N-110 Nursing Informatics Lecture 2: Issues in Informatics
Summary
TLDRThis video lecture delves into nursing informatics, a specialty that emerged in the 1980s, combining nursing, information, and computer sciences to manage nursing data effectively. It discusses the importance of understanding data structures, information management, and technology in nursing practice. Addressing the nursing shortage and the need for improved patient safety through technology, the lecture highlights the significance of automation, computerized prescriber order entry (CPOE), barcode-enabled point-of-care technology, and standardization in healthcare data. It also emphasizes the necessity of safeguarding patient data and building dependable systems in nursing informatics.
Takeaways
- 😀 Nursing informatics is a sub-specialty that combines nursing, information, and computer sciences, managing nursing data into useful information for practice.
- 💻 The field emerged in the 1980s in the U.S. and involves the application of information structures, processes, and technology in nursing.
- 🔍 Understanding various disciplines like linguistics, organizational dynamics, and cognitive science is crucial for designing effective nursing information systems.
- 🚑 The development of nursing informatics was driven by the need to address nursing shortages, improve patient safety, and manage complex documentation and information technology needs.
- 👵 An aging nursing workforce and the necessity to adapt to technological advancements are key reasons for the growth of nursing informatics.
- 💊 A primary goal of nursing informatics is to resolve medication errors and communication issues to enhance patient safety.
- 🤖 Automation in nursing informatics helps save time and resources by streamlining repetitive tasks and improving efficiency.
- 💹 Computerization of hospital documents has been shown to produce positive outcomes, including reduced paper expenditure.
- 📋 The implementation of Computerized Provider Order Entry (CPOE) systems in developed countries has significantly reduced medication errors.
- 🔑 Standardization of healthcare data is essential for efficient processing and communication between computer systems in the medical field.
- 🛡️ Protecting the privacy and confidentiality of patient data is a fundamental aspect of nursing informatics and system development.
Q & A
What is the definition of nursing informatics?
-Nursing informatics is defined as the combination of nursing, information, and computer sciences to manage and process nursing data into information and knowledge for use in nursing practice.
When was nursing informatics identified as a sub-specialty in the United States?
-Nursing informatics was identified as a sub-specialty in the United States during the 1980s.
What is the significance of understanding different hardware and software in nursing informatics?
-Understanding different hardware and software is crucial in nursing informatics as it is where information structures, processes, and information technology are applied in managing nursing data.
Why was nursing informatics developed as a specialty?
-Nursing informatics was developed as a specialty to address the nursing shortage, improve patient safety, resolve errors, and cope with an aging nursing workforce by utilizing available technology.
What is the role of automation in nursing informatics?
-Automation in nursing informatics involves letting computers perform repetitive instructions, which saves time and effort, and can potentially save lives and resources by streamlining organizational processes.
What is the purpose of Computerized Provider Order Entry (CPOE) in healthcare?
-CPOE is a system that uses direct entry of medical orders electronically into a system that transmits those orders electronically to the concerned department, with the aim of reducing medication errors and improving patient safety.
Why is standardization important in healthcare data?
-Standardization is important in healthcare data to reduce ambiguity in data communication, streamline the exchange of information between computer systems, and achieve compatibility between systems for efficient processing.
What are the four broad classes of message format that have emerged in healthcare data standards?
-The four broad classes of message format are medical device communication, digital imaging communication, administrative data exchange, and clinical data exchange.
What is the significance of Nursing Minimum Data Set (NMDS) in nursing informatics?
-NMDS provides a standard data set for nurses to enter patient data into a system, ensuring that the data is useful, readily collectable, non-duplicative, and respects patient confidentiality.
What are some challenges faced when implementing barcode-enabled point-of-care technology in medication administration?
-Challenges include nurses finding it difficult to deviate from traditional medication administration methods and the potential for nurses to circumvent the point-of-care technology.
How can the implementation of nursing informatics improve patient safety?
-The implementation of nursing informatics can improve patient safety by reducing medication errors, avoiding miscommunication, and ensuring that the right drug is administered to the right patient at the right dose and time.
