Group 5: INTERNATONAL PERSPECTIVE OF NURSING INFORMATICS

MEMBERS

ELLAINE R. HERNANDEZ

JOHN MICHAEL TUMANENG

ERICKSON ARIOLA

RAMIL A. ELEN

Nursing Informatics Perspectives Conceptual Model

Nursing Informatics in Canada 

"Registered nurses need to be able to demonstrate their unique contribution 

to the health of Canadians within Canada's rapidly evolving health care system. 

Basic, essential nursing information is required by nurses, employers,

researchers, educators, policy makers, and clients so that informed decisions can be

made about nursing's role in the changing health care system,”.

Canadian Nurses' Association, 1993: Policy

Statement on Health Information

The Canadian Nurses’ Association wrote this policy statement to highlight the importance of

developing the nursing data components that will be included in their emerging national health

information system. The CNA has also spearheaded an initiative, the National Nursing Informatics

Project, to begin to develop a national consensus on definition, competencies, and educational

strategies and priorities.

Brief History

“Nurses in Canada have made an enormous contribution to all aspects of Canadian society. Their involvements have influenced the wider social, economic and political history of Canada, as well as the history and politics of health care. Nursing history provides the public with valuable perspectives on emerging technologies, health care reform and gender issues in Canadian history” (Canadian Nurses Association, 2004, p. 2).

Jeanne Mance (1606-1673) founded the first hospital

in Montreal, Canada in 1642. Various forms of

machinery such as ventilators and

physiological monitors were first used in

intensive and critical care settings.

By the late 1980s, most hospitals had at least a

rudimentary information system that required

nurses to enter common data such as admission profiles and basic care requirements like diet,

medications, and treatments into a computer

as part of their routine duties.

It begins to develop a national consensus on definition,

competencies, and educational strategies and priorities in

nursing informatics develop.

"In 1998 a national steering committee was formed to

address Nursing Informatics issues and develop strategies

to ensure that Registered Nurses have the competencies required to successfully carry

out the responsibilities of their practice.

The National Nursing Informatics Project

Develop consensus

on a definition of

Nursing Informatics for Canada;

Recommend Nursing

Informatics competencies for

entry level nurses and specialists, managers,

educators, and researchers

Identify curriculum

implications and strategies for both basic and

continuing nursing

education

Determine priorities for implementing

national nursing informatics education strategies.

Each participating organization appointed a nurse expert in Nursing Informatics to a five-member working group to develop and initiate a plan to:

The Nursing Minimum Data Set was the first major Canadian Nurses Association informatics initiative

beginning in 1990. This was in response to the strong conviction

that nursing data must be included in the centralized national health data system being planned by the

Canadian Institute of Health Information (CIHI)

 Canadian Institute for Health Information (CIHI)

CIHI has described its' role as: 

Setting National standards for

financial, statistical, and clinical data 

Setting National standards for

health information technology,

Collecting, processing, and

maintaining health related databases and

registries

The Core Functions of CIHI Identify and promote national

health indicators.

Coordinate and conduct education sessions and conferences

Develop and manage health databases and registries.

Conduct analysis and special studies and participate in research.

Publish reports and disseminate health information.

Founded in 1975, and has actively initiated professional protocols for

using computer systems in Canadian health care. It launched the Patron Program. As an individual member

based organization, COACH promotes understanding and effective utilization

of information and information technologies within the Canadian

Healthcare industry through education, information, networking and

communication.

Canadian Organization for the Advancement of Computers in Health or COACH

 Canadian Nursing Informatics Association (CNIA)

The intent of the study was to describe the current state of:

Informatics education opportunities currently available to students of nursing across the country.

The level of preparedness of nursing faculty to deliver these offerings.

Information and communication technology infrastructure and support for faculty in delivering these offerings.

Opportunities to enhance nursing curricula, faculty preparedness, and ICT infrastructure and support in schools of nursing across Canada.

The CNIA conducted a study in 2002 - 2003 on the Informatics Educational Needs of Canadian Nurses, which was titled, “Educating Tomorrow's Nurses: Where's Nursing Informatics?”

The Canadian Journal of Nursing Informatics

June Kaminski launched  in 2006,

which invites papers, multimedia, and other

electronic media focused on the diverse

arena of nursing informatics.

MissionProvide a peer -

reviewed venue for Canadian nurses and researchers who work with Nursing Informatics to disseminate their research, essays, reviews, presentations, multimedia and other digital publishable materials on a global scale. They have decided to offer this journal free of charge in order to make informatics research and theory openly available to all Canadian nurses.

The Canadian Nurses Portal Project, Nurse ONE, E-Nursing Strategy

Initial goals of this e-nursing strategy include:

advocating fo

r nurses'

access to In

formatio

n

Communication

Technology (ICT) a

nd

the resources re

quired

to integrate IC

T into

nursing practice;

supporting the development and implementation of

nursing informatics competencies among the competencies required for

entry-to-practice and continuing competence;

advocating for the

involvement of nurses in

decision-making about

information technology

and information systems.

(Canadian Nursing

Association, 2006, p. 10). “The purpose of the e-

nursing strategy is to guide the development of ICT initiatives in nursing to

improve nursing practice and client outcomes”

(Canadian Nurses Association, 2006).

