** Please see the attached document with complete instructions**

Assignment: The Nurse Leader as Knowledge Worker  

The Assignment:

In this Assignment, you will consider the evolving role of the nurse leader and how this evolution has led nurse leaders to assume the role of knowledge worker:

· You will prepare a PowerPoint presentation with an infographic (graphic that visually represents information, data, or knowledge. Infographics are intended to present information quickly and clearly.) to educate others on the role of nurse as knowledge worker.

Deadl

in

e

–

Friday 3/

1

2

/20

21

Assignment

:

The Nurse Leader as Knowledge Worker

The term “knowledge worker” was first coined by management consultant and author

Peter Drucker in his book

,

 

The Landmarks

of

Tomorrow

 

(1959)

. Drucker defined

knowledge workers as high

–

level workers who apply theoretical and analytical

knowledge, acquired through formal training, to develop products and services. Does

this sound familiar?

Nurses are very much knowledge workers. What has changed

since Drucker’s time are

the ways that knowledge can be acquired. The volume of data that can now be

generated and the tools used to access this data have evolved significantly in recent

years and helped healthcare professionals (among many others) to ass

ume the role of

knowledge worker in new and powerful ways.

Reference: Drucker, P. (1959).

 

The landmarks of tomorrow. New

Y

ork, NY: HarperCollins

Publishers.

To Prepare:

·

Review the concepts of informatics as presented in the Resources.

(Attached articles)

References

Sweeney, J. (2017).

Health

care

Informatics

.

 

Online

Journal

of

Nursing

Informatics, 21

(1), 4

–

1.

References

NAGLE, L. M., SERMEUS, W.,

&

JUNGER, A. (2017). Evolving Role of the

Nursing Informatics

Specialist…NI 2016, Switzerland.

 

Studies

in Health

Technology

& Informatics, 

232

,

212

–

221. https://doi

–

org.ezp.waldenulibrary.org/10.3233/978

-1-

61499

–

738

-2-212
·

Reflect on

the role of a nurse leader as

a knowledge

worker.

·

Consider how knowledge may be informed by data that is collected/accessed.

The Assignment:

In this Assignment, you will consider the evolving role of the nurse leader and how this

evolution has led nurse leaders to assume the role of knowledge worker

:

· Y

ou will prepare a

PowerPoint presentation with an infographic

(graphic that

visually

represents

information, data, or knowledge. Infographics are intended to present

information quickly and clearly.) to

educate others on the role of nurse as knowledge

worker.
1.

Explain the concept of a

knowledge worker.

2.

Define and explain nursing informatics and highlight the role of a nurse

leader as a knowledge worker.

3.

Include one slide that

 visually represents the role of a nurse leader as knowledge worker.

4. Your PowerPoint should Include (please see attached document) the hypothetical scenario you originally shared in the Discussion Forum. Include your examination of the data that you could use, how the data might be accessed/collected, and what knowledge might be derived from that data. Be sure to incorporate feedback received from your colleagues’ responses.

** AT least 3 references**

** APA 7 Guidelines**

Deadline
–

Friday 3/12/2021

Assignment: The Nurse Leader as Knowledge Worker

The term “knowledge worker” was first coined by management consultant and author
Peter Drucker in his book,

The Landmarks of Tomorrow

(1959)
. Drucker defined
knowledge workers as high
–
level workers who apply theoretical and analytical
knowledge, acquired through formal training, to develop products and services. Does
this sound familiar?

Nurses are very much knowledge workers. What has changed

since Drucker’s time are
the ways that knowledge can be acquired. The volume of data that can now be
generated and the tools used to access this data have evolved significantly in recent
years and helped healthcare professionals (among many others) to ass
ume the role of
knowledge worker in new and powerful ways.

Reference: Drucker, P. (1959).

The landmarks of tomorrow. New York, NY: HarperCollins
Publishers.

To Prepare:

·

Review the concepts of informatics as presented in the Resources.

(Attached articles)

References

Sweeney, J. (2017). Healthcare Informatics.

Online

Journal

of

Nursing

Informatics
,

21
(1), 4
–
1.

References

NAGLE, L. M., SERMEUS, W., & JUNGER, A. (2017). Evolving Role of the

Nursing Informatics
Specialist…NI 2016, Switzerland.

Studies

in

Health

Technology

&

Informatics
,

232
, 212
–
221. https://doi
–
org.ezp.waldenulibrary.org/10.3233/978
–
1
–
61499
–
738
–
2
–
212

·

Reflect on the role of a nurse leader as a knowledge worker.

·

Consider how knowledge may be informed by data that is collected/accessed.

The Assignment:

In this Assignment, you will consider the evolving role of the nurse leader and how this
evolution has led nurse leaders to assume the role of knowledge worker
:

·

Y
ou will prepare a
PowerPoint presentation with an infographic

(graphic that visually

represents information, data, or knowledge. Infographics are intended to present

information quickly and clearly.) to

educate others on the role of nurse as knowledge
worker.

1.

Explain the concept of a knowledge worker.

2.

Define and explain nursing informatics and highlight the role of a nurse
leader as a knowledge worker.

3.

Include one slide that

visually
represents

the role of a nurse leader as
knowledge worker.

Deadline – Friday 3/12/2021

Assignment: The Nurse Leader as Knowledge Worker

The term “knowledge worker” was first coined by management consultant and author

Peter Drucker in his book, The Landmarks of Tomorrow (1959). Drucker defined

knowledge workers as high-level workers who apply theoretical and analytical

knowledge, acquired through formal training, to develop products and services. Does

this sound familiar?

Nurses are very much knowledge workers. What has changed since Drucker’s time are

the ways that knowledge can be acquired. The volume of data that can now be
generated and the tools used to access this data have evolved significantly in recent

years and helped healthcare professionals (among many others) to assume the role of

knowledge worker in new and powerful ways.

Reference: Drucker, P. (1959). The landmarks of tomorrow. New York, NY: HarperCollins

Publishers.

To Prepare:

 Review the concepts of informatics as presented in the Resources. (Attached articles)

References

Sweeney, J. (2017). Healthcare Informatics. Online Journal of Nursing Informatics, 21(1), 4–1.