Outlines
💻 Introduction to Nursing Informatics
The video begins with an introduction to the field of nursing informatics, which emerged as a specialty in the 1980s in the United States. It is defined as the intersection of nursing, information, and computer sciences, aimed at managing and processing nursing data into useful information for practice. The importance of understanding information structures, processes, and technology is emphasized, as well as the relevance of various disciplines like linguistics, organizational dynamics, and cognitive science in designing nursing information systems. The development of nursing informatics is tied to the challenges of nursing shortages, the complexity of healthcare technology, and the aging nursing workforce, with a focus on improving patient safety and reducing errors in medication and communication.
🛠️ Automation and Technology in Nursing
This paragraph delves into the role of automation in nursing informatics, highlighting its potential to save time and effort by handling repetitive tasks, thus allowing nurses to focus more on patient care. The benefits of computerizing hospital documents are discussed, including streamlined organizational processes and reduced paper expenditure. The paragraph also touches on the importance of technology in the medication process, emphasizing patient safety as a top priority. The implementation of Computerized Provider Order Entry (CPOE) in developed countries is mentioned, noting its absence in the Philippines, and its role in minimizing medication errors and improving communication among healthcare providers.
💊 Benefits and Challenges of CPOE and Barcode Technology
The benefits of Computerized Provider Order Entry (CPOE) are outlined, including a significant reduction in medication errors and the improvement of patient safety through the elimination of illegible handwriting and multiple volumes of patient records. The paragraph also introduces barcode-enabled Point-of-Care (BPOC) technology, used in medication administration to ensure the right drug is given to the right patient at the correct dose and time. Challenges with BPOC, such as nurses' resistance to change and the potential for circumventing the system, are acknowledged. Additionally, the paragraph mentions the use of QR codes for transmitting patient information to healthcare establishments.
📊 Standardization in Healthcare Data
The importance of standardizing healthcare data is discussed to ensure reliable computer systems that can efficiently process information. Standardization involves specifying the collection, exchange, storage, retrieval, and processing of healthcare data, aiming to reduce ambiguity in data communication. The paragraph outlines the four broad classes of message formats that have emerged: medical device communication, digital imaging communication, administrative data exchange, and clinical data exchange. The core of standard development is the secure, patient-centered Electronic Health Record (EHR), with a focus on safeguarding patient data privacy and confidentiality.
🔒 Data Security and System Dependability in Nursing Informatics
This paragraph addresses the vulnerability of patient data in nursing informatics and the importance of building dependable systems. Guidelines for system development include designing for dependability, anticipating failures, and ensuring the system can be expanded. The need for meticulous management in identifying potential issues and expansion opportunities is highlighted. The paragraph also warns against being adventurous with untested computer products or systems, advocating for the use of commonly recommended and tested systems to ensure success in system development.
📝 Nursing Minimum Data Set (NMDS)
The final paragraph introduces the Nursing Minimum Data Set (NMDS), a standardized data set used in nursing informatics for assessing, diagnosing, intervening, and evaluating patient care. The NMDS consists of 16 elements categorized into three major groups: demographic, service, and nursing care elements. The criteria for NMDS include usefulness to potential users, collectability with reasonable accuracy, non-duplication of data, and the protection of confidentiality. The paragraph concludes with an invitation for viewers to ask questions or engage in discussions through various communication channels.
Mindmap
Keywords
💡Informatics
💡Nursing Informatics
💡Information Management
💡Healthcare Data
💡Nursing Shortage
💡Automation
💡Medication Errors
💡Computerized Provider Order Entry (CPOE)
💡Barcode-enabled Point-of-Care Technology
💡Standardization
💡Electronic Health Record (EHR)
💡Nursing Minimum Data Set (NMDS)
Highlights
Nursing informatics is defined as the combination of nursing, information, and computer sciences to manage and process nursing data.
It is essential for nurses to be familiar with various hardware and software used in nursing informatics.
Understanding concepts in linguistics, organizational dynamics, and other fields is crucial for designing effective nursing information technology.
Nursing informatics developed as a specialty due to the persistent nursing shortage and the need for improved healthcare delivery.
The average age of nurses being 45 implies a need to use technology to improve care as the nursing workforce ages.
Nursing informatics aims to resolve errors and improve patient safety, particularly in medication and order confusion.
Automation in nursing informatics can save time and resources by streamlining repetitive tasks.
Computerization of hospital documents has been shown to produce positive outcomes and save paper expenditure.
The implementation of Computerized Provider Order Entry (CPOE) in developed countries has reduced medication errors significantly.
CPOE eliminates the use of paper-based systems and improves the transmission of medical orders.
