Nursing Informatics: Roles, Tools, and Technology in Practice

Introduction

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

The Role of the Nurse Informaticist

According to the interviewed preceptor, the role of the nurse informaticist is to oversee all aspects of technology use among nurses at the healthcare facility. This means the nurse informaticist must know how to use and teach software skills and computer usage in the facility. The nurse must be able to answer questions about computer usage, recordkeeping in systems, accessing data, and related tasks.

The preceptor also noted that the nurse informaticist must 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 for purchase. Selecting and evaluating technology for the healthcare facility is therefore another important function of the nurse informaticist. The nurse must also be able to customize the functions of whatever technology is in use — which means being thoroughly knowledgeable about how new technology is designed, how it can be modified to meet the needs of personnel, and how it can best be implemented to create an efficient workplace.

Beyond staying current with new technology, the nurse informaticist must be able to design and deliver training courses for nurses at the facility regarding how to use new tools. This requires not only technical expertise but also the ability to develop effective instructional programs tailored to the staff's needs.

Concepts, Standards, and Core Competencies

The concepts and standards of nursing informatics at the selected site, and how they apply to the healthcare setting, include three theoretical frameworks: 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 the input, output, and processing of information related to the patient; and change theory, which addresses how processes are used in nursing informatics.

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

These concepts and competencies apply to: upholding core measures and the submission of clinical quality measures; protection of patient privacy; and the electronic exchange of information. Specific applications include the use of electronic health records, exchange of information, medication reconciliation, recording of advanced directives, incorporating clinical lab tests as structured data, placing computerized provider order entries, maintaining up-to-date problem lists of current and active diagnoses, and providing patients with an electronic copy of their health information. Together, these practices illustrate how systems theory, cognitive theory, and change theory work in conjunction with core nursing informatics competencies to achieve meaningful use.

Conclusion

The site investigated for this report allowed for in-depth exposure to a number of important points related to nursing informatics. An interview with a nurse informaticist shed light on the professional role of this specialist at the facility. Observation of how concepts and standards are implemented helped to illustrate how technology supports quality of care, and telehealth, telemedicine, and telenursing tools were readily apparent and actively in use to support holistic care for both patients and their families. Administrative software and network systems were also examined to demonstrate how technology is used to keep track of both nurses and patients in an organized and efficient manner. The one area that could be noticeably upgraded is in patient admittance, where an outdated manual system remains in place and could be meaningfully improved by the adoption of teletracking technology.