What does informatics Mean for Nursing

Use of artificial intelligence or decision making systems for use of nursing process Use of computer based scheduling package to allocate staff in a hospital Use of computers for patient education

 Use of computer decisions and how those decisions are made Use of computer assisted learning in Nursing Education For Hospital Information System Research Information nurses use in making patient care decisions and how those decisions are made

What does informatics Mean for Nursing (Contd.)

INTEGRATING INFORMATICS
MULTI SYSTEMS APPROACH

FINANCIAL FLOW

INTEGRATING INFORMATICS
MULTI SYSTEMS APPROACH

COMMUNICATION FLOW

MANAGEMENT FLOW

MEDICAL FLOW

COMPARISON OF NURSING PROCESS TO CLASSIC SYSTEM DEVELOPMENT LIFE CYCLE

OBSERVE REQUIREMENTS DEFINITION ANALYSIS

NUR- ASSESS SING DIAGNOSE PROCESS

PLAN

PRELIMINARY DESIGN DETAIL DESIGN

IMPLEMENT CODING TESTING EVALUATE IMPLEMENTATION

MAJOR PHASES IN SYSTEM DEVELOPMENT

PLANNING SYSTEM DESIGN

PROGRAMMING

SYSTEM CODE SYSTEM IN USE

IMPLEMENTATION

PLANNING PROCESS
P -----------L A N N I N G --------DESIGN ANALYSIS

STRATEGIC PLANNING

INSTITUTION OBJECTIVES
DETAILED REQUIREMENTS

USER INTERFACE

NURSING DATA ELEMENTS

EXAMPLES OF DATA SETS PATIENT DEMOGRAPHICS AGE AND DATE OF BIRTH SEX RESIDENCE LANGUAGE RELIGION OCCUPATION EDUCATION LEVEL

NURSING DATA ELEMENTS (Contd.)

CARE ITEMS NURSING DIAGNOSIS NURSING INTERVENTIONS CIENT OUTCOMES NURSING INTENSITY

SERVICE ITEMS MAIN NURSE PROVIDER

NURSING DATA ELEMENTS (Contd.)

MAIN DOCTOR ADMISSION DATE AND HOUR LENGTH OF STAY DISCHARGE DATE AND HOUR MAIN PATIENT SERVICE RESPONSIBILITY FOR PAYMENT

NANDA-NURSING MINIMUM DATA SET ELEMENTS

NURSING ELEMENTS PATIENT DEMOGRAPHIC ELEMENTS PERSONAL IDENTIFICATION DATE OF BIRTH SERVICE ELEMENTS SERVICE AGENCY NUMBER PATIENT HEALTH RECORD NUMBER NUMBER OF MAIN RN EPISODE ADMISSION OR ENCOUNTER DATE DISCHARGE OR TERMINATION DATE DISPOSITION OF PATIENT EXPECTED PAYOR OF BILL

NURSING DIAGNOSIS NURSING INTERVENTION

NURSING OUTCOME INTENSITY OF NURSING CARE

SEX RACE AND ETHNICITY

DRAFT UNIFORM DATA SET INDIVIDUAL LEVEL-PATIENT DATA

DEMOGRAPHIC PERSONAL IDENTIFICATION CLINICAL ITEMS MEDICAL ITEMS SERVICE ITEMS PROVIDER IDENTIFICATION ADMISSION DATE DISCHARGE DATE EPISODE OF CARE RELIGION LENGTH OF CARE

DATE OF BIRTH

SURGICAL DIAGNOSIS

LENGTH OF STAY
SEX NO. OF HOSPITAL ADMISSIONS

DRAFT UNIFORM DATA SET INDIVIDUAL LEVEL-PATIENT DATA (Contd.)

