Faculty Learning Module 4

Informatics

Introduction

Nurses are expected to provide safe, competent, and compassionate care in a highly technical and digital environment. They are directly engaged with the electronic health record and other information technologies that support evidence-based practice. Future nurses must develop the knowledge, skills, and attitudes necessary to perform within this environment, at a time when many practicing nurses are also learning about informatics.

The module explores how innovations in health information technology have changed our work with nursing students in classroom, clinical and lab settings. Strategies to integrate informatics content across these settings are suggested, along with key resources for further information.

Objectives

Upon completion of this module, you will be able to:

• Describe innovations in health information technology that are designed to better inform clinical practice, interconnect clinicians, personalize care and improve population health

• Consider how such innovations assist nurses with clinical decision-making and improve their ability to communicate, manage knowledge, and mitigate error

• Discuss teaching strategies for clinical, classroom, and skills lab settings that could help nursing students engage with information systems designed to improve the quality and safety of patient care

Disclaimer

Permission was obtained to use screenshots depicting Epic and Alaris products as examples of health care technology innovations. It is not intended to promote the use of these over similar products.

The screenshots provided in this module are confidential information of Epic or CareFusion (as noted on each slide). You should maintain them in confidence and not disclose or use them (or any derivatives depicting the software) except for the agreed-upon purpose.

Contributors

• Paula Jarzemsky, MS, RN

Content

Many nursing educators struggle to integrate informatics into their courses because they are relatively unfamiliar with the field or because they are unsure how to make informatics a seamless part of the prelicensure student’s experience. In this module, Paula Jarzemsky, a clinical professor at the University of Wisconsin-Madison presents ways she has used informatics to prepare her students to use informatics to provide safe, quality care.

Presentation

Resources

Bibliography

Barnard, A., Nash, R. & O’Brien, M. (2005). Information literacy: Developing lifelong skills through nursing education. Journal of Nursing Education, 44(11), 505-510.

Bates, D. & Gawande, A. (2003) Improving safety with information technology. New England Journal of Medicine, 348, 2526-34.

Cronenwett, L., Sherwood, G., Barnsteiner, J., Disch, J., Johnson, J., Mitchell, P., et al. (2007). Quality and safety education for nurses. Nursing Outlook, 55(3), 122-131.

Hebda, T. and Calderone, T. (2010). What nurse educators need to know about the TIGER initiative. Nurse Educator, 35(2):56-60.

HIMSS Nursing Informatics Awareness Task Force (2007).An emerging giant: Nursing informatics. Nursing Management, 38 (3), 38-42.

Institute for Health Care Improvement Open School: http://www.ihi.org/IHI/Programs/IHIOpenSchool/

Koppel R. Wetterneck, Telles, J. & Karsch, B. (2008).Workarounds to barcode medication administration systems: Their occurrences, causes, and threats to patient safety. Journal of the American Medical Informatics Association 15 (4), 408-423.

Listen Project: http://www.listenuphealth.org/home/

Maag, M. M. (2006). Nursing students’ attitudes toward technology: A national study. Nurse Educator, 31(3), 112-118.

Malloch, K. (2007). The electronic health record: An essential tool for advancing patient safety. Nursing Outlook, 55(3), 159-161.

Mangan, K. (2009) Panel Discusses How Digital Medical Records Alter the Learning Experience for New Doctors. The Chronicle of Higher Education, Retrieved from http://chronicle.com/article/Digital-Medical-Records-Can/49105/

McNeil, B.J., Elfrink, V.L., Bickford, C.J., Pierce, S.T., Beyea, S. C., Averill, C., et al. (2003). Nursing information technology knowledge, skills, and preparation of student nurses, nursing faculty, and clinicians: A U.S. survey. Journal of Nursing Education, 42(8), 341-349.

Pravikoff, D., Tanner, A., & Pierce, S. (2005). Readiness of U.S. nurses for evidence-based practice. American Journal of Nursing, 105(9), 40-51.

Staggers, N., Gassert, C.A. & Curran, C. (2002). A Delphi study to determine informatics competencies for nurses at four levels of practice. Nursing Research, 51(6), 383-390.

Technology Informatics Guiding Education Reform (TIGER). Evidence and Informatics Transforming Nursing: 3-Year Action Steps toward a 10-Year Vision. Retrieved from http://www.tigersummit.com

Discussion

After you have reviewed the module presentations and resources, consider how this material is relevant to your own work and experience. The following is a list of questions for self-reflection or for use in class.

1. While an electronic health record (EHR) may be more accessible, has it made patient preferences more visible?

2. How well does EHR capture and communicate patient preferences across settings or institutions?

3. How would one determine whether interdisciplinary collaboration improves with an electronic record?

4. Should nursing students stay in a single clinical environment – to allow mastery of the clinical information systems and equipment, rather than taking time to re-orient them at the start of each clinical?

5. What strategies are helpful to faculty needing to stay current on healthcare innovations?

6. While human factors can contribute to error, human interaction is important to patient-centered care. In your experience, have healthcare innovations increased opportunities for nurses to interact with patients?

7. How can we help students understand what human intelligence contributes to the goals of enhancing safety and patient-centered care?

8. How can we help students feel empowered (vs. overwhelmed) by the information available to them?

9. If your students are using electronic resources on a hand-held device (e.g. PDA), how have you adjusted your expectations about preparation for med administration?

10. What may be lost and what can be gained from a system that no longer requires nurses to use their own words for clinical documentation?

11. What strategies have you tried to encourage students to report near-misses/errors?

12. Are providers prepared to honor the preferences of well-informed patients?

13. Though some find a standardized nursing language restrictive, others argue that it is absolutely necessary for the purpose of quantifying how nursing care influences health outcomes. How is this debate communicated to students in your program?

14. Will health disparities widen as we move forward with computer-based healthcare innovations?