• Nursing-IT

    By Cathy Fant 
    Google+ Profile


    In 2008, just 4 years after the launch of Kaplan University's School of Nursing, a monumental initiative was undertaken by the Robert Wood Johnson Foundation and the Institute of Medicine to evaluate and transform nursing. The purpose of the initiative was to produce a report that would make recommendations for changes within the nursing profession as it moved into the twenty-first century. Four critical points were developed:

    • Nurses should practice to the full extent of their education and training.
    • Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression. 
    • Nurses should be full partners, with physicians and other health care professionals, in redesigning health care in the United States.
    • Effective workforce planning and policy-making require better data collection and information infrastructure (Institute of Medicine, 2011).

    As we celebrate 10 years of online nursing education at Kaplan University, we recognize the imperative, as a profession, to achieve these goals and understand the important role nurse leaders have to play as we move forward in the twenty-first century and this era of great technological change. Technology is becoming more fully integrated into health care, and nurses must be full partners as decisions are made regarding the implementation of information technologies (IT). Nurses at all levels of leadership should appreciate the critical role they play in ensuring nursing systems meet their requirements. As a consequence, nurses must be in a position to "champion" the system requirements for nursing care and also understand the value of these nursing documentation systems. 

    IT is Critical to Nursing's Future

    Before the nursing profession can fully facilitate this valuing and acceptance, it must understand why IT is critical to nursing and the changes that are occurring in health care. Without this knowledge and appreciation, nurses will not have a major role when technological decisions are being made. Furthermore, nurses must be aware of the political environment in which decisions are being made, and how they can best position themselves to ensure their ability to provide optimal care. If nurses aren't "at the table" when decisions are made, they will be in a reactive position rather than a proactive role.

    Advanced Practice Nurses Need to be Competent in Information Management

    An important complement to this process of involvement is ensuring that nurses have a level of competency in information management in order to promote the importance of nursing systems through the selection to evaluation process for new information systems and processes. Technology competencies for nurses are outlined in several documents, including the American Nurses Association's Nursing Informatics: Scope and Standards of Practice, Technology Informatics Guiding Education Reform (TIGER) nursing informatics competencies, and the American Organization of Nurse Executives (AONE) executive competencies. Depending on the role of the nurse, the competencies will vary, and there may be overlaps. As one moves toward an informatics role, the competencies become more technical. Nevertheless, advanced practice nurses (APNs) need to understand and appreciate the many concepts outlined in the different organizations' competencies. 

    As nurse leaders, it is important to maintain the knowledge necessary to function effectively in this changing health care arena. In this environment, because of the importance of technology, APNs should be strongly encouraged to practice to the full extent of their education. Depending on the particular role of the APN, either in a management or a technical informatics role, the level of education that is required will vary. Nurses in management positions require the education that will maximize their ability to lead and support the staff in the utilization of information technologies; this often entails seeking advanced degrees. 

    Activities to Support and Enrich IT for APNs

    There are many other activities that can support and enrich the knowledge of IT for APNs in management roles. These can include attending training sessions, which also makes them visible to the staff showing their support for the systems, becoming superusers, attending informatics conferences, reading informatics journals, taking computer courses, and/or joining an informatics association, such as Healthcare Information and Management Systems Society (HIMSS) or American Nursing Informatics Association (ANIA). More technical roles may require an advanced nursing degree like a Master of Science in Nursing (MSN) with an informatics specialization or a non-nursing degree like a Master of Health Information Management (MHIM) or Master of Health Informatics (MHI).

    APNs as Change Agents

    Change is ongoing in our health care world as the IT transformation occurs. APNs can and should play a key role as change agents in the process. Change evokes many emotions, from negative to positive. Much of the attitudes of the staff can be traced back to how the individuals perceive change and technology. It is important to understand the concerns of the staff as they are facing change. As a change agent the nurse should create an environment that promotes change-one in which the change will be seen as beneficial to the staff. This includes empowering the staff to have a significant role in the change endeavor, which in turn can significantly reduce any anxiety related to change. Consequently, this should make the change process move forward more smoothly and with greater acceptance.

    Evidence-Based Practice and Data Analytics

    Data analytics are becoming more critical as organizations place greater emphasis on evidence-based practice. Data are analyzed to measure the benchmarks for metrics that in turn will facilitate positive patient outcomes. For example, hospital readmissions are a metric that is receiving a great deal of attention for reimbursement of care. Analysis of the data can produce a better understanding of why readmissions are occurring. This in turn can reduce these rates and guide more effective patient follow-up.

    Nurses produce a significant amount of data as they document events in a patient's electronic health record (EHR). They are increasingly being required to transform data into "wisdom" that then can be applied to facilitate positive patient outcomes. The management of these data is an important role for APNs. Given analytic tools, nurses can transform data into information by collecting and organizing it. Interpreting the data produces knowledge, which can be integrated to gain wisdom. Wisdom encompasses the application and understanding of this knowledge resulting in actions that can be used to manage human problems (Englebardt & Nelson, 2002).

    Nursing Leaders: A Critical Part of IT Transformation

    Advanced practice nurses have many opportunities to assume leadership roles as this IT transformation evolves, because nursing is at the center of all these changes. All IT "touches" nursing. Unless nursing is willing to step up and participate in these changes, it will find itself reacting to the decisions of others.

    Tell Us What You Think!

    What do you think nurse leaders should do in an increasingly technology-driven health care world? Follow the Kaplan University School of Nursing on Twitter and Facebook and let us know what you think about the role of nurse leaders and technology. We'd love to hear from you.

    Twitter: @kaplanunursing

    Facebook: http://www.facebook.com/kaplannursing




    Englebardt, S. & Nelson, R. (2002). Health Care Informatics: An Interdisciplinary Approach. St. Louis, MO:

    IOM (Institute of Medicine). 2011. The Future of Nursing: Leading Change,Advancing Health. Washington, DC: The National Academies Press. Retrieved from http://thefutureofnursing.org/sites/default/files/Future%20of%20Nursing%20Report_0.pdf.

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