References
NAGLE, L. M., SERMEUS, W., & JUNGER, A. (2017). Evolving Role of the

Nursing Informatics Specialist…NI 2016, Switzerland. Studies in Health

Technology & Informatics, 232, 212–221. https://doi-

org.ezp.waldenulibrary.org/10.3233/978-1-61499-738-2-212

 Reflect on the role of a nurse leader as a knowledge

worker.

 Consider how knowledge may be informed by data that is collected/accessed.

The Assignment:

In this Assignment, you will consider the evolving role of the nurse leader and how this

evolution has led nurse leaders to assume the role of knowledge worker:

 You will prepare a PowerPoint presentation with an infographic (graphic that visually

represents information, data, or knowledge. Infographics are intended to present

information quickly and clearly.) to educate others on the role of nurse as knowledge

worker.

1. Explain the concept of a

knowledge worker.

2. Define and explain nursing informatics and highlight the role of a nurse

leader as a knowledge worker.

3. Include one slide that visually represents the role of a nurse leader as

knowledge worker.

HEALTH INFORMATICS 2

Discussion Week 1

Within the contemporary mental healthcare sector within the psychiatric unit in hospitals, professionals have realized the importance of availability a wide range of information in regards to patients so as to identify the best approach to treatment. This notion explains the main reason behind the increased changing roles for nursing information specialists whereby healthcare centers seek to improve the quality of care while at the same time reducing the rising healthcare expenditures and increased risk of chronic disease incidences during healthcare (Nagle et al., 2017 p.215).

Some of the important data within the evidence based patient care practice involves the patient background, family history, and the patient’s mental health history which is normally conducted using tools like the Mental status Examination during diagnosis (Forrest & Blenenfeld, 2020). The data could be used to provide personalized or individualized treatment plan since mental problems are usually described as unique to every patient within the psychiatry health sector. This information could be collected via electronically recorded interviews with the patients as well as simple questionnaires that could be sent to the respective family members for filling. However, accessibility to this information requires an integrative information system of recording and reporting crucial information related to the patient.

Some of the important information that could be derived from the data involves the origin of the patient’s mental problems such as delinquent behavior whereby a history of family violence could help establish the main reason behind the morally backward behaviors. This notion also provides a platform for development of a treatment plan, for example, whereby a nurse leader could use the information to determine the most prevalent reason behind the mental problems being exhibited by a variety of patients. The statistical analysis of the data could help back the clinical reasoning by nursing leaders about the best mode of treatment for mental health patients exhibiting the same problems such as juvenile delinquents. It is worth noting that the work of healthcare professionals involves making sure that the informatics are effectively used to facilitate effective time management and not slow the treatment process hence faster identification of the patient needs, as well as the most effective framework to use during treatment aligns with the main purpose of incorporating informatics into the healthcare system (Sweeney & Julianne, 2017 p.3).

References

Forrest,

 

J. S., Shortridge, A. B., Talavera, F., & Bienenfeld, D. (2020). History and mental status examination: Overview, patient history, mental status examination. Medscape.

https://emedicine.medscape.com/article/293402-overview

Nagle, Sermeus, W., Junger, A., & Bloomberg. (2017). Evolving Role of the Nursing Informatics Specialist. Forecasting Informatics Competencies for Nurses in the Future of Connected Health, 212-221.

https://doi.org/10.3233/978-1-61499-738-2-212

Sweeney, J. (Feb, 2017). Healthcare Informatics. Online Journal of Nursing Informatics (OJNI), 21( 1), Available at http://www.himss.org/ojni

Feedback

Karen Robson WALDEN INSTRUCTOR MANAGER 

RE: Discussion – Week 1

Top of Form

Hi Ariel, thank you for your initial post including the information describing the role of data and clinical reasoning.  Technology may support clinical reasoning among healthcare professionals, including nurse leaders.  Chon et al. (2019) describes the use of technology, specifically gaming, to support sound clinical reasoning and decision making in healthcare education.  Chon et al. (2019) reminds the reader educational, serious games support simulation of clinical workflows and provide an opportunity for one to acquire knowledge.  The gaming experience described by Chon et al. (2019) included a simulation exercise in an emergency department setting and evaluated knowledge before and after participation in the gaming experience.  Overall, the study had a significant impact on knowledge retention and the overall impression among the medical students (who volunteered to participate) was positive.   Chon et al. (2019) concluded serious gaming is an effective learning strategy in addition to formal teaching to gain knowledge.

Does anyone have any thoughts regarding this?  Do you think innovative technology (such as gaming) supports clinical reasoning in healthcare?

Chon, S. H., Timmermann, F., Dratsch, T., Schuelper, N., Plum, P., Berlth, F., … & Kleinert, R. (2019). Serious games in surgical medical education: a virtual emergency department as a tool for teaching clinical reasoning to medical students. Journal of Medical Internet Research Serious Games, 7(1), e13028.

 

ARIEL CORDOVA Lopez 

RE: Discussion – Week 1

Top of Form

Dr. Robson,

I believe technology has an effective method of providing a safe and risk free environment to support the development of skills and knowledge of nurses and physicians mainly because the simulation provides a real—time depiction of the events that happens within the Emergency room, or example. Thus, I think that the fact that a person can redo their mistakes helps develop their skills by identifying errors and subsequently learning how to handle them. This notion also supports clinical reasoning mainly because the best practices can be identified from the simulation. An example of this involves a simulation of the theater whereby the best strategies for coordinating the activities to save on time can be identified from the simulation.

Karen Robson WALDEN INSTRUCTOR MANAGER 
RE: Discussion – Week 1
Top of Form

Hi Ariel.  Thanks so much for your insight and continued discussion.  Simulation is an effective learning strategy, especially if an experienced facilitator guides the simulation experience.  Pre/post test scores evaluating knowledge retention is one form of data collection and analysis that can be used to improve teaching strategies.

Thanks again for your discussion.

Dr. Robson

Bottom of Form

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Title:
Authors:
Source:

Publication Type:
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Major Subjects:

Minor Subjects:

Abstract:

Journal Subset:

ISSN:
MEDLINE Info:

Entry Date:
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Accession Number:
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Record: 1

Healthcare Informatics.

