With computerized records, decision-support tools, wireless communication systems and barcode scanners, todays hospitals are full of electronic devices aimed at improving safety, quality and efficiency. Because of this new technology, many nurses have been given opportunities to develop informatics skills to lead transformation initiatives.
Nursing informatics is a burgeoning field, said Cathy Binck, RN, MSN, nursing informatics administrator at Beth Israel Medical Center in New York, who previously had worked in med/surg and critical care. In her role as a nursing educator, Binck became fascinated with the intricacies of implementing an electronic medical record about five years ago. Now she focuses on how to use the system to drive better patient outcomes and ensure interoperability between electronic programs.
My ultimate service is to the patient, but I view myself in a service position to the nursing staff, to the provider community, to the users of the system, Binck said. How can we make it smarter, better, quicker, more user-friendly, so you, as a direct caregiver, can spend the most time with your patient and the least time with the computer.
The role of nursing informaticists can vary. Lorraine Woltman, RN-BC, MS, director of nursing education at Long Island College Hospital in Brooklyn, N.Y., helps nurses and other staff members learn to use new electronic systems, and she troubleshoots application problems. She finds students initial resistance to computerization vanishes over time.
They go from being afraid to touch a mouse to not wanting to go back to paper, Woltman said.
Maureen Scanlon, RN, MSN, director of nursing informatics and decision support at Montefiore Medical Center in the Bronx, N.Y., views her role as creating technical solutions that contribute to quality improvements.
Its getting systems and processes in place that make it safer or more efficient for the bedside nurse, Scanlon said. Were involved with process standardization.
Clinical nurse informaticists at hospitals in the North Shore-LIJ Health System in Great Neck, N.Y., complete workflow analyses and mapping before implementing technology projects. They then help communicate the clinical needs to computer analysts. Once a program goes live, the informatics team helps staff nurses learn to use the system and evaluate the results.
Nurse informaticists challenge the current state, understand the best practices and bring evidence to the table, said Cathy Halloran, RN, vice president for clinical systems at North Shore-LIJ. Were not only bringing a new tool but a workflow.
Halloran likens informatics to the discovery of the stethoscope both being tools to obtain data about patients and allow for better clinical decisions. Our goal is to make sure we are providing the data the clinicians need at the right time and place, she said.
Foundation in Nursing
Sue Robertson, RN, director of clinical information systems nursing at North Shore-LIJ, calls her clinical experience critical to her success with CIS.
Its an understanding of the day-to-day operations on a clinical unit and the needs of the physician, the nurse, the respiratory therapist and to be an interpreter [for the computer analyst], Robertson said.
Without nursing background, I dont think I would be as effective in my nursing informatics role, said Scanlon, explaining she has a clear understanding about existing processes because she has followed them.
Aurelia G. Boyer, MSN, MBA, chief information officer at NewYork-Presbyterian Hospital, also credits nurses mindset and skills developing and following a plan, listening, advocating, facilitating and setting goals that she learned as a nurse with helping her succeed in her role, which offers access to every aspect of a hospitals operations. If you want to be in hospital administration, this is a great track, Boyer said.
Halloran calls informatics another avenue nurses can go down and still feel connected at the clinical level but in a different vein than doing bedside care.
The American Nurses Credentialing Center offers an informatics nursing certification for baccalaureate-prepared RNs with experience and continuing education coursework in informatics.
Although many nurses have learned information technology on the job, augmenting their skills with information technology courses, nursing education programs have developed graduate programs.
New York University College of Nursing offers a masters and an advanced certificate program in nursing informatics, where nurses with an interest in electronic systems build on a nursing foundation to improve nursing processes.
The program focuses on analysis, design, implementation and evaluation of clinical and nursing information systems used in the delivery of patient care and how it is integrated into evidence-based protocol, said Nadia Sultana, RN, BC, MBA, clinical assistant professor and program coordinator of NYUs nursing informatics and advanced certificate program.
More than 100 nurses have graduated from NYUs program since its inception in 1998. Some work for vendors and others for facilities, home care agencies or universities.
Columbia University School of Nursing in New York focuses on doctoral and post-doctoral nursing informatics preparation, and its Graduate School of Arts and Sciences offers a masters degree in biomedical informatics.
[The nursing school] is primarily preparing researchers, said Suzanne R. Bakken, RN, DNSc, FAAN, alumni professor of the school of nursing and professor of biomedical informatics.
Students research areas vary from developing consumer health applications to designing and evaluating decision-support systems for providers. Bakken reports an informatics education presents many career opportunities, with doctoral graduates enjoying a choice of faculty job offers, and software developers and institutions seeking masters prepared specialists.
I see the opportunities growing, Bakken said. Nursing informatics is a wonderful specialty for nurses who are analytically inclined, like to problem solve, and like project-oriented work.