Current Strategies to Implement Informatics Into the Nursing Curriculum an Integrative Review

Citation: Webb, Due north. (2021 Nursing Informatics every bit Caring: A Literature Review. Online Journal of Nursing Informatics (OJNI), 25(1).  https://www.himss.org/resources/online-journal-nursing-computer science

Abstract

Despite some societal influencers sounding the alarm on the malevolence of big data, the bear witness shows that nursing information science is ane of the all-time hopes for healthcare in terms of keeping patients condom and doing no harm. Locsin'south theoretical framework (2017) demonstrates that technology can peacefully coexist with nursing and is perhaps necessary for the profession to move forward and be truly integrated. Nurse leaders who are trained and can demonstrate informatics competencies are in a position to track, tendency, and prevent patient harm from occurring, which volition not only benefit patient outcomes but likewise preclude reduced federal healthcare reimbursement penalties and reduce litigation exposure.

Introduction and Groundwork

  On a recent trip to Oregon, the author, who loves reading books almost as much as nursing practise, visited the earth'south largest bookstore. Housing more than two million tomes within its many shelves, a plethora of precious pieces of prose on printed parchment were procured. Ane particular work entitled "Weapons of Math Devastation: How Large Information Increases Inequality and Threatens Republic" (2016) by Dr. Cathy O'Neil, was an impulse buy on the way to the register which turned out to be quite a thought-provoking text that was consumed in but i sitting.

In her text, O'Neil (a statistician who completed graduate studies in mathematics at Harvard) examined some of the pitfalls of utilizing big information (in this text, the terms informatics, and big data may be used interchangeably). "Big data processes codify the by" and "exercise non invent the future" (p. 204). She argued that for data to shape the future, it must take moral imagination, which must be facilitated by humans.  She also stated that we "have to explicitly embed better values into our algorithms, creating big data models that follow our upstanding lead" (p.204) which might entail putting fairness ahead of turn a profit. O'Neil best-selling the power of algorithms and big data but chose instead to focus on those instances where big information was not used responsibly. Perhaps part of the reason that the examples she provided turned out the way they did was that at that place was no harmony between (caring) humans and the engineering. In the nursing profession, at that place must be a connection between the homo element of caring and technology, which is used to help deliver nursing intendance.

Failure to employ informatics constitutes a deficiency in care

The United States federal government's efforts to ameliorate quality care outcomes through the Centers for Medicare & Medicaid Services' (CMS) Meaningful Use and Value-Based Purchasing ways that healthcare organizations that do not reduce patient harm and amend the health and outcomes of their patients put themselves at take chances. McCarty (2016) reported that more fifty-pct of eligible professionals faced penalties nether Meaningful Use in 2022 totaling $200 meg in federal government reimbursement reductions. Failure to prefer EHRs and computer science reporting tin can result in reduced reimbursements from CMS, which can hurt an organization's bottom line. Impacts on a healthcare organization's bottom line may impact its ability to care for patients in the local customs. If penalties are steep enough, they could theoretically put a healthcare organization out of business concern. For these reasons, nurse leaders need to embrace nursing information science.

Nursing informatics tin can be used not only to rails and trend information associated with quality outcomes associated with CMS Meaningful Apply Requirements, but engineering has advanced to the bespeak where patients most probable to exist at chance for impairment tin be identified early on on in their hospital admissions. Kipnis and colleagues (2016) examined the efficacy of using an EMR to develop an automated Early on Alert Organization (EWS) to predict patient deterioration in patients exterior of the ICU and found that it had amend sensitivity at predicting deterioration than traditional EWS's. Utilizing such systems would not only assist identify patients at risk earlier, helping them avert more acute illness or injury, simply it would besides help increase Meaningful Utilize reimbursement from CMS. It would be a different situation if nurse leaders had no control over the outcomes, but we do take the ability to influence outcomes significantly using nursing information science. Positively influencing patient outcomes tin can exist a course of caring.

Theoretical framework

Through Locsin (2017), we detect an prove-based theoretical model where technology tin peacefully coexist and thrive with the caring aspects of nursing. Concepts such as technology, which may not historically be looked at as being of a caring nature, have a identify in the realm of nursing. Locsin asserted there are a series of 5 assumptions that permit engineering science to coexist and thrive in nursing peacefully . These include that people fundamentally care by virtue of their humanness; that the ideal of wholeness is a perspective of the unit of measurement; that knowing people occurs through a multidimensional process; incorporation of both health and engineering science are components of caring, and that nursing is fundamentally a field of study and a professional do . It is Locsin's fourth assumption, that incorporation of both wellness and engineering science are components of caring, that is central to the writer's assertion that computer science can be used for the greater good, especially for patient care. Locsin's assumptions are summarized in Figure 1, below.

Locsin's V Assumptions Structure of the Theory of Technological Competency as Caring in Nursing

Nursing icon Jean Watson famously said that "Caring is the essence of nursing " (1999, p. 33). There is cypher more key to nursing than the power of nurses to intendance for the sick, the tired, and the forgotten. How, then, practise nursing informaticists care for their patients? Tin can informatics be used to care for the sick? Informatics tin allow nurse leaders to champion and support initiatives that reduce damage, keep patients safe, better quality outcomes, and decrease the amount of time patients spend in a hospital.