Barcode-enabled Point-of-Care (BPOC) technology is used for medication administration, enhancing patient identification and safety.
Standardization of healthcare data is necessary for efficient processing and to reduce ambiguity in data communication.
Healthcare data standards aim to achieve compatibility between systems and streamline the exchange of information.
Nursing Minimum Data Set (NMDS) is essential for standardized data entry in nursing informatics systems.
NMDS should meet criteria such as usefulness, collectability, non-redundancy, and confidentiality.
The importance of safeguarding patient data in nursing informatics to respect patient dignity and privacy.
Guidelines for building dependable systems in nursing informatics include designing for dependability and anticipating failures.
The video lecture concludes with a discussion on the importance of standardization and the role of NMDS in nursing informatics.
Transcripts
hello students so for this video we will
talk about the different issues
in informatics most especially when we
apply it
into the nursing profession now
nursing informatics was only identified
as a sub-specialty in the united
states during the 1980s
it was defined as the combination of
nursing
information and computer sciences to
manage and process nursing data
into information and knowledge for use
in nursing practice
it means that we need to utilize
information structures processes and
information technology
so that's why we talked about it in our
earlier lecture
we have to be familiar with the
different uh
different hardware software that we use
in our daily lives because in nursing
informatics
this is the part where we apply our
information structure
and technology in managing nursing data
so our the practice of nursing
informatics
includes the domain of data and its
structure
information management and technology
so if you will look into how how our
information is being processed
how our information is being stored
we have to understand know some concepts
in linguistics
organizational dynamics communication
engineering
library science and even cognitive
science or the way we understand
things because it is by understanding
the nature of our data that we can
store it into our computer systems
it is by understanding how an
organization works that we can
design appropriate nursing information
technology
that is suited to the needs of the
nurses in that organization
so why do we need to study or why did
why why not why did nursing informatics
develop now as a specialty
because we all know that during the
early 90s
1900s and as of now and until now
there has been always a nursing shortage
okay
which is seen as detrimental in the
delivery of quality healthcare
okay so the more uh
it becomes or the nurses becomes more
overburdened
with work no especially when uh when
patients come in
at dumadamian paciente du magdamere
and documentation past nurses
complex and documentation needs no and
information technology needs the manner
says
okay so the development of health
science also necessitated
the the development of nursing
informatics because
uh the more complex that our technology
gets the more that we must
be informed as nurses of this technology
all right and we also need to develop
nursing informatics as a specialty no
because we uh in 2000 the average age of
nurses is 45 years old
it implies that our nursing uh
our nursing workforce is getting older
and we need to cope
with this challenge now when our nursing
workforce is getting older we need to
use
the available technology to improve our
care
okay after 20 years
nursing but still no technology is uh
can provide solutions
you know in the burden that we have as
nurses
as nurses in the in clinical practice
in education in research and other
aspects
of nursing practice okay
now primarily
nursing informatics is needed because we
need to resolve
no we need to resolve errors
we need to resolve uh problems
stemming from medication
uh confu order confusion
or miscommunication because in the
maison
or the terminology is different from the
way we understand it
so one reason why nursing informatics
emerged no is because we want to avoid
this
avoidable error sana so to help us avoid
these errors
we used or we tap technology
okay in our nursing practice
so primarily the reason for nursing
informatics is also to improve
patient safety okay
so another another issue
that we have to identify on nursing
informatics
is the issue of automation now
uh automation is the process wherein we
we try to uh we let the computer
uh do a certain set of repetitive
instructions
so that for us no you know the important
data
can save time and allocate it more to
our patients
okay so computerization of hospital
documents no
has been seen no to produce good
outcomes
so they utilized a database
spreadsheets document production systems
which streamlined our organizational
processes
if you come to work in if or if you have
experienced
uh the effect of computer in
making your work easier then you can
relate it to the bulk of hospital
uh documents that has been uh
that have been processed not using
computer
okay so they technically
automation can save nurses some time
some effort okay and it can also save
lives
and it can also save resources because
automation or computerization
has uh has caused production
in paper expenditure okay
now uh another issue or another issue
that we need to tackle
in um in
in this in in nursing informatics is the
use no
of technology in the medication use
process
or the medication process always
remember
that in medication process and the
integration of technology into it
the top priority or the top concern will
always be the safety of your patient