DEMOGRAPHIC CLINICAL ITEMS SERVICE ITEMS

LOCATION OF RESIDENCE

REASON FOR DISCHARGE DISCHARGE DISPOSITION EXPECTED PAYOR UNIT OF SERVICE-VISIT UNIT OF SERVICE-HOUR UNIT OF SERVICE PER DISCIPLINE NO. OF DAYS PER LEVEL OF HOSPICE CARE

THE OMAHA SYSTEM

It is a research-based, comprehensive taxonomy that consist of the Problem Classification Scheme, the Intervention Scheme, and the Problem Rating Scale for Outcomes

THE OMAHA SYSTEM (Contd.)

It is based on the dynamic, interactive nature of the nursing or problem solving process, the clinician-client relationship, and concepts of diagnostic reasoning, clinical judgement, and quality improvement. It follows taxonomic or classification principles, it consists of terms and codes arranged from general to specific.

THE OMAHA SYSTEM (Contd.)

The goal of this system was to develop a taxonomy that would provide a useful guide for practice, a method for documentation, and a framework for information management

PROBLEM CLASSIFICATION SCHEME

It is a comprehensive client-focused taxonomy that describes clients health related concerns and problems. It consists of four levels: domains, problems, modifiers, and signs/symptoms. The domains are Environmental, Psychosocial, Physiological, and Health Related Behaviours.

PROBLEM CLASSIFICATION SCHEME (Contd.)

Client problems, the second level of the Scheme, are the 40 nursing diagnoses that represent matters of difficulty and concern to the client. Two sets of modifiers appear at the third level of the Scheme and are used in conjunction with problems. The user identifies a problem as either an individual or family problem and as either a health promotion, potential, or actual problem.

PROBLEM CLASSIFICATION SCHEME (Contd.)

Using two modifiers with a problem increases applicability across the health-illness continuum and adds specificity to the problem. The fourth level of the Scheme involves a cluster of signs and symptoms specific to each problem. For eg: signs and symptoms for the problem, Income, include uninsured medical expenses and difficulty buying medicines or other supplies.

INTERVENTION SCHEME
The terms, codes, and definitions of the Scheme are designed to help users identify and document both plans and interventions for clients specific problems or nursing diagnoses. The four categories in the first level of the scheme are Health Teaching, Guidance, and Counseling; Treatments and Procedures; Case Management ; and Surveillance.

INTERVENTION SCHEME (Contd.)

The second level of the scheme is an alphabetical listing of 62 targets Targets are defined as objects of health related interventions or activities, and further describe problems-specific intervention categories The third level of the Intervention Scheme is designed for client-specific information

PROBLEMS RATING SCALE FOR OUTCOMES

It is a comprehensive framework designed to measure clients health related changes It is a 5-point, ordinal scale comprised of Knowledge, Behavior, and Status subscales Status is the condition of the client, in relation to objective and subjective defining characteristics For eg. for problems such as Grief and Circulation, the user would identify and document baseline Knowledge, Behavior, and Status ratings during the first home visit, hospital shift, or clinic encounter

NURSING INFORMATION SYSTEM (NIS)

EVALUATED ON THE AVAILABILTY OF FOLLOWING A CARE PLAN A NURSING WORK SHEET AN ASSESSMENT DOCUMENT A DISCHARGE PLANNING GUIDE FOR A SPECIFIC PATIENT

NURSING INFORMATION (NIS) (Contd.)

A QUALITY ASSURANCE RECORD A NURSE CHARTING RECORD IS THE CHARTING SYSTEM FLEXIBLE TO ADAPT TO DIFFERENT APPROACHES (SOAP) IS THE CARE PLANNING SYSTEM FLEXIBLE TO ADAPT TO DIFFERENT APPROACHES (DIAGNOSIS ORIENTED PROBLEM ORIENTED)

NURSING INFORMATION (NIS) (Contd.)

Are physician orders automatically loaded into the NIS application and available in the care plan, nursing worksheet, assessment report, and discharge planning record without any redundant entry? Spend a minimum 1 hour on the patient care unit Go to at least two patient care areas. See whether the system is fully operational on more than one unit Meet nursing officer and gain feedback