom are critical in the development of an effective pre-appointment program where greater efficiency is achieved and patients keep their appointments as scheduled.

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Data, Information, Knowledge, Wisdom
Obtaining data regarding the significance of medication administration is an important component of understanding the degree of success of this process and if it is likely to continue to be impactful for healthcare operations over the long term. Most importantly, the identification of data and information from existing databases is an important step towards understanding the effectiveness of this method and whether or not it has a lasting impact on outcomes and the overall ability to improve patient health and wellbeing. In addition, the impact of this process on the number of no-shows who fail to make their appointments is significant and requires further analysis. In order to determine whether or not this type of system is likely to be effective, it is important to identify prior articles and information that address this concept in greater detail and which influence whether patients are likely to meet their appointments more frequently as a by-product of these phone calls. An examination of databases to extract articles and information regarding this topic is necessary, and this may include CINAHL, PubMed, and searches using Google Scholar. This requires the use of specific keywords and phrases that are relevant to the topic, including but not limited to “pre-appointment calls,” “reminder systems,” “missed appointments,” among others in order to capture this information effectively. It is likely that these sources will lead to information regarding the importance of appointment reminder systems and/or phone calls that may or may not be the difference maker in determining how to overcome the challenges that are associated with appointment no-shows. Nursing Informatics And The Foundation Of Knowledge Essay

The use of information regarding pre-appointment calls and reminder systems is relevant and must be organized in a manner that will provide clear and concise results regarding these objectives so that researchers are able to recognize behavioral patterns that impact these practices, including the use of a reminder system to ensure that patients meet their appointments to improve their health (Liu, Abba, Alejandra, Sinclair, Balanag, & Lansang, 2014). There are a number of interventions that may be instrumental in this process, including the interventions that are necessary to ensure that appointments are met to achieve optimal health (Schauman, Aschan, Arias, Beards, & Clement, 2013). This reflects the importance of tools that have been proven with prior evidence regarding how to improve attendance at appointments that have been made with the intent to address health concerns that must be taken seriously and evaluated as a priority for a given patient (Farias, Klug, Tschiedel, Gerchman, & Punales, 2015). This is an important step towards understanding the challenges associated with promoting an efficient and effective system to keep appointments that are made and to be mindful of the issues that may evolve relative to developing a strategy to improve cooperation between patients and their healthcare providers. This is an important step in developing an organized system that patients will take seriously and which will enable them to obtain the healthcare services that they need in a manner that is likely to have a positive impact on their overall wellbeing. Nursing Informatics And The Foundation Of Knowledge Essay

Organizing a system to establish pre-appointment calls and to measure their effectiveness is important because it enables providers to determine if this task reduces the number of no-shows that occur. Therefore, using prior wisdom and knowledge of what has already taken place is critical in this regard and enables providers to measure whether or not these phone calls are impactful for patients in any way. At the same time, it ensures that patients are able to be effective in meeting their responsibilities and that they will benefit from the services that they receive in the healthcare setting. There must be a greater emphasis on understanding the nature of these tools and how to best use them in a manner that will lead to the best possible results to not only improve patient quality of care, but also to improve patient wellbeing.

Conclusion
The use of pre-appointment reminders for patients may lead to mixed results, but it requires an understanding of this process and whether or not it is likely to be effective in its use for patients over the long term. From this perspective, it is necessary to identify an approach that will have lasting benefits for patients and which will also improve operations for a healthcare organization in different ways. This reflects a need to explore prior data and information regarding this process through the use of databases and specific keywords/phrases in prior literature and how to overcome the obstacles that exist relative to expanding knowledge and resources to determine if pre-appointment phone calls are the most feasible option to reduce no-shows over time. Nursing Informatics And The Foundation Of Knowledge Essay