Nursing may not be the get-go profession i thinks of when speaking about technology. However, if nurse leaders are going to be successful in helping nursing become a truly integrated profession that is split up from medicine, they must learn how to navigate toward the intersection of caring and technology. This needs to change because if nursing leaders do not define the parameters of success and failure within their profession when it comes to quality outcomes, they volition be defined by outside stakeholders (such as physicians, for example).  Nurse leaders must be able to speak in terms that interdisciplinary teams similar medicine, pharmacy, and finance can empathize and respect. Nurses are already known for their exemplary ability to care and must also be renowned for their power to influence patient care outcomes through informatics. Big information and nursing information science, therefore, is not the problem simply instead a novel solution.

Literature Review

A literature review was conducted on over 40 scholarly peer-reviewed periodical articles, with xiii eventually being selected. Search terms included "nursing informatics competencies", informatics nurse leaders", and "nurse informatics affect." Inclusion criteria included articles published in the last five years and articles from scholarly peer-reviewed journals. Articles from international journals were considered. Exclusion criteria included articles older than five years and manufactures which did not have a defined methodology. Many of the manufactures which were initially reviewed were excluded equally they didn't include clear methodology or data analysis sections.

The word "informatics" was introduced around 1957 and believed to be Russian in origin, being influenced by the words information and automatic. (Sengstack, 2015). Automatic information, either pushed from a centralized source or available at the nurse leader'southward fingertips, can be used to brand clinical nursing decisions and leadership practice decisions. Nurse leaders who tin employ empirical data through nursing computer science can make decisions that positively impact care commitment at the bedside. Amend care commitment also means higher reimbursement from CMS and fewer penalties for providing substandard care.

Computer science competencies for nurse leaders at the graduate level

Kassam et al., (2017) wrote about the importance of nursing computer science and acknowledged that nurse leaders are often non equipped with the requisite competencies to put the discipline to good use. Withal, there is hope. Informatics competencies are often taught at the nursing graduate school (MSN, Ph.D., and DNP) level. Equally more and more nurse leaders become educated at the graduate level, they must sympathize nursing informatics competencies and so that they can exist valuable participants and contributors to the profession. Shea and colleagues (2019) advocated that nurses who learn how to apply data volition be able to transform health care commitment, assertive that nurses must have the skills to manage information for determination-making.  There remains a shortage of clinicians to support these changes, and graduate didactics does not necessarily instill relevant nursing informatics competencies in students. The importance of ensuring that nurse leaders embody informatics competencies cannot be understated.

Nursing computer science competencies are a necessity

In order for nurse leaders to positively impact healthcare, they must showroom prove-based behaviors, in the form of competencies. The Event-Based Teaching Model (OB-CE), described by Graebe (2019), provides a framework to appraise nurse competence, where achieving learner outcomes is the focus and time is the variable. The OB-CE model focuses less on time, as many traditional educational curriculums do (such as credit hours or continuing pedagogy hours), but rather on the validation of learner knowledge and performance (Graebe, 2019). The OB-CE, adult past the American Nurses Credentialing Center (ANCC), points out that learning takes place when environmental factors such as civilization, institutional construction, resources, and systems bug exist (Graebe, 2019).  This can undoubtedly be true of nursing informatics, where long-existing cultures and practices are starting time to meld with new technological advances and discoveries. Competency frameworks have also been institute to assist ready clear goals and targets and better how practise is organized (Stanford, 2016).

Competencies: closing the gap

Information technology is essential to assess the baseline competence of nurse leaders as it relates to nursing informatics. Pordeli (2018) conducted an evidence-based written report at a 304-bed, non-profit magnet recognized hospital in Florida. There, twenty-1 informatics nurses were provided a pre-assessment to examine competency gaps in nursing informatics competencies. The researcher's primary objective was to construct a professional development program to meet the organization's informatics competency needs. The post-assessments later on the education was delivered determined an increase in computer skills competency past 25.41%, privacy/security competencies increased by 26.21%, and data mining competencies by 51.64%.
It is imperative that to go and remain an integrated profession, leaders at the forefront of nursing must adopt and encompass informatics. Remus (2016) institute that the inability of wellness systems to reap the total benefits of an EHR is related to deficiencies in informatics competencies among nurse leaders, including chief nurse executives (CNEs). Remus further argued that informatics-savvy CNEs can be transformational by helping nurses become noesis workers that tin can more positively affect patient care outcomes.

Conclusion

Though in that location are some in academia and manufacture who focus on the potential downsides of big data, their voices will exist eclipsed past the swarms of nurse leaders beingness trained in informatics competencies and applying them to better intendance outcomes. Locsin'south theoretical framework provides an avenue where caring and applied science in the form of informatics tin peacefully coexist and even thrive in nursing. Nurse leaders who are competent in informatics competencies can contribute to the body of evidence-based practice and dramatically transform care delivery for the better.

Online Journal of Nursing Informatics

Powered by the HIMSS Foundation and the HIMSS Nursing Informatics Community, the Online Journal of Nursing Informatics is a free, international, peer reviewed publication that is published three times a year and supports all functional areas of nursing informatics.

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