Sweeney, Julianne

Online Journal of Nursing Informatics (ONLINE J NURS INFORM),
Winter2017; 21(1): 4-1. (1p)

Article

English

Nursing Informatics — Trends
Diffusion of Innovation
Health Informatics — Trends

American Recovery and Reinvestment Act; Meaningful Use; Health
Policy; Policy Making

Healthcare Informatics is defined as “the integration of health-care
sciences, computer science, information science, and cognitive science
to assist in the management of healthcare information” (Saba &
McCormick, 2015, p. 232). Nursing Informatics is a subset of
informatics, specific to the field and the role of the nurse in the
healthcare setting. The American Nurses Association (ANA) identified
nursing informatics as “a specialty that integrates nursing, science,
computer science, and information science to manage and
communicate data, information, and knowledge in nursing practice”
(ANA, 2001, p.17). Healthcare and nursing informatics are both vastly
growing fields within the medical field and are continuously incorporating
new and evolving technology. Both have been around for the past three
decades, at least. The technology boom at the turn of the century has
helped informatics and information systems further evolve. Enhanced
delivery of care, improved health outcomes, and advanced patient
education are just a few aspects that have improved. With any new
technology or innovation there are implications, some foreseeable and
some that come to light after the unveiling of the new process or
product: some impacts that are most notable are clinical, managerial,
and policy implications. This paper explores the implications, (both
constructive and adverse), that are the most notable in today’s
healthcare world within the healthcare and nursing informatics fields.

Computer/Information Science; Core Nursing; Nursing; Peer Reviewed;
USA

1089-9758

NLM UID: 9806523

20180412

20201019

128848047

CINAHL Plus with Full Text

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Healthcare Informatics

Healthcare Informatics is defined as “the integration of health-care sciences, computer science, information
science, and cognitive science to assist in the management of healthcare information” (Saba & McCormick,
2015, p. 232). Nursing Informatics is a subset of informatics, specific to the field and the role of the nurse in the
healthcare setting. The American Nurses Association (ANA) identified nursing informatics as “a specialty that
integrates nursing, science, computer science, and information science to manage and communicate data,
information, and knowledge in nursing practice” (ANA, 2001, p.17). Healthcare and nursing informatics are
both vastly growing fields within the medical field and are continuously incorporating new and evolving
technology. Both have been around for the past three decades, at least. The technology boom at the turn of
the century has helped informatics and information systems further evolve. Enhanced delivery of care,
improved health outcomes, and advanced patient education are just a few aspects that have improved. With
any new technology or innovation there are implications, some foreseeable and some that come to light after
the unveiling of the new process or product: some impacts that are most notable are clinical, managerial, and
policy implications. This paper explores the implications, (both constructive and adverse), that are the most
notable in today’s healthcare world within the healthcare and nursing informatics fields.

Citation
Sweeney, J. (Feb, 2017). Healthcare Informatics. Online Journal of Nursing Informatics (OJNI), 21( 1),
Available at http://www.himss.org/ojni

Introduction
Healthcare Informatics is defined as “the integration of health-care sciences, computer science, information
science, and cognitive science to assist in the management of healthcare information” (Saba & McCormick,
2015, Pg. 232). Nursing Informatics is a subset of informatics, specific to the field and the roll of the nurse in
the healthcare setting. The American Nurses Association (ANA) identified nursing informatics as “a specialty
that integrates nursing, science, computer science, and information science to manage and communicate data,
information, and knowledge in nursing practice” (ANA, 2001, Pg.17). Healthcare and nursing informatics are
both vastly growing fields within the medical field and are continuously incorporating new and evolving
technology. Both have been around for the past three decades, at least. The technology boom at the turn of
the century has helped informatics and information systems further evolve. Enhanced delivery of care,
improved health outcomes, and advanced patient education are just a few aspects that have improved. With
any new technology or innovation there are implications, some foreseeable and some that come to light after
the unveiling of the new process or product. Some impacts that are most notable are clinical, managerial, and
policy implications. This paper will explore the implications, both constructive and adverse, most notable in
today’s healthcare world within the healthcare informatics and nursing informatics fields.

Clinical Implications
The use of informatics is seen in a multitude of processes within the clinical setting. Whether inpatient or
outpatient, clinicians and patients utilize online portal systems, electronic medical records, data collection
devices such as vital sign machines and glucometers, as well as personal data devices and email, to name a
few. When considering these systems and how they effect the process and flow of the clinical setting, it is
important to not only consider the technology at hand but also the workflow and the data collection process.
Norris, Hinrichs, & Brown, tell us “gaps are present between the technology and the process. Informatics can
help bridge that gap. Skills needed include understanding of data collection, storage, and extraction, in addition
to an appreciation for the power of data to drive and inform practice” (2015, p. 11-12). Healthcare
informaticists, especially nursing informaticists, are the prime group to help bridge that gap. Without a strong

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clinician presence in the building and implementation process, gaps will remain. With healthcare informaticists
involved in the development, a strong product can be delivered that is usable to all members of the healthcare
team.

President Obama signed the American Recovery and Reinvestment Act (ARRA) into law in 2009. This law
includes the Health Information and Technology for Economic Clinical Health Act (HITECH). HITECH
formulated the Meaningful Use (MU) program under the Centers for Medicare and Medicaid Services (CMS).
Meaningful Use incentivizes providers to use their Electronic Health Records (EHR) by financially rewarding
them when demonstrating their use, but also poses a threat by penalizing them if not used in the future (Norris,
Hinrichs, & Brown, 2015). These Acts greatly impact both nursing and the healthcare field clinically. Providers
who do not typically use an EHR are now finding themselves in a learning curve while still maintaining their
patient caseload, and providing comprehensive care. However this vast amount of data collection across a
multitude of healthcare settings has provided opportunity in enhancements of care. While the initial roll out of
these initiatives may cause chaos, the benefits of these initiatives will allow clinicians to provide
comprehensive, safe, evidence-based care to all of their patients. Health care staff will be able to quickly and
safely access pertinent information on their patients throughout the health institution and beyond.

In addition to enhancements in care and improved evidence-based practice, the increased amount of data
collected by EHRs and other data systems has created a massive amount of data that hospitals and health
care organizations now have to manage and analyze. “This has led to increased demand for professionals who
are well versed in both informatics and medicine. To meet this demand, the American Medical Informatics
Association spearheaded the establishment of professional-level education and certification for physicians in
informatics” (Simpao, Ahumada, Galvez, & Rehman, 2014, p. 45). We are now seeing a new influx of
healthcare professionals entering this sub-specialty. The needs for these professionals to collect, interpret, and
study the data and the operation of information systems is crucial to the success and usability of these
systems. Lehman, Shorte, & Gundlapalli (2013) stated that “it is reasonable to predict that the number of
leadership positions in clinical informatics with titles and roles such as chief medical informatics officer, chief
health informatics officer, directors of clinical informatics, and lead of EHR implementation, etc., will increase in
the near future” (p. 528).

