The Role of Nurse Informaticists in Healthcare

Nursing Informatics in Healthcare

The integration of technology in healthcare is increasingly embraced. The reasons for increased incorporation include the demonstrated benefits in improving patient outcomes, improving workflow, and reducing patient and healthcare professionals’ resistance to such innovations. The latter is attributed to the incorporation of information management and patient care technologies in nursing curricula, particularly at the baccalaureate level (Reid et al., 2021).

The Role of Nurse Informaticists in Healthcare

While the project has assisted nurses in demonstrating knowledge and skills in information management and patient care technologies, they are also expected to use the tools at the bedside or organizational levels. Having attended a meeting where a nurse informaticist conducted a presentation on her roles and impact on patient and organizational outcomes, I realized how the role would impact my organization. Drawing from evidence-based literature on the impact of a nurse informaticist on patient care, workflow, costs, and return on investment, the purpose of this paper is to create a proposal for a new nurse informaticist position.

Nursing Informatics and the Nurse Informaticist

The quest for cost-effective and high-quality patient care has resulted in greater integration of technology in healthcare. With the increased incorporation of technologies comes a new challenge: developing a unified definition of the use of technology in healthcare. Because of the lack of a consistent taxonomy, there has been consensus on definitions within healthcare informatics, with each country developing and adopting its own.

All definitions, however, are heavily influenced by the International Medical Informatics Association (IMIA), which defines nursing informatics as a science and a practice that integrates nursing, information communication technologies (ICT), and professional knowledge to promote people’s health (Honey et al., 2022). Honey et al. (2022) state definitions from Australia, the United States, and Canada to gain a common understanding of nursing informatics across diverse geographical contexts.

Nursing informatics is defined by the Australian Nursing and Midwifery Accreditation Council (ANMAC) in Australia as the knowledge and skills required by registered nurses to integrate nursing practice, computer and information science in data management, communication, and decision-making in nursing practice (Honey et al., 2022). In the United States, the American Nurse Association (ANA) Council of Computer Application in Nursing defines nursing informatics as a specialty that integrates nursing science, computer, and information science in the identification, collection, processing, and management of data to support nursing practice (Honey et al., 2022).

According to the Canadian Organization for the Advancement of Computers in Health (COACH), nursing informatics is the use of any information technology by nurses to influence patient care (Honey et al., 2022). Nursing science, ICT, professional knowledge, and the influence on patient care are consistent themes that appear in all definitions of nursing informatics.

With the global implementation of health informatics projects, the nurse informaticist’s role is expanding in various clinical settings. The need for innovative technological solutions to improve care, such as mobile applications, interactive decision aids, web-based technologies, and electronic health records (EHR), broadens the scope of nurse informaticists and gives them a more defining role.

According to King et al. (2020), the primary role of a nurse informaticist is to support technological advances that improve patient care, safety, and quality. Nurse informaticists contribute to such advancements by educating staff on new yet-to-be-implemented technologies, leading quality and process improvement initiatives, and evaluating the impact of technology on care before its implementation. Their education, certification, training, and practice experience position them more appropriately in designing and implementing technological interventions and fulfilling their other scopes of practice.

Nurse Informaticists and Other Healthcare Organizations

Healthcare organizations have had a variety of heartwarming experiences with nurse informaticists. In one case, Billings Clinic, a Magnet-designated non-profit health organization in Montana, northern Wyoming, and the western Dakotas, shares its experience with nurse informaticists. The Billings Clinic Cancer Center serves over 1800 patients annually and employs more than 70 registered nurses (RNs) in the cancer unit (Billings Clinic, 2018).

The Chief Nursing Officer (CNO) observed that the cerebellar toxicity assessment of patients receiving high-dose Cytarabine was inconsistently documented in the medical records by the nursing staff during care for patients receiving high-dose Cytarabine in the cancer unit. As a result, the CNO sought assistance from a nursing informaticist, who created a new evidence-based assessment tool. According to the CNO, the tool improved the assessment and documentation of therapy-related complications (Billings Clinic, 2018). The Billings Clinic scenario is representative of many other healthcare organizations that employ nurse informaticists.

Nurse informaticists must collaborate with other care providers to achieve the goals of a nursing informatics project. In the clinical scenario described above, for example, the nurse informaticist would collaborate with other RNs, a medical oncologist, a gynecologic oncologist, a surgical oncologist, a radiation oncologist, a pediatric oncologist, and a general surgeon.

