Nursing Informatics Track

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Nursing informatics is a field in which information processes and tools are used to improve health care decision-making, communication and delivery, and to facilitate the unique contribution of nurses across the care continuum. The American Nurses Association defines nursing informatics as:


Nurse informaticians actively participate in all levels of health care to leverage health care technology and informatics processes to support the health of people worldwide.

Learning Objectives:

• Identify the maximal role of nursing informatics for supporting nurses as patient advocates, care-coordinators and communicators.
  
• Describe the uses of informatics to improve nursing clinical and operational outcomes.
  
• Describe best practice and future directions for using informatics to integrate evidence into practice.
  

S01 Invited Panel
Tuesday, May 22, 2007, 10:30 am - 12:00 pm

Nursing Informatics Competency Continuum: Bridging Education, Practice and Management

Widespread adoption of health care information and communication technology continues to expand, and, with it, the requirement - and the public expectation - for health care professionals to possess core competencies for its use. During this panel presentation, three expert nurse informaticians will present the definition, application, and integration of informatics competencies in nursing academia, nursing practice, and nursing management

- Ruth Schleyer, Providence Health & Services
- Susan Newbold, Vanderbilt University School of Nursing
- Nancy Staggers, University of Utah

S05 Presentations-Informatics for Quality & Patient Safety
Tuesday, May 22, 2007, 1:30 pm - 3:00 pm

Adapting a Production-Ready CIS for Academic Use

Nursing students are increasingly expected to function in automated environments. Yet, few nursing programs have functional clinical information systems (CIS) in place for students to learn about electronic medical records systems. How information is managed using paper based systems differs from how humans organize and manage information with electronic systems. The Ohio State University College of Nursing has adapted the CliniComp CIS for use in their undergraduate curriculum. The overall program goal is to enhance clinical decision-making and patient care processes of undergraduate nursing students through informatics-facilitated practice.

- Christine Curran, The Ohio State University

Interruption of RNs and MDs in a Level One Trauma Center: Are Interrupted Tasks Resumed?

The purpose of this study was to observe if registered nurses (RNs) and medical doctors (MDs) resumed the original interrupted task following an interruption. The talk will describe a non-participatory ethnographic study at an urban level one trauma center. Eight RNs were observed for 40 hours, 9 minutes. Five MDs were shadowed for 29 hours, 31 minutes. Registered nurses returned to complete the primary interrupted task more often than MDs. Registered nurses and MDs were observed to return to the original interrupted task more often than leaving the task incomplete. Although the primary task was resumed, it was not known if the original task was correctly resumed or if an error had occurred.

- Juliana Brixey, University of Kansas School of Nursing

Magnetism and Nursing Excellence: The Catalyst to Successful Nursing Informatics Initiatives

Providence Portland Medical Center (PPMC) has long understood that systems support the work of nursing by providing efficiencies as well as assisting with safe, quality care. Nurses are expected to function well within a technologically advanced health care environment, carry out higher-level, complex activities, and are held responsible and accountable for the systematic planning of humanistic nursing care for patients and their families. To accomplish the vision of having an electronic health record at PPMC and the tools to support the work of nurses, various structures were put into place with a great deal of nursing staff involvement.

- Ivy Holt, Providence Portland Medical Center

A New Nursing PDA Application for Patient Vital Signs Monitoring

Patients at a hospital can greatly benefit from technologies that continuously monitor their vital status while they are admitted at the hospital. This application allows nurses to monitor all of their patients' vital signs at a glance via a hand-held personal digital assistant (PDA). The PDA software provides an advanced graphical interface to view a color-coded list of all patients, details for any given patient, and the last 15 minutes of data for a patient.

- Dave Tahmoush, University of Maryland

S10 Panel
Wednesday, May 23, 2007, 8:30 am - 10:00 am

Nursing Informatics Roles in Knowledge Management: From the Books to the Bedside

The ongoing need to impact the quality of care is clear (IHI 5 Million Lives Campaign, www.ihi.org). In addition, research shows that the automatic delivery of evidence based knowledge to clinicians at the bedside significantly increases the quality of clinician decision making. (Kawamoto, 2005) The purpose of this panel is to explain and discuss the responsibilities and skill sets of nurse informaticians in managing knowledge to support care delivery at the bedside. Specific roles to be discussed include: the academic role in basic and advanced nursing education regarding knowledge management; the knowledge vendor role in defining and implementing a research methodology for the identification, updating and packaging of evidence based content to be used at the bedside; the electronic health record (EHR) vendor role in structuring, coding and integrating evidence based knowledge to be delivered in software applications at the bedside; and the provider organization role in integrating evidence-based knowledge in clinical workflow and data management systems.