okay because we all know that health
care
can be a high error prone industry
okay and that debts in hospitals are
usually attributed with practitioners
but interacting with bad systems
okay so the acquisition of computers
were sometimes focused on standalone
system
in the use hindi analysis gamut
in for the whole organization which
minimizes
its usefulness okay
now one use that they did no
uh for for uh for
for the use of technology in medication
is the use of co is the implementation
of cpoe
ctoe stands for computerized prescriber
order entry
wherein this is a system that use direct
entry of one or more types of medical
orders
electronically into a system that
transmits those order
electronically to the department concern
so everything that the
physician or any healthcare provider
orders or wants to be executed will be
entered
into the cpoe okay sadly
uh in the philippines cpo is not being
implemented or used no but it's used in
the united states
no or in the in developed countries okay
that it hasn't been used here in the
philippines you adding
so that's how cpoe works okay
so this eliminates not the use of paper
based system or minimizes the use of
paper-based stem
as a form of communication among
healthcare providers
okay since uh it's uh difficult to
locate you know the important
information in paper-based
system cpoe must be
located
prescriber order entry we can have uh we
can use the search function for any
orders that may be related to your
keywords
okay and ultimately
uh the benefit of cpo is that it removes
eligible handwriting and multiple
volumes of patient records no
are are sometimes compressed no
[Music]
okay so here are some uh based on
studies no
here are some advantages of ctoe number
one it may it reduced medication errors
by 55
that's according to baits right
so the non-missed those errors fell to
26.6 per 1000 cases that's according to
beats again
and that handwriting misinterpretation
champion would be limited
errors of commission are reduced and
that fewer handoffs
occur what do we what do we mean when we
say hand off
it's the transmission of the order from
one person to the other
so the tendency or an error of omission
might be committed if handoffs
are prevalent
information there's a tendency that you
omit the data
originally so fewer handoffs
are lessened because uh
com because of the with the aid of the
of the ceo
okay and since fewer hand of salman gre
there's the transmission of information
will be faster
as families another type of
uh of technology used in hospitals
no in developed countries are your
barcode-enabled point-of-care technology
or international bpoc technology
so this is primarily used in medication
administration process
and barcode which is usually placed on
his id tag
no so the barcode once scanned
will display donsa pda or handheld
device
nurse medications
any other preparations that need to be
done to the patient
so it has an impact on productivity and
identification and patience
okay so centre we recognize that barcode
enabled point of care is not perfect
in this system it is also a second
identifier for a patient
is also included
so the system helps to verify that the
right drug is administered to the right
patient
at the right dose and at the right time
okay
so there are some negative effects no
here in uh here in dpoc now sometimes it
it it finds it difficult or some nurses
find it difficult
to deviate from the usual way of
administering education that's
understandable okay and number two
nurses have their own strategies
not sometimes to circumvent the ppoc
okay although hindi pa
uh
so uh dpoc
can sometimes be if you will look into
its system
and sometimes related to your
uh you know you you stay safe ph nagina
are good so your stay safe
uh stay safe
app will generate a barcode for you
no will generate a barcode for you
so once you enter an establishment when
you scan a qr
you can open uh you can your your qr
code
can automatically transmit no your
uh your information to the establishment
so for example here's the exam here's an
example of my
uh of my qr code
so when this uh when when this uh
qr code and or when the qr code of the
establishment is scanned
my information will be transmitted to
them
no so when it's transmitted to them then
that's the that's that's it no my
identification is already
submitted to organization or
establishment
oc in a sense no because you use barcode
you use the scanner
to transmit information etc
systems
so when you try to computerize
everything
another issue that we need to discuss is
the issue of
standardization no
okay it can be written in different
forms
it can be expressed not in different
units
so healthcare data is very diverse in a
sense
for the computer to create a system that
is reliable for you
you need to standardize your healthcare
data
okay so standardizing your healthcare
data
or healthcare data standards is the
method
or the protocol wherein
you specify the collection exchange
storage retrieval
and also how the the way you process
the information okay
so it's like making everything
the same no it's like making everything
at level
so that their computer can process it
more efficiently
now healthcare data standards
aims to reduce the level
of ambiguity in the communication of
data
and it also streamlines not the way
you transmit your information
it addresses it addresses your format of
information
okay the syntax okay that are exchanged
between computer systems
document architecture clinical templates
and user interface and patient data
linkage
so that it achieves compatibility
okay between systems so there are four
broad classes of message format
that has emerged no so is it all new
medical device communication