Furthermore, for the assessment and documentation tool to be successfully implemented, oncology nurse informaticists would collaborate with informaticists from other departments, including the pharmacy. According to the CNO, the oncology nurse informaticist follows regulatory standards in designing, building, and maintaining order sets to ensure smooth operation (Billings Clinic, 2018).

The CNO also reported that the system was so efficient that laboratory and vital sign monitoring, therapies, referrals, and nursing orders were all available with a single click (Billings Clinic, 2018). This would make the job of medical oncologists or any other professional who would be reviewing the patient for treatment continuation easier.

Impact of Full Nurse Engagement in Healthcare Technology

The inclusion of nurse informaticists in healthcare has implications for patient care, cost, workflow, and the privacy of patient’s health information. Sensmeier and Anderson (2020) and Williams (2019) assert that nursing informatics provides a platform for solving several patient problems. Technology is used in all processes, from patient triage upon hospital admission to discharge following recovery or any prompting factors. For example, a computerized physician order entry (CPOE) system detects incorrect dosages, frequencies, routes, and durations of therapy in medication prescriptions (Sensmeier & Anderson, 2020; Williams, 2019).

Early detection and treatment of cerebellar toxicity caused by high-dose Cytarabine therapy were critical in reducing mortality rates in the clinical scenario at Billings Clinic Cancer Center.  Regarding workflow, a nurse informaticist ensures that the majority of the tasks involved in data assessment and documentation are accessible with a single click.

Management of symptoms and toxicities, laboratory and vital sign monitoring, therapies, referrals, and nursing orders are all available with a single click at Billings Clinic Cancer Center (Billings Clinic, 2018). This would improve workflow because all care providers who would need to access the patients’ information for review would be able to do so easily. A nurse informaticist will also implement measures to protect patient’s health information in accordance with the Health Insurance Portability and Accountability Act (HIPAA) privacy and confidentiality rules.

While patients’ privacy refers to the non-disclosure of their health information, confidentiality refers to the avoidance of unauthorized individuals accessing their protected health information (Bani Issa et al., 2020). Nurse informaticists assist in the implementation of patient privacy and confidentiality safeguards such as data encryption, biometrically enabled system logins and password-protected logins.

In addition, nurse informaticists may assist in the installation of anti-hack software, which prevents breaches into information systems, to ensure the security of the patient’s health information (Koppel & Kuziemsky, 2019). Concerning cost implications, recent studies on healthcare systems across the U.S. show that $760 billion to $935 billion, which represents 25% of total U.S. healthcare spending, is wasted annually (Shrank et al., 2019). Nurse informaticists and other health informatics specialists help reduce costs in various ways, one of which is the prediction of health outcomes using analytics, which aids in accurate budgeting for resources required and thus prevents overspending.

Additionally, health informatics drives process improvement initiatives in billing, human resource management, and marketing, lowering costs (Kruse & Beane, 2018). According to a website that analyzes health IT news in the U.S., the Mercy Hospital Network saved more than $4 million in one year by implementing a nursing analytics dashboard (Fox & Ang, 2018). The various examples provided justify the importance of a nurse informaticist to a healthcare organization, which would be used to decide whether or not to hire one.

Opportunities and Challenges

As the field of health informatics expands, so does the number of healthcare professionals working in it. This presents an opportunity for health and technology enthusiasts who want to collaborate with healthcare providers to improve patient outcomes. Furthermore, it has enabled the opportunity to work in close collaboration with other health stakeholders to identify patient needs that would require technology as a solution. However, while health informatics offers promising benefits in resolving patient problems, it also presents challenges.

The flaws in the equipment, techniques, observation, and data collection tools may lead to misleading conclusions (Otokiti, 2019). Further, data artifacts may give misleading impressions or result in an inability to predict trends in specifically identified health issues. Moreover, due to the high likelihood of system breaches, health informatics interventions are increasingly needed to protect patients’ security, privacy, and confidentiality.

Summary of Recommendations: Takeaways

The increased use of technology in healthcare has broadened the scope of health informatics specialists. Nurse informaticists are best suited to assist hospitals in implementing health informatics projects due to their nursing practice experience and knowledge of ICT. Their impact on improving patient care, lowering healthcare costs, improving workflow, and protecting patients’ privacy and confidentiality are critical in informing their employment in healthcare organizations.

While the opportunities for improving patient care are obvious, potential challenges exist, raising concerns about upgrading measures to protect patient privacy and confidentiality in the event of a system breach. However, as multiple evidence-based studies show, the benefits nurse informaticists bring to healthcare organizations outweigh the risks, justifying their increased importance in healthcare.

The Role of Nurse Informaticists in Healthcare References

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