Managerial Implications
The use of healthcare informatics is not only prevalent in the clinical setting but also in the managerial setting.
In our society, communication comes in a multitude of applications: verbal, physical, and now electronic. We
often find that individuals can contact us by using various applications such as telephone, fax, pager, instant
messenger, email, and so on. It is crucial for those in managerial positions to utilize these information systems
to aid their work and the work of their staff while being mindful to set limits and standards. Time management is
a prevalent issue in the healthcare setting, thus the use of informatics to aid and organize and not create
barriers is essential. However, these expansive communication tools can create stress and feelings of intake
overload. Marquis & Huston (2013) suggested “to reduce interruptions and distractions, individuals should shut
off their email, isolate themselves, and make sure the environment around them is working to strengthen their
willpower and focus” (p. 189). Healthcare professionals need to ensure that they are utilizing informatics to aid
their work and time management, not impeding them. Marquis & Huston (2013) go on to note that “creating a
workspace that has a desk with enough clear space to do your work, good lighting, and a comfortable chair” is
crucial (p.190).

Information systems in the managerial role often consist of interpreting information and modifying data to be
utilized in decision-making processes. Managerial programs facilitate payroll functions, streamline material

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control, and assist with financial and administrative factors of their role (Pacheco de Souza, Santiago & Izu,
2015, p.7284). As seen in clinical implications, Meaningful Use also plays a role in the role of the manager. It is
important for “nurse managers to utilize information from the EHR to show Meaningful Use and are important
to the process of determining how information is organized and categorized within the EHR” (Biddle &
Milstead, 2016, p.12). Without nurse manager and other administrator identification of how to best capture and
report Meaningful Use information, the healthcare organization may not be compliant with this aspect of the
HITECH Act.

The continuously growing field of informatics is of great benefit to healthcare managers at all levels. Using this
growing technology can greatly benefit their role and improve the function of their staff. Pacheco de Souza,
Santiago, & Izu (2015) go on to acknowledge that this advancing technology “should be utilized as a
management tool, giving power and autonomy to nurse managers in more efficient use of available
technological resources” (p.7285). One example of this is where a unit may identify incomplete documentation
on a given point of care. The nurse manager can then construct a work group of colleagues who are involved
in the process including an IT specialist. Once this group identifies the issues and improved processes, they
can present their recommendations to administration, ultimately improving documentation in the EHR (Biddle &
Milstead, 2016). Thus, healthcare information systems can improve communication, time-management, and
delivery of information amongst staff and patients.

Policy Implications
As previously noted in clinical implications and managerial implications, the amount of data that is now
available from EHRs and other forms of information systems, is larger than healthcare providers have ever
dealt with. Policy makers are now able to utilize this data to inform their decision-making about public-health
issues. It is crucial now, more than ever, that epublic health staff are available at various levels of the health
system to develop skills and knowledge to better utilize existing datasets. Adair (2012) identified guidelines to
help public health officials understand, interpret, and best utilize this influx of information. “These guidelines
were developed to assist public health officials assess the quality of existing health data, and effectively utilize
such data to compute indicators to inform health sector policy-making” (p. 53). If policymakers are not able to
thoroughly understand data derived from the utilization of electronic health records, patient portals, and other
data sources, then people cannot expect them to make sound judgments when voting on new laws.

In this age of technology it is important that healthcare providers, managers, and informaticists are mindful of
adhering to HIPAA regulations to ensure that growing technology is incorporated in current policies. With the
use of EHRs and mobile health applications there is an increased “liability for healthcare organizations if there
is a breach in patient confidentiality or privacy, which is why organizations must have policies in place that
guide the use of telehealth and communication” (Biddle & Milstead, 2016). Ensuring proper policy is in place
and that changes are made as needed when new technology is introduced is crucial.

McGowan, Cusack, and Bloomrosen (2012) wrote, “since 2006, the American Medical Informatics Association
(AMIA) has convened an annual investigational Health Policy meeting to examine Cutting edge issues in
healthcare and health-information technology (health IT) policy” (p. 460). These meetings will identify and
discuss potential issues with health IT and informatics as well as develop a plan and report to present to our
nation’s policymakers so they are well informed when making and voting for pertinent policies and laws
(McGowan, Cusack, & Bloomrosen, 2012). It is important that health professionals, information technology
developers, and policymakers are able to communicate and work together in the interest of delivering the most
efficient and safest patient care.

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Meaningful Use is one example of health policy and health informatics working together. The initiative behind
Meaningful Use was to encourage the use of Electronic Health Records in all health systems nationwide.
However with this initiative, some providers may find themselves not being truthful in their documentation in
order to meet the incentives set by the HITECH legislation. McGowan, Cusack, and Bloomrosen (2012),
identified that “with the mandate for meaningful use of health IT by providers, there is ample opportunity for
inappropriate and even fraudulent or illegal activities, ranging from lack of oversight to deliberate
misrepresentation” (p. 461). Although dishonorable, some providers may lie to ensure their practice is able to
receive the best monetary incentive by adhering to Meaningful Use measures and may alter their
documentation to fit the criteria.

McGowan, Cusack, and Bloomrosen (2012) also identified policy concerns with health IT and informatics when
discussing federal and state roles. Often federal and state regulations and health IT initiatives lack
coordination. “Without explicit guidelines, proprietary state systems may be created, with many not being able
to connect to the national health information infrastructure and some not acknowledging the healthcare
systems that cross state lines” (McGowan, Cusack, and Bloomrosen, 2012, p.462). It is crucial that not only
health professionals and government coordinate their objectives and policy, but also governing officials of the
state and federal government. Conflicting or uncoordinated health initiatives may lead to patient and public
mistrust as well as financial complications with both the government and health organizations.

Summary
Health informatics and Nursing Informatics are very relevant in evolving health systems. New technology and
initiatives are constantly being developed. These new innovations do not go without implications in the clinical
setting, managerial setting, and the policy setting. It is crucial that all participants whether it is the nurse,
manager, provider, politician, lobbyist, or President of the United States remain coordinated. Multidisciplinary
unity is crucial to ensure public trust in our health systems and to provide safe and effective patient care.

