The History of Healthcare Informatics

The History Behind Nursing Informatics Nursing informatics (NI) has become a vital part of healthcare delivery and has become a defining factor in the selection, execution, and assessment of technology that supports safe, exceptional quality and patient-centered care. Nursing has become so uniform. The data in patient records has become a valuable resource and has improved assessments and overall patient care.

Before the launch of nursing informatics throughout the second half of the 20th century there were not any real standards for language. The use of data restricted the function and effectiveness of any early informatics applications. Nurses began developing standardized language systems during the turn of the century. International collaborations involving different medical disciplines have led to the improvement of standards and have opened the door for strong and reliable information tools. Nurses have the ability to change and improve healthcare.

They have the potential to change outcomes with the use of informatics. The use of this technology does require change; a change in the person, the institute, and the systems. Nurses are developing and applying informatics to find new knowledge and are improving the quality of care given on a global level (Edwards, H. 2011). Nurses have identified three important factors in nursing informatics: basic computer skills, informatics knowledge and information literacy (Thede, L. 2012). In the beginning there was Florence Nightingale.

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Not only did Nurse Nightingale pioneer the nursing profession she also started the first informatics in nursing. She stated ‘In an attempt to arrive at the truth, I have applied everywhere for information, but scarcely an instance have I been able to find hospital records fit for any purpose of comparison. If they could be obtained, they would enable us to decide many other questions besides the one alluded to? …if wisely used, these improved statistics would tell us more of the relative value of particular operations and modes of treatment than we have any means of obtaining at present.

They would enable us, besides, to ascertain the influence of the hospital … upon the general course of operations and diseases passing through its wards; and the truth thus ascertained would enable us to save life and suffering, and to improve the treatment and management of the sick … . ” (Florence Nightingale. Ozbolt, J. G. , Saba, V. K. 2008). Nurse Nightingale began nursing informatics by introducing three health sciences into nursing: health services research, evidenced-based practice and informatics (Ozbolt, J. G. , Saba, V. K. (2008).

She requested that clinical records be analyzed to assess and improve care and outcomes (Ozbolt, J. G. , Saba, V. K. (2008). She noticed the need for change before there really was a need for change. Her efforts brought about nursing informatics and the nursing profession became more modernized. Nearly 100 years later a woman by the name of Harriet Werley started to encourage the use and growth of informatics in the nursing profession (Murphy, J. 2010). In the late 1950’s she was the first nurse to participate in research in a hospital (Ozbolt, J. G. , Saba, V. K. 2008). She was asked to provide consultation for IBM on the possible use of computers in healthcare (Ozbolt, J. G. , Saba, V. K. 2008). Nurse Werley saw the benefits of computers used to store patient information and to improve patient care (Ozbolt, J. G. , Saba, V. K. 2008). She devised a minimum data set to be collected from every patient Ozbolt, J. G. , Saba, V. K. 2008). In the 1970’s nursing informatics really began to bloom. The first records of the use of computers in the nursing field started to appear in professional and scholarly literature (Murphy, J. 2010).

Nursing care plans began to focus on reducing the amount of documentation and keeping it as accurate and as detailed as possible (Ozbolt, J. G. , Saba, V. K. 2008). Another system focused on patient scheduling in a rehabilitation setting (Ozbolt, J. G. , Saba, V. K. 2008). Nurses at a California hosptial assisted in developing the first comprehensive hospital information system and helped integrat the system for nursing care planning, documentation, and feedback (Ozbolt, J. G. , Saba, V. K. 2008). They developed the standard care plans that are used throughout the world today (Ozbolt, J. G. Saba, V. K. 2008). Another big achievement of this decade was the introduction of the first commercial electronic medical record (Thede, L. 2012). This new system was patient-oriented and was implemented throughout the hospital (Thede, L. 2012). Nursing informatics really gained momentum in the 1980’s. The first national conference on computer technology and nursing was held (Ozbolt, J. G. , Saba, V. K. 2008). Scholarships and the first educational courses on Nursing Informatics were introduced into the nursing programs at Boston College, University of New York and University of Utah (Ozbolt, J.

G. , Saba, V. K. 2008). The growing record of accomplishment allowed nurses to move into managerial roles (Edwards, H. 2011). By the mid ‘80’s, nearly three decades after Nurse Werley pushed for minimum data sets, was the idea finally embraced by nurse professionals (Ozbolt, J. G. , Saba, V. K. 2008). Four specific elements of the minimum data set became a standard for nursing care: nursing diagnosis, nursing intervention, nursing outcome and the intensity of the care provided (Ozbolt, J. G. , Saba, V. K. 2008). Beginning in the 1990’s a real change was noticed.

The technological advances that had been made were astonishing (Ozbolt, J. G. , Saba, V. K. 2008). A new technology called the internet had been introduced allowing for worldwide communication of healthcare information (Ozbolt, J. G. , Saba, V. K. 2008). In 1994 the American Nurses Association published the first versions of the “Scope of Nursing Informatics Practice” and the “Standards of Nursing Informatics Practice”. In 1995, the American Nurses Credentialing Center started the basic certification in nursing informatics as an area of specialty practice (Ozbolt, J. G. Saba, V. K. 2008). Also in 1994, the American Nurses Association (ANA) published the first definition of nursing informatics: "Nursing Informatics is the specialty that integrates nursing science, computer science, and information science in identifying, collecting, processing, and managing data and information to support nursing practice, administration, education, research, and the expansion of nursing knowledge. " (Murphy, J. 2010). The International Classification of Nursing Practices was initiated by three nurses throughout the world (Ozbolt, J. G. , Saba, V. K. 2008).

