National Nursing Informatics Deep Dive Program
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1 National Nursing Informatics Deep Dive Program Integrating AACN Essentials, QSEN KSA s and TIGER Competencies for Nursing Informatics Thomas R. Clancy, PhD, MBA, RN, FAAN Clinical Professor and Assistant Dean Faculty Practices, Partnerships and Professional Development November 19, 2014
2 Disclosure I have no relevant financial interest to disclose nor am I endorsing any commercial products identified in this presentation.
3 Workshop Objectives Discuss methods of integrating professional standards for nursing informatics into program curricula aimed at prelicensure nursing students. Explore various methods used to teach nursing informatics to prelicensure students. Provide nursing informatics resources and tools that can be easily incorporated into existing prelicensure program curricula.
4 Presentation Objectives Discuss the Knowledge Complexity Framework as it relates to curriculum development for nursing informatics. Review the integration of The AACN Essentials for Information Management, The TIGER Competencies for Practicing Nurses and the QSEN knowledge, skills and attitudes for nursing informatics into a nursing informatics curriculum.
5 Information (Procedural) Knowledge Work Data statistics, financial data, metrics procedures, standards, user guides, specifications, regulations, audits, filing and classification, order processing Knowledge (Functional) Meaning (Managing) Philosophy (Systems) Wisdom (Renewing) Union workflow planning, priorities, graphs, engineering, historical data, tracking, database design & management business plans, goals, objectives, budgets, resources, roles, culture, managing variables, developing projects strategic planning, systemic mapping, competitive analysis, market forecasts values, vision, future trends social, environmental & global issues, activism, ecological values work 2002 Verna Allee, used with permission
6 Key 1. Classroom Activities 2. Simulation Activities 3. Clinical Activities 4. Syllabus 5. Readings 6. Assignments Knowledge Complexity Curriculum Framework DATA (Instinctual Learning) Sensing Sample Crosswalk Between AACN BSN Essentials/ Knowledge Framework/Semester INFORMATION (Single Loop learning). Action without reflection KNOWLEDGE (Double Loop learning) Self-conscious reflection. MEANING (Communal learning) Understanding context, relationships & trends. PHILOSOPHY (Duetero learning) Self-organizing WISDOM (Generative learning) Value driven UNION (Synergistic) Connection FALL FRESHMAN YEAR ICL, 1,5,6 ICL, 1,5,6 SPRING FRESHMAN YEAR ICL, 1,5,6 ICL, 1,5,6 FALL SOPHOMORE YEAR SPRING SOPHOMORE YEAR FALL JUNIOR YEAR SPRING JUNIOR YEAR ICL, PCT, CIS, CD, CDS, SNT, 1,2,4,5,6 ICL, PCT, CIS, CD, CDS, SNT, 1,2,4,5,6 ICL, PCT, CIS, CD, CDS, SNT, CL, HIPAA, CI 1,2,3,4,5,6 ICL, PCT, CIS, CD, CDS, SNT, CL,CI, HIPAA 1,2,3,4,5,6 ICL, PCT, CIS, CD, CDS, SNT, 1,2,4,5,6 ICL, PCT, CIS, CD, CDS, SNT, 1,2,4,5,6 ICL, PCT, CIS, CD, CDS, SNT, CL, HIPAA, CI 1,2,3,4,5,6 ICL, PCT, CIS, CD, CDS, SNT, CL, HIPAA, CI 1,2,3,4,5,6 ICL, 1,2,4,5,6 ICL, PCT, CIS, CD, CDS, SNT, 1,2,3,4,5,6 ICL, PCT, CIS, CD, CDS, SNT, CL, CI, HIPAA, 1,2,3,4,5,6 ICL 1,2,3,4,5,6 ICL, PCT, CIS, CD, CDS, SNT, 1,2,3,4,5,6 FALL SENIOR YEAR ICL, PCT, CIS, CD, CDS, SNT, CL, HIPAA, WA, 1,3,4,5,6 ICL, PCT, CIS, CD, CDS, SNT, CL, HIPAA, WA 1,3,4,5,6 ICL, PCT, CIS, CD, CDS, SNT, CL, HIPAA, WA, 1,3,4,5,6 ICL, PCT, CIS, CD, CDS,, SNT, CL,HIPAA, WA,, 1,3,4,5,6 ICL, PCT, CIS, CD, CDS, SNT,,1,3,4,5,6 SPRING SENIOR YEAR ICL, PCT, CIS, CD, CDS, SNT, CL, HIPAA, WA,1,3,4,5,6 ICL, PCT, CIS, CD, CDS, SNT, CL, HIPAA, WA, 1,3,4,5,6 ICL, PCT, CIS, CD, CDS, SNT, CL, HIPAA, WA1,3,4,5,6 ICL, PCT, CIS, CD, CDS, SNT, CL, HIPAA, WA 1,3,4,5,6 ICL, PCT, CIS, CD, CDS, SNT, CL, HIPAA, WA 1,3,4,5,6
7 Standards and Guidelines AACN Essentials for Information Management And Patient Care Technologies Quality, Safety & Education for Nurses Knowledge, Skills and Attitudes Technology Informatics Guiding Education Reform Competencies for Practicing Nurses
