NR 599 Nursing Informatics for Advanced Practice Week 2 Discussion

NR 599 Nursing Informatics for Advanced Practice Week 2 Discussion

NR 599 Nursing Informatics for Advanced Practice Week 2 Discussion

      Informatics is used in many ways in nursing and directly affects the way in which we provide care. Informatics identifies important data and information based on nursing and computer sciences and ultimately guides evidence-based practice, process/protocol changes, and ways to improve patient care and safety.  Prior to taking the TANIC self- assessment I perceived my competency level to be fairly high. I am typically good with the basic aspects of computers and try to stay up to date on new technology. I have also used multiple different EHRs throughout my career in healthcare and can very clearly identify the differences in what aspects work well based on our unit workflows. For instance, my current facility just switched from an older EHR to EPIC. In the transition process, we’ve identified the need for major workflow changes to ensure all documentation and patient care is being accurately completed. When the initial EPIC changeover happened, all the original process and procedures remained in place which left us with no idea how to correctly find and do things, including restraint documentation which drastically changed with the new system. The nice thing we are finding with EPIC is that despite the issues we initially found, the system is able to be tailored more directly to our needs (although it takes a little while to get there). After completing the self-assessment, I still believe my competency level is high. I was able to score myself as proficient and expert on the majority of the questions. Since the TANIC assessment is based on the lower-level competencies and I have nursing, research, and computer experience I believe my perceived competency to be relatively accurate.  

            In my current role I use aspects of level 1 competencies such as turning on/logging on to the computer via password, sending and receiving emails, and basic collection of patient data. I also use aspects of level 2 competencies regularly, which includes gathering and synthesizing data and protecting health information. Basic use of the computer is something I use on a daily basis, as we are reliant on the computer and EHR for all our unit communications and documentation. Logging on to the computer, sending emails, and charting are three main functions in my role. Protecting health information is also vital in my position. There are many factors on my unit that make it easy for PHI to unintentionally be revealed, but also many ways to prevent it. We have an open nurse’s station, meaning the patients can reach over and grab/see anything that sits on the desk. They are also able to hang around on the sides of the desk and potentially see our documentation and what is pulled up on the screens. To protect this information, we have the darkening screen protectors that make it difficult to see the screen unless directly in front of it, and we make it a point to leave all paperwork, charts, and anything with patient identifiers in the locked conference room behind the nurse’s station. We also use only first name and last initials to ensure privacy for our patients and staff alike.   

            One resource that with directly enhance informatics competency is the use of interprofessional education. According to Reynolds (2018), interprofessional education or IPE refers to when two or more professions work together to increase education, collaboration, and quality of care. When utilized with informatics, IPE increases collaboration and teamwork, quality improvement strategies, and can guide in depth EBP. When each profession has a better understanding of what the other does and their ultimate goals, quality of care ultimately increases. Cooperation among various professionals lends new perspectives to developmental work (Ahonen, 2018). Continued education in informatics is another incredibly useful resource for enhancing knowledge and skills. For me, this is my first official informatics class and while my basic knowledge is proficient, my advanced knowledge of informatics is lacking. The best way to gain competence and skill is to continue exploring educational information and classes that build on the basic concepts. Informatics as a specialty includes more in-depth knowledge and training with technological aspects and advancements, and without additional schooling would be increasingly difficult to become competent in. For me specifically, the best method would be to continue my informatics education to become more skilled in the specialty and be able to adequately apply it to my work. IPE is something I see being done quite often in my current facility through regular treatment team meetings and I find it to be incredibly beneficial. As a nurse I don’t always understand why the social workers, dieticians, physicians, etc. do things the way they do, but when everyone gets together in these meetings there are open discussions and education on why/how to create the best plan for each patient. This collaboration effort greatly increases the quality of patient care. In my future practice I plan to encourage such meetings and ensure open lines of communication between providers to decide the best possible practice. I also intend to continue learning as much as I can throughout this course and subsequent courses in order to improve my informatics competencies to the best of my ability.

References

Ahonen, Kinnunen, U.-M., Lejonqvist, G.-B., Apkalna, B., Viitkar, K., & Saranto, K. (2018). Identifying Biomedical and Health Informatics Competencies in Higher Education Curricula. Studies in Health Technology and Informatics, 251, 261–264. https://doi.org/10.3233/978-1-61499-880-8-261,

Reynolds, & Wilson, G. M. (2018). The Power of Interprofessional Education to Enhance Competency-Based Learning in Health Informatics and Population Health Students. The Journal of Health Administration Education, 35(3), 377–387.

Week 2 Discussion Pre TANIC Self-Assessment and Reflection Post

Manage Discussion Entry

How is informatics used?