References
Adair, T. (2012). Building the evidence base for health policy: guidelines for understanding and utilizing basic
health information. Pacific Health Dialog, 18(1), 53-62

American Nurses Association. (2001). Scope and Standards of Nursing Informatics Practice. Washington, DC:
American Nurses Publishing.

Biddle, S. & Milstead, J. (2016). Nursing informatics. The intersection of policy and informatics. Nursing
Management, 47(2), 12-13 2p. doi:10.1097/01.NUMA.0000479453.73651.89

Lehmann, C. U., Shorte, V. & Gundlapalli, A. V. (2013). Clinical informatics sub-specialty board certification.
Pediatrics In Review, 34(11), 525-530. doi:10.1542/pir.34-11-525

Marquis, B. L. & Huston, C. J. (2012). Leadership roles and management functions in nursing: Theory and
application (7th ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.

McGowan, J. J., Cusack, C. M. & Bloomrosen, M. (2012). The future of health IT innovation and informatics: a
report from AMIA’s 2010 policy meeting. Journal Of The American Medical Informatics Association: JAMIA,
19(3), 460-467. doi:10.1136/amiajnl-2011-000522

Norris, B. J., Hinrichs, D. J., & Brown, D. A. (2015). Meaningful Use Clinical Quality Measures and Beyond:
Meeting the Challenges of eMeasurement. Nursing Informatics Today, 30(1), 8-12 5p

3/8/2021 @ Walden University Library

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~~~~~~~~
By Julianne Sweeney, BSN, RN

My name is Julianne Sweeney and I am a baccalaureate prepared registered nurse who is currently enrolled in
the MSN program at Regis College: Masters of Nursing Leadership and Informatics, located in Weston
Massachusetts. I currently work in the RN capacity at the Department of Veteran Affairs in Jamaica Plain,
Massachusetts. At the VA I work in the primary care department and am involved in a number of committees
and organizations that have a main focus on nursing and healthcare informatics. 15 Virgil Rd. West Roxbury,
MA 02132 Phone: 508-397-5454 Julianne.sweeney@gmail.com

This article is copyrighted. All rights reserved.
Source: Online Journal of Nursing Informatics

Evolving Role of the Nursing Informatics

Specialist

Lynn M. NAGLE

a

, Walter SERMEUS

b

, Alain JUNGER
c

a

Lawrence S. Bloomberg, Faculty of Nursing, University of Toronto, Toronto, Ontario,

Canada

b

Leuven Institute for Healthcare Policy, University of Leuven, Belgium

c

University Hospital of Lausanne, Lausanne, Switzerland

Abstract. The scope of nursing informatics practice has been evolving over the

course of the last 5 decades, expanding to address the needs of health care

organizations and in response to the evolution of technology. In parallel, the

educational preparation of nursing informatics specialists has become more

formalized and shaped by the requisite competencies of the role. In this chapter,

the authors describe the evolution of nursing informatics roles, scope and focus of

practice, and anticipated role responsibilities and opportunities for the future.

Further, implications and considerations for the future are presented.

Keywords. Nursing informatics specialist, role function, connected health, data

science, big data, personalized medicine, clinical intelligence, virtual care

1. Introduction

By 2018, 22 million households will use virtual care solutions, up from less than a

million in 2013. Average (healthcare) visits among these adopter households will

increase from 2 per year in 2013 to 6 per year in 2018, which include both acute care

and preventive follow-up services in a variety of care settings—at home, at retail kiosk

or at work. [1]

Nursing informatics roles have taken many forms in focus and function over the

last decades; suffice it to say that they have not been consistently described or defined

in terms of scope of practice. At the time of this writing it is clear that role of nursing

informatics specialists will continue to evolve at an increasingly rapid rate in the

coming years. The unfolding of new health care paradigms will bring greater

connectivity between care providers and patients, include a wide array of emerging

technologies and an increasing emphasis on data analytics will make the integration of

informatics competencies into every area of nursing an imperative.

2. Brief history of roles of the past and present

The earliest and most common types of informatics work assumed by nurses has

included: oversight of organizational workload measurement systems, project

leadership, systems educator, and nursing unit or departmental information

technology

resource. In many instances, these roles were enacted on the basis of a specific

identified organizational need and were often secondments to the Information

Technology Department. It was not unusual for these roles to have the designation of

Forecasting Informatics Competencies for Nurses in the Future of Connected Health
J. Murphy et al. (Eds.)

© 2017 IMIA and IOS Press.
This article is published online with Open Access by IOS Press and distributed under the terms

of the Creative Commons Attribution Non-Commercial License 4.0 (CC BY-NC 4.0).
doi:10.3233/978-1-61499-738-2-

212

212

“IT nurse” [2]. As role responsibilities and job titles have been widely varied, so have

the qualifications for each. The need for more specificity and consistency in nursing

informatics roles has been recognized for several years [3, 4, 5].

The advent of formal education programs for nurses interested in specializing in

informatics has occurred in conjunction with increasing sophistication in the use of

information and communication technologies (ICT) in clinical practice settings. Today,

nurses have the option to pursue specialization and credentials at a variety of levels

including graduate specialization and specialty certification. Advanced credentials and

certification (e.g., Certified Professional in Healthcare Information and Management

Systems – CPHIMS) have afforded nurses the opportunity to achieve credibility and

legitimacy regarding the specialty informatics knowledge and skills they bring to bear

in nursing practice and academia and healthcare in general [6]. This credibility has

been recognized with the development of executive level positions such as the “Chief

Nursing Informatics Officer” (CNIO) in some countries. The position of the “Chief

Medical Informatics Officer” (CMIO) is much more prevalent and deemed essential in

medium and large health care organizations while the C-level nursing counterpart

remains less common. Several authors [7-11] have described the role and competencies

for these senior informatics positions, yet the valuing of these positions remains limited

among health care provider organizations.

