Nursing Informatics: A Historical View

• Historical Perspective in Nursing Informatics

Historical Perspective

• More than 150 years ago, Florence Nightingale emphasized the importance of using accurate data for decision-making in patient care.
• The first hospital information systems appeared in the late 1950s to mid-1960s, focusing on financial and administrative data.
• In 1965, the American Hospital Association conferences signaled a move towards clinical adaptations of systems in healthcare.
• The advent of the silicon chip in the 1970s shifted focus from large supercomputers to smaller personal computers for hospital applications.
• Computers were being used for diverse hospital functions like radiology, pharmacy, and laboratories by the 1980s.
• There was a strong drive within healthcare to understand how clinicians would use the new tools to advance practice.
• In the 1990s, as nurses used computers to improve patient care and conduct research, the use of computers expanded.
• The American Nurses Association (ANA) set recent standards of nursing informatics practice in 2001.
• This included practice applications involving computers, controversies surrounding nomenclature, the use of decision support systems, and nursing perspectives on the value of information systems in patient care.

Evolving Definitions of Nursing Informatics

• In 1980, it was defined as nurses interacting with technology to produce greater knowledge. It also included the role of nurses specializing in developing technology applications for nursing practice.
• In 1989, Graves and Corcoran defined it as the combination of nursing science, information science, and computer science to manage and process nursing data, information, and knowledge to support nursing practice and care delivery.
• In 1992, It was defined as a specialty integrating nursing science, computer science, and information science to identify, collect, process, and manage data and information. This was to support nursing practice, administration, education, and research, as well as expand nursing knowledge.
• In 1994, it was specified that nursing informatics supports nursing specialties in all sites and settings, involving the development of applications, tools, processes, and structures to assist nurses in managing data for patient care and nursing practice support.
• In 2001, it was defined as a specialty integrating nursing science, computer science, and information science to manage and communicate data, information, and knowledge in nursing practice.
• The goal of nursing informatics is to improve the health of populations, communities, families, and individuals by optimizing information management and communication, including the use of technology in care provision, administrative systems, educational experiences, life-long learning, and nursing research.

Standards for Practice (Informatics Competencies)

• Computer literacy skills: Basic computer skills for using word processors, accessing databases, creating spreadsheets, communicating via email, and interacting with clinical documentation systems.
• Information literacy skills: The ability to recognize the need for information and the skill to access, evaluate, and interpret information correctly.
• General informatics competencies: Identifying, collecting, and recording data relevant to patient care, analyzing and interpreting patient/nursing information, using informatics applications as an integral part of nursing, and implementing policies on privacy, confidentiality, and security.
• According to the ANA (2001), informatics nurse specialists move into a practice specialty with organized and recognized standards. These standards mirror the traditional nursing process.
• The ANA (2001) standards mirror the traditional nursing process, and include: assessment, diagnosis, identification of outcomes, planning, implementation, and evaluation.

Recognized Terminologies Supporting Nursing Practice

• 13 languages are recognized by the American Nurses Association (ANA) as classification systems uniquely developed to document the entire process of clinical care for patients.
• NANDA—nursing diagnosis, definition, and classification
• NIC—Nursing Interventions definitions, and classifications
• HHCC—Home Health
• OMAHA system
• NOC—Nursing Outcomes Classification
• NMMDS—nursing management minimum data set
• PCDS—patient care data set
• PNDS—peri-operative data set
• SNOMED CT
• NMDS—nursing minimum data set
• ABC codes
• ICNP—International Classification for Nursing Practice
• LOINC - Logic Observation Identifiers Names And Codes