We use informatics in several ways. It is used to collect and store information and data, such as information our EHR. EHR’s have come a long way and now connect patients to their provider with the click of a button from their phones. Informatics is also used in research. We are able to gather data related to new and best practices which is used to initiate evidence-based changes. Informatics can also be applied to general workflows in our care settings. It is a part of every aspect of medicine. The American Medical Informatics Association describes informatics as “… computer and information science to the advancement of life sciences research, health professions education, public health, and patient care” (What is informatics, n.d.).

Regarding the Pre-TANIC Self-Assessment for this week, how did your perceived competency level prior to the self-assessment compared to after the self-assessment? Explain in detail. 

Prior to the assessment I felt good about the technology that I use daily within my current role. After using the TANIC Self-assessment tool, I was not much surprised by my results. I am confident and competent in use of systems tools and our daily technology. I am less competent when it comes to informatics research or informatic process changes. Also, informatics is such a large category. I think it would be difficult to master all of it. Finding areas of competence and mastering those areas can be helpful. For example, I excel with use of Epic. As such, I have requested to be one of our Super Users for the program. But even though I scored myself lower in some areas of the assessment, I still had no categories in the assessment that I rated as Novice. I was competent or higher in all areas. Expert or proficient when it comes to operation of personal computer and the various applications and competent or proficient with respect to use of technology to guide patient care.

What TWO competencies do you use in your current clinical role? Provide examples.

In my current role we use HIS to guide patient care (guidelines, plan of care, protocols) and we use HIS to communicate electronically with providers. We are able to use HIS to access policies and procedures from our organizations employee portal. This is an important guide for patient care. We always have nursing resources available on best practice procedures. For example, if we need to refresh on proper procedure for changing a central line dressing, we can go on to our employee portal, access Eslevier clinical skills, and are able to search and view proper procedure for central line dressing changes. We have an online database of policies for use as well. While our policies cover every topic from general roles, to patient guided care, we can often cross reference clinical skills with a corporate policy addressing the same issue. We also have built in nursing protocols for triage in our emergency room. We are able to execute appropriate protocols in Epic when triaging our patients based off chief complaint, assessment, and clinical judgment. 

In my current role we also use telehealth. We are a small community based hospital. We have a 4-bed inpatient unit that I float to frequently. Since all our hospitalists are staffed at the larger locations in the city, we use telehealth for patient admissions, assessments, and any change in patient conditions. Continued innovations in the technology of telehealth has created the opportunity to provide better care to patients in remote settings (Brown, et al., 2022). By becoming familiar and competent with use of this technology allows us to stay connected with other providers and optimize the best possible care to our patients when they are admitted to our community locations. Our telehealth equipment is fully functional. We have tools that attached to the computer station which allow our hospitalist to assess our patient in real-time but from a remote location. With assistance of the RN, they are able to inspect skin and even listen to heart and lungs. So, for my role, being able to operate the telehealth equipment and its applications with competence allows my provider to fully assess my patient leading to more accurate plan of care. 

Identify TWO resources to develop a strategic plan to enhance your competency skills.

A study was done by Akbari, et al. gauged toward nurses self-competency related to basic computer skills, informatics knowledge, and informatics skills (Self-assessment, 2020). They found that the higher the education and training, the higher the competency in informatics (Akbari, et al., 2020). Once we have been able to identify our weaknesses in informatics (self-assessment), then we are able to develop a plan to increase our competency. Goal setting is one tool I can use to increase my competency. Because I have been able to assess my areas of weakness and reflect on areas of needed improvement, I can set goals to increase my knowledge in the areas where I am less confident. As we grow as leaders, we must be able to assess our own knowledge base and determine what additional skills and/or experience is needed to advance our competency (Backonja, et al., 2021). I have higher competence in basic computer skills than I do in informatics knowledge and informatics skills. So, I can use goal setting as a resource to increase my competence in these two areas.

As Akbari, et al. noted, education and training lead to higher competence (Self-assessment, 2020). I can use continuing education opportunities within my facility as a resource to increase my knowledge. I am also fortunate to have great teachers and mentors in my department. I can utilize this as a resource for learning. Backonja, et al. states that mentoring programs are resources that can provide support that take us from novice level to expert in HIT (How to support the nursing, 2022). Backonja, et al. goes on to state that mentorship is an important tool because mentors can provide real-time feedback on areas of needed improvement (How to support the nursing, 2022).

Which resources are suited to your needs and why?

Mentorship on the job is better suited for me. I do well with a hands on approach and having a interactive dialogue with someone. I work in a teaching environment and our providers embrace this atmosphere. I have ample opportunity to learn from them and they are a wealth of knowledge. They are also good about pointing out additional resources for learning. And while I still plan to use the educational tools offered by my organization, I think combining these education with what I can learn from my mentors will draw a better understanding in the areas of informatics where I am less proficient.

How do you intend to enact this improvement plan? 

Miller, et al. states that looking for teachable moments is an important concept because a vast amount of learning occurs within our clinical environment (Recognizing and seizing, 2021). In this respect, learning is a purposeful and continual process that we have to act on. To enact my improvement plan I will continually assess my level of competencies, revise, or set new goals, and then actively seek teachable moments with my mentors. I will also incorporate educational modules or courses offered by my organization into my learning. This will allow me to bring learned concepts into practice and ask questions of those with more experience than myself.

