Extending TIGER Education Collaborative: Informatics Content in Doctorate of Nursing Practice (DNP) Programs. Cathy R. Fulton, ANP-BC, FNP-BC



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Extending TIGER Education Collaborative: Informatics Content in Doctorate of Nursing Practice (DNP) Programs Cathy R. Fulton, ANP-BC, FNP-BC DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.

Conflict of Interest Disclosure Cathy Fulton, ANP-BC, FNP-BC Has no real or apparent conflicts of interest to report. 2012 HIMSS

Learning Objectives: 1. Examine the link between TIGER Phase II goals of impacting nursing education programs and accreditation criteria programs set by the NLN and AACN. 2. Describe different ways that DNP programs are nationally implementing nursing informatics content to address AACN Essential IV criteria for the DNP. 3. Identify the percentage of DNP programs that are (and are not) overtly including nursing informatics content in their curriculum based on a descriptive study conducted as part of Phase III outcomes assessment for the TIGER Initiative.

TIGER: ORIGINAL VISION* Allow informatics tools, principles, theories and practices to be used by nurses, other interdisciplinary providers and consumers Interweave enabling technologies transparently into practice, education and research to improve outcomes, patient safety and reduce costs of healthcare Better preparing workforce to use technology and informatics for improvement of patient care * TIGER Initiative Foundation Board in process of refreshing the vision to include Interprofessional and Emerging Science (related to Comparative Effectiveness and other related research)

TIGER Phases I and II TIGER Phase I Engaged practice, education, industry, organizational and federal stakeholders to create a common vision of Health IT enabled practice, education, research and policy in an Invitational Symposium in 2006. TIGER Phase II Facilitated collaboration among participating organizations to achieve the vision and strategic plan through development of nine collaborative reports involving over 1500 nurses nationally bringing expertise from all types of practice, education, research and policy.

TIGER Phase III Integrate interdisciplinary & allied health professionals into efforts Disseminate reports and increased TIGER diffusion through TIGER presentations and major publications (such as Nursing Informatics: Where Technology & Caring Meet) Develop vision and partnerships for a Virtual Learning Environment to enhance adoption of Health IT Added emphasis on research such as CER Paved the way for successfully launching the TIGER Initiative Foundation established as of July, 2011.

TIGER Phase III Vision: Built on TIGER Phases I & II Linking Phase II Outcomes to Virtual Learning Environment (VLE), Invitational Interdisciplinary Symposium and Longer Term Implications for Comparative Effectiveness and Personalized Medicine Nine Collaboratives from Phase II: 1.Informatics Competencies 2.Education and Faculty Development 3.Staff Development 4.Leadership 5.Usability and Clinical Design 6.Standards and Interoperability 7.Health IT Policy 8.Virtual Demonstration Center (now VLE) 9.Consumers and Personal Health Record (PHR)

Informatics Competencies Collaborative Component of the Model Standard Source (Standard-Setting) Body Basic Computer Competencies European Computer Driving License European Computer Driving License Foundation Information Literacy Information Management Information Literacy Competency Standards Electronic Health Records Functional Model Clinical Care Components International computer Driving License - Health American Library Association Health Level Seven (HL7) European Computer Driving License Foundation

TIGER Phase III Vision: Built on TIGER Phases I & II Linking Phase II Outcomes to Virtual Learning Environment (VLE), Invitational Interdisciplinary Symposium and Longer Term Implications for Comparative Effectiveness and Personalized Medicine Nine Collaboratives from Phase II: 1.Informatics Competencies 2.Education and Faculty Development 3.Staff Development 4.Leadership 5.Usability and Clinical Design 6.Standards and Interoperability 7.Health IT Policy 8.Virtual Demonstration Center (now VLE) 9.Consumers and Personal Health Record (PHR)

Collaborative Report Co-Chairs: Drs. Mary Anne Rizzolo & Diane Skiba Website: http://www.tigersummit.com/education_ne w.html

Goals for the Collaborative Team Describe the work of the faculty development and education collaborative Examine the impact of the collaborative in nursing education and practice

Collaborative Goals Use the informatics competencies, theories, research, and practice examples throughout nursing curriculum Create programs and resources to develop faculty with informatics knowledge, skill and ability and measure the baseline and changes in informatics knowledge among nurse educators and nursing students Develop a task force to examine the integration of informatics throughout the curriculum. Develop strategies to recruit, retain, and educate current and future nurses in the areas of informatics education, practice, and research

Background One way for TIGER to achieve these Goals: Impact accreditation and regulatory groups to achieve: - Computer Literacy Knowledge and Skills - Information Literacy Knowledge and Skills - Informatics Knowledge and Skills

National League of Nursing (NLN) In May 2008, the NLN released a critical position statement "in support for reform of nursing education to promote quality education that prepares a workforce capable of practicing in a healthcare environment where technology continues to increase in amount and sophistication. http://www.nln.org/newsreleases/informatics_relea se_052908.htm

American Association of Colleges of Nursing (AACN) AACN was the first organization to include informatics as an essential element of Baccalaureate and DNP education. Further information about the Essentials of Baccalaureate Education can be accessed at: http://www.aacn.nche.edu/education/bacessn.htm

AACN s Doctorate of Nursing Practice Essential IV DNP graduates are distinguished by their abilities to use information systems/technology to support and improve patient care and healthcare systems, and provide leadership within healthcare systems Knowledge and skills related to information systems/technology and patient care technology and/or academic prepare settings. the DNP graduate to apply new knowledge, manage individual and aggregate level information, and assess the efficacy of patient care technology appropriate to a specialized area of practice.

