UNTIL RECENTLY, nursing informatics (NI) was one of the lesser known nursing specialties, even though it's been a recognized specialty for over 30 years. The Healthcare Information and Management Systems Society (HIMSS) defines NI as "a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, knowledge, and wisdom in nursing practice."1
Due to the increased implementation of technology such as the electronic medical record (EMR), NI has been gaining in popularity and the number of informatics nurses is growing. With the anticipated emergence of the EMR as the primary tool for documenting and communicating patient information in the coming years, the role of an informatics nurse is becoming more important. In the coming months, this new department will explore various aspects of the NI field as it relates to patient care, care quality, and overall healthcare improvement.
What's an informatics nurse?
Depending on where he or she works and the role he or she has, an informatics nurse could have one of many titles. For example, an informatics nurse may be known as a nurse informaticist, a clinical informaticist, a clinical systems analyst, an informatics nurse specialist (INS), or simply an informatics nurse. All of these titles refer to a nurse with knowledge and experience using technology and applying this knowledge to all facets of nursing practice to improve nursing and patient care. This article focuses on the INS, an advanced informatics professional.
In the beginning
The INS is a clinician with extensive clinical experience who understands and is experienced in utilizing and implementing the nursing process. This clinician also has additional knowledge and experience related to technology and information systems.2
According to the HIMSS 2014 Nursing Informatics survey, most NI respondents (58%) said they received informatics education and training on the job. There's no minimum education level for becoming an informatics nurse but according the HIMSS survey, 60% of the respondents had a post-graduate degree in informatics or other field or specialty. The survey also noted that 19% of the respondents had a certificate in NI or other informatics.3 This certification can be acquired through a post-graduate education program or by taking the American Association of Colleges of Nursing certification test.
Florence Nightingale is often referred to as one of the first INSs because she sought better patient data to guide her work. We learn early on in nursing school that due to her meticulous documentation and presentation of this information, Florence improved the nursing care provided to British soldiers during the Crimean War. She demonstrated that with well-documented information, patient care can be improved.
Relevance to nursing
The unique skill set that an INS brings to the table is invaluable for dealing with an institution's technology. Through the application of nursing clinical knowledge and the understanding of computer and information sciences, the INS brings a nursing perspective to the implementation and integration of clinical applications into nursing workflow and patient care. Because of the INS's insight into clinical needs and keen understanding of the EMR system, he or she can communicate to the technical staff about the ongoing needs of nurses who are using the EMR. The INS is an advocate and voice for nurses in matters involving the EMR and other applications of technology to nursing care.
Drawing on knowledge and skills in working with information systems, the INS can partner with systems analysts and information services to conduct a needs assessment when a documentation issue or need arises. The INS then matches the nursing process to the appropriate tool or system or helps develop a tool that will meet the nursing need, such as creating a tool for improving patient handoff at shift changes.
To ensure that an organization's EMR is practical and relevant to nursing practice, the INS serves as the nursing representative and advocate during system development discussions. Because the INS can speak two languages, nursing and information technology, the INS helps ensure that nursing needs and requirements are addressed during these discussions and identifies any gaps in nurse workflow and EMR design.4
Nurses want an EMR that's easy to use and understand. It should also present needed information in an easy-to-find, consistent manner and assist them in working smarter. The INS, with his or her background and knowledge, is the person that can help make this possible by serving as a bridge between technology and nurses' clinical needs. It's important to note that the INS has to be a team player who must always work in collaboration with other staff members.
Work setting, workflow
INSs aren't just employed in hospitals; they can also work at universities, consulting firms, or other healthcare organizations.1 As more institutions begin to recognize the potential of NI to improve the quality of patient care and reduce costs, more INS positions are being created. INSs are working in all areas of patient care, including acute care, ambulatory care, home health, and telehealth.
According to the HIMSS 2014 Nursing Informatics survey, most INSs (58%) work in a hospital setting. The next largest group (13%) works within a health system. The other work settings listed in the survey by prevalence include an academic setting, government/military, private vendors, consulting firms, and ambulatory care.3 In addition, the number of respondents who reported that they had 1 to 5 years of clinical experience increased compared with previous HIMSS surveys. This may suggest that the NI field is growing as a specialty, which means that an increasing demand for the role is drawing nurses from the bedside.3
Within the various work settings, the INS has many roles. Along with being an advocate for nursing, an INS also may be a project manager, overseeing the development and implementation of a project. The INS may be a consultant or an analyst providing input on a project, ensuring data integration and integrity, or overseeing workflow design. The INS may also be an educator, instructing fellow nurses in the use of the EMR or developing staff education material.
In order to understand the various workflows within an organization, an INS works with the nurses on the unit as well as the clinical nurse specialist and nurse leaders. The INS also works with nursing education specialists to develop training materials, and, as previously mentioned, with the computer programmers and analysts to create an EMR that meets the needs of the nursing staff.
Bridging the gap
NI is the bridge between technology and patient care. As more institutions begin to recognize the potential of NI for improving the quality of patient care, the number of INS positions being created will only increase. These positions can be found in all patient care settings as well as in private industry. For nurses looking to specialize, NI is a rewarding career choice.
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