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Why Nurses Need to Understand Nursing
Informatics
McGonigle, Dee; Hunter, Kathy; Sipes, Carolyn; Hebda, Toni . AORN Journal : The Official Voice of
Perioperative Nursing; Denver Vol. 100, Iss. 3, (Sep 2014): 324-327.

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ABSTRACT

Nursing informatics is an exciting nursing specialtydit affects learning environments, meaningful use,
interprofessional collaboration, patient care settings, strategic planning, patient satisfaction, and, ultimately,
patient outcomes. Simply put, nursing informatics is the practice of using nursing science and technology to
enhance the pathway that data take to become knowledge to improve patient care. Furthermore, nursing
informatics is the synthesis of nursing science, information science, computer science, and cognitive science for
the purpose of managing and enhancing health care data, information, knowledge, and wisdom to improve patient
care and the nursing profession.

FULL TEXT

EVERYDAY INFORMATICS
Why Nurses Need to Understand Nursing Informatics
http://crossmark.crossref.org/dialog/?doi=10.1016/j.aorn.2014.06.012&domain=pdf
Web End = DEE McGONIGLE, PhD, RN, CNE, FAAN, ANEF; KATHY HUNTER, PhD, RN-BC, CNE; CAROLYN SIPES,
PhD, RN-BC, CNS, APN, PMP; TONI HEBDA, PhD, RN-BC, MSIS, CNE
Nursing informatics is an exciting nursing specialtydit affects learning environments, meaningful use,
interprofessional
collaboration, patient care settings, strategic planning, patient satisfaction, and, ultimately, patient outcomes.
Simply put, nursing informatics is the practice of using nursing science and technology to enhance the pathway
that data take to become knowledge to improve patient care. Furthermore, nursing informatics is the synthesis of
nursing science, information science, computer science, and cognitive science for the purpose of managing and
enhancing health care data, information, knowledge, and wisdom to improve patient care and the nursing
profession.1(p90) According to
Hebda and Czar, it is broadly dened as the use of information and computer technology to support all aspects of
nursing practice, including direct delivery of care, administration, education, and research. The denition of nursing
informatics is evolving as advances occur in nursing practice and technology.2(p6)
Nursing informatics is important to all nursing specialty areas. It is important for nurses to understand the
relevance of nursing informatics to their practice. In clinical practice, for example, nursing informatics can be used
to track patient outcomes, nd data trends, and assess workload and interventions. It also can help develop
technologies, such as apps, to help health care workers virtually monitor and stay in touch with patients,
improve workows, and help patients deal with their diseases. The use of nursing informatics in nursing education
supports virtual teaching and learning, assessment, analytics associated with educational outcomes, and the
paradigm shift of bringing the library to the student virtually. Nurse executives use nursing informatics to help
them with cost containment, improved workows, decision support, budgeting tools, and trending costs and

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savings. Nursing informatics also can facilitate and support nursing research by evaluating patient outcomes,
evidence-based practice, standardized terminologies, and virtual knowledge bases. As nurses learn nursing
informatics, they must learn to use all information technologies effectively, recognize the benets and limitations of
this technology, and integrate them into how they implement these technologies. In this era of large amounts of
data, nursing informatics competencies are key to safe, efcient, and quality practice, and good use of nursing
informatics can result in enhanced patient care outcomes.
THE DATA, INFORMATION, KNOWLEDGE, AND WISDOM PATHWAY
The principles and practices of nursing informatics allow nurses to understand the process they useto convert raw
data into the wisdom they need to care for patients. This process is called the data, information, knowledge, and
wisdom pathway. The data, information, knowledge, and wisdom
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324 j AORN Journal September 2014 Vol 100 No 3 AORN, Inc, 2014
EVERYDAY INFORMATICS http://www.aornjournal.org
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pathway is used in all levels of nursing practice. As nurses access data and process it into information and
knowledge, they build the wisdom necessary to positively affect the lives of their patients. Nursing informatics
provides the tools and capabilities necessary to enrich the data, information, knowledge, and wisdom pathway and,
therefore, literally puts the information and knowledge nurses need at their ngertips.
The pathway begins with data. Data are raw facts that do not have meaning without context. After data have been
processed to have meaning, they become information. For information to be valuable, it must be accessible,
accurate, timely, complete, cost effective, exible, reliable, relevant, simple, veriable,and secure.
The next step isfor information tobecome knowledge,which is informationthat the user can relateto other
informationand can apply to a taskor use to reach an informed decision. As nurses acquire important knowledge
and skills and hone their ability to observe patients and their environments (ie, acquiring more data), they learn to
place their observations in proper contexts to generate information. As their knowledge grows, nurses can assess
the information they have acquired, communicate applicable ndings, and take appropriate actions based on these
assessments. Nursing informatics informs and supports these activities.
Wisdom, the nal step on the pathway, is the application of knowledge to appropriate situations by using insight or
intuition while being thoughