Roles, Competencies, Skills, Organizations and Legislative Aspects Michelle R. Troseth, MSN, RN, DPNAP

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1 Objectives 1. Describe the history of nursing informatics as an emerging field in the nursing profession 2. Discuss evolving roles, competencies and skills impacting nursing informatics practice 3. Identify key nursing informatics organizations shaping nursing informatics impact in healthcare 4. Identify key nursing reports, journals and books shaping nursing informatics impact in healthcare 5. Describe key legislative aspects impacting nursing informatics Introduction This module provides an overview of the historical development of nursing informatics as well as critical factors shaping the profession (roles, competencies and skills) and landmark legislative acts providing future direction on the significance of nursing informatics. Each objective will be met by providing information and resources for nursing faculty and educators to incorporate into their respective school and health system curriculums. This is an exciting time as healthcare becomes digitalized and our healthcare system becomes a learning healthcare system, therefore, the roles, competencies and skills that nursing brings to integrate informatics into education and practice has never been more important. A key takeaway of this module is not only how to provide methods for integrating knowledge, skills and actions (KSAs) necessary for training nursing informatics competencies but how faculty, educators, students and practicing nurses can engage in the shaping of the future of nursing informatics as well as healthcare education and practice transformation.

2 Outline Module Objective Topic/Content Methods for Teaching Describe the history of nursing informatics as an emerging field in the nursing profession I. Decade of Nursing Informatics II. III. IV. Nursing Informatics Pioneers Nursing Informatics as an ANA Recognized Specialty Advancing Practice and Technology Lecture Discussion Activities Provide an overview of history of nursing informatics Introduce to ANA Nursing Informatics: Scope and Standards of Practice Describe nursing informatics evolution for the past five decades Describe the metastructures of data, information, knowledge and wisdom Why is advancing practice with technology so critical for the nursing profession? Assign students to view a Nursing Informatics Pioneer on the AMIA History Project website (Pioneer and/or Theme) Write reports Group discussion Interview a nurse informatics specialists in geographical area

3 Discuss evolving roles, competencies and skills impacting nursing informatics practice I. Overview of IOM s Core Competencies for Health Professionals II. III. IV. Evolving Competencies: QSEN, ANA and TIGER Introduction to Competencies for Interprofessional Collaborative Practice Electronic Health Record Vendor Applications V. Nursing Informatics Roles VI. Skills: Project Management & Polarity Management Lecture Informatics competencies and their relevancy to today s IOM competencies and rapid advancements in health information technology Provide examples of informatics competencies available (QSEN, TIGER, ANA) Introduce Interprofessional Education (IPE) competencies and relevancy to informatics Nursing informatics roles and emergence of informatics executive positions Discussion Describe different types of informatics competencies Describe the correlation between informatics and interprofessional competencies What are different nursing informatics roles today? The future? How can large scale transformational change benefit from project and polarity management skills? Describe experiences with living the upsides/downsides of the Technology Practice polarity? What is the correlation between Practice Based and Standards Based interoperability? Activities Read and reflect on IOM Report The Future of Nursing as it relates to

4 technology (paper/discuss) Read and reflect on the HIMSS Position Paper on Transforming Nursing Practice through Technology & Informatics (paper/discuss) Identify key nursing informatics organizations shaping nursing informatics impact in healthcare I. Key Nursing Informatics Organizations: HIMSS Nursing Informatics, ANIA, AMIA NIWG II. III. History and relevance of Alliance for Nursing Informatics (ANI) The TIGER Initiative Foundation Lecture Key organizations shaping nursing informatics Discussion How do nursing informatics organizations advance the specialty and nursing practice? Activities Compare and contrast the major nursing informatics organizations discuss/report Divide the organizations among students/participants and have them report back JOIN an organization! Download the TIGER Collaborative Reports and design learning activity all/select ones Explore the TIGER VLE select activities to participate in using VLE content/functionality Paper on international aspects of nursing informatics

5 Identify key nursing reports, journals and books shaping nursing informatics impact in healthcare I. Landmark IOM Reports that address the significant role of technology and healthcare transformation II. III. Key Nursing Informatics Books Key Nursing Informatics Journal Lecture IOM The Future of Nursing Report and its impact on nursing and technology Review current nursing informatics books and journals Intro to Social Media as a learning tool for informatics and trends Discussion What implications does the IOM Future of Nursing Report have on nursing practice? Why is technology important for nurses to expand their roles? What is the role of health information technology and patient safety? Describe ways that social media keeps nurses current on trends related to informatics and health information technology? IV. Nursing Informatics Social Media Activities Utilize Power of Ten book for group conversation (or other related book) Select a social media tool and find resources related to informatics/health information technology Select a journal article and provide report on pertinent topic

6 Describe key legislative aspects impacting nursing informatics I. American Recovery and Reinvestment Act (ARRA) and Health Information Technology for Economic and Clinical Health (HITECH) Act II. Meaningful Use Stages and Resources for current status Lecture Overview of ARRA HITECH Act Overview of Accountable Care Organizations (ACOs) Review of current state of the Meaningful Use journey and where it is heading Discussion What are legislative implications of HITECH for nursing? Describe the stages of Meaningful Use (1 2 3) What are ways nursing informatics is engaged with meeting Meaningful Use criteria? What are ways to stay current on National IT Initiatives? III. Accountable Care Organizations (ACOs) Activities Select a section on HHS ONC website to review and report content Paper on Meaningful Use and EHR Incentive Programs Paper on an article written on implications for nurses on HITECH Act Poster on Meaningful Use Stage 1 s impact on nursing Poster on Meaningful Use Stage 2 s impact on nursing

