Incorporating home healthcare nurses' admission information needs to inform data standards.

OBJECTIVE: Patient transitions into home health care (HHC) often occur without the transfer of information needed for critical clinical decisions and the plan of care. Owing to a lack of universally implemented standards, there is wide variation in information transfer. We sought to characterize missing information at HHC admission. MATERIALS AND METHODS: We conducted a mixed methods study with 3 diverse HHC agencies. Focus groups with nurses at each agency identified what information supports patient care decisions at admission. Thirty-six in-home admissions with associated documentation review determined the available information. To inform information standards development for the HHC admission process, we compared the types of information desired and available to an international standard for transitions in care information, the Continuity of Care Document (CCD) enhanced with Office of the National Coordinator for Healthcare Information Technology summary terms (CCD/S). RESULTS: Three-quarters of the items from the focus groups mapped to the CCD/S. Regarding available information at admission, no observation included all CCD/S data items. While medication information was needed and often available for 4 important decisions, concepts related to patient medication self-management appeared in neither the CCD/S nor the admission documentation. DISCUSSION: The CCD/S mostly met HHC nurses' information needs and is recommended to begin to fill the current information gap. Electronic health record recommendations include use of a data standard: the CCD or the proposed, more parsimonious U.S. Core Data for Interoperability. CONCLUSIONS: Referral source and HHC agency adoption of data standards is recommended to support structured, consistent data and information sharing.

Improving the informatics competency of critical care nurses: results of an interventional study in the southeast of Iran.

BACKGROUND: Nursing informatics (NI) along with growth and development of health information technology (HIT) is becoming a fundamental part of all domains of nursing practice especially in critical care settings. Nurses are expected to equip with NI competency for providing patient-centered evidence-based care. Therefore, it is important and necessary to improve nurses' NI competency through educational programs for effective using of HIT. This study aimed to evaluate the impact of a training program on NI competency of critical care nurses. METHODS: This interventional study was conducted in 2019. Stratified sampling technique was used to select 60 nurses working in critical care units of three hospitals affiliated with a large University of Medical Sciences in the southeast of Iran. These nurses were assigned randomly and equally to the control and intervention groups. NI competency was trained to the intervention group in a three-day workshop. Data were collected using demographic questionnaire and the adapted Nursing Informatics Competency Assessment Tool (NICAT) before and 1 month after the intervention. Rahman in the US (2015) developed and validated the original NICAT to assess self-reported NI competency of nurses with 30 items and three dimensions (Computer literacy, Informatics literacy Information management skills). The NICAT is scored on a five-point Likert scale and the overall score ranges from 30 to150. Two medical informatics specialists and eight nursing faculty members approved the validity of the adapted version of NICAT and its reliability was confirmed by Cronbach's alpha (95%). RESULTS: All 60 participants completed the educational program and returned the completed questionnaire. Majority of participants in the intervention and control groups were female (83.30%), married nurses (70.90, 73.30%) aged 30-40 years (51.6, 35.5%). In the pretest stage, both intervention and control groups were competent in terms of the NI competency and its dimensions, and no significant difference was observed between them (p = 0.65). However, in the posttest, the NI competency and its dimensions in the intervention group significantly increased with a large effect size compared with the control group (p = 0.001). This difference showed that the intervention group was proficient in the posttest stage. The highest mean difference in the intervention group was associated with the informatics literacy dimension and the lowest mean difference was associated with the informatics management skills dimension. CONCLUSIONS: The improved scores of NI competency and its dimensions after using the training program implied the effectiveness of this method in enhancing the NI competency of nurses working in the critical care units. The application of the training program in diverse domains of nursing practice shows its high efficiency. The project is fundamental for improving nurses' NI competency through continuous educational programs in Iran, other cultures and contexts.

Oncology Nurse Informaticists: An Evolving Role to Support Nursing Practice.

Nursing informatics is an evolving field in the burgeoning context of technologic and digital advances in health care. Nurse informaticists are integral in translating these advances into evidence-based clinical practice to improve the quality and safety of patient care and professional practice. This article describes the role and operationalization of nurse informaticists in the oncology setting. A case study is presented to exemplify how nurse informaticists can lead interprofessional teams in evaluating opportunities for process or quality improvement and implementing and evaluating digital solutions to improve oncology care.

Pilot Test of a Theory-Based Instrument to Measure Nursing Informatics Leadership Skills.

Understanding organizational cultures helps leaders focus on the content, context and levels of perspective needed to be successful leaders in the area of nursing informatics. The Minnesota Nursing Informatics Leadership Inventory (MNILI) was developed to expand assessment options and tools in the area of nursing informatics leadership. This article describes the result of the pilot test of the instrument. Using an ordinal Likert scale (0 = not like me to 4 = very much like me), respondents rated 12 leadership skills associated with four types of cultures across four scenarios. Respondents preferred collaborative culture leadership skills across all scenarios and differentially preferred culture-specific skills by scenario. Overall, older and more experienced respondents were more satisfied as leaders (p = 0.003) and more often used a democratic leadership approach (empower and care about all voices; p = 0.012). In three of the four cultures, nursing informatics leaders reported preferred and collaborative leadership skills that matched the scenario. This study provides preliminary evidence for using the MNILI to assess the requisite variety of nursing informatics leadership skills. Further research is needed to understand the dynamic interactions between organizational culture and nursing informatics leadership that are informed by conscious leadership and attention to the requisite variety of leadership skills.

Emerging Professionals' Observations of Opportunities and Challenges in Nursing Informatics.

The importance of nursing informatics (NI) is highlighted because of changing healthcare landscapes in response to rising digital health and technology integration and use. However, NI education, competency requirements and roles are not standardized across the world, and the potential of NI is modestly understood internationally. This paper explores opportunities and challenges in NI discussed in a panel at the 14th International Congress on Nursing and Allied Health Informatics. The panel was organized by the International Medical Informatics Association's - Nursing Informatics Working Group's Student and Emerging Professionals group. Discussions during the panel session were synthesized and analyzed using content analysis. Results indicate that challenges in NI education, career opportunities and roles continue to exist across healthcare settings and regions. Findings suggest that the following issues need attention: (1) collaboration to build stronger infrastructure to guide NI education, research and practice; (2) improved visibility and appreciation of NI; and (3) greater dissemination of evidence of NI in various health settings. This paper offers recommendations for nurse leaders on strategies to address these issues in NI at the local, regional and global levels.

Alignment of American Association of Colleges of Nursing Graduate-Level Nursing Informatics Competencies With American Medical Informatics Association Health Informatics Core Competencies.

This study yielded a map of the alignment of American Association of Colleges of Nursing Graduate-Level Nursing Informatics Competencies with American Medical Informatics Association Health Informatics Core Competencies in an effort to understand graduate-level accreditation and certification opportunities in nursing informatics. Nursing Informatics Program Directors from the American Medical Informatics Association and a health informatics expert independently mapped the American Association of Colleges of Nursing competencies to the American Medical Informatics Association Health Informatics knowledge, skills, and attitudes. The Nursing Informatics Program Directors' map connected an average of 4.0 American Medical Informatics Association Core Competencies per American Association of Colleges of Nursing competency, whereas the health informatics expert's map connected an average of 5.0 American Medical Informatics Association Core Competencies per American Association of Colleges of Nursing competency. Agreement across the two maps ranged from 14% to 60% per American Association of Colleges of Nursing competency, revealing alignment between the two groups' competencies according to knowledge, skills, and attitudes. These findings suggest that graduates of master's degree programs in nursing, especially those specializing in nursing informatics, will likely be prepared to sit for the proposed Advanced Health Informatics Certification in addition to the American Nurses Credentialing Center bachelor's-level Informatics Nursing Certification. This preliminary map sets the stage for further in-depth mapping of nursing informatics curricula with American Medical Informatics Association Core Competencies and will enable interprofessional conversations around nursing informatics specialty program accreditation, nursing workforce preparation, and nursing informatics advanced certification. Nursing informaticists should examine their need for credentials as key contributors who will address critical health informatics needs.

Approaches for defining and assessing nursing informatics competencies: a scoping review protocol.

REVIEW QUESTION: How are nursing informatics competencies defined or assessed in the literature?

Competencies for nursing in a digital world. Methodology, results, and use of the DACH-recommendations for nursing informatics core competency areas in Austria, Germany, and Switzerland.

