Unit 6 Educational Applications

EDUCATIONAL APPLICATIONS
Nursing Curriculum Reform and Healthcare Information Technology

Objectives:
1. Describe the background of and needs for curriculum reform in nursing education
in the twenty-first century.
2. Discuss prior academic and other professional organizational efforts to transform

nursing education with an emphasis on healthcare information technology.
3. List information technology competencies required by nurses with different levels

of education.
4. Identify current national trends in nursing education associated with informatics.
5. Explain the content and process of the American Nurse Credentialing Center
(ANCC) Nursing Informatics Certification examination.
Efforts in Nursing Curriculum Revisions

● An increased awareness of patient safety and the use of HIT in healthcare called
for changes in the nursing curriculum.
● The IOM report, Health Professions Education: A Bridge to Quality, is a result of
a 2002 summit followed by the IOM’s report, Crossing the Quality Chasm
(Committee on Quality of Healthcare in America & Institute of Medicine, 2001).
● This interdisciplinary summit was held to discuss reforming education for health
professionals to enhance quality and patient safety (Institute of Medicine
Committee on Health Education Profession Summit, 2002).
● The report proposed five core competencies for healthcare professionals
(Committee on Quality of Healthcare in America & Institute of Medicine, 2001;
Institute of Medicine Committee on Health Education Profession Summit, 2002):
1. Provide patient-centered care – identify, respect and care about patients’
differences, values, preferences, and expressed needs …. and continuously
advocate disease prevention, wellness, and promotion of healthy lifestyles,
including a focus on population health.
2. Work in interdisciplinary teams – cooperate, collaborate, communicate, and

integrate care in teams.
3. Employ evidence-based practice – integrate best research with clinical
expertise and patient values for optimum care, and participate in learning and
research activities to the extent feasible.
4. Apply quality improvement – identify errors and hazards in care; understand

and implement basic safety design principles … design and test interventions
to change processes and systems of care, with the objective of improving
quality.
5. Utilize informatics – communicate, manage knowledge, mitigate error, and

support decision making using information technology.
Quality and Safety Education for Nurses (QSEN)
● The three phases of the QSEN project are to address the competencies
necessary to continuously improve the quality and safety of the healthcare
systems.
Phase I
- Identified six competencies that needed to be developed during pre-licensure
nursing education.
Phase 1 QSEN Competencies
 Patient-Centered Care - Recognize the patient or designee as the source of
control and full partner in providing compassionate and coordinated care
based on respect for a patient’s preferences, values, and needs.
 Teamwork and Collaboration - Definition: Function effectively within nursing

and inter-professional teams, fostering open communication, mutual respect,
and shared decision-making to achieve quality patient care.
 Evidence-based Practice (EBP) - Integrate best current evidence with

clinical expertise and patient/family preferences and values for the delivery of
optimal healthcare.
 Quality Improvement (QI) - Definition: Use data to monitor the outcomes of

care processes and use improvement methods to design and test changes to
continuously improve the quality and safety of healthcare systems.
 Safety - Minimize the risk of harm to patients and providers through both
system effectiveness and individual performance.
 Informatics - Use information and technology to communicate, manage