In addition to the evolution of formalized training programs for nurses interested in

informatics, the specialty of nursing informatics has continued to evolve and has

become recognized in local jurisdictions, nationally and internationally. Groups of like-

minded nurses have organized into special interest groups affiliated with larger

interdisciplinary organizations (e.g., International Medical Informatics Association –

Special Interest Group on Nursing Informatics (IMIA-NI-SIG)). Organizations such as

the Canadian Nursing Informatics Association (CNIA), the American Nursing

Informatics Association (ANIA), the Nursing Informatics Working Group of the

European Federation for Medical Informatics (EFMI-NURSIE) are examples of forums

for nurses to network, collaborate and profile their work in informatics. The existence

of these specialty organizations has served to further legitimize the work of nurse

informaticians and provided a venue for advancing regional, national and international

efforts in nursing informatics. Through conferences, meetings and the offering of

educational sessions, virtually and face to face, these networks of nurse informaticists

have collectively advanced the practice and science of nursing informatics. A case in

point is the International Nursing Informatics Congress and post-conference, now held

bi-annually and hosted by countries across the globe. Outputs of these meetings include

publications such as this one; benefitting nursing informatics specialists and the nursing

profession worldwide.

At the time of this writing, we find nursing informatics specialists in virtually

every clinical practice setting. The roles and focus of their work endeavors are wide

and varied. The titles of “informatics nurse”, “nurse informatician”, and “nursing

informatics specialist” are but a few of the titles applied to nurses working in the field.

Many of the roles of the past and present have been more extensively described

elsewhere [2,12]. For the purpose of this chapter, the authors use the title of nursing

informatics specialist to provide illustrations of the potential focus of these roles

current and future.

Roles to date have largely focused on supporting acquisition, implementation and

evaluation of clinical information systems in health care organizations. As noted by

McLane and Turley [4], “informaticians are prepared to influence, contribute to, and

mold the realization of an organization’s vision for knowledge management” (p.30).

L.M. Nagle et al. / Evolving Role of the Nursing Informatics Specialist 213

Nurses have been in pivotal roles at every step of the systems life cycle and

instrumental in the success of deployments at every level of an organization. From the

provision of executive oversight, project management, systems education and training,

and analytics, nurses in clinical settings have become core to organizations’

information management infrastructure and support.

In addition to health care provider organizations, nursing informatics specialists

can be found in the employ of technology vendors, retail outlets, and consulting firms

while many others have created their own entrepreneurial enterprise. Over the last few

decades, technology vendors, hardware and software, have come to appreciate the

invaluable contribution of nurses to the development, sales and deployment of their

solutions. Throughout the world, nurses are also engaged in academic pursuits to

advance the knowledge base of nursing informatics through the conduct of research.

Efforts are underway in many countries to advance the adoption and integration of

entry-to-practice informatics competencies into undergraduate nursing programs.

Notwithstanding some of the ongoing gaps in the provision of informatics content in

undergraduate nursing education, many courses and programs have been taught in a

variety of post-secondary education institutions over several years by nursing

informatics specialists. In fact it is not unusual for many nurses to develop an interest

in informatics through a single course and subsequently pursue further studies and

employment opportunities.

Since the early 90’s many graduate level courses and degrees, certificate and

certification programs have been developed and offered world-wide. Nurses have

pursued these opportunities recognizing the necessity of informatics knowledge and

skills now and particularly into the future, as they face an increasingly connected world

of digital healthcare. To a large extent, the core competencies of the nursing

informatics specialist have become essential for all nurses and expectations of the

specialist role will continue to evolve even further.

3. Emerging roles for nursing informatics specialists

The healthcare sector continues to evolve in the application and use of technologies to

support the delivery of care. Factors including: a) rising health care expenditures, b) the

increasing incidence of chronic disease, c) the ubiquity of technology, d) an aging

demographic, e) personalized medicine, f) mobile and virtual healthcare delivery, g) the

emergence of consumer informatics, h) genomics, i) big data science, and connected

health are and will continue informing the evolution of nursing informatics roles.

One of the main challenges we have to cope with is the difference in growth rate

that is exponential for the new technology and knowledge yet is still linear for

changing human behavior, learning, organizations, legislation, ethics, etc, A linear

growth rate is mostly represented by a function in a form like ����� �� ��
�� An

exponential growth rate is mostly represented by a function in a form like ����� ��
�
�

���

���� example: In an exponential world where the information is doubling every year, 5

exponential years would equal to 2
5

or 32 linear years which has a massive impact on

the management of professional knowledge. In reality, we estimate that knowledge

development in healthcare, which has doubled every century until 1900, is now

estimated to double every 18 months. And the pace is getting faster. This means that

when nurses finish their education, the knowledge they gained might be already

outdated. The traditional way of developing procedures, protocols and care pathways,

sometimes requiring a year to develop, are outdated when they are finalized and are

L.M. Nagle et al. / Evolving Role of the Nursing Informatics Specialist214

insufficient to guide future practice. The only way forward is to integrate and embed

the new knowledge in electronic patient records using algorithms and decision support

systems so that practice remains aligned with new knowledge and insights. The impact

might be that best practices can change very quickly and what is viewed as best

practice before your holiday leave might be different upon your return to work. Making

the connection between these different dimensions of time will be a key-role of the

evolving role of the NI specialist.

A second challenge is that clinical practice in the future will be largely team based.

The nature of teams will include interprofessional teams, patients and their relatives

and a wide range of virtual devices (internet of things – IoT) that are all connected.

Teams will work across boundaries of organizations and will be organized around a

particular patient. We still have to come up with new labels for naming these temporary

virtual interprofessional patient teams. Practically it will mean that nurses will be

(temporary) members of different teams at the same time. This notion of teamwork is

in contrast with what we normally see as teams organized in organizations, departments

and units. It will challenge how teams will be managed, led, and evaluated. But it will

also challenge the communication within teams and the exchange of information.

3.1 Virtual and connected care

The delivery of health services virtually is becoming commonplace in many places

around the globe. Virtual care has been defined as: “any interaction between patients

and/or members of their circle of care, occurring remotely, using any forms of

communication or information technologies, with the aim of facilitating or maximizing

the quality and effectiveness of patient care” [13, p 4].

The most common modalities of virtual care are currently in use in telemedicine.

Telemedicine has been largely used to conduct remote medical consultations,

assessments and diagnosis (e.g., teledermatology, telestroke, telepsychiatry) through

the use of computer technology and associated peripheral devices including digital

cameras, stethoscopes and opthalmoscopes, and diagnostic imaging. More recently, the

tools of telemedicine have been extended to the provision of remote nursing monitoring

and assessment particularly for individuals with chronic diseases such as congestive

heart failure (CHF) and chronic obstructive pulmonary disease (COPD). The nurses

providing these tele-homecare services are not necessarily informatics specialists but

the design and management of the monitoring tools, infrastructure and support services

may be provided by them in the future.

