N-110 Nursing Informatics Lecture 2: Issues in Informatics

Summary

This 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

00:00

💻 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.

05:00

🛠️ 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.

10:01

💊 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.

15:04

📊 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.

20:06

🔒 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.

25:08

📝 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.

Keywords

💡Informatics

Informatics is the interdisciplinary field that studies the design, development, use, and consequences of information technologies. In the context of the video, it is particularly applied to the nursing profession, focusing on the application of information and computer sciences to manage and process nursing data into useful information for practice. The term is integral to the video's theme, as it sets the stage for discussing how technology is revolutionizing nursing practices.

💡Nursing Informatics

Nursing Informatics is a specialty that combines nursing, information, and computer sciences to support nursing practice, administration, and education. Defined in the 1980s, it is crucial for managing nursing data effectively. The video emphasizes its importance in improving patient care and safety by leveraging technology in nursing practices, highlighting the need for nurses to be familiar with information structures, processes, and technology.

💡Information Management

Information Management refers to the processes and strategies employed to collect, curate, analyze, and utilize information within an organization. In the video, it is discussed as a critical component of nursing informatics, where the speaker explains the necessity of understanding how information is processed and stored, and how this knowledge can aid in designing appropriate nursing information technology systems.

💡Healthcare Data

Healthcare Data encompasses all the information generated by healthcare providers during patient care. The video script discusses the importance of understanding the nature of healthcare data for effective storage in computer systems and the development of nursing informatics to manage this data, which is essential for improving patient care and outcomes.

💡Nursing Shortage

Nursing Shortage refers to a situation where there is an insufficient number of nurses to provide adequate care to patients. The video mentions the persistent nursing shortage as a driving factor for the development of nursing informatics, as it aims to alleviate the burden on nurses and enhance the delivery of quality healthcare through technological solutions.

💡Automation

Automation is the use of technology to perform tasks with minimal human intervention. In the context of the video, it is highlighted as a way to streamline repetitive tasks in healthcare, allowing nurses to allocate more time to patient care. The script gives examples of how computerization of hospital documents can save time and resources, and potentially save lives.

💡Medication Errors

Medication Errors are mistakes made in any part of the medication process. The video discusses the importance of nursing informatics in resolving medication errors, which are a significant concern in healthcare. It mentions the use of technology to improve patient safety and avoid errors stemming from miscommunication or order confusion.

💡Computerized Provider Order Entry (CPOE)

CPOE is a system that allows healthcare providers to enter medical orders electronically, which are then transmitted to the concerned department. The video explains that CPOE can reduce medication errors, improve patient safety, and eliminate the use of paper-based systems, although it notes that it is not yet widely implemented in the Philippines.

💡Barcode-enabled Point-of-Care Technology

Barcode-enabled Point-of-Care Technology is a system used in medication administration processes, where barcodes on patient ID tags are scanned to verify the correct medication, dose, and timing. The video script describes how this technology can impact productivity and patient identification, while also noting potential challenges and resistance to its adoption among nurses.

💡Standardization

Standardization in healthcare refers to the process of making healthcare data and processes uniform to facilitate efficient communication and processing of information. The video emphasizes the importance of standardizing healthcare data for reliable computer systems, mentioning the need for healthcare data standards to reduce ambiguity and streamline information exchange.

💡Electronic Health Record (EHR)

An Electronic Health Record is a digital version of a patient's paper chart, containing all of the important information about a patient's medical history. The video script discusses the concept of a secure, patient-centered EHR as a core component of nursing informatics, highlighting the need to safeguard patient data and maintain confidentiality and privacy.

💡Nursing Minimum Data Set (NMDS)

NMDS refers to a standardized set of data elements that are essential for nursing practice, including demographic, service, and nursing care elements. The video explains that NMDS should be useful, readily collectable, non-duplicative, and must not violate confidentiality. It is used for assessing, planning, implementing, and evaluating nursing care.

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

facebook

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