okay number two is digital imaging
communications
number three is administrative data
exchange
and last but not least in clinical data
exchange
so this one pertains no new medical
device
pertains to medical devices used in the
hospital
when we say digital imaging
communication this refers to the
diagnostics
particularly imaging data
administrative data refers to the
managerial
or the management of employ of the
employees of the hospital and as well as
its transactions and lastly for the
clinical data of your patients
okay
now there are uh there's a process no
in standards development the first is
the core of every system is the concept
of secured
patient-centered ehr or electronic
health record
okay now safeguarding
the safety and security of patient data
is the core
no of all process of all
of all of all process that involves
standard development
nursing informatics
must secure and privacy and
confidentiality
because there's a danger no there's a
danger of
of misusing this data about your patient
in other words and it's also a respect
for the patient's dignity
now not all computer systems
are are invincible sata
like for example what happens are you a
scare group no
no attacks now we don't us
no in blaster and so big worm attacks
in august 2003 attacked the care
group data in the united states
so maraming exposed the data which was
used
in a number of ways no
reading news no there's an issue with
as with the issue of facebook of sharing
data with
uh with uh advertisement no
with advertisers even if you want to own
your facebook account to be
just your personal space
personal personal digital space
but then i invade union space to say
there's a tendency of facebook
no to give this analytics your data
to advertisers so
inanna
it's because the analytics of the fee of
facebook no
uh the facebook algorithm uses your data
to show you what
you are you might be interested in based
on your data
okay so you import issue with
uh with with your nursing informatics no
the vulnerability of your patient's
so for the guidelines for building
dependable systems
i leave this one to you to read no it's
in your book
it's explicitly uh stated in that part
okay and you need to understand
somehow the core essence know of the
of building the dependable system
you need to design for dependability
that's the first one
when you design your nursing informatics
system
number two you need to anticipate
failures
by anticipating failures you try to
address
any failure mode that might that might
be experienced by your patient
when accessing their data or the users
when they access
the data number three you also have to
anticipate success
when you say anticipate success we must
be open
not for expansion of our data
your system if you develop it in your
own unit
hospital you will be uh
you will be using no you have to
you have to expand the use of your
system for the whole hospital
okay next is that you hire also
meticulous managers when we say
meticulous managers
they are uh proactive not in identifying
problems no potential for expansion and
the likes
and lastly don't be adventurous
it just said that when you build your
system you do not acquire computer
products
or systems or hardware or software that
are not
tested stick only to what uh
to what it systems have been
recommending
what iq systems that uh
people are using or commonly using
so that you can uh succeed in developing
your system
so another another address another
items that address standardization of
data
is international nmds nmds
stands for nursing minimum data set
systems
no so subbing on nothing for you to
enter data into a system
patience data to enter your system you
need to have
the minimum data set a standard data set
saturn for nurses we use the nursing
minimum data set
which comes from your assessment not
from your diagnosis
from your outcomes and then your
evaluation
now your nmds should meet the following
criteria
no data must be useful number one genre
to potential users number two the items
in the set must be readily collectable
with reasonable
accuracy number three items should not
duplicate other available data
and that number four confidentiality
must not be violated
so in the united states there are three
categories or three
recognized terminologies
a nursing minimum data set that includes
the data that the data standard the
standardization
uh categories found in your nanda
or your north american nursing diagnosis
association
the one that you can see unique and i
see you nursing intervention
classification and the no
your nursing outcome classification so
that's what they use in the united
states in categorizing
nursing data
okay but technically
there are 16 elements of nursing minimum
data set
now categorized into three major
categories aside from the nursing no
here are the other two
so one is demographic element no in
personal identification they talk birth
gender race residence
the second part is in service element or
something that talks about the
administrative
administrative aspect
hospital okay or the service agency
so it includes service agency number
health record number
unique number of principal uh registered
nurse provider
union union manager
fourth is the episode admission or
encounter a discharge
termination date disposition of client
and expected pay
so for the nursing care element on your
nursing diagnosis
nursing intervention patient outcome
intensity of nursing care
with that i end my video lecture for
this week
i hope you learned something from me and
if you have any questions
do not hesitate to contact me through my
messenger
send an email or you can start a
discussion
in our facebook group with that have a
nice week
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