For several decades, the professionals in nursing have not been able to provide an exhaustive definition of who the nurses are, what they do, how to pass the knowledge to the next generation, and how to transform healthcare to fit the new technology. Nursing informatics attempts to simplify and improve documentation through embracing advanced computer technology. The potential to transform nurses into nursing informatics lies on the fundamental changes that will involve individuals, organizations, as well as relevant systems. In order to create meaning to the nursing informatics, the organizational culture and administrative structures should change. The general mission of nursing informatics revolves around structuring and processing information that assist the healthcare providers in making clinical decisions, in addition to establishing systems that can automate that process. This study will focus on explaining the nursing informatics, its metastructures concepts and science that underpin the nursing informatics, implications, organizational culture and the future directions of the profession.
Since the foundation of modern nursing, nurses are perceiving data from regular patient records as a great resource for evaluating and advancing healthcare. Nursing informatics is a new specialty from nursing, which is characterized by rapid growth in terms of numbers of practitioners, and outburst of knowledge (Jones, 2007, p. 132). As new directions evolve, nursing informatics professionals are gaining popularity in the health care environment. Nurses are utilizing informatics methods to ascertain knowledge and enhance provision of healthcare while seeking wisdom from other disciplines to effect the essential changes.
Human beings are perceived to be exceedingly slow, inaccurate, but bright. On the other hand, computers are quite fast, accurate, but cannot run without human hands. Thus, nurses should study the nursing informatics to incorporate technology, which is increasing at a rapid rate. Technology will facilitate creativity in nursing, especially in handling patients. Information is power, and the more the nurses are informed, the better they will satisfy their clients. Nursing informatics can become a reality when nurses become used to working with computers as they offer their services based on the evidence stored in the computers. Every action that nurses undertake depend on the preceding information and knowledge, thus, technology will enhance faster services.
The current roles that health care providers play in their working environment are expanding. Nurses with the knowledge in informatics are employed as project managers, chief information officers, consultants and policy developers. Health information technology has embarked on employing nurses in various senior posts in order to offer vision and management necessary for execution of clinical systems. All that the nurses need to become nursing informatics is knowledge in nursing science, in addition to both information and computer sciences. The cardinal rule that guides on informatics is that many people can use a single entry of data. Re-entry of data will only raise the likelihood of committing an error. Nursing informatics, accompanied by healthcare technology enhances the passion for nursing, where innovation led to better patient outcomes and high quality healthcare.
The Profession of Nursing Informatics
No individual is capable of holding all the relevant information in his/her head. Due to emergence of numerous diseases and complications in human bodies, electronic tools should accompany critical thinking to ensure that relevant information in the head is not lost. Nursing informatics involves finding ways to develop information management, as well as communication in nursing, with an aim of increasing efficiency, minimizing costs and improving the quality of health care. According to Graves and Corcoran (1989), nursing informatics is “a blend of computer science, information science, and nursing science created to assist in the management and processing of nursing data, information and knowledge to support the practice of nursing and the delivery of nursing care” (Jones, 2007, p. 132). The profession has become an integral part of nursing, as almost all nurses have embraced information technologies to enhance their practice. Computers are essential in nursing informatics because they are the medium for communication. They also assist in processing and storing information that the nurses use in attending to the patients.
Nursing informatics has experienced rapid growth due to the number of practitioners who have desired to specialize in electronic documentation within the nursing practice. Nurses who specialized in nursing informatics utilize nursing science to offer directions and to influence designing of nursing information structures. This process usually occurs whenever nurses are in contact with the patients. Nurse informatics professionals aim at developing systems that are simple and effective. Nursing informatics has the potential to facilitate and support the care of patients and communities through management and communication of information concerning the patients (Jones, 2007, p. 133). Informatics professionals usually work in hospitals, consulting firms, and other firms that develop and utilize healthcare information systems. Nurses utilize information and technology in supporting a particular field of practice. On the other hand, informatics nurses sustain, change, develop, and convert practice using design and execution of information technology. They ensure that the new systems are capable of aligning with existing systems to avoid confusion and lack of acceptance.
Metastructures Concepts and Theories
According to the American Nurses Association (ANA), nursing informatics is a specialty where nurses utilize data, information, knowledge and wisdom in offering support to patients and other healthcare providers, and making decisions in the healthcare environment (Treas & Wilkinson, 2013, p. 1572). The four aspects are what the nursing informatics refers to as metastructures. Nursing concepts are usually evidence-based and serve to enhance the comprehension of nursing informatics.
