Foundation of Practice Flashcards
What are the foundations of practice
A. Professional practice
B. Methodologies & Theories
C. Rules, regulations, & requirements
D. Interprofessional collaboration
ANA definition of NI (2008)
Nursing informatics is a specialty that: A. integrates nursing science B. Computer science C. Information science to manage and communicate: 1. Data 2. Information 3. Knowledge and 4. Wisdom in nursing practice NI Supports: a. consumers b. patients c. nurses d. other providers in their decision-making in all roles and settings. This support is accomplished through: i. use of information structures ii. information processes iii. information technology
ANA definition of NI (2015)
NI is a specialty that integrates nursing science with multiple information and analytical sciences to: A. Identify B. Define C. Manage and D. Communicate data, information, knowledge, and wisdom in nursing practice NI supports: 1. Nurses 2. Consumers 3. Patients 4. Users 5. Interprofessional healthcare team 6. Other stakeholders in their decision-making roles and settings to achieve desired outcomes
This support is accomplished through the use of:
a. information structures,
b. information processes, and
c. information technology
Tenents (beliefs) of Nursing Informatics
- A unique body of knowledge, preparation, and experience that aligns with the nursing profession.
- Involves the synthesis of data & information into knowledge & wisdom
- Supports decision-making of healthcare consumers, nurses, and other professionals achieve healthcare consumer safety and advocacy
- Supports data analytics, including quality of care measures, to improve population health outcomes and global health
- Promotes data integrity and the access and exchange of health data for all consumers of health information
- Supports national and international agendas of interoperability and the efficient and effective transfer and delivery of data, information, and knowledge
- Ensures that collaboration is an integral characteristic of practice
- Interleaves user experience and computer-human interaction concepts throughout practice
- Incorporates key ethical concerns of NI such as advocacy, privacy, and assurance of the confidentiality and security of data and information
- Considers the impact of technological changes on patient safety, healthcare delivery, quality, reporting, and the nursing process
- Leads in the design and promotion of useful, innovative information technologies that advance practice and achieve desired outcomes
(Scope & Standards )
What year did the ANA identify NI as a nursing specialty?
1992
When was the first scope of practice statement for NI published?
1994
When was the ANA Standards of Practice for NI released?
1995
When was the scope and standards of NI practice released combining both scope and standards of practice?
2001 then updated in 2008
What are analytical sciences?
A listing of sciences that integrate with NI includes:
- computer science
- cognitive science
- science of terminologies and taxonomies (including naming and coding conventions)
- information management
- library science
- heuristics
- archival science
- mathematics
What are the NI competencies for all RNs?
TIGER-Technology informatics guiding education reform identified that all nurses in every role must be prepared to make HIT. TIGER formed an informatics competency collaborative which defines the competencies recommended for the NI discipline:
- Basic computer skills
- Information literacy
- information management
According to Staggers, Gassert, Curran 2002, what are the levels of informatics competencies?
- Beginning nurse
- Experienced nurse
- Informatics nurse specialist
- Innovator
Name some additional competencies
- Pierce, Tanner, & Pravikoff (2005) information literacy
- Telehealth competencies (ATA, ICN)
- Genetics & genomics competencies
- National league for nursing
- Amer Assoc of College of Nurses
- Forecasting informatics competencies for nurses in the future of connected health IOS Press 2017
Name the types of roles
- Project manager
- Decision support/outcomes
- Educator
- Product developer
- Systems analyst
- Consultant
- Programmer
- Advocate/policy developer
- Web developer
- CIO/CNIO
- Entrepreneur
- Researcher
- Sales and Marketing
- Consumer advocate
What are the functional areas: Informatics nurses
- Administration, leadership, & management
- Systems analysis & design
- Compliance & integrity management
- Consultation
- Coordination, facilitation, & integration
- Development
- Educational & professional development
- Genetics & genomics
- Information management/operational architecture
- Policy development & advocacy
- Quality & performance improvement
- Research & evaluation
- Safety, security & environmental health
What are the standards of nursing informatics Practice?
- Evaluates quality & effectiveness of NI practice
- Performance appraisal
- Maintains knowledge and NI competency-life-long learning
- Contributes to the professional development of others
- Bases decisions and actions on ethical principles
- Collaborates with others
- Contributes to the body of informatics research
- 16 Standards are highlighted with measurement criteria
What are the NI Standards of practice?