Akbari, H., Frazandipour, M., Jabali, M., Mohamadian, H. & Safari, S. (2020). Self-assessment of nursing informatics competencies in hospitals. HIMSS. Retrieved on 03/12/2023 from: https://www.himss.org/resources/self-assessment-nursing-informatics-competencies-hospitalsLinks to an external site.

American Medical Informatics Association (March, n.d.). What is informatics? Informatics: Research and Practice. Retrieved on 03/12/2023 from: https://amia.org/about-amia/why-informatics/informatics-research-and-practiceLinks to an external site.

Backonja, U., Langford, L. & Mook, P. (2021). Calling nursing informatics leaders: opportunities for personal and professional growth. OJIN: The Journal of Issues in Nursing, 26(3). https://doi.org/10.3912/OJIN.Vol26No03Man06Links to an external site.

Backonja, U., Langford, L. & Mook, P. (2022). How to support the nursing informatics leadership pipeline recommendations for nurse leaders and professional organizations. Computers Informatics Nursing, 40(1), 8-20. DOI: 10.1097/CIN0000000000000827. Retrieved on 03/12/2023 from: https://www.journals.lww.com/cinjournal/Fulltext/2022/01000/How_to_Support_the_Nursing_Informatics_Leadership.3.aspxLinks to an external site.

Brown, J. & Hewner, S. (2022). The role of telehealth and clinical informatics in data driven primary care redesign.  Journal of Informatics Nursing, 6(4). Retrieved on 03/12/2023 from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9211055/Links to an external site.

Miller, B. & Szymusiak, J. (2021). Recognizing and seizing the teachable moment. Academic Pediatrics, 21(5), 767-771. Retrieved on 03/12/2023 from: https://www.sciencedirect.com/science/article/pii/S187628592030485XLinks to an external site.

Purpose

The self-assessment is completed using the TIGER-based  Assessment of Nursing Informatics Competencies  (TANIC) tool. TIGER refers to the Technology Informatics Guiding Education Reform Initiative which identified a list of the minimum informatics competencies for all nurses and students graduating from pre- and post-licensure programs.  The  graded self-evaluation of your informatics competencies is required in order to increase one’s own

understanding  of competencies in nursing informatics which will enable  the planning of strategies to  enhance knowledge and skills.

Activity Learning Outcomes

Through this assignment, the student will demonstrate the ability to:

Apply knowledge of nursing informatics and non-nursing science (CO 1 and  2)

Assess nursing informatics competencies (CO2)

Evaluate progress in enhancing nursing informatics competencies (CO4)

Foster professional and personal development with planning strategies to enhance these competencies  (CO4)

Examine ethical decision making in relation to these competencies (CO3)

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Requirements:

In order to prepare for this assignment, read the lessons as well as the assigned readings BEFORE attempting the self-assessment.

Please use the following hyperlink to access and complete the survey: Week 2 Pre-TANIC Self-Assessment Survey    (Links to an external site.)

FAILURE TO COMPLETE THE SURVEY WILL RESULT IN A GRADE OF ZERO (0) FOR THE ASSIGNMENT.

After completing the survey, navigate to the Week 2 Module in Canvas and respond to EACH of the q uestion s for your Reflection Post.

The Reflection Posts DOES NOT require cross-posting to a peer or faculty .

ATTENTION: Students will not receive results following completion of this survey. For the reflection questions, please recall how you rated your proficiency/competency with the skills on the survey.

*IMPORTANT* Upon completing the TANIC self-assessment survey, please TAKE A SCREENSHOT of the last page of the survey using a program such as Snipping Tool and save as a PDF or JPG and for your records. If you are unable to take a screenshot, please inform your faculty.

Reflection Questions:

Reflect upon your current or most recent clinical practice and answer the following:

How is informatics used?

Regarding the Pre-TANIC Self-Assessment for this week, how did your perceived competency level prior to the self-assessment compared to after the self-assessment? Explain in detail.

What TWO competencies do you use in your current clinical role? Provide examples.

Identify TWO resources to develop a strategic plan to enhance your competency skills.

Which resources are suited to your needs and why?

How do you intend to enact this improvement plan?

As BSNs, we had to know how to make the most of the tools at our disposal to ensure the health and safety of our patients. Those who excelled at their jobs over time became the unit’s go-to source for assistance. Eventually, these nurses are thrust into positions of greater authority, either as preceptors or supervisors. Now that we’ve reached the graduate level, we’ll be expected to use the aforementioned technological tools to effectively communicate with peers in different fields, manage our courses, and lessen the likelihood of undesirable medical outcomes. It’s intriguing in that I’ve already come up with an idea (albeit an invention if it isn’t already out there) that can further aid in error prevention just from reading the chapters. Research is required