Nursing informatics utilizes data to derive information. The data can only be meaningful if it is utilized to provide information. According to Baker (2012), the data cannot stand by itself, as it require information to be processed, and later analyzed within the information system science (p. 153). For instance, if a nurse reports that a child is suffering from malaria, this information lacks meaning until it indicates who is sharing this information, and the details of the child. The multifaceted nature of nursing experience poses some difficulties in measurement, as measurement must replicate the multi-dimensional instead of elemental character of the phenomenon.
Nurses utilize data as primary facts. The collected data can be used in deriving information. Information is outlined when data are grouped and processed to create a structured form. When nurses group the units of measure, gender and age, they create information. For the information to have value, it has to be accurate, timely and useful. Information technology incorporates systems, such as computers and programs, which direct and process information. The nurses feed the information they collect from patients to the computer, in order to create a comparison with the previous information that may be stored in the computer.
To have knowledge in nursing informatics is essential, as knowledge seeks to discover what is already known. Through communication, nurses become aware of the patient’s condition. Nurses form knowledge when they group data and create meaningful information. Having gathered some information about a patient, the nurses can use the knowledge to create an informed decision concerning the patient’s current condition. The previous knowledge about the patient can assist in making decisions about treatment. Decision-making process in nursing is usually driven by the perception of critical thinking. Knowledge influences the way nurses make decisions concerning patients’ condition. As more information is transformed into knowledge, the level of complexity rises, thus, compelling the nurses to apply more knowledge in caring for the patient.
A nursing informatics is said to have wisdom if he/she depicts competence in the practice. It is quite hard for a fresh graduate to collect data swiftly in the emergency room during his/her first day at work. Experienced nurses can perform this routine with ease, as they are a thorough understanding of organizing and interpreting information. Experienced nurses apply knowledge with compassion and wisdom. Thus, wisdom is the application of knowledge in solving human problems. Wisdom develops through experience, critical thinking and insight. Optimal task completion involves the concepts that guide efficiency and effectiveness, as well as deliberations on the safety of technology users. Due to complexity of the patients’ information, nurses have developed strategies to evaluate information structures that can assist in attending the patients with ease.
Theories in nursing informatics have been utilized in developing skills, knowledge and expertise in carrying out this profession. Several theories exist in the study of nursing informatics. General system theory asserts that a single system, such as a human body, incorporates other subsystems that form the whole body. Subsystems are held by the boundary (skin), which is always present. Systems are mainly used to generalize reality. Using a common framework, nurses can communicate the patients’ information with a given setup. With the help of the patients, nurses can work on the best techniques to accomplish their goals.
Cybernetics (controlled system) theory involves transfer of information between system and its environment (Baker, 2012, p. 153). The controlled system allows feedback depending on its environment, giving room for automatic adjustment. Nursing informatics allows information to move within the specified boundaries in the healthcare environment. In doing so, nurses are capable of getting feedback from their clients, thus, maintaining the system. The system detects errors and makes corrections to actions that aim at achieving the goals.
The cognitive theory is closely connected to the way a computer arranges data, information and facts into the system. In the cognition theory, human thought processes affect how individuals perceive and interact with the environment. The theory assumes that humans are rational and usually make the best out of every situation. Information is fed into a computer system to offer description on the mental process. Change theory illustrates directly how healthcare facilities amplify the use of electronic medical records to transform the nursing profession. This theory is incorporated into Lewin’s change theory, which emphasizes that clinical information undergoes three steps, which include unfreezing, creating changes and refreezing. For instance, when a patient’s record is transferred from the paper file to an electronic record in a computer, this represents a change a traditional format to a solidified state, which can be utilized by other healthcare providers for practice.
Administrative Structures and Organizational Culture
The collaboration between the management and the staff is fundamental in implementation of information technology. Healthcare organizations have well defined line of authority, which guide the flow of information. They remain hierarchical organizations under this line of power, thus, controlling the flow of information. Informatics nurses usually carry out the responsibility of determining the impact that the system has on the workflow. If a nurse informatics becomes a project manager, another nurse informatics should take charge of the nursing users. The project manager may not have enough time to spend with users, thus, a new team leader is required to be in charge of the team. The project manager is accountable to the director, who is answerable to the Chief Information Officer.
For a long time, physicians had held the monopoly on disease information, as they did not want nurses to have access to so much information (Thede, 2009). This is one of the limitations of a hierarchical structure. Hierarchical structures delay the passage of information. Decisions concerning move towards information technology rest on one individual, who chose what to do and what to avoid. However, new technologies can transform power structures with an organization. Technology has made some personnel seem redundant, thus, weakening their chances of being used in giving orders. Change processes not only affect structures, but also how tasks are undertaken, thus, enhancing efficiency.
