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Discussion question Week 2: Wisdom Versus Judgment

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Discussion question Week 2: Wisdom Versus Judgment

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How does the concept of wisdom in nursing informatics compare to the concept of professional nursing judgment? What is DIKW and how do you “use” it in your practice?

Lecture

NI integrates nursing science, computer science, and information science to manage and communicate data, information, knowledge, and wisdom in nursing practice (American Nurses Association, 2015). While only a few of you will choose NI as your specialty area of practice, all nurses need an appreciation for the focus and practice of NI as well as the resources and support that it can provide, and the NI skills that you require as nurse leaders. The rapid emergence of technology and informatics may lead to the identification of additional NI skills in the future. As a specialty, NI is fairly new. It was recognized in 1992, based upon evidence of the following criteria for designation of a nursing specialty:

how the specialty is different from other nursing specialties and from general practice nursing;

specific academic preparation for the specialty;

defined research programs;

organizational representation; and

a credentialing program.

The American Nurses Association published the Scope of Practice for Nursing Informatics in 1994. The first credentialing exam was offered shortly afterwards. The American Nurses Credentialing Center provides the only certification available in nursing informatics, although certification is offered in other informatics areas by other organizations.

NI differs from other areas of nursing specialization because its phenomena of interest are the structures and processing of data, information, and knowledge used by practicing nurses rather than nursing’s phenomena of interest, namely person, health, environment, and nurse. In fact, the processing of data, information, and knowledge provides the foundation for the metastructures of NI.

Nursing Informatics for All Nurses

Last week, we spoke of nursing as “knowledge work” and that nurses routinely collect data, turning it into information, knowledge, and ideally, wisdom. This process can be completed without information technology (IT), although IT can support the transformation. In either event, the transformation makes use of information-management principles.

Current Status of Nursing Informatics

NI continues to grow and evolve as it works to create its own knowledge base. NI has its own research agenda that holds interest and benefits for all nurses because NI supports all areas of nursing practice. The National Institute for Nursing Research Strategic Plan addresses the use of informatics and informatics-based solutions to facilitate health, prevent disease, and engage patients in the management of their own care.

The American Nurses Association (ANA, 2015, p. 1) defines NI as

…a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, knowledge, and wisdom in nursing practice. NI supports consumers, patients, nurses, and other providers in their decision making in all roles and settings. This support is accomplished through the use of information structures, information processes, and information technology.

The Nursing Informatics Special Interest Group of the International Medical Informatics Association (IMIA-NI, 2009) adopted a similar definition that differs primarily in its emphasis upon promotion of global health.

The Nursing Informatics: Scope and Standards of Practice (American Nurses Association, 2015) addresses two levels of NI practice—generalists and informatics-nurse specialists (INSs). Generalists have experience in the field and may be very knowledgeable, but have not been educated at the graduate level. The INS has completed graduate-level education in informatics or a related field. Practice at the INS level reflects innovation and often research. There are many formal degree programs today that offer an informatics or nursing informatics focus. Another popular option may be seen with post-graduate certificate programs that can range from 9–30 credits in length. Both the informatics nurse and the INS can be invaluable resources for nurses in other areas of practice, but not every setting has either informatics nurses or INSs in place; although, every setting that employs nurses requires at least a basic level of nursing-informatics competencies.

Nursing Informatics Functional Areas

Informatics nurses and INSs wear many different hats and work under many different titles. The Nursing Informatics: Scope and Standards of Practice (American Nurses Association, 2015) identifies the following functional areas for INS practice:

  • administration, leadership, and management;
  • analysis;
  • compliance and integrity management;
  • consultation;
  • coordination, facilitation, and integration;
  • development;
  • educational and professional development;
  • research and evaluation;
  • policy development and advocacy; and

The Role of the Master’s-Prepared Nurse in Promoting and/or Using HIT and Informatics

The master’s-prepared nurse is expected to develop and display a more advanced understanding and mastery of informatics competencies that include the activities listed below.

  • Critical review of HIT for benefits (safety, cost effectiveness, improved outcomes) as well as potential problems
  • Input into the design, selection, and use of HIT
  • Support the integration of HIT and evidence-based practice
  • Use data and information to drive decisions
  • Role model appropriate/effective HIT use
  • Serve as a resource on HIT matters
  • Safeguard PHI
  • Use electronic communication and systems to communicate effectively and appropriately
  • Use HIT for quality improvement activities
  • Provide oversight for optimal use of HIT by subordinates
  • Use technology to support education

Discussion question Week 2: Wisdom Versus Judgment

Summary

NI is a fairly new nursing specialty, but one that has implications for all areas of nursing practice because its purpose is to support all areas of nursing practice as well as healthcare consumers and other healthcare professionals.

The phenomena of NI interest are the structures and processing of data, information, and knowledge. It is not enough to use technology it needs to be used well in order to avoid negative consequences.

The master’s-prepared nurse must be prepared to analyze HIT for its benefits as well as possible problems, provide input into HIT decisions, use data and information to drive decisions, role model a positive attitude and appropriate use of HIT, use technology effectively for education and communication, and provide oversight for optimal HIT use.

References

American Nurses Association. (2015). Nursing informatics: Scope and standards of practice. Silver Spring, MD: Nursebooks.org.

International Medical Informatics Association-Nursing Informatics Workgroup (IMIA-NI). (2009). Definition. Retrieved from http://imianews.wordpress.com/2009/08/24/imia-ni-definition-of-nursing-informatics-updated

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