While Nursing Informatics competencies seem essential for the daily work of nurses, they are not formally integrated into nursing education in Austria, Germany and Switzerland, nor are there any national educational recommendations. The aim of this paper is to show how such recommendations can be developed, what competency areas are most relevant in the three countries and how the recommendations can be implemented in practice. To this end, a triple iterative procedure was proposed and applied starting with national health informatics recommendations for other professionals, matching and enriching these findings with topics from the international literature and finally validating them in an expert survey with 87 experts and in focus group sessions. Out of the 24 compiled competency areas, the relevance ratings of the following four recommended areas achieved values above 90%: nursing documentation (including terminologies), principles of nursing informatics, data protection and security, and quality assurance and quality management. As there were no significant differences between the three countries, these findings laid the foundation of the DACH Recommendations of Nursing Informatics as joint German (D), Austrian (A), and Swiss (CH) recommendations in Nursing Informatics. The methodology proposed has been utilized internationally, which demonstrates the added value of this study also outside the confines of Austria, Germany, Switzerland.

Informe sobre necesidades de formación en nuevas tecnologías de los enfermeros militares / Report on training needs in new technologies for military nurses

ANTECEDENTES: En los últimos años, la Sanidad Militar ha ido incorporando diferentes innovaciones tecnológicas para mejorar la calidad y la eficiencia asistencial y resolver las necesidades sanitarias, tanto de los centros de la Red Hospitalaria Militar como de las Unidades Sanitarias desplazadas. El enfermero militar ha tenido que adaptar su forma de trabajar a las características de los nuevos sistemas, por lo que debe desarrollar nuevos conocimientos y competencias, con la formación tecnológica adecuada y los recursos y dispositivos necesarios y más actualizados. OBJETIVOS: Hacer un sondeo sobre la formación tecnológica de los enfermeros militares y los medios de los que disponen y descubrir los problemas que se encuentran. METODOLOGÍA: Encuesta a 33 enfermeros destinados en diversas unidades de las Fuerzas Armadas sobre los medios tecnológicos de los que disponen y la formación recibida. RESULTADOS: Existen equipos y sistemas obsoletos y deficiencias en la formación de los enfermeros

ANTECEDENS: In recent years, the Military Health has been incorporating different technological innovations to improve the quality and efficiency of care and to solve the health needs of both the centers of the Military Hospital Network and the displaced Health Units. The military nurse has had to adapt his way of working to the characteristics of the new systems, so he must develop new knowledge and skills, with the appropriate technological training and the necessary and most updated resources and devices. Objectives: To carry out a survey on the technological training of the military nurses and the means at their disposal and to discover the problems that are found. Methodology: Survey of 33 nurses assigned to various units of the Armed Forces about the technological means available to them and the training received. Results: There are obsolete equipment and systems and deficiencies in the training of nurses

What Nurses Need to Know About Cybersecurity.

It's all part of protecting patients, and vigilance is key.

The use of gamification to teach in the nursing field.

OBJECTIVES: To investigate whether the course offer with elements of gamification contributes to the formation of competences in Informatics in Nursing; and evaluate it based on teaching and learning criteria and content structure. METHOD: Exploratory, applied and technological innovation research, with a qualitative and quantitative approach, developed at a university in the southern region of the country between February and November 2016. Participants were professors (5) and nursing students (10). RESULTS: The adoption of gamification was considered an interesting and innovative approach, as an alternative to traditional practices and applicable to Nursing teaching. In the quantitative analysis, it was observed that the course contemplates the set of evaluated criteria. Final considerations: Gamification contributes to the formation of competences among Nursing students for positively influencing the teaching-learning process. It can be understood as one more resource in the teaching work with a view to student motivation and meaningful learning.

The use of gamification to teach in the nursing field / Uso de gamificación en la enseñanza de la informática en enfermería / Uso de gamificação para o ensino de informática em enfermagem

ABSTRACT Objectives: To investigate whether the course offer with elements of gamification contributes to the formation of competences in Informatics in Nursing; and evaluate it based on teaching and learning criteria and content structure. Method: Exploratory, applied and technological innovation research, with a qualitative and quantitative approach, developed at a university in the southern region of the country between February and November 2016. Participants were professors (5) and nursing students (10). Results: The adoption of gamification was considered an interesting and innovative approach, as an alternative to traditional practices and applicable to Nursing teaching. In the quantitative analysis, it was observed that the course contemplates the set of evaluated criteria. Final considerations: Gamification contributes to the formation of competences among Nursing students for positively influencing the teaching-learning process. It can be understood as one more resource in the teaching work with a view to student motivation and meaningful learning.