The 1990’s were a big decade for the advancement of nursing informatics. The first journal pertaining to informatics in nursing was initiated and it was online. The Online Journal of Nursing Informatics hit the wires in 1996. This online publication focused, and still focuses on publishing peer-review articles, scientific papers, review articles, practice-based articles and data bases related to nursing informatics (McGonigle, D. , Seymour, R. , Englebardt, S. , Allen, M. , Chang, B. 2001).

This journal is currently published with the amazing staff of one (McGonigle, D. , Seymour, R. Englebardt, S. , Allen, M. , Chang, B. 2001). In the 2000’s and today nursing has the tools and the terminology, which had taken years of development with the collaboration of numerous nursing professionals globally (Ozbolt, J. G. , Saba, V. K. 2008). A standardized language had been developed and nursing terminology and data standards were implemented mainstream (Ozbolt, J. G. , Saba, V. K. 2008). In 2004 nursing informatics had blown up. Education had accelerated and nursing informatics had become a staple in healthcare. Knowledge discovery methods were the key in discovering risks in health.

Nurses knew that the discovery of knowledge brings the responsibility of that knowledge and with this information nursing care is the best it has ever been (Murphy, J. 2010). In 2001 the definition of nursing informatics was expanded by the ANA. They described it as: A specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, and knowledge in nursing practice. NI facilitates the integration of data, information, and knowledge to support patients, nurses, and other providers in their decision-making in all roles and settings.

This support is accomplished through the use of information structures, information processes, and IT (Murphy, J. 2010). And in 2008, the current definition of nursing informatics was published. It was essentially the same as the first published definition in 1994, however, now includes the additional concept of wisdom. It reads "NI is a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, knowledge, and wisdom in nursing practice. " (Murphy, J. 2010).

Additionally, the ANA published three editions of Nursing Informatics Scope and Standards of Practice (ANA. 2008). We as nurses must remember that change is always a difficult thing to embrace. By studying information in an informatics prospective discover how to deliver care and support decisions more effectively and safely, with better outcomes for all constituencies. Informatics tools can support the translation of knowledge into practice, but changing the behavior of people, organizations, and systems requires collaboration across a range of disciplines.

Nursing and healthcare will always be ever-changing. Change and collaborations for implementing change are fundamental in the education of nurses today. Today nurses are able to access new information and resources easier and faster than ever. Nurses are constantly being challenged to amalgamate new resources on a cognitive, psychomotor and executive level. Nurses of the future can learn technological skills and expand their knowledge and wisdom and can utilize the data.

They are encouraging the changes to take place for the nursing practice and healthcare systems by learning, implementing and teaching. Change and evolution through informatics will only improve healthcare and will save more lives. Nursing informatics has become a well established specialty within the nursing field. Solid fundamentals have been laid out over the past 25 years and NI has become an essential part of healthcare delivery despite the many barriers yet to be overcome. It is influenced by environmental, political, economic and professional forces.

The change that nurses are bringing are being influenced by new up-and-coming concepts of health and illness, advancements in the field of medical science, the patterns of diseases, demographics and an increasing ability to meet the needs of disease management and prevention as well as the needs of the patients and their families through the use of technology, knowledge and wisdom. As the specialty of nursing informatics continues to evolve new knowledge and technology will be available making the role of the nurse much more important and powerful and making the care and outcomes of each person served improved.

It is how the nurse participates in saving a life; one step at a time.

References

Edwards, H. (2011). Nursing informatics: past, present and future. Retrieved from www. theconference. ca/nursing-informatics. Murphy, J. (2010). Nursing informatics: the intersection of nursing, computer, and information sciences. Nursing Economics, vol. 28, Iss. 3, 204-7, May/June 2010. Anthony J. Jannetti, Inc. Pitman, USA. Retrieved from http://ezproxy. ccu. edu/login? url=http://search. proquest. com/docview/577364695? accountid=10200. Ozbolt, J. G. , Saba, V. K. (2008). A brief history of nursing informatics in the United States of America.

Mosby’s Nursing Consult. Vol. 56, Iss. 5, September 2008. American Nurses Association. (2008). Retrieved from: http://www. nursingworld. org/HomepageCategory/NursingInsider/Archive_1/2008NI/Jan08NI/RevisedNursingInformaticsPracticeScopeandStandardsofPractice. html. Thede, L. , (January 23, 2012) "Informatics: Where Is It? " OJIN: The Online Journal of Issues in Nursing Vol. 17 No. 1. McGonigle, D. , Seymour, R. , Englebardt, S. , Allen, M. , Chang, B. (March 1, 2001) "The Online Journal of Nursing Informatics (OJNI)" Online Journal of Issues in Nursing. Vol. 6 No. 2. CIS312A, Healthcare Informatics

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