7 References and Resources Accountable Care Organizations (ACO) s. Fee for Service Payment/ACO/index.html?redirect=/ACO/ American Association of Colleges of Nursing American Association of Colleges of Nursing Essentials of Baccalaureate Education for Professional Nursing Practice American Nurses Association Nursing Informatics: Scope and Standards of Practice. Silver Spring. MD. Ball, MJ, Douglas, JV, et al (Eds). (2011) Nursing informatics: Where technology and caring meet (4 th Ed). London, Springer. Cheeseman, S. (2012). Information literacy: Using computers to connect practice to evidence. Neonatal Network. 31(4) Cheeseman, S. (2011). Are you prepared for the digital era? Neonatal Network. 30(4) Cronenwett, L., Sherwood, G., Barnsteiner J., Disch, J., Johnson, J., Mitchell, P., Sullivan, D., Warren, J. (2007). Quality and safety education for nurses. Nursing Outlook, 55(3) Delaney, C. & Gugerty, B. (2011). Competencies: Nuts & Bolts. In Ball, MJ, Douglas, JV, et al (Eds). Nursing informatics: Where technology and caring meet (4 th Ed)t. London, Springer.

8 EHR Incentive Program : and Guidance/Legislation/EHRIncentivePrograms/index.html?redirect=/EHRIncentivePrograms/30_Meaningful_Use.asp Elias, B., Moss, J., Anderson, C. & McCasky, T. Local Global Access: Virtual Learning Environment. In Ball, MJ, Douglas, JV, et al (Eds). Nursing informatics: Where technology and caring meet (4 th Ed). London, Springer. Farrell A. & Taylor, S. (2011). Electronic Health Record Vendor Applications. In Saba, V. & McCormick, K. (Eds.), Essentials of Nursing Informatics (5 th ed.), McGraw Hill Companies. HIMSS HIMSS 2011 Nursing Informatics Workforce Survey Full Results HIMSS HIMSS Nursing HIMSS Position Statement on Transforming Nursing Practice through Technology & Informatics Institute of Medicine (2012). Best care at lower costs: The path to continuously learning health care in America. (Pre publication copy). Washington, DC. National Academies Press. Institute of Medicine (2012). Health IT and patient safety: Building safer systems for better care. Washington, DC. National Academies Press. Institute of Medicine (2011). Digital infrastructure for the learning health system: The foundation for continuous improvement in health and health care. Washington, DC. National Academies Press.

9 Institute of Medicine (2010). The future of nursing: Leading change, advancing health. Washington, DC: National Academies Press. Institute of Medicine (2003). Health professions education: A bridge to quality. Washington, DC. National Academies Press. Johnson, B. (1996). Polarity management: Identifying and managing unsolvable problems. Amherst, Mass. HRD Press Inc. McBride, A. (2005). Nursing and the informatics revolution. Nursing Outlook. 53: Meaningful Use for updates go to: and Guidance/Legislation/EHRIncentivePrograms/Meaningful_Use.html Murphy, J. & Dykes, J. (2011). Healthcare Project Management.. In Saba, V. & McCormick, K. (Eds.), Essentials of Nursing Informatics (5 th ed.), McGraw Hill Companies. Murphy, J, & Gugerty, B. (2006). Nurses in Project Management Roles. In Weaver, C., Delaney, C. Weber, P. & Carr, R. Nursing and informatics for the 21 st century: An international look at practice, trends and the future. HIMSS. Saba, V. & McCormick,K (Eds). (2011). Essentials of Nursing Informatics (5 th Ed). McGraw Hill Companies. Saba, V & Westra, B. (2011). Historical Perspectives of Nursing Informatics. In Saba, V. & McCormick, K. (Eds.), Essentials of Nursing Informatics (5 th ed.), McGraw Hill Companies. Technology Informatics Guiding Education Reform. (2007). The TIGER Initiative: Evidence and informatics transforming nursing: 3 year action steps toward a 10 year vision.

10 Technology Informatics Guiding Education Reform. (2009). The TIGER Initiative: Collaborating to integrate evidence and informatics into nursing practice and education: An executive summary. Technology Informatics Guiding Education Reform. (2009). Informatics competencies for every Practicing nurse: Recommendations from the TIGER collaborative. Troseth, M. (2011). The TIGER Initiative.. In Saba, V. & McCormick, K. (Eds.), Essentials of Nursing Informatics (5 th ed.), McGraw Hill Companies. Weaver, C., Delaney, C. Weber, P. & Carr, R. (2010). Nursing and informatics for the 21 st century: An international look at practice, trends and the future (2 nd Ed). HIMSS and AMIA. Wesorick, B., Troseth, M, and Cato, J. (2004) Intentionally Designed Automation Creates the Best Places to Work and Receive Care. Health Care Technology (Volume 2), Montgomery Research, Inc. Wesorick, B. & Fairfield, C. (2010). Technology to Transform Practice at the Point of Care. In N. Rollins Gantz (Ed). 101 global leadership lessons for nurses. Sigma Theta Tau International.

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