Standard 1: Assessment Standard 2: Diagnosis, Problems & Issues Identification Standard 3: Outcomes Identification Standard 4: Planning Standard 5: Implementation Standard 6: Evaluation Standard 7: Ethics Standard 8: Education Standard 9: Evidence-Based Practice and Research Standard 10: Quality of Practice Standard 11: Communication Standard 12: Leadership Standard 13: Collaboration Standard 14: Professional Practice Evaluation Standard 15: Resource Utilization Standard 16: Environmental Health ADOPIEEEEQCLCPRE
What makes up EBP?
- Literature searches
- Clinical practice guidelines
- Clinical protocols
Boolean search
Definition of EBP
- A problem-solving approach to clinical decision-making within a healthcare organization
- Integrates best available scientific evidence with best available experience
- Uses research & non-research evidence (ethical or personal)
Evidence-Based nursing practice is the process:
By which nurses make a clinical decision using:
- The best available research evidence
- Their clinical expertise
- Patient preferences
Formulating answerable clinical questions is the foundation of EBP.
- Start with the patient: clinical problems & questions arise out of patient care
- Translate the clinical questions into a searchable question using PICOT
- Decide on the best type of study to address the question
- Perform a literature search in the appropriate sources
What is the PICOT model to support EBP
P-Population/condition I-Intervention C-Comparison O-Outcome T-Time of study
What is the ACE Star Model of EBP (2004)?
5 points of knowledge transformation:
- Discovery
- Summary
- Translation
- Integration
- Evaluation
NI support nurses, consumers, patients, interprofessional healthcare team, and stakeholders through the use of which three things?
- Information structures
- Information processes
- Information technology
Name a Metastructure
DIK (Blum-1986) 1. Data 2, Information 3. Knowledge 4. Wisdom DIKW (Graves & Corcoran-1989)
What is Data?
Discrete entities that are described objectively with interpretation
What is Information?
Data that have been:
- Interpreted
- Organized or
- Structured
What is Knowledge?
Information that is synthesized so that relationships are identified and formalized
Focuses on what is known
The appropriate use of knowledge involves?
Integration of empirical, ethical, personal, and aesthetic knowledge into actions
What is Wisdom?
The appropriate use of knowledge to manage and solve human problems.
It consists of knowing when and how to apply knowledge to deal with complex problems or specific human needs
Focuses on the appropriate application of that knowledge and an appreciation of the consequences of selected actions
Example of DIKW
(D) A nurse receives list of numbers (28, 68, 94, 98, 110) which are just raw data and meaningless
(I) If the numbers are ordered or structured and identified as follows: T 98, P 94, R, 28, BP 110/68, the nurse recognizes this series and measurements of vital signs and will regard those numbesrs as information
(K) Applying context to the information knowing that these numbers mean different things in different populations such as NB and Adults.
(W) Nurse can take appropriate action
Relationship of Data, Information, Knowledge, and Wisdom
Nelson 2002
Data - naming, collecting, and organizing
Information - Organizing and interpreting
Knowledge - Interpreting, integrating, and understanding
Wisdom - Understanding, applying and applying with compassion
NI is concerned with
Creation Structure Storage Delivery Exchange Interoperability Reuse of nursing and clinical information along the continuum of care.
What is the informatics nurse specialist often responsible for?
Implementing or coordinating projects
involving multiple professions and specialties
Support other RNs to best use data, information, knowledge, and technology
NIs support through the use of:
Information structures
Information processes
Information technology
NIs Foci
Information user, information recipients, exchange data, information, knowledge, and wisdom
Design, structure, interpretation, and representation of data, information, knowledge, and wisdom
Design, develop, implement, and evaluate applications and technologies, ensuring their safety, quality, effectiveness, efficiency, and usability
Standardized terminologies
Have become a significant vehicle for facilitating interoperability between different concepts, nomenclatures, and information systems
How is the HITECH’s act (2009) continuing to evolve, map, and integrate concepts as well as research efforts in today’s terminology environment?
HITECH funding continue to stimulate more rapid movement towards electronic data capture and health information exchange (HIE)
Two examples:
1-International classification for nursing practice (ICNP)-developed and maintained by the International Council of Nurses (ICN), provides a global cross-map of nursing terminologies and unite practice through comparison, new research generation, and to inform and influence health policy. ICNP has harmonized with SNOMED CT and offers more than 18 diff translations
2-Systematized Nomenclature of Medicine or (SNOMED CT) is a comprehensive universal healthcare reference terminology and messaging structure. Enables multiple nursing terminology systems to be mapped to one another thru harmonized concepts.