Another emerging area of nursing informatics practice will likely focus on the use

of remote monitoring technologies such as sensors and alerts embedded in structures

(e.g., flooring, lighting, furniture, fixtures) and appliances (e.g., stove, refrigerator) in

the homes of citizens. These tools offer the promise of supporting seniors to maintain a

level of independence in their own homes longer, particularly those with cognitive or

sensory impairments. Such devices might trigger direct messaging to providers, lay and

professional, flagging potentially harmful situations and affording early intervention as

necessary. Different types of sensors (e.g., sleep, activity, falls, ambulation,

continence, fluid and electrolyte) will also contribute new supplementary data to health

information repositories, offering the possibility of linking to other data sets and

provide new insights to the well-being of individuals in the community especially the

aged and those living with chronic illness.

With the increasing use of consumer health solutions such as patient portals and

smartphone apps for self-monitoring and management of health and disease, nurse

L.M. Nagle et al. / Evolving Role of the Nursing Informatics Specialist 215

informatics specialists will likely play a key role in their support and development.

From the perspective of application design and usability, and training, nursing input

and informatics expertise will be important to ensure appropriate and safe use of these

tools. As individuals and their families become more active participants in their care

through the use of applications and devices to connect with providers, they will likely

also need expertise and support from the nursing informatics specialist.

3.2 Knowledge generation and innovation

The traditional ways of new knowledge generation is through research and the

dissemination of findings in research journals. Knowledge is consumed by researchers

and clinicians who transform it into relevant guidelines and care pathways. The time

between the generation of research findings and application in the real clinical work

can take several years. It is generally estimated that it takes an average of 17 years for

research evidence to reach clinical practice [14]. Therefore clinicians are not always

aware of existing evidence. In a landmark study, McGlynn et al. [15] evaluated the use

of evidence-based guidelines in 30 conditions and 439 indicators for the use of the

same. They showed that clinicians (doctors, nurses) only apply 50% of them in their

daily practice. The use varied from 80% for structured conditions such as cataract to

10% for unstructured conditions such as alcohol addiction. There is also a lot of

research demonstrating that nurses lack knowledge related to common procedures.

Dilles study illustrated [16] that nurses lack sufficient pharmacological knowledge and

calculation skills. Baccalaureate prepared nurses’ pharmacological knowledge averaged

between 60% and 65% of the level expected. Segal et al. [17] analyzed the use of hip

arthroplasty care pathways in 19 Belgian hospitals finding a high variability in

providing evidence-based interventions. While post-op pain monitoring is in 100% of

the care pathways, pre-op physiotherapy was only present in 25% of the care pathways.

In the future of connected health, there will be direct links to knowledge generated

by specialists from around the world. New knowledge will be automatically integrated

and embedded into electronic patient records, and include new algorithms for decision

support systems. It is interesting to note that Hearst Health Network, one of the largest

media and communication groups in the world, is taking a leading role in healthcare.

They started an intensive collaboration among strong health knowledge companies

such as First Databank (FDB), Map of Medicine, Zynx Health and Milliman Care

Guidelines (MCG). FDB is a United Kingdom company specialized in integrated drug

knowledge to prescribe medication, follow-up drug interactions, improve clinical

decision making and patient outcomes. Map of Medicine was created in the UK for

clinicians by clinicians. It offers a web-based visual representation of evidence-based

patient journeys covering 28 medical specialties and 390 pathways. Zynx Health offers

a similar story from the US to provide evidence-based clinical decision support system

solutions at the point of care through electronic patient records. MCG produces

evidence-based clinical guidelines and software and is widely used in the US, UK and

Middle East. Other examples of health information networks are CPIC (Clinical

Pharmacogenetics Implementation Consortium) to help clinicians understand how

available genetic test results could be used to optimize drug therapy, the International

Cancer Genome Consortium (ICGC) which facilitates data sharing to describe genomic

sequences in tumor types among research groups all over the world. In the information

models, such as archetypes and Detailed Clinical Models (see section C chapter 1) offer

summaries of evidence for specific clinical concepts.

L.M. Nagle et al. / Evolving Role of the Nursing Informatics Specialist216

Likely one of the most significant areas of focus for nursing informatics specialists

in the near term is data science and the use of “big data”. Big data has been defined as:

“large amounts of data emerging from sensors, novel research techniques, and

ubiquitous information technologies” [18, p. 478]. Access to big data unveils a whole

new sphere of informatics opportunities related to health and nursing analytics.

According to Masys [19], big data is “that which exceeds the capacity of unaided

human cognition and strains the computer processing units, bandwidth, and storage

capabilities of modern computers”. The future development of nursing capabilities in

data science will essentially lead to an entirely new cadre of nursing informatics

specialists whose work will focus on deriving new nursing knowledge from not only

electronic health record data, but also the data from sensor and remote monitoring

technologies, patient portals and mobile apps described above. The implications of –

omics data such as genomics, metabolomics, and proteomics, being included as part of

the electronic health record in the near future, should be taken into account. Nurse

informatics specialists will be pivotal in assisting to identify potential ethical and

practice implications in the use of these data.

Using big data, the knowledge generating process might be reversed into practice-

based evidence where data from electronic health records, patient portals, sensors etc.

are uploaded into large databases that identify patterns and clinical interesting

correlations. An example of the power of analyzing large datasets is the Vioxx-case

(rofecoxib). Although a clinical trial initially showed no increased risk of adverse

cardiovascular events for the first 18 months of Vioxx use, a joint analysis of the US

FDA and Kaiser Permanente’s Healthconnect database of more than 2 million person-

years of follow-up, the NSAID arthritis and pain drug was found shown to have an

increased risk for heart attacks and sudden cardiac death. [20] After the findings were

confirmed in a large meta-analysis, Merck decided to withdraw the drug from the

market worldwide in 2004.

With the proliferation of these emerging data sources and databases, the nursing

informatics specialist will play a key role in the use of these data to inform quality and

safety improvements in every practice setting.