Sir, can you please step up to the glass, put your palm on the screen and follow the directions from the computer? This is where our future lies…in biometrics, computers, and science. Soon there will be no need to fill out tedious paperwork, to try to remember medications or past medical history. I know it exists in hospitals across America, I have seen it in action many times. Are we as nurses changing with the times? What is nursing informatics? Why is it important to me? How do I rate on the nursing informatics knowledge scale? What is my plan to increase my knowledge base? These questions should be at the forefront of every nurse’s thoughts. The information age has come crashing down on us from every possible angle in our lives, it…show more content…
They are not. Although these terms are related, they are not interchangeable. Health (healthcare) informatics is defined as “the study and application of computers to assist the gathering storage, processing and use of information to improve the procedures or outcomes of healthcare services” (Sullivan, F. 2001). Electronic Medical Records (EMR’s) are a great example of healthcare informatics. The nurse, at that juncture, will utilize the information gathered on the EMR to determine the direction of care for his/her patient, this process is called nursing informatics. I would venture to say that all nurses are using some form of nursing informatics but the degree of usage may vary dependent on many factors, namely, the nurses comfort level with computers. I took the “Pretest Toward Computers in Healthcare (PATCH) Assessment Scale, version 3,” (Kaminski, J.). I scored 92.0, a reasonably good score, but I would have projected a higher score because of my background in Tele-Medicine. I have spent the last 10 years in Tele-Medicine, so it would be a safe assumption that I am computer and/or technology savvy and fluent with multiple platforms. That holds true to a point, but the fact that technology is constantly evolving keeps us all somewhat behind the bubble since computer science is not our primary focus. Nursing informatics will remain a fluid environment, as each nurse becomes more comfortable with technology, each will be able to incorporate innovative  Nursing Informatics And The Foundation Of Knowledge Essay

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In health care settings, the consequences of a bad decision can be dire. Medical professionals need complete, accurate, relevant, and timely information on which to base their decisions about patient care. The field of nursing informatics is dedicated to supporting health care decision-makers by providing the advanced data analytics that medical staff increasingly rely on.

The textbook Nursing Informatics and the Foundation of Knowledge, written by Dee McGonigle and Kathleen Mastrian, was among the first texts for teaching basic to advanced nursing informatics courses. Now in its fourth edition, the book is designed to give students a foundation in bioinformation, data mining, and health information system design. More importantly, the material has been updated to match the fast pace of change in data analytics and health care technology.

Health Care Informatics Past, Present, and Future
Health care informatics integrates medical science with computer, information, and cognitive technologies to enhance information management in health care settings. In 2001, the American Nurses Association first recognized health care informatics as a specialty to create systems supporting communication among nursing and other medical staff. While growth in the field over the past 20 years has been tremendous, nursing informatics promises to have an even greater impact on the future of health care. Nursing Informatics And The Foundation Of Knowledge Essay

The Growing Importance of Information to Quality Health Care Delivery
In 2004, the federal government adopted electronic health records (EHR) as a way to reduce medical errors and improve the safety of patients. The application of nursing informatics in health care settings increased substantially as a result, and the field was boosted further by the government’s decision in 2009 to provide incentives for hospitals and other health care providers to use EHRs as part of the Medicare and Medicaid programs. EHRs streamline the management of medical records by eliminating paper files and reducing data errors, yet the real promise of EHRs lies in the access to the data that supports an evidence-based approach to practice.

Surveys conducted by the Healthcare Information and Management Systems Society (HIMSS) in 2011, 2014, and 2017 found that 82% of people who work in nursing informatics had at least five years of clinical experience before they entered the field. Initially, most nursing informatics professionals were trained on the job, but in recent years more people have been entering the profession after earning a master’s or doctoral degree and postgraduate certificates such as a board certificate from the American Nurses Credentialing Center (ANCC) or a professional certificate from HIMSS or a project management organization. Nursing Informatics And The Foundation Of Knowledge Essay

It is difficult to underestimate the vital role health informatics will play in the future of health care. Like nearly every other industry, health care organizations continue to generate unprecedented amounts of data, all of which must be managed, analyzed, and converted into knowledge that supports medical decisions.