knowledge, mitigate error, and support decision-making.
Phase II
Focused on competencies for graduate and advanced practice nurses (APNs). The
QSEN faculty members collaborated with APNs who practiced in direct patient care and
worked on the development of standards of practice, accreditation of educational
programs, and certification.
Phase III
The AACN worked on developing the capacity of faculty engaged in pre-licensure
nursing education to mentor their colleague faculty integration of the evidence-based
content on the six QSEN competencies.
Phase IV
Supports Institute of Medicine’s recommendation increasing number of nurses with
advanced degree. These efforts are being led by the Tri-Council for Nursing, consisting
of the American Association of Colleges of Nursing, National League for Nursing,
American Nurses Association, and the American Organization of Nurse Executives
(AONE).
Technology Informatics Guiding Educational Reform (TIGER) Initiative
● Epitomizes nurses’ efforts to translate high-level initiatives on nursing education
reform to a practice level.
● Aim is to fully engage practicing nurses and nursing students in the electronic era
of healthcare.
● Goal is to create and disseminate action plans that can be duplicated within
nursing and other multidisciplinary healthcare training and workplace settings.
TIGER Initiative
Phase I
TIGER summit, stakeholders from various fields, including nursing practice, education,
vendors, and government agencies, participated in the discussions, and the TIGER
team developed a 10-year vision and three-year action plan for transforming nursing
practice and education.
Phase II
TIGER formalized cross-organizational activities/action steps into nine collaborative
TIGER teams.
TIGER 2009
1. Standards and Interoperability
2. Healthcare IT National Agenda/HIT Policy
3. Informatics Competencies
4. Education and Faculty Development
5. Staff Development/Continuing Education
6. Usability/Clinical Application Design
7. Virtual Demonstration Center
8. Leadership Development
9. Consumer Empowerment/Personal Health Record
Current Situation of TIGER
 Currently TIGER is working on Phase III that integrates the TIGER
recommendations into the nursing community as well as other disciplines across
the continuum of care. Some of the important activities include the development
and implementation of a Virtual Learning Environment Center (VLE) and
developing another invitational summit (TIGER, 2014b). The VLE is an
interactive Web-based learning environment where the learners can develop
knowledge and skills in the area health information technology.
Information Management and Technology-Related Essentials for Nursing
Education
INFORMATICS COMPETENCIES FOR PRACTICING CLINICIANS
The essentials and competencies recommended by the IOM, AACN, QSEN, and TIGER
address essential competencies that need to be addressed in educational programs. A
great deal of effort also has been made in developing more executable competency lists
that can be used in practice settings.
American Nurses Association
● Nursing Informatics. The Scope and Standard of Practice (ANA, 2008) addressed
an NI-specific domain.
● The competencies contained in the NI Scope and Standards matrix were categorized
into three overall areas:
○ computer literacy-addresses competencies in the area of the psychomotor
use of computers and other technological equipment.
○ information literacy - competencies are related to the ability to identify a
need for information as well as the ability to find, evaluate, organize, and use
the information effectively
○ professional development/leadership - competencies address ethical,
procedural, safety, and management issues for informatics solutions in
nursing practice, education, research, and administration.
The categories of educational and functional roles within the competency matrix
include:
• Beginning Nurse
• Experienced Nurse
• Informatics Specialist/Informatics Innovator
• Administration Analysis
• Compliance and Integrity Management
• Consultation
Coordination
• Facilitation and Integration
• Development
• Educational and Professional Development
• Policy Development and Advocacy
• Research and Evaluation
• Integrated Areas
Certification in Nursing Informatics and Related Hit
Currently the American Nurses Credentialing Center (ANCC), an accredited agency,
offers the generalist nursing informatics certification (RN-BC) (ANCC, 2014b). The
minimum academic degree required to take the examination for this certification is a
bachelor’s or higher degree in nursing or a bachelor’s degree in a relevant field. The
test content outline for the nursing informatics certification examination can be found on
ANCC’s Web site (http://www.nursecredentialing.org/InformaticsTCOs) (ANCC, 2014c).
Selected Certifications Relevant to Nursing Informatics
Simulation-Based Learning
● Use of high-fidelity simulation has become the gold standard in current nursing
education.
● The purpose of simulation in clinical settings is to replicate the important aspects
of a clinical situation where students or clinicians can work to gain knowledge
and experience.
● Most nursing schools have multiple high-tech simulation labs including high
fidelity simulators, those labs provide students with various simulated clinical
settings.
● Implementing the EHR in simulation labs allows students to have an opportunity
to develop competencies in using HIT before they go into the clinical setting. In
addition, most EHRs have decision support systems which could significantly
augment students’ learning.
Informatics Competencies for Faculty Members
● Faculty members who teach informatics must have a specific expertise in the
field.
● With the heightened awareness of IT in healthcare technologies.
● There is a significant shortage of faculty members who have an expertise in
healthcare informatics and who can teach students. More doctorally prepared
informatics faculty members with a proper education/training are needed in NI
education.
Conclusion
● Information technology has revolutionized current healthcare. Consumers now
can access enormous amounts of health information online even before they
come to the hospital.
● with the advancement of information communication technology, face-to-face
classes are being replaced by online classes, and high-tech and high-fidelity
simulation-based nursing education has become a standard.
● New generations of nursing students are expected to be informatics competent.

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EDUCATIONAL APPLICATIONS

Nursing Curriculum Reform and Healthcare Information Technology

2. Discuss prior academic and other professional organizational efforts to transform

3. List information technology competencies required by nurses with different levels

4. Identify current national trends in nursing education associated with informatics.

Efforts in Nursing Curriculum Revisions

2. Work in interdisciplinary teams – cooperate, collaborate, communicate, and

4. Apply quality improvement – identify errors and hazards in care; understand

5. Utilize informatics – communicate, manage knowledge, mitigate error, and

 Teamwork and Collaboration - Definition: Function effectively within nursing

 Evidence-based Practice (EBP) - Integrate best current evidence with

 Quality Improvement (QI) - Definition: Use data to monitor the outcomes of

 Informatics - Use information and technology to communicate, manage

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