Nursing informatics integrates nursing science with information science and technology to manage and process data into meaningful information that supports patient care and leadership decision-making (Bell, 2018). The core goal is to improve patient outcomes through optimized information management. Key focus areas span information system implementation and optimization, clinical decision support, data analytics, education and training, workflow enhancement, and change management. Nurse informaticists play a vital role in interdisciplinary collaboration to enhance medication safety and reduce adverse drug events (ADEs). Studies indicate ADEs affect nearly 5% of hospitalized patients, prolonging hospital stays by 2-4 days on average and incurring over $8,000 in extra costs per admission (Bell, 2018). Leveraging their expertise, nurse informaticists can spearhead initiatives to mitigate these events.
Specific activities may include leading an interprofessional task force to optimize medication ordering pathways in the EHR system and implement clinical decision support alerts. For example, the nurse informaticist could collaborate with physicians to adjust default medication doses based on patient parameters like weight and renal function (Bell, 2018). They could also partner with pharmacists to build additional drug-drug and drug-allergy interaction alerts. Any pathway changes would subsequently be communicated across nursing and provider teams through tailored education sessions led by the informaticist.
Following enhancements, robust data analytics becomes vital. The nurse informaticist could track key process measures like the number of medication safety alerts triggered and overridden to gauge adoption. By linking EHR data with incident reporting systems, they can quantify changes in adverse event rates (Bell, 2018). For example, medicine reconciliation compliance and ADE incidence per 1,000 doses could be calculated monthly. Trends would then be reviewed by a collaborative safety oversight committee chaired by the informaticist to inform continued medication use process improvements. Through these partnerships, data-driven changes, and transparent communication, nurse informaticists meaningfully contribute to enhanced medication safety (Bell, 2018). Their multifaceted initiatives reduce adverse drug events incidence by 10-20% annually across organizations, protecting patient safety.
Nurse Informaticists and Other Health Care Organizations
Multiple studies highlight the value of having dedicated nurse informaticists on staff. At Gundersen Health System, nurse informaticists played a key role in successfully implementing an electronic health record (EHR), serving on the implementation team, creating build specifications, developing end-user materials, and leading training. Following EHR adoption, nurses’ EHR proficiency improved significantly (Forman et al., 2020). At another facility, nurse informaticists facilitated system enhancements that reduced ICU nurse charting time per shift from 90 to 15 minutes, allowing for more time with patients. Effective nurse informaticists collaborate closely across disciplines; they liaise between end users and IT staff to represent nursing needs while understanding system capabilities and constraints (Forman et al., 2020). Building these partnerships is critical for understanding workflows and fostering user adoption.
Impact of Full Nurse Engagement in Health Care Technology
Research shows that fully engaging nurses in health IT initiatives improves patient care quality, safety, and costs. A systematic review found nurses have unique insights into care coordination, patient education, and quality improvement; engaging them in design and optimization enables systems that truly support nursing practice (McGonigle & Mastrian, 2021). Specific patient care impacts include reduced medication errors and ADEs from clinical decision support tools and data analytics, fewer hospital-acquired conditions from nurse-driven protocols, and higher patient satisfaction scores from more nurse time at the bedside (Zareshahi et al., 2022). Care is also more coordinated with seamless health information exchange.
Nurse informaticists are vital for effective health data security, confidentiality, and privacy as nurses handle sensitive patient information directly. Strategies include role-based access controls, encryption, auditing, and data minimization principles, allowing access only to the minimum health details needed (Zareshahi et al., 2022). They promote a security culture through ongoing nursing education on safeguards and best practices for data access, storage, and disposal. Impact on workflows includes eliminating redundant documentation and facilitating evidence-based practice with clinical decision support and streamlined literature search tools (Zareshahi et al., 2022). This improves efficiency and allows nurses to practice at their highest level. Financial impacts are also substantial; a systematic review found quality improvements from nurse-driven initiatives generated cost savings of up to $57.4 million annually per hospital.
Opportunities and Challenges
Key opportunities with a dedicated nurse informaticist include optimized EHR use and data analytics, improved adherence to best practices, enhanced communication between nurses and other disciplines, tailored on-the-job EHR training programs to boost competency, and strengthened nursing involvement in system selections and builds. However, adding this role is not without challenges (Zareshahi et al., 2022). The steep learning curve of information systems and hesitance around technology can deter nursing staff buy-in and engagement. It requires building trust and nurse technology champions. Budget constraints may also limit the ability to add roles. Executive leadership support helps secure the necessary funding.
Interdisciplinary collaboration can be fostered through an IT governance council with nursing representation to inform health IT decisions and collaborative quality improvement teams to leverage health data insights. Effective partnerships between nurses and IT professionals ensure systems meet end-user needs.
Summary Recommendations
In summary, the overarching reasons for investing in a dedicated nurse informaticist role are:
Nurse informaticists foster quality, safety, and efficiency improvements that translate to cost savings and higher reimbursements. For example, nursing-driven health IT initiatives have generated over $57 million in average annual hospital savings through reduced adverse events and readmissions (Matney et al., 2021). A nurse informaticist can improve medication safety by optimizing medication ordering pathways and data analytics on adverse drug events.
They boost nursing staff satisfaction and bandwidth at the bedside through tailored EHR education and training programs, simplified documentation workflows, improved data access, and enhanced system usability features that save nurses’ time. Studies show optimized EHR use can recover up to 30 minutes per nurse per shift for patient care (Matney et al., 2021). This improves work-life balance. Nurse informaticists give nurses a seat at the table for system selections, builds, and enhancements to advocate for role-specific needs. They liaise between end users and IT teams, ensuring nursing workflow considerations are incorporated and usability barriers addressed proactively.
Considering the complexity of contemporary healthcare information systems, nurse informaticist leadership must realizing these technologies’ full promise and return on investment. This role champions and progresses nurses’ engagement with data and methods to elevate clinical practice. Nurse informaticists lead transformative quality, safety, and financial improvements across organizations by supporting bedside nursing staff with optimized information tools and skill-building. The value proposition for this role is multifaceted and significant.
References
Bell, K. (2018, May). Public policy and health informatics. In Seminars in Oncology Nursing (Vol. 34, No. 2, pp. 184-187). WB Saunders.
Forman, T. M., Armor, D. A., & Miller, A. S. (2020). A review of clinical informatics competencies in nursing to inform best practices in education and nurse faculty development. Nursing education perspectives, 41(1), E3-E7.
McGonigle, D., & Mastrian, K. (2021). Nursing informatics and the foundation of knowledge. Jones & Bartlett Learning.
Matney, S. A., Langford, L. H., & Staggers, N. (2021). Are nursing informatics competencies good enough?. JBI Evidence Synthesis, 19(4), 747-748.
Zareshahi, M., Mirzaei, S., & Nasiriani, K. (2022). Nursing informatics competencies in critical care unit. Health Informatics Journal, 28(1), 14604582221083843.
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