Providing Students with a Conceptual Perspective of Nursing Informatics
The textbook Nursing Informatics and the Foundation of Knowledge introduces students to the Foundation of Knowledge Model that presents nurses as knowledge workers who collect and manage the organization’s information to create a body of nursing knowledge. Among the informatics competencies covered in the text are Quality and Safety Education in Nursing (QSEN) and the data, information, knowledge, wisdom (DIKW) hierarchy or pyramid. Nursing Informatics And The Foundation Of Knowledge Essay

The coursework comprising Regis College’s online BSN to Doctor of Nursing Practice (DNP) degree program ties directly to the concepts covered in Nursing Informatics and the Foundation of Knowledge. The courses help students gain expertise in the health informatics field by teaching concepts ranging from basic to complex. For example, the course Informatics in Healthcare provides students in all five of the BSN to DNP concentrations with a foundation in the application of advanced data management analytics to specific health care settings.

Key Health Care Informatics Concepts
The goal of nursing informatics is to combine nursing and physical sciences with computer and information technology in ways that enhance patient outcomes, improve the delivery of care, and enable regular communications with patients about treatments and healthy lifestyles. Nursing Informatics And The Foundation Of Knowledge Essay

EHR Systems and Wearable Tech as Models of Integration
The impact of nursing informatics is seen in the ways health care systems combine aspects of many old and new processes. For example, EHR systems can now collect and organize a greater amount of information about patients over time, which provides medical staff with a more complete picture of the patient’s health and potential risks. Wearable technology that tracks the level of people’s daily activities can help educate the public about the health benefits of staying active.

The converse of micro-collection of an individual patient’s data is the growing ability of medical information systems to connect globally and share critical updates on epidemics and other threats to public health. The conversion of medical records to EHR systems dramatically increased the amount of health information available for analysis.

Planning Efficient Care Strategies with the Help of Informatics
The emphasis of Nursing Informatics and the Foundation of Knowledge is to teach students nursing informatics competencies in all applications of informatics: practice, education, and research. These skills allow nurses to integrate health technologies into their patients’ lives in ways that increase awareness about the benefits of a proactive approach to health care. Nursing Informatics And The Foundation Of Knowledge Essay

The need to convert large amounts of raw health data into knowledge that enhances health care delivery and patient outcomes has increased demand for nursing professionals able to interpret the data and report their results to health administrators and providers. Among the leadership positions forecast for clinical informatics are chief medical informatics officer, chief health informatics officer, and director of clinical informatics.

Education’s Role in Understanding Health Informatics
The field of health informatics is so new that health care providers and nursing leaders struggle to translate health data into effective policy and patient-care decisions. Educators are in the best position to communicate the results of their research involving health informatics to policy makers and health care professionals. Nursing Informatics And The Foundation Of Knowledge Essay

A Curriculum That Serves as a “Foundation of Knowledge”
At the heart of Regis College’s online BSN to DNP program are courses that build upon the information students learn from Nursing Informatics and the Foundation of Knowledge. In addition to courses in the five nurse practitioner concentrations of Pediatrics, Family, Psychiatric Mental Health, Women’s Health, and Adult Gerontology, the program offers courses in Advanced Research Methods, Epidemiology/Biostatistics, Cultural Perspectives in Health Care, and Health Policy, Politics, and Perspectives.

Applying Health Informatics in Real-World Situations
The growing demand for advanced practice nurses is particularly acute in the health care areas where nursing practice and technology meet. The nexus between sound nursing practice and advanced technology is the province of nursing informatics professionals whose knowledge is grounded in the fundamentals taught in Nursing Informatics and the Foundation of Knowledge. Having a strong understanding of techniques for applying informatics concepts to health care situations prepares students for diverse nursing management and leadership roles. Nursing Informatics And The Foundation Of Knowledge Essay

Preparing Nurse Leaders for Tomorrow’s Data-Driven Health Environments
The same technologies that make possible the tremendous enhancements to the performance and profits of businesses are being applied to realize equivalent improvements in patient outcomes and efficient provision of health care services. Nursing informatics plays a vital role in ensuring health care decision-makers and managers have the information they need to make sound policy and patient-care judgments. Nursing Informatics And The Foundation Of Knowledge Essay

Programs such as Regis College’s online BSN to DNP degree prepare nursing professionals for lead roles in the ongoing transformation of the health care industry. Find out more about the benefits of the program’s supportive environment, flexible schedule, and reputation for academic excellence. Nursing Informatics And The Foundation Of Knowledge Essay

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