- Patricia Button, Zynx Health
- Rosemary Kennedy, Siemens Medical Solutions Health Services
- Ida Androwich, Loyola University Chicago
- Julie Glen, Loyola University Health System

S15 Presentations-Informatics for Knowledge Management
Wednesday, May 23, 2007, 10:30 am - 12:00 pm

Connecting Health Information Technology Standards to the Point-of-Care

The Use of Log Files in the System Development Life Cycle for Nurses

Clinicians depend on the ability to efficiently locate information when performing their clinical tasks. Essential steps to producing systems that effectively organize and present relevant information include understanding the needs of potential end-users early in the development process and iteratively evaluating their ability to meet the needs of these users for guiding enhancements. Log files that automatically record system activity can play a valuable role in the various phases of the system development life cycle. This presentation will provide an overview of log files and analysis techniques, describe the adaptation of these techniques to clinical information systems, and present several case studies exemplifying how log files have been used at our institution.

- Elizabeth Chen, Columbia University

Transforming Care Delivery Through Automated Evidence-based Practice

This presentation will detail how Health-First implemented an interdisciplinary, pre-configured clinical documentation solution that transformed its care delivery by providing its nurses embedded content within the context of individualized patient information at the point of care. This initiative has helped Health First improve patient outcomes by promoting evidence-based care that is individualized, timely, effective and safe. The improved quality of the documentation has encouraged critical thinking in clinical care and enhanced patient safety by identifying potential patient complications, and then driving complication-specific assessments. The project also has increased staff retention by reducing the documentation burden - an important achievement given the difficult time health care organizations have recruiting and retaining personnel.

- Janice McCoy, Chief Nursing Officer, Cape Canaveral Hospital, Health-First Health System
- Jim Cato, Chief Nursing Officer, Eclipsys

Plan of Care Knowledge-driven Model Formation

Significant challenges exist in integrating the plan of care into documentation and point of care operational processes. Existing plan of care solutions are often static artifacts, without standard terminology or information models. Although they may meet regulatory standards, they have limited influence on supporting outcome-driven care delivery processes. Underlying information and terminology models are necessary to support effective tools for managing problems, orders/interventions, and the patient's progress towards expected outcomes. A knowledge infrastructure that consists of a fully represented terminology, structured clinical expressions using controlled terminology models, and clinical knowledge representing evidence-based practice is a rigorous, extensible, and scalable foundation for plans of care.

- Rebecca DaDamio, Siemens Medical Solutions Health Services

S20 Presentations-Recent Result from Nursing Informatics Surveys
Wednesday, May 23, 2007, 1:30 pm - 3:00 pm

Best Practices in Nursing Documentation Implementation: Results of the HIMSS 2007 National Survey

Health care organizations are increasingly using computer systems to support nursing care documentation, however, processes used to select and deploy such systems are widely varied. The purpose of this survey is to understand current practices related to implementation of computerized nursing documentation systems with the goal to establish best practice guidelines. In Spring 2007, the HIMSS Nursing Informatics and Management Management Engineering and Process Improvement Working Groups will interview a national sample of hospitals to solicit information regarding the following processes: leadership activities, clinical transformation processes, project management activities, implementation processes, evaluation metrics, terminology and other standards used, and methods used to facilitate end-user adoption. This presentation will report the results of this survey.

- Kathleen Kimmel, McKesson

The Impact of Health Information Technology on the Role of Nurses

A survey of nurses was conducted to understand nurses' perception of HIT in their workplace. 207 nurses responded to the survey. The results demonstrate an overall satisfaction with HIT but also identified many areas that warrant improvement.