8 AACN Essentials for Baccalaureate Education For Professional Nursing Practice Information Management and Application of Patient Care Technology AACN Essentials I. Liberal Education for Baccalaureate Generalist Nursing Practice II. Basic Organizational and Systems Leadership for Quality Care and Patient Safety III. Scholarship for Evidence Based Practice IV. Information Management and Application of Patient Care Technology V. Healthcare Policy, Finance, and Regulatory Environments VI. Inter-professional Communication and Collaboration for Improving Patient Health Outcomes VII. Clinical Prevention and Population Health VIII. Professionalism and Professional Values IX. Baccalaureate Generalist Nursing Practice
9 Course by AACN Essential Sample Crosswalk Between AACN BSN Essentials for Information Management and Patient Care Technologies and Curriculum Key 1. Classroom Activities 2. Simulation Activities 3. Clinical Activities 4. Syllabus 5. Readings 6. Assignments 1.0 Demonstrate skills in using patient care technologies, information systems, and communication devices that support safe nursing practice. 2.0 Understand the use of CIS (clinical information systems) to document interventions related to achieving nurse sensitive outcomes. 3.0 Advocate for the use of new patient care technologies for safe, quality care 4.0 Use telecommunication technologies to assist in effective communication in a variety of healthcare settings. FALL SOPHOMORE YEAR NURS 3703 Assessment and Basic Nursing (lab I) NURS 3801PCC Adults/Older Adults I or NURS 3802 Nursing Care of Families I (1/2 Class in each) NURS 3806 Professional Nursing NURS 5010 Foundations of Interprofessional Communication/Collaboratio n 1,2,4,5,6 1,2,4,5,6 1,5 1,5 1,5 1,5 1,5 1,5 1,5 1,5 1,2,4,5,6 1,2,4,5,6 1,5 1,2,4,5,6
10 AACN Essentials For Information Management and Application For Patient Care Technology 1.Demonstrate skills in using: patient care technologies, information systems and communication devices that support safe nursing practice.
11 AACN Patient Care Technologies Patient Care Technologies Computers, printers IV smart pumps, Bar coded medication management systems, Pulse oximeters, Automated blood pressure and pulse Monitoring equipment (ECG, arterial blood pressure, respirations) Automated temperature Defibrillators AACN Sample Content Use of patient care technologies
12 AACN Communication Devices Communication Devices Smart phones, Hands free mobile communication devices (Vocera), Tablets (ipads) Quantified Self
13 AACN Information Systems Operations Support Basic computer hardware and software Software (spread sheets, , word processing, databases) Core Systems Admission, discharge, transfer Financial systems Order entry system Ancillary systems (lab, pharmacy, radiology) Results reporting systems Documentation systems Administrative systems (scheduling) Sample AACN Content Computer skills that may include basic software, spreadsheet, and healthcare databases.
14 QSEN Attitudes Appreciate the necessity for all health professionals to seek lifelong, continuous learning of information technology skills Knowledge Explain why information and technology skills are essential for safe patient care Skills Seek education about how information is managed in care settings before providing care.
15 Technology Informatics Guiding Education Reform (TIGER) Informatics Competencies for Every Practicing Nurse: TIGER Competencies European Computer Driving License Basic Computer Competencies 1.1 Hardware 1.2 Software 1.3 Networks 1.4 Information/communication tech. 2.1 Operating systems 2.2 File Mgt 2.3 Utilities 2.4 Print Mgt 3.1 Using the Application 7.1 The Intranet 7.2 Using the browser 7.3 Using the Web 7.4 Web outputs
16 AACN Essentials For Information Management and Application For Patient Care Technology 2. Understand the use of CIS (clinical information systems) to document interventions related to achieving nurse sensitive outcomes. Small, D. (2011). Patients First! Engaging the hearts and minds of nurses with a patient-centered practice model American Nurses Association On-line Journal of Issues in Nursing: Vol 16.
