Nursing Q&A: Nursing Informatics with Patrisha Trangenstein



most people would probably quote to you the AMA definition which is the American Nurses Association definition which is pretty standard and pretty much falls on that same pathway with a little bit of expansion I kind of have developed for myself emerging as some different ways of thinking in nursing informatics and the first thing I think that that is essential is that it is a specialty it requires advanced knowledge and skills it involves the processing management communication and transformation of data deformation to knowledge and then to wisdom really to support nursing actions and decisions but I'd like with Judy Afghan added in a research article about the order of the outcomes we're not just using this technology for technology sake but we ought to be doing this to improve cost quality safety satisfaction efficiency and effectiveness so the five qualities for any definition is for me it has to have advanced knowledge and skills it involves a lot of data to information to knowledge to wisdom to support appropriate nursing decision and actions to impact client outcomes probably the best example I can give you is what we call the case of the ventilator acquired pneumonia we have a number of patients that are hospitalized and end up on a ventilator or an artificial breathing machine and a certain number of those will come down with pneumonia but we have found over time that they're about 6 or 7 things that if you do significantly reduces the incidence of ventilator acquired pneumonia so a number of hospitals what they have done is take this six or seven things and put it in kind of like a dashboard so the bedside nurse giving care can say okay need to do oral care need to make sure the head of the beds up need to suction and then put on time tables and if it's overdue it kind of turns a little red if it's needs to be done it's yellow if it's been done it's green so you get a data visualization of those six or seven things it really helps the bedside nurse this is actually saved millions of dollars in prevented deaths already if we could take just this example and move it to other healthcare problems we really couldn't pass the outcomes well I probably came the same route that many of us did and that was on-the-job training I had an early interesting computers and a strong patient for nursing and every time they're really involved in recognizing the value of using data and information to make a bigger difference in health outcomes I started out very heavy clinically oriented mostly in coronary care units which seems to be where a lot of people that are comfortable technology you know come from into informatics from ICUs and ORS and then actually I moved my probably informatics into educational informatics and have done a lot at the universities I've been involved with with supporting informatics use within academic programs the first is to enjoy problem solving where you can see the the bigger picture you were a systems thinker they need a passion about Nursing with a strong clinical background strong interest in technology they need to be a good communicator or what I call can translate Geek Speak and use not the acronyms that we use or the tech terms that we use but put it in a way that the end user can understand they need to be detail-oriented but also thrive on change with the willingness to learn new things as well as the tolerance for the continual change that's occurring in this area and to value more than one way to solve a problem and last but probably not least is being a team player remember this is a multidisciplinary process oh I think so but a much more grander scale while you're not impacting a few patients on any given day you can really impact thousands by making changes and how the data goes the information goes to knowledge and change the way health care is delivered the impact is is just amazing when you get into the area I think the first thing you have to look at is where the position reports to within a hospital structure is it reporting to an Information Systems department or the nursing department or administration quality improvement you may actually be working with the physician practice in this area or vendors or consultations software design there are a wide variety of titles currently being used in this area of nursing informatics anywhere from clinical director of Informatics to nurse informatics to informatics nurse specialists director of patient care informatics informatics analysts clinical informatics Asst clinical quality informatics specialists of nursing informatics system analyst clinical analysts project managers what we're finding in the areas the titles are starting to standardize a bit so I think in the future we'll be a little bit easier I'm a little bit old school and I came up where most of us did in terms of on-the-job training however what we're finding is at least more than half of that the same survey respondents head of masters or a higher degree in nursing or another field so we're seeing the bar being set because I think of all the changes in health care that the expectation is for someone in nursing informatics so the Masters is really going to be the preferred degree what I'm also seen as a bit of a trend if someone is interested in what we call a chief nursing informatics position or a CIO we're seeing more the DNP or the Doctor of Nursing Practice degree being pursued by those candidates oh I think this is the mother lode of what can be done in the future everybody knows if we could just get the data the better evidence-based care we've had written records for so long that you really cannot capture across cases what's going on with electronic data and being able to data mined all that data we can give much better evidence-based care we can provide real-time decision support at the point of care not just for the care provider now we're talking for the care recipient so the patient or the family also has the data the information and knowledge they need to make their appropriate decisions we're going to have more data from available from a lot more different places it's not just going to be the electronic record we're talking about mobile apps we're talking about home monitoring and remote sensing think about that for the elderly where you have devices in the home that's going to be sending data or information either to the family or your health record being able to monitor that in real time where someone is not within a health care environment it's going to be phenomenal I think what we will also see is better data visualization schemas and probably better algorithms for care we're going to start analyzing particular cases and say okay these are the six or seven things that really make a difference so I think once we can get the data across so many different electronic records and really mine that data looking at patient outcomes I think we're going to be a tremendous advantage to really will be doing things differently in healthcare you

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