Access – better connectivity in work environment, more

access to a variety of computer technologies, e.g. PDAs,

hardware, software, station computers.

Competency- ongoing ICT skill development, integration

into nursing curriculum.

Participation - “as knowledge workers in this

technological age, it is essential that nurses play an

increased role in the development of ICT solutions”

(Canadian Nursing Association, 2006, p. 15).

The e-nursing strategy will address these goals by adopting a three pronged approach:

Learning activities which include:

1.a Cognitive, ("to know" or

epistemological),

2.an Interactive, ("to do" or

ontological) as well as

3.a Reflective, ("to be" or

phenomenological)

The curriculum designed to

prepare caring nurses as

"knowledge workers" for the

changing economy of this new millennium.

The assumption is that as students use computers to

manage information in their student

role, they will more readily use their critical thinking skills to learn

related applications in their work as

nurses.

Nursing Informatics at Kwantlen Polytechnic

University

The main rational for implementing a greater use of

information technology (IT) in

the healthcare sector is to improve safety and quality,

improve patient outcomes, and at

the same time try to reduce costs of

 healthcare. care.

Nursing Informatics In Europe

The main mission in Europe is to establish stable infrastructure that improves healthcare quality facilitates the reduction of errors and the delivery of evidence based and cost effective care.

Confidence in IT and competence to use ITInformation about society

services available to all citizensContinuity of Care and

Availability of  Information.

Three Objectives of National IT Strategy:The European commission (EC)

is a driving force of healthcare informatics development by funding projects that are all

cross-cultural involving healthcare professional users, educators and administrators, always three or more countries

participating.

IT in the European Union (EU)

Development of Common Terminology for Nursing Practice in Europe

The common factors that may have contributed are the

increasing cost constraints in the mostly publicity financed

healthcare systems, which have raised demands for cost-effective

care and quality improvement.

International Council of Nurses (ICN)

ICN has initiated the development of the

ICNP, which has been translated into at least 12 European languages

and tested in several countries.

The method of concept and information

modeling has been carried out in many countries during the last decennium. The model was divided into three parts:

Concept and Process Modeling

Core Process- whic

h is the clinical

process in healthcare.

Management Process- whic

h monitors and

evaluates the clinical

process.  

Communication

Process- dealing with

information and

interaction with the

surrounding.

Implementation of IT in Healthcare

The tradition of participatory design, when developing applications, is

created a tradition for user involvement and participation that has impact not only on design, but also on project management and

implementation

Organizational ImplementationProject Management

The organizational implementation is more

about how the application supports planed and wanted

changes in work flow and organizational structure

Project teams are mostly selected to be

representatives of different categories of

clinicians and organizational parts of

the healthcare enterprise.

Clinical and Nursing Implementation

Variety of views on data- appears to be a very attractive advantage.

Structures of  data- is important if data are to be reused and presented in several different ways.

Decision support- is advantageous if the clinician enters the data

Supports of other data analysis- may prove an important feature or quality control, quality improvement, and resource management.

Electronic data exchange and sharing care support- assumes reused of data.

Future development needed for nursing

informatics in Europe is implementation of decision support

systems, integration of research-based

knowledge in patient records, and feedback

of clinical experience by aggregated data from

patient records.

Future Development

3. The cost of improving the network and

computer environment

is high.

2. There is little

development on

educational tools.1. There are

few researchers

and educators in NI.

Barriers to development of NI continue to remain:

QUIZ:1. Give the acronym of CNIA.2. Give the acronym of EC. 3. Enumerate the N.I. Perspectives Conceptual Model.4. Give The 3 Concept and Process Modeling.

NURSING INFORMATICS IN SOUTH AMERICA

Nursing Informatics in South America has

been based more on ACTIVITIES of

INDIVIDUALS than on a policy established by

governments or national efforts.

Each country in South America has varied levels

of development and deployment of

technological resources.

The use of Technology has

visible tendency in: Health

Nursing Education

Nursing Practice

Nursing Research

Administration

TECHNOLOGY

COMPUTERS NURSING

Are considered an important tool to help nurses take care of

patients and to recognize nursing service and nursing

education.The growth of information technology in Latin

America and the Caribbean has been consistently the

world’s highest for 20 years.

Has been identified around the world as an emerging profession

for over 100 years.

Nurses were considered as the primary users of technology in

healthcare (Safran, Slack and Bleich 1989).

Historically nurses are used to facing challenges, adapting new

tools in to the practice to improve their performance. Creating new models to enhance patient care.

INFORMATION

TECHNOLOGY

Is the key element for decision making process in

the healthcare area. The more specific information in

place to support clinical decisions, the better care

can be delivered to the patient.

Plays an important role in facilitating access to the information because

for the information to be useful and

meaningful, it has to be timely. There is a clear trend in the direction of the computerization of

health records.

The initial motivation to develop computer systems in

the healthcare area was driven by financial and

administration concerns.The hospital sector can be

considered the area better served by information

systems. Brazil, Mexico, Argentina, Colombia, Chile and Paraguay have clinical

information systems in hospitals or health institutes.

Patient data that are also used for nursing administration are integrated in the systems or nurses have to collect and

analyze nursing data separately

NURSING INFORMATICS INITIATIVES IN SOUTH AMERICA