17 AACN Clinical Information Systems Clinical Information Systems Electronic health records in: Acute care Ambulatory care Skilled nursing care Home, public and community health systems Applications to manage care. Provider order entry Clinical documentation (assessment, care planning, other) Results reporting Bar coded medication administration (BCMA) Electronic medication administration record (emar) Ancillary systems (pharmacy, lab, radiology) AACN Sample Content Electronic health records/physician order entry.
18 QSEN Attitudes Appreciate the necessity for all health professionals to seek lifelong, continuous learning of information technology skills Knowledge Explain why information and technology skills are essential for safe patient care. Skills Document and plan patient care in an electronic health record. Navigate the electronic health record.
19 Technology Informatics Guiding Education Reform (TIGER) Informatics Competencies for Every Practicing Nurse: TIGER Competencies European Computer Driving License Information Management 1.0 Demographic 2.0 Consents 3.0 Medication Mgt 4.0 Planning care 5.0 Order results 6.0 Care documentation
20 AACN Essentials For Information Management and Application For Patient Care Technology 3. Advocate for the use of new patient care technologies for safe, quality care
21 Emobile Health Telehealth Patient Engagement/Personal Health Records Social Media Predictive analytics and Big Data Robotics Nano-technology and 3D computing 3D Printing Wearable Technology Science Roll, The Journey of a Geek Medical Futurist accessed Sept. 2, 2014: The Future is Here! Google Glasses
22 AACN Essential 4. Use telecommunication technologies to assist in effective communication in a variety of healthcare settings. Telecommunications Technologies: AACN Sample Content Technology for virtual care delivery and monitoring. Interstate practice regulations (e.g., licensure, telehealth). Information literacy
23 Telehealth Patient monitoring technologies (virtual assessments, ICU s) Home sensing devices (weight scale, BP monitor, bed chair, glucose meter, implant monitors, baby monitors, spirometer, medication monitoring, pedometer) Patient engagement Personal health records Health literacy Social networking AACN Essentials Telehealth Communication Technologies
24 QSEN Attitudes Appreciate the necessity for all health professionals to seek lifelong, continuous learning of information technology skills Knowledge Contrast benefits and limitations of different communication technologies and their impact on safety and quality Skills Employ communication technologies to coordinate care for patients.
25 Technology Informatics Guiding Education Reform (TIGER) Informatics Competencies for Every Practicing Nurse: TIGER Competencies European Computer Driving License Communication Technologies Basic Computer Competencies Electronic Communication 7.6 Using management Information Mgt Competencies 9.0 Facilitating Communications
26 AACN Essentials For Information Management and Application For Patient Care Technology 5. Apply safeguards and decision making support tools embedded in patient care technologies and information systems to support a safe practice environment for both patients and healthcare workers.
27 Safeguards and Decision Making Support Medication dosing support (medication pick lists, dosing calculators) Order facilitators (order sets for specific conditions based on evidence based guidelines: pneumonia, adult prosthetic hip replacement, myocardial infraction) Point of care alerts (drug to drug interactions, duplicate therapy, drug allergies, contraindications to specific conditions) Point of care reminders (immunizations, cancer screenings, fall prevention, pain management). Information displays (dashboards of relevant data) Courtesy of icare AACN Sample Content Use of technology and information systems for clinical decision-making. Technology and information systems safeguards
28 QSEN Attitudes Value technologies that support clinical decision-making, error prevention, and care coordination Knowledge Describe examples of how technology and information management are related to the quality and safety of patient care Skills Respond appropriately to clinical decision-making supports and alerts. Apply technology and information management tools to support safe processes of care.
29 TIGER Competencies Decision Support 7.1 Standard Assessments 7.2 Patient Context- Driven assessments 7.3 Identification of Potential Problems and Trends 7.4 Patient and Family Preferences 7.5 Standard Care Plans, Guidelines, and Protocols 7.6 Context-Sensitive Care Plans, Guidelines, and Protocols 7.7 Consistent Healthcare 7.8 Patient Groups or Populations 7.9 Research Protocols Relative to Individual Patient Care 7.10 Self-Care 7.11 Medication and Immunization Ordering 7.12 Drug Interaction Checking 7.13 Patient Specific Dosing and Warnings 7.14 Medication Recommendations 7.15 Medication and Immunization Administration 7.16 Non-Medication Ordering 7.17 Support for Result Interpretation 7.18 Referral Process 7.19 Referral Recommendations 7.20 Safe Blood Administration 7.21 Accurate Specimen Collection
30 AACN Essentials For Information Management and Application For Patient Care Technology 6. Recognize the role of information technology in improving patient care outcomes and creating a safe care environment. Big Data
31 Information Technology and Improving Patient Outcomes Benefits of Big Data Population management Cost benefit/effectiveness Best practices & EBG s Health analytics Descriptive Predictive Clinical research Comparative analysis Nurse sensitive quality outcomes Dashboards
32 AACN Essentials For Information Management and Application For Patient Care Technology 7. Use standardized terminology in a care environment that reflects nursing s unique contribution to patient outcomes.
