Module I

Why do you as a graduate level nurse need to know about information management?

Graduate nurses are leaders. Leaders must be the driving force to embrace the future, which includes a maze full of complex information and technological advancements. We are cresting the top of a tall mountain where the impending ride up and down on the Information Technology rollercoaster is going at full speed. The use of technology will only grow. There is no turning back. Now that we cook with stoves, no one wants to go back to cooking over an open fire. Such is the way with technology. And smart leaders in healthcare are the ones who learn to use it, and make the technology work for them. Not the other way around.

I was surprised that both Imhoff and Curran painted broad strokes regarding the need to know informatics. She contends that informatics encompasses much more than learning to work the computer and make spread sheets. Curran (2003) even goes so far as to say that competency in informatics is necessary to master the information and knowledge required to be successful in the health care environment.

To reiterate: Curran claims competency in informatics equals competency in practice. Those are strong words, placing information management on equal footing with other well accepted competencies such as knowledge, clinical decision making, critical thinking, etc. Imhoff (2000) also infers a similar message and again uses a broad definition with informatics as the basis for learning, assimilating and distributing knowledge.

So in essence, we need to learn information technology because it, along with the patients, are at the very core of everything we do as practitioners / educators / managers, etc.

Describe what is happening related to IT in your clinical or practice setting.


I will speak to the great things that are happening in the world of teaching. I am impressed with the way the professors at the U are embracing technology to enhance the adult learner's experience. Effective teaching is learner centered. And effective learning happens through active (not passive) means. Use of webCT, discussion boards, Wimba, etc. all help students to be more actively engaged. And the use of the internet for asynchronous learning extends the ability of education to those in rural areas without having to relocate. This ability to educate has such a positive trickle down effect in many areas of nursing.

When I think about IT in the clinic settings where I worked for practicum, I echo what everyone has said regarding the use of computer charting. But I also think IT extends beyond record keeping and management. Think about the use of a digital camera to aid documentation. I worked with a plastic surgeon whose digital camera was more important to him than a stethescope. Simply having a photo in the patient's chart can save the provider a lot of time from having to accurately describe the lesion, rash, etc.

The use of Information Management can be used to reduce errors, enhance compliance, promote prevention, save time, improve communication, and lower costs. Some may argue that technology weakens the interpersonal component of healthcare. I actually disagree.

What structured documentation, standards, and/or coded terminologies do you see within your practice setting (if none--where might they be applicable)? 


Documentation at the places where I did my practicum was all computer generated. Templates were often used. There are pros and cons to using templates. But I must admit, they were a huge timesaver. Especially for a novice like myself who was slow at charting. Coding was done without the computer. I think if somehow coding could be done on the computer, it would be more accurate and consistent.

How are structured/coded clinical data useful in promoting quality patient care?


In order to evaluate quality outcomes, data must first be gathered and analyzed. Using structured / coded data makes the analysis process so much easier. Charts and graphs can be created which speak volumes at a simple glance. Spreadsheets are also great in managing large amounts of data and side by side comparisons. Klijakovic et al. (2004), points out that coded clinical data is not uniformly utilized and implemented between inpatient and outpatient settings, pointing out that there is still great room for improvement, and that many providers still need to grasp the concept that informatics is their friend.

References
Curran, C.R. (2003). Informatics competencies for nurse practitioners. American Academy of Clinical Nurses, 14 (3), pp 320-330.

Imhoff, M., Webb, A., Goldschmidt, A. (2000). Health informatics. Intensive Care Medicine, 27, pp 179-186.

Klijakovic, M., Abernathy D., & de Ruiter, I. (2004). Quality of diagnostic coding and information flow from hospital to general practice. Informatics in Primary Care, 12, 227-234.