3.3 Sharing knowledge and communication

In the realm of the new normal of connected health, nurses will work in temporary

teams around patients. Within these teams it will be essential that goals are clear and

shared, that roles are defined and accepted and that the way of working is clear to

everyone. It requires systems for coordination and communication to ensure the

continuity of care. Reid et al. [21] defined continuity of care as: “how one patient

experiences care over time as coherent and linked; this is the result of good

information flow, good interpersonal skills, and good coordination of care”. They

make a distinction between information continuity, relational continuity and

management continuity. Information continuity consists on one hand in the exchange

and transfer of information among health care providers and to patients and on the

other hand how the knowledge of the patient is accumulated. It is about their specific

knowledge, preferences, expectations, social network. With the existence of the new

technology of the quantified self, it is important that these new data are effectively

integrated and connected. Relational continuity consists of the trusted relationship

between patient and healthcare provider. Increasingly advanced practice nurses are

assuming this pivotal role within the health team. Management continuity is referring

to a consistent and coherent approach to the health problem across organizations and

L.M. Nagle et al. / Evolving Role of the Nursing Informatics Specialist 217

boundaries. The Belgian healthcare system offers an interesting example of this:

General Practitioners are stimulated (financially) to prescribe generic drugs. Hospitals

are stimulated to negotiate discounts with pharmaceutical companies leading to brand

named drug choices. Although they might chemically be identical, for the patient they

often are not as they have different names. Like drugs may be different in size and

color leading to more medication errors as patients may take two pills without being

aware that they are the same drug.

Although nurses spend a lot of time documenting care, the accuracy of nursing

documentation has been found to be poor. In a study within 10 Dutch hospitals, Paans

et al. [22] found that within 341 patient records the accuracy of documentation of

diagnoses was poor or moderate in 76% of the records. The accuracy of the

intervention documentation was poor or moderate in 95% of the patient records. Only

the accuracy for admission, progress notes and outcomes evaluation and the legibility

were acceptable. The work of Connected Health should support the documentation

systems of nurses and other health professionals. The use of structured documentation

methodologies and standardized terminologies should improve the quality of the

patient record and improve the capacity for comparability of care processes and

outcomes across the care continuum and within patient care groups.

3.4 Impact of connected health on the Scope of Practice of Nurses and Advanced

Practice Nurses (APN)

In Connected Health, the scope of practice of nurses will change. For example, based

on time and motion studies, it has been shown that nurses spend 5-7% of their time [23,

24] collecting vital sign data. In the future this work will be assimilated by sensors and

other devices. However, nurses’ work will be more focused on analyzing the data and

evaluating thresholds for action (e.g., alerting rapid response teams). Another example

is the use of sensors for pressure ulcer monitoring [25]. The used sensors will provide

information about patient temperature, skin humidity, pressure points and position.

These data will generate a whole new set of information for review and action

including pressure intensity map and humidity intensity maps. These data would lead to

more precise management of pressure sores. Other examples of data gathering that will

change the focus and processes of nurses’ work include: barcode scanning for checking

identity of patients, patient and device tracking systems, and robotic dispensing of

medication.

Patient access to their own records and partnering in their own health will change

the roles of physicians, nurses and hospitals drastically. The work of nurses will

increasingly shift from a direct care provision to the role of knowledge broker in

helping patients to understand care alternatives, manage their health, and navigate

information access.

4. Impact of connected health on the evolving role of the Nursing Informatics

Specialist

Connected health will alter the future role of the nursing informatics specialist and

require a new set of competencies. To a large extent these competencies will build

upon existing competencies but have an increasing emphasis on information use rather

than technology use. Table 1 provides a summary of the anticipated new competencies

L.M. Nagle et al. / Evolving Role of the Nursing Informatics Specialist218

and role responsibilities that are likely to be necessary for Nursing Informatics

Specialists in the emerging world of connected health and the IoT.

Table 1. New competencies related to the future role of nursing informatics specialists

New Competencies New Roles

Knowledge Innovation and

Generation

• Provide guidance and support to others (nurses, patients) in the

application and use of emerging knowledge (e.g., clinical decision

support, Practice-Based Evidence (PBE), genomics, expert and

patient/citizen knowledge)

• Inform-teach others (clinicians, teams, patients) about new

knowledge and knowledge innovations relevant to specific

situations

• Provide direction and support to others in the use of international

guidelines and knowledge

• Contribute internationally to new knowledge generation and

innovations ensuring the inclusion of relevant team member and

patient perspectives and expertise

Monitoring the use of new

technology

• Monitor and maintain vigilance over data/technologies to identify

those that add value to a given health situation.

• Recognize that nurses, other clinicians and patients may engage and

assume responsibility independently and or interdependently for

specific data (e.g., remote monitoring, self-monitoring, wearables,

appliances).

• Recognize the emergence of patient self-service and relevance of

patient expertise in specific situations.

Value judgement & quality

assessment

• Provide guidance as to the value and relevance of specific data and

information as derived from single or multiple sources for any given

set of circumstances, or health situations.

Change Management • Identify the broader scope and considerations for change

management in the context of connected health (e.g., virtual and

physical participants/partners)

• Recognize the extended complexities of technology adoption in the

context of connected health.

Communication &

Documentation

With increasingly complex and personalized approaches to health care,

participate in the identification and/or development of new:

• models of clinical documentation

• methods of communication

• data standards

• terminology standards

• data sources

• data models

• data repositories

Data Analytics In addition to traditional quantitative and qualitative analyses, support

and participate in the development and use of new approaches and

methods of data analytics for:

• knowledge generation (e.g., natural language processing,

experiential data)

• reporting outcomes

• demonstrations of value (e.g., patient-caregiver perspectives, health

and financial outcomes)

• predictive and retrospective analyses

L.M. Nagle et al. / Evolving Role of the Nursing Informatics Specialist 219

5. Conclusion

The future Nursing Informatics Specialist will function in the context of virtual care

delivery, be informed by data aggregated from a multiplicity of sources and real-time

knowledge generation that will inform individualized care. In addition to the

competencies required to date, they will be required to support other clinicians and

patients and families as they assume new roles and use data analytics to interpret and

appropriately apply new knowledge. With the IoT, connected care will pose as yet

unknown challenges for the Nursing Informatics Specialist in the future; what is certain

is that the role will continue to evolve from the role scope and responsibilities known

today.

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