33 Standardized Terminologies Multidisciplinary terminologies (SNOMED-CT, LOINC) Nursing terminologies (CCC, ICNP, NANDA, NIC, NOC, OS, PNDS) AACN Content Sample: Information management for patient safety.
34 QSEN Attitudes Value technologies that support clinical decision-making, error prevention, and care coordination Knowledge Identify essential information that must be available in a common database to support patient care Skills Use information management tools to monitor outcomes of care processes
35 Technology Informatics Guiding Education Reform (TIGER) Informatics Competencies for Every Practicing Nurse: TIGER Competencies European Computer Driving License Standardized Nursing Terminology Information Literacy 2.9 Understand how to use classification systems and their rationale.
36 AACN Essentials For Information Management and Application For Patient Care Technology 8. Evaluate data from all relevant sources, including technology, to inform the delivery of care.
37 Relevant Sources, Including Technology AACN Sample Content Retrieval from information systems, including access, evaluation of data, and application of relevant data to patient care. On-line literature searches Technological resources for evidence based practice
38 QSEN Attitudes Value technologies that support clinical decision-making, error prevention, and care coordination Knowledge Identify essential information that must be available in a common database to support patient care Skills Use high quality electronic sources of healthcare information.
39 Technology Informatics Guiding Education Reform (TIGER) Informatics Competencies for Every Practicing Nurse: TIGER Competencies European Computer Driving License Information Literacy Competencies 1. Knowledge 2. Access 3. Evaluate Information 4. Application of information 5. Evaluate Outcomes
40 AACN Essentials For Information Management and Application For Patient Care Technology 9. Apply patient-care technologies as appropriate to address the needs of a diverse patient population. Institute for Family Health Early adopter of the patient portal, introducing the Epic MyChart, MyHealth in 2007 and the Spanishlanguage version, MiRecord, MiSalud, in 2011.
41 Diverse Patient Populations The Institute implemented a robust patient portal that patients can use to: Send and receive secure messages Access and review clinical summaries Access and review their health information (medications, health history, allergies, current medication, lab and other test results) Download their medical record Create a wallet card that lists their medications Access MedlinePlus patient education resources, schedule appointments Request medication refills Specific programs to address health care needs in these communities: including education and support for people with HIV, a comprehensive diabetes program, school-based clinics, and clinics for the homeless.
42 AACN Essentials For Information Management and Application For Patient Care Technology 10. Recognize that redesign of workflow and care processes should precede implementation of care technology to facilitate nursing practice.
43 AACN Essentials For Information Management and Application For Patient Care Technology 11. Participate in evaluation of information systems in practice settings through policy and procedure development.
44 QSEN Attitudes Value nurses involvement in design, selection, implementation, and evaluation of information technologies to support patient care. Knowledge Recognize the time, effort, and skill required for computers, databases and other technologies to become reliable and effective tools for patient care
45 AACN Essentials For Information Management and Application For Patient Care Technology 12. Uphold ethical standards related to data security, regulatory requirements, confidentiality, and clients right to privacy. AACN Sample Ethical and legal issues related to the use of information technology, including copyright, privacy, and confidentiality issues
46 Technology Informatics Guiding Education Reform (TIGER) Informatics Competencies for Every Practicing Nurse: TIGER Competencies European Computer Driving License Basic Computer Competencies 1.10 Security 1.11 Law
47 Protect confidentiality of protected health information in electronic health records QSEN Attitudes
48 Information Management Systems as Enablers of BSN Essentials III. Scholarship for Evidence Based Practice The baccalaureate program prepares the graduate to evaluate the credibility of sources of information, including but not limited to databases and Internet resources. locating and evaluating sources of evidence electronic database search strategies (e.g., CINAHL, PubMed, the Cochrane Database of Systematic Reviews) IV. Information Management and Application of Patient Care Technology Baccalaureate graduates must have competence in the use of information technology systems, including decision support systems, to gather evidence to guide practice. Improvement of cost effectiveness and safety depend on evidence based practice, outcomes research, interprofessional care coordination, and electronic health records, all of which involve information management and technology (McNeil et al., 2006).
49 Questions?
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