AACN s Doctorate of Nursing Practice Goals for DNP Graduates Essential IV: Information Systems/Technology and Patient Care Technology for the Improvement and Transformation of Health Care 1. Design, select, use and evaluate programs the evaluate and monitor outcomes including consumer use 2. Analyze and communicate critical elements in selection, use and evaluate HIT

AACN s Doctorate of Nursing Practice Goals for DNP Graduates 3. Demonstrate conceptual ability and technical skills to develop and execute an evaluation plan including data extraction 4. Provide leadership in resolution of ethical issues related to use of HIT 5. Evaluate health information sources for accuracy, timeliness, and appropriateness.

Pilot Study The purpose of the pilot study was to assess and describe the inclusion of informatics content in DNP curricula nationally. 124 DNP programs were identified nationally from the AACN website as accepting DNP students in March, 2010.

Pilot Study Design - Process 1. Identify the current DNP programs from the AACN website http://www.aacn.nche.edu/dnp/dnpprogramlist.htm. 2. Survey the school websites of the DNP programs to construct an Excel table. 3. Table to include: Institutions, course name, course instructor, DNP program contact information, offer specialty in informatics yes/no, required course yes/no. 4. Email sites if unable to determine integrated informatics content. 5. Call site contact as identified on the AACN website if no response to email.

Study Design - Process 1. Rogers Diffusion Theory was the organizing framework. 2. Developed survey questions with input from TIGER leaders. 3. Consulted three nursing informatics leaders to establish content validity and revised survey based on their responses. 4. Piloted survey using three academic leaders at three educational institutions and revised survey based on their responses. 5. Identified the current DNP programs from the AACN website http://www.aacn.nche.edu/dnp/program-schools 6. Distributed the survey electronically to all current DNP Program Directors and followed up weekly with email/telephone reminders.

Survey Results Response Rate 81.2% valid response rate 138 DNP Program Directors/Chairs of national educational institutions identified 117 representatives responded 3 educational institutions had two responders 2 schools were not included in the survey as they were not accredited or seeking accreditation at the time Sample Characteristics Type of educational institution 50% are employed by Academic Health Sciences Centers 25.0% are employed by private liberal arts schools/universities 22.3% are employed by public state institutions Size of nursing faculty 29.5% have 41-60 faculty members 23.2% have 21-40 faculty members 21.4% have 81+ faculty members

WHEN DNP DEGREE WAS FIRST OFFERED

Type of DNP Program Offered

Type of applicants accepted into DNP programs

Accreditation Status

Institutional Response: Faculty Characteristics 1. 55.4% have Nursing Informatics Certified Faculty or Master s Informatics Prepared Faculty 2. 44.6% do not have or are not sure if there are Nursing Informatics Certified Faculty, Master s Informatics Prepared Faculty However, 70% identified an Informatics Champion 3. 51% understand the AACN Essential IV requirement 4. 83% understand nursing informatics is NOT only about the use of technology for distance learning 5. 83.9% Understand the definition of nursing informatics

Nursing Informatics Certified or Informatics Master s Prepared Faculty Of the 55.4% (institutions) reporting Nursing Informatics Certified Faculty or Master s Informatics Prepared Faculty 28.6% reported one faculty member 13.4% reported two faculty members 8.9% reported three faculty members 4.5% reported 4 or more faculty members 44.6% reported no nursing informatics certified or informatics master s prepared faculty*

Nursing Informatics Courses Offered

Institutions Reporting: Nursing Informatics- Related Courses Offered 33 report no courses offered-29.5% 44 report one course offered-39.3% 14 report two courses offered-12.5% 6 report three courses offered-5.4% 15 report four or more courses offered-13.4%

Informatics Courses Required vs. Elective 44.6% of DNP Programs have no required nursing informatics courses 36.6% of DNP Programs have one required nursing informatics course 11.6% of DNP Programs have two required nursing informatics courses 5.4% of DNP Programs have three required nursing informatics courses.9% of DNP Programs have four required nursing informatics courses.9% of DNP Programs have five required courses

Acknowledgements for Pilot Project Naomi K. Mutea MSN, RN, DNP student, Third Author Sally Schlak MBA, RN, Second Author Patricia Hinton Walker PhD, RN, FAAN, PCC, Chair of TIGER Josette Jones PhD, RN, Instructor for Nursing Informatics Sally Schlak MBA, RN

Acknowledgements for Inquiry Project Julie Meek PhD, RN Patricia Hinton Walker PhD, RN, FAAN, PCC, TIGER Initiative Foundation-Senior Advisor Deborah Stiffler PhD, RN Mikyoung Lee PhD, RN Stephanie Dickinson, IU Department of Statistics Hugh Jessop HSD, Director of the Indiana University Health Center and Staff

Summary of Content Covered: 1. Examine the link between TIGER Phase II goals of impacting nursing education programs and accreditation criteria programs set by the NLN and AACN. 2. Describe different ways that DNP programs are nationally implementing nursing informatics content to address AACN Essential IV criteria for the DNP. 3. Identify the percentage of DNP programs that are (and are not) overtly including nursing informatics content in their curriculum based on a descriptive study conducted as part of Phase III outcomes assessment for the TIGER Initiative.

Extending TIGER Education Collaborative: Informatics Content in Doctorate of Nursing Practice (DNP) Programs Cathy R. Fulton, ANP-BC, FNP-BC catrsmit@indiana.edu DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.