Nursing Informatics The site used for this interview is a healthcare facility that offers a range of exposure to a nursing informatics investigation. The preceptor offered valuable insight into the role of the nurse informaticist at the site, and the concepts and standards utilized therein were readily demonstrable and manifested in terms of how they were implemented or oriented towards providing holistic care to patients and their families. The same was true of the use of telehealth, telemedicine and telenursing tools also available at the site. The facility used administrative software effectively to help oversee all the information needs of the staff, as well. This paper will discuss these points and provide details about what was observed during the investigation.

The Role of the Nurse Infomaticist According to the Interviewed Preceptor

The role of the nurse informaticist according to the interviewed preceptor is in overseeing all aspects of technology use among nurses at the healthcare facility. This means, the nurse informaticist has to know how to use and teach software skills and computer usage in the facility. The nurse has to be able to answer questions about computer usage, keeping records in systems, accessing data, etc.

The preceptor also noted that the nurse informaticist has to take responsibility for deciding which type of technology will be used at the facility based on the needs of the facility and what is available in terms of purchasing. Therefore, selecting and evaluating technology that will be used in the healthcare facility is another important aim of the nurse informaticist. The same nurse also has to be able to customize the functions of whatever technology is being used -- which means that the nurse informatist has to be really knowledgeable of how new tech is designed, how it can be modified to meet the needs of personnel, and how it can best be implemented to effect an efficient workplace. On top of staying up to date on all new tech, the nurse informaticist has to be able to give training courses to nurses in the facility regarding how to use new tech -- which means the nurse also has to know how to design an effective training program.

Concepts and Standards

The concepts and standard of nursing informatics at the selected site and how they apply to the healthcare setting consist of the following: systems theory, which focuses on how parts interact within a set of parameters and is relevant to the use of technology with patients; cognitive theory, which focuses on input, output and processing of information related to the patient; and change theory, which focuses on the how the processes are used in nursing informatics.

Core competencies include basic computer skills (word processing, spreadsheets, information and communication technology concepts), information literacy (accessing needed data, evaluating outcomes of information use, appraising information and sources critically), and managing information.

These concepts and competencies apply to a) upholding core measures and submission of clinical quality measures b) submission of clinical quality measures and protection of patient privacy c) protection of patient privacy and electronic exchange of information, and d) electronic exchange of information and submission of clinical quality measures: electronic health records, exchanges of information, conducting medication reconciliation, recording advanced directives, incorporating clinical lab tests as structured data, placing computerized provider order entry, maintaining up-to-date problem lists of current and active diagnoses, and providing patients with an electronic copy of their health information are just a few of the ways that the concepts of systems theory, cognitive theory and change theory are used in conjunction with the core competencies of nurse informatics to achieve meaningful use.

TeleHealth, Telenursing, and Telemedicine

The emergence of telehealth, telenursing and telemedicine at the site includes meeting the holistic needs of patients and their families via the use of 1) telepsych, 2) E-ICU critical care monitoring, and 3) the patient portal.

Telepsych allows patients at the site to receive access to psychiatric treatment from trained psychiatrists by using digital communications technology...

Telepsych makes it possible for patients to receive care without having to travel to meet the psychiatrist in person. Bringing psychiatrists and patients together is made possible through this technology, without which the two would be separated by barriers (not enough time to meet at a given location, limited options in terms of who can provide care, etc.). As a result of this technology, patients have access to immediate availability of emergency psychiatric assessments and interventions, a wider range of experts, reduction in delays associated with care giving, better continuity of care, avoidance of stigma; patients can also be assured of secure, safe and private communications. Overall, telepsych enables a much improved quality of care to be possible for patients in need of psychiatric treatment.
E-ICU critical care monitoring works in a similar fashion at the site by allowing nurses who are off-site to remotely monitor patients in the ICU. This is a great way to reduce nurse burnout and overburden among the staff as it adds an extra set of eyes to the ICU. It also helps in a holistic manner by administering to the needs of the patient and the patient's family: the two-way cameras let the patients and the patient's family know that there is always somewhere available, ready to answer questions or respond to a medical emergency. The patient and family do not have to rely upon nurses making the rounds -- instead, the two-way camera affords them 24-7 care, as they know there is always a nurse essentially right there with them. It is the next best thing to having a nurse physically in the room at all times.

The patient portal grants access to patients' health information so that nurses are readily knowledgeable of a patient's history, medication, and procedures: it is a quick and easy way to keep up to date, and allows nurses to provide holistic care to patients and the family by enabling them to set up a messaging system that will alert nurses when patients/families have opened messages; that allows nurses to post lab and test results immediately they come back; and gives proxy access to family and caregivers. All of this is oriented towards providing optimal quality care to patients and their families so that communication is constantly ongoing in a two-way flow, no one is left out of the loop that should be included, and feedback is immediate and clear. Information is not lost through the cracks of nurse changeovers and families and patients can see in the portal everything that has been put in and what messages await them.

The Primary Use of Administrative Software

The administrative software in use at the site is KRONOS -- which is an automated workforce management tool that is used for scheduling and timekeeping. It works with HR on payroll solutions, and enhances worker productivity by keeping times orderly and workers informed. This software also helps to boost the quality of patient care provided by the nurses to patients in that it is used to create the nursing shifts to ensure that enough nurses are always scheduled so that the workload does not become too burdensome. Nurses are kept to shifts that are designed to keep them from being overworked and the rotations are monitored by this software. It is meant to be easy to use and thus can be viewed as increasing employee satisfaction as workers are able to improve their compliance with regulations in the workplace regarding scheduling and hours worked.

The Workforce Scheduler is used in the scheduling of thousands of employees across multiple departments and even locations. This tool is helpful in providing the right alignment of workers with skills so that they are in the right place at the right time to deliver the right kind of quality care to patients. It is an exceptional way to help organize the site and keep everything coordinated -- so that patients and providers are matched in the expected ways.

The Workforce Timekeeper offers a similar function in that it is used to track, manage, and oversee employee time and attendance so that payroll inflation is kept to a minimum and manual errors are reduced. The Workforce Timekeeper also helps to reduce the risk of compliance errors, as it helps the administration to track and enforce complex compliance requirements that would otherwise go missed and unaccounted for. These include FLSA and ACA requirements as well as union rules. The combination of these compliance regulations can be daunting if not organized into the Workforce Timekeeper. Realistically, there is no better way -- or even an alternative or more efficient way -- to keep track of nurse's times, etc. Without this software, the administration would quickly become bogged down under an avalanche of information that would still need sorting and tracking -- so this system is highly effective in doing what administrators need done, and that is keeping track of nursing hours so that regulations are adhered to.

The Workforce Mobile enables the workers at the site to be both visible and mobile as they coordinate using the mobile platform…