RESUMEN Objetivos: Investigar si la oferta de curso con elementos de gamificación contribuye a la formación de competencias en Informática en Enfermería; y evaluarlo a partir de criterios de enseñanza y aprendizaje y de estructura del contenido. Método: Investigación exploratoria, aplicada y de innovación tecnológica, de abordaje cualitativo y cuantitativo, desarrollada en una universidad de la Región Sur del país entre febrero y noviembre de 2016. Participaron docentes (5) y estudiantes de enfermería (10). Resultados: La adopción de gamificación fue considerada un abordaje interesante e innovadora, como alternativa a las prácticas tradicionales y aplicable a la enseñanza de Enfermería. En el análisis cuantitativo, se observó que el curso contempla el conjunto de criterios evaluados. Consideraciones finales: La gamificación contribuye para la formación de competencias entre estudiantes de Enfermería pues influye positivamente el proceso de enseñanza-aprendizaje. La gamificación puede ser entendida como un recurso adicional al trabajo docente que se destina a motivar los estudiantes y el aprendizaje significativo.

RESUMO Objetivos: Investigar se a oferta de curso com elementos de gamificação contribui para a formação de competências em Informática em Enfermagem; e avaliá-lo a partir de critérios de ensino e aprendizagem e de estrutura do conteúdo. Método: Pesquisa exploratória, aplicada e de inovação tecnológica, de abordagem qualitativa e quantitativa, desenvolvida em uma universidade da Região Sul do país entre fevereiro a novembro de 2016. Participaram docentes (5) e estudantes de enfermagem (10). Resultados: A adoção de gamificação foi considerada uma abordagem interessante e inovadora, como alternativa às práticas tradicionais e aplicável ao ensino de Enfermagem. Na análise quantitativa, observou-se que o curso contempla o conjunto de critérios avaliados. Considerações finais: A gamificação contribui para a formação de competências entre estudantes de Enfermagem por influenciar positivamente o processo de ensino-aprendizagem. Ela pode ser compreendida como mais um recurso no trabalho docente com vistas à motivação dos estudantes e à aprendizagem significativa.

Understanding the Essence of Caring from the Lived Experiences of Filipino Informatics Nurses.

Caring is considered a unique concept in nursing because it subsumes all intrinsic attributes of nursing as a human helping discipline. Scholars have argued that caring is usually seen as an encounter between nurses and patients, but how about nurses with minimal or absent nurse-patient encounters, like informatics nurses? In this study, we explored the meaning of the phenomenon of caring to present lived experiences of caring, namely caring as actions of coming in between; caring as expressed within embodied relations; and caring and the path traversed by informatics nurses. The informatics nurse-cyborg-patient triad speaks of Filipino informatics nurses' insightful understanding of the phenomenon of caring.

The Health Information Technology Competencies Tool: Does It Translate for Nursing Informatics in the United States?

Information technology use in healthcare delivery mandates a prepared workforce. The initial Health Information Technology Competencies tool resulted from a 2-year transatlantic effort by experts from the US and European Union to identify approaches to develop skills and knowledge needed by healthcare workers. It was determined that competencies must be identified before strategies are established, resulting in a searchable database of more than 1000 competencies representing five domains, five skill levels, and more than 250 roles. Health Information Technology Competencies is available at no cost and supports role- or competency-based queries. Health Information Technology Competencies developers suggest its use for curriculum planning, job descriptions, and professional development.The Chamberlain College of Nursing informatics research team examined Health Information Technology Competencies for its possible application to our research and our curricular development, comparing it originally with the TIGER-based Assessment of Nursing Informatics Competencies and Nursing Informatics Competency Assessment of Level 3 and Level 4 tools, which examine informatics competencies at four levels of nursing practice. Additional analysis involved the 2015 Nursing Informatics: Scope and Standards of Practice. Informatics is a Health Information Technology Competencies domain, so clear delineation of nursing-informatics competencies was expected. Researchers found TIGER-based Assessment of Nursing Informatics Competencies and Nursing Informatics Competency Assessment of Level 3 and Level 4 differed from Health Information Technology Competencies 2016 in focus, definitions, ascribed competencies, and defined levels of expertise. When Health Information Technology Competencies 2017 was compared against the nursing informatics scope and standards, researchers found an increase in the number of informatics competencies but not to a significant degree. This is not surprising, given that Health Information Technology Competencies includes all healthcare workers, while the TIGER-based Assessment of Nursing Informatics Competencies and Nursing Informatics Competency Assessment of Level 3 and Level 4 tools and the American Nurses Association Nursing Informatics: Scope and Standards of Practice are nurse specific. No clear cross mapping across these tools and the standards of nursing informatics practice exists. Further examination and review are needed to translate Health Information Technology Competencies as a viable tool for nursing informatics use in the US.