- Victoria Tiase, NewYork Presbyterian Hospital

Report of a statewide survey of nurses on issues with nursing documentation of patient care

A Documentation Work Group of the Maryland Nursing Workforce Commission investigated nursing documentation, frequently identified by Maryland nurses as a concern. In focus group discussions, nurses indicated they believe an increasing amount of time is spent on documentation, time that could be more appropriately spent on direct patient care. In addition, nurses in the focus groups reported that documentation is often redundant and done primarily to benefit regulators and third-party payers.

- Brian Gugerty, Siemens Medical Solutions

S25 Panel
Thursday, May 24, 2007, 8:30 am - 10:00 am

Changing roles of hospital/clinic committees, physician and nurse informaticians to implement and sustain the clinical information technologies.

The panel will present on the case study of a health care information technology implementation within a rural referral hospital and clinics. The panel represents team members from the Agency for Healthcare Research and Quality grantee research team for the Rural Iowa Redesign of Care Delivery using EHR Functions grant. Participating authors will share the story of roles and responsibilities in preparation steps, the "big bang" approach for implementation and the changing roles of physicians and nurse informaticians to sustain and improve the care delivery with the EHR functions. The panel discusses the needs for new structures for the organization and the roles to sustain and improve with updated standards, updated technologies, and the translation of new research evidence into practice. The team includes hospital and system informaticians, health policy advocates, and educators training health administrators and clinical professionals for these new informatics roles. The panel shares the upcoming steps to implement redesigned processes and technologies in critical access hospitals within the EHR

- Jane Brokel, The University of Iowa
- Donald Crandall, Trinity Health
- Tammy Schwichtenberg, Mercy Medical Center - North Iowa
- Scott Henderson, Mercy Medical Center - North Iowa

Nursing Informatics Posters

Poster Session One
Tuesday, May 22, 2007, 3:30 pm - 5:00 pm

Development of a Registry to Improve Infection Control Efficiency, Brian Dixon, Regenstrief Institute

Automate a Sustainable Approach to Succeeding with Quality, Regulatory, and Pay for Performance Initiatives, Linda Greene, Covenant Health

Patient-assisted Syndrome Screening During Primary Care Visits, Dexter Klock, Klockwork, Inc

Expanding the Role of Nurses into Triage Software Algorithm Programming: Nurse Experience with Mayo Clinic Health Solutions Triage Algorithm Development, Barbara Kreinbring, Mayo Clinic

Making speech recognition work even in high ambient noise environments, Peter Mitchell, University of Miami

Medication Reconciliation: Institutional Implementation and Evaluation of One Surgical Unit, Cynthia Murphy, UTMDACC

Integrating On-line Patient Safety Reporting into Nursing Practice, Debora Martoccio, University Community Hospital & Donna Scott, SafeCare Systems, Div of Apptis, Inc.

What are Nurse Wages in California?: Comparing Acute Care Wages Across the State's Regions, Michelle Tellez, University of California San Francisco

Metadata Registries with Nursing Terminology, Virginia Saba, Sabacare & Luann Whittenburg, University of Maryland

Poster Session Two
Wednesday, May 23, 2007, 3:30 pm - 5:00 pm

Impact of Two Prototype Clinical Information Displays on ICU Nurses? Oxygenation Management, Judith Effken, University of Arizona

Strategies to improve adoption of nursing information technology: A nursing informatics and nursing leader partnership, Linda Dietrich, University of Colorado

Blue Sky: Developing Technology-enhanced Chronic Care Management for Teens with Depression, Susan Kossman, University of Wisconsin-Madison

Standardizing Hand-off Communication Using Voice Technology, Kathy A. Mikos, Provena Saint Joseph Medical Center

Variability of Triage Nurse Disagreement with Software Recommendations for Triage, LeTesha Montgomery, MayoClinic Health Solutions

Evaluation of Nursing-specific Drug Information References for PDAs, Hyla Polen, CVS/Pharmacy

Easy Production of Self Paced EMR Nurse Training Systems, Edward Stern, NothingBetter Healthcare Team

Triage Nurse Disagreement with Algorithm Generated Triage Conclusions - Useful Variation to Guide Algorithm Quality Improvement, Darlene Vsetecka, Mayo Clinic