For 25 years nursing informatics has evolved into a prominent nursing field and a critical piece to the healthcare system. The American Nurses Association (ANA) describes nursing informatics as a specialty that integrates nursing science, computer science and information science to manage and communicate data, information, knowledge and wisdom in nursing practice.1
EMR for Nurses
The healthcare field in the U.S. has been resistant to the information age and EMR (electronic medical record) systems.2 Moving from a paper record system to an EMR system has been slow, but it has been moving quicker within the past 10 years. Many healthcare professionals believe that paper record systems are the way of the past and the future encompasses a computerized system. EMR systems reduce unnecessary repetitive paperwork and data is more legible and thorough compared to paper record systems.3
Stakeholders (e.g., administrators, doctors, nurses, etc.) are embracing the change to an EMR system and feel that more valuable time can be vested to patient care with the use of these computerized systems.4 Evidence suggests a correlation between advanced EMR systems and lower costs, staffing and positive patient outcomes.5 Leaders in healthcare today often are pursing EMR systems combined with sound nursing informatics tools to maximize quality care to manage information and data while minimizing costs.
While improvements in the healthcare system have occurred exponentially due to the ever-growing expansion of technology, it is noted that nursing informatics has not been able to keep up to the powerful and fast pace of this technology. In fact, there are fewer than 600 nurses that hold a certification for informatics under the ANA.6 There are fewer than 6,000 nurses in the role of informatics under the Alliance for Nursing Informatics.6 These are not large numbers in the scope of the medical field.
Nursing informatics as a technology across the healthcare system remains in its infancy stage of development and has not been widely utilized or maximized to its fullest potential by all hospitals. Nursing informatics in the healthcare system is a tool that emphasizes safety and quality care outcomes, which are tools that leaders in healthcare should strongly consider. Nursing informatics allows nurses to enter and access patient information in an expedient time frame that matches individualized expectations for each patient.
A Need for Nursing Informatics Support
Every day, nurses make many important decisions about patient care. Using quality nursing informatics saves nurses time and prevents unnecessary work. For example, there are systems that automatically enter vital signs and other assessment notables in EMR systems for nurses.7 Imagine how much time this saves and how many errors are minimized. This type of automatic system can also be feasibly designed to help support clinical decision making through evidence-based criteria.7
The clinical environment has increased in acuity and complexity of care, reimbursements have shrunk, and this requires nurses to be more efficient.7 These are challenges for many leaders in the healthcare field. To aid in this change, newer technology allows nurses to fulfill their routine tasks and enable better outcomes within the amount of money available.7 Leaders need to consider these new technologies and how they can improve the workflow and the quality of work in their facility.
Suppose a healthcare facility were to link the technology of a wireless touch screen iPad with nursing informatics tools and their EMR system. This technology has potential to improve the work environment, decrease staff time and save money.
The use of an EMR system that is embedded with solid nursing informatics tools is something that leaders in the healthcare field should consider.
From a business standpoint, the use of paper records does not make sense as it creates unnecessary costs to the organization. For example, it takes time, money and requires too many people to enter data on paper, file it, store it, maintain it, analyze it, formulate custom reports, etc. This can all be managed efficiently and more effectively with the use of an EMR system that encompasses nursing informatics tools. In fact, reports can often be generated within seconds with just a few keystrokes. This would save much time and minimize many errors than older reporting and tracking systems.
In the poor economy today, businesses, including in the healthcare field, continuously reevaluate themselves to find ways to save money and time in order to produce a quality product or service that consumers want. This is an expectation of many successful businesses. Leaders in the healthcare field are no different than any other type of business.
Leadership continuously seeks ways to manage documentation time constraints in a method that fosters quality care. Nursing informatics conceptualizes a language that vastly expands the potential for information and transforms patient care.8 In today's world, leadership has a vast array of information and technology available to use. Nursing informatics is a portal that aids nurses and leadership in achieving better and faster quality care, which also allows nurses to be more physically available to the patient. Information systems are tools that facilitate nursing practice and the goal is not intended to take nurses away from patient care, but to enhance the workflow.9
Components of a nursing informatics infrastructure that supports patient safety include: data acquisition methods and user interfaces, standards that facilitate healthcare data exchange among heterogeneous systems, data repositories and clinical event monitors, data mining techniques, digital sources of evidence or knowledge, communication technologies, and informatics competencies.10
From the perspective of patient safety and quality care, the informatics tools that support shared decision making and enhance communication include: interactive education to improve risk comprehension; multiple, individualized formats for conveying risk; individualized risk calculations; application of decision analysis methods to calculate options with the highest expected value; automated updates of evidence to support shared decision making; and utilization of different preferences.10
Nursing Informatics: A Time-Saving Intervention
If Florence Nightingale were alive today, she would be extremely pleased with nursing informatics tools, which uses science, nursing, statistics and evidence-based care, as a time saving intervention with the ultimate goal of helping patients in the best manner possible.
Nursing informatics are tools that enable better utilization of nursing resources, improves accuracy and completeness, and allows for nursing data to be accessed and evaluated in a timely manner for patient outcomes.9 Nursing informatics are an integral part of the healthcare delivery process and a differentiating factor in the selection, implementation and evaluation of health, which supports safe, high-quality and patient-centered care.6
Quality healthcare is a nationwide demand and concern. Leaders in healthcare need to consider nursing informatics tools to meet these demands and expectations.
- Thede, L.T., & Sewell, J.S. (2010, July 25). Informatics and nursing: Competencies and applications. Retrieved from the World Wide Web May 23, 2011: http://dlthede.net/Informatics/Chap01Overview/Chap01.html
- Doyle, M.D. (2006). Promoting standardized nursing language using an electronic medical record system. AORN Journal, 83(6), 1336-42.
- Lyden, C.L. (2008). From paper to computer documentation: One easy step?. Online Journal of Nursing Informatics, 12(3), 5. Retrieved from the World Wide Web May 23, 2011: http://ojni.org/12_3/Lyden.pdf
- Gruber, N.G., et. al. (2010). Embracing change to improve performance: Implementation of an electronic health record system. Long-Term Living: For the Continuing Care Professional, 59(1), 29-31. Retrieved from the World Wide Web May 23, 2011: www.ltlmagazine.com/ME2/dirmod.asp?nm=&type=Publishing&mod=Publications%3A%3AArticle&mid=8F3A7027421841978F18BE895F87F791&tier=4&id=38CF66CD495246228150F47DAC2D9658
- Furukawa, M.F.F, et. al. (2010). Electronic medical records, nurse staffing, and nurse-sensitive patient outcomes: Evidence from California hospitals, 1998-2007. HSR: Health Services Research, 45(4), 941-62. Retrieved from the World Wide Web May 23, 2011: www.hsr.org/hsr/abstract.jsp?aid=45294236303
- Murphy, J.M. (2010). Nursing informatics: The intersection of nursing, computer, and information sciences. Nursing Economic$, 28(3), 204-207.
- Ericksen, A.B. (2009). Informatics: The future of nursing. RN, 72(7), 34-37.
- Fetter, M.S. (2009). Mastering the challenge of interoperability in nursing informatics. Issues in Mental Health Nursing, 30(9), 591-592.
- Elkind, E.C. (2009). Why information systems are helpful to nursing. The Pennsylvania Nurse, 64(1), 24-25.
- Bakken, S.B. (2006). Informatics for patient safety: A nursing research perspective. Annual Review of Nursing Research, 24, 219-54.
Gregory K. Shuler is a charge nurse at Worcester State Hospital, Worcester, MA.