El desarrollo del lenguaje enfermero produce avances / Nursing language development achieves breakthroughs

La importancia de los lenguajes enfermeros estandarizados (LEE) ya no se pone en duda en nuestro país. Utilizar un lenguaje normalizado para documentar la práctica permite comparar y evaluar la efectividad de los cuidados suministrados en múltiples situaciones y por distintos profesionales de la enfermería. Además, en el ámbito educativo en España, los currículos recogen la necesidad de que las enfermeras tengan competencias específicas respecto a los LEE y el proceso enfermero. En este sentido, habría que destacar el papel de la NANDA- I, que comenzó a codificar, agrupar y dar nombre a los diagnósticos de enfermería dentro de una taxonomía lógica. El lenguaje del cuidado, del aprendizaje del autocuidado, de la autonomía del otro, supuso un cambio también en la percepción que tenían de la enfermería otros profesionales de la salud y la población en general. En los últimos veinticinco años, se ha tratado el desarrollo teórico y práctico de los cuidados de enfermería y de su lenguaje preciso y unificado. En España, en estas aportaciones, destacaron especialmente numerosas profesoras de las escuelas de enfermería que han abierto las puertas a conocimientos nuevos e impulsado la renovación de la enfermería, y también un gran número de enfermeras clínicas de centros conosanitarios que, en los distintos niveles de atención, han tenido el empeño de trabajar con procesos de enfermería, con diagnósticos enfermeros y, ahora, con las nuevas taxonomías enfermeras (NOC, NIC). Juntas, han hecho un buen trabajo para estimular la utilización de un lenguaje común y para impulsar el despliegue práctico de las nuevas aportaciones teóricas para mejorar los cuidados de enfermería. El empleo de terminologías estandarizadas se considera un requisito previo imprescindible para la historia clínica electrónica (HCE), de la cual forma parte el plan de cuidados de enfermería. El progreso de la profesión enfermera pasa necesariamente por la insistencia en la formación y el trabajo moderno de la enfermería, y la investigación con los LEE (AU)

The importance of standardised nursing languages (SNLs) is no longer questioned in our country. Using a standardised language to document practice enables comparison and assessment of the effectiveness of care provided in multiple situations and by different nursing professionals. In addition, curriculums in the Spanish educational field pick up on the need for nurses to possess specific competence with regard to SNLs and the nursing process. Accordingly, it is necessary to highlight the role of NANDA-I, which is starting to codify, group and give a name to nursing diagnoses within a logical taxonomy. The language used in care, in the learning process of self-care, and for the autonomy of the other, represents a change too in how nursing is perceived by other health professionals and the population. In the past 25 years, the theoretical and practical development of nursing care and its precise, unified language have been addressed. In Spain, this input particularly comes from numerous teachers in nursing schools that have opened the doors to new knowledge and fostered the renewal of nursing. It also includes a large number of clinical nurses from health centres who, in the different levels of care, are committed to working with the nursing process, nursing diagnoses and now with the new nursing taxonomies (NOC, NIC). Together, they have done a good job in stimulating the use of a common language and fostering the practical deployment of the new theoretical contributions for the improvement of nursing care. The use of standardised terminology is considered an absolute prerequisite for the electronic medical record (EMR) of which the nursing care plan forms part of. Nursing profession’s progress necessarily involves persisting with training, modern nursing work and research on SNLs (AU)