Despite numerous technological changes experienced in healthcare, many organizations have still maintained paper records. It is a reality that technology has the capacity to eliminate paperwork, but organizational culture is a major hindrance in achieving this goal. Organization culture encompasses human behavior in the organization, and how humans attach meanings to their actions in the organization’s environment. Organization culture influences the adoption of informatics, thus, affecting patient outcome. Behaviors preserve authority and strive to uphold certain values. Employees have to be assured of their safety before they accept nontraditional ideas. Any system, regardless of how it is designed, hinders certain values, some of which are entrenched in the organizational culture (Thede, 2009).
Since organizations incorporate individuals with varied personalities and views, organizational culture influences the success or failure of the organization. Organizational climate will support innovation when it begins to understand the essence of technology. Organizational culture should be flexible to allow information technology to take place. It is the responsibility of managers to integrate nursing informatics with healthcare organizational culture to attain better patient outcomes. Molding individual behaviors should start from the institutions that train nurses. Training students on information technology will help in changing the organizational culture in healthcare. Federal agencies have encouraged the use of electronic medical records in healthcare through funding the hospitals and training personnel on the benefits of information technology.
Implications of the Nursing Informatics
The end goal of encouraging nursing informatics is to improve patient care while assuring clients safety through effective use of informatics principles. Implementation of electronic medical record (EMR) systems in health care has assisted in improving patient safety while instilling knowledge among clinicians on the management of patients (Multak, et al., 2013, p. 874). Expectations are high on the use of EMRs, as they have helped the healthcare providers in exchanging data and capturing of clinical notes. Training nurses on documenting information in EMRs has contributed to reduction in errors based on eligibility. Access to updated electronic patient notes can assist healthcare workers in making appropriate decisions concerning patients’ care.
Nursing administration has embraced the use of Information systems. Use of E-mail has enhanced communication and saving the cost of sending information through letters. Internet has become the medium for education in several nursing environments. Nursing informatics has developed patient documentation and implementation plans through computer software. Informatics has helped in the adoption of standardized languages in nursing, which has consequently led to numerous researches in nursing (Baker, 2012, p. 157). It is essential to note that although the nursing profession has encountered significant changes, the profession has faced several daunting challenges that have affected smooth transition to nursing informatics. These challenges include nursing shortage, education-practice gap, indefinite practice roles, changes in demographics, and work-related issues. Although information technology has been proved to enhance clinical practices, nurses have been reluctant in adopting computer use.
The future of this profession is promising, as there is an increase in dissemination of informatics concepts, as well as solutions into conventional nursing and overall health care practices. According to Sugrue (2011), the future of nursing informatics should emphasize on leadership, practice and education (p. 13). This is because data reporting and documentation has continued to rise within the healthcare environment. Leadership will help nurses in expanding opportunities to diffuse improvement efforts while education will assist in increasing the number of professionals and commitment to life-long learning. By practicing, the nursing profession will be able to remove barriers to advancement programs. Without appropriate data and information, nurses cannot cultivate values that can assist in pushing the profession forward.
The Congress can also contribute to the future of nursing informatics. The Congress should formulate and implement bills that will ensure that information technology is fully integrated in health care providers, and that sustainable processes should be encouraged to harmonize standards in health care. Information infrastructure should be enhanced to eliminate health risks, in addition to ensuring care for the people who have been affected by natural disasters. By creating a favorable environment, nurse informatics can be encouraged to increase efficiency in their practices, in addition to undertaking more research to improve the informatics. The best technique for predicting the future is through creating the future.
Informatics is nowadays a fundamental requirement in the nursing profession. Healthcare providers require information to undertake their services effectively. As nursing informatics, the current situation in healthcare reform should be viewed as an opportunity to harness the caring passion using information technology, to provide quality and safe services to patients. Nursing informatics has continued to evolve as technology keeps on changing. The professionals rely on data to derive information while information develops knowledge. Working for a considerable period enhances wisdom in nursing informatics. Documentation is the principal emphasis on nursing informatics. Since nurses communicate to patients mainly through their notes, nurse informatics is capable of improving the speed and accuracy in documenting patients’ information. The practice of nursing informatics brings together human factors, information technology, ergonomics and usability ideas. By balancing technology, knowledge and nursing science, the outcome of patients will be improved significantly.
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