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Clinical information system (CIS)
- - Array or collection of applications and functionality; amalgamation of systems,
- medical equipment, and technologies working together that are committed or
- dedicated to collecting, storing and manipulating healthcare data and
- information and providing secure access to inter-disciplinary clinicians
- navigating the continuum of cient care; designed to collect patient data in real time to enhance care by providing data at the clinician's fingertips and enabling
- decision making where it needs to occur, at the bedside; also known as clinical
- documentation systems.
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Clinical decision support (CDS)
- A computer based program designed to assist clinicians in making clinical
- decisions by filtering or integrating vast amounts of information, and
- providing suggestions for clinical intervention. May also be called a clinical decision support system (CDSS)
- .
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Evidence-based practice (EBP)
Nursing practice that is informed by research generated evidence of best practices. "The conscientious, explicit and judicious use of theory-derived, research-based information in making decisions about care delivery to individuals or groups of patients and in consideration of individual needs and preferences”of clinical expertise and best practices based on systematic research to enhance decision-making and improve patient care; "evidence-based nursing is the process by which nurses make clinical decisions using the best available research evidence, their clinical expertise, and patient preferences.
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Three areas of research competence are:
interpreting and using research, evaluating practice, and conducting research
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Nursing informatics (NI)
- A specialty that integrates nursing science, computer science, and information
- science to manage and communicate data, information, knowledge and wisdom in nursing practice; Nursing informatics facilitates the integration of data,
- information, and knowledge to support patients, nurses, and other providers in
- their decision-making in all roles and settings. This support is accomplished
- through the use of information structures, information processes, and
- information technology; “a specialty that integrates nursing science, computer
- science, and information science to manage and communicate data, information,
- and knowledge” synthesis of nursing science, information science, computer science and cognitive science to facilitate the management of healthcare data for the improvement of patient care and advancement of the nursing profession
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Nursing knowledge
- A body of facts accumulated over time from experience, education, and research
- that are used to make nursing decisions. “simultaneously the laws and
- relationships that exist between the elements that describe the phenomena of
- concern in nursing (factual knowledge) and the laws or rules that the nurse
- uses to combine the facts to make clinical nursing decisions
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Research utilization (RU)
The process of moving new understandings generated in research into practice.
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Nurses in identified informatics roles typically focus their efforts on:
- a) articulating meaningful clinical nursing data and information structures that
- can be codified and processed
b) identifying the information processes associated with nurses’ work
c) determining ways in which information and communication technologies can be most effectively utilized to support the capture, retrieval, and use of data, information, and knowledge.
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The umbrella of “health” informatics suggests that
the informatics work being done by nurses must fit within the context of the “whole system”.
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Health service organizations, societies, and governments throughout the industrialized world are obsessed with assuring that healthcare delivery is:
a)safer
b) knowledge-based
c) cost-effective
d) seamless
e) timely
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Nurse Knowledge Workers
Studies have identified that depending upon the setting, nurses spend anywhere between 25-50% of their day managing and recording clinical information and seeking knowledge to inform their practice
- *It could be suggested that as knowledge workers, nurses are also, albeit
- unwittingly, informaticians to a large extent. With the advent of clinical information systems (CIS), specifically electronic documentation and clinical decision support (CDS) applications, every nurse has the capacity to be contributing to the advancement of nursing knowledge on many
- different levels.
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Graves and Corcoran (1989) suggest that nursing knowledge is
- is “simultaneously the laws and relationships that exist between the elements that describe the phenomena of concern in nursing (factual knowledge) and the laws or rules that the nurse uses to combine the facts to make clinical nursing
- decisions”
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Empirics
- –access to factual knowledge derived from repositories of aggregated clinical
- research findings and integrated with the CIS
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Esthetics
– access to multicultural practices and beliefs.
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Personal
– access to a personal repository of clinical experiences and reactions.
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Ethics
- –access to standards of ethical practice, but also access to experts in the
- field of moral reasoning to guide interaction.
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•Nurses must be
involved in the process
•Nurses
should :
- Be encouraged and supported to participate in the acquisition, design,
- implementation, and evaluation phases of CIS.
Demand the adoption of IT solutions that support the delivery of safe, quality care.
Be provided with material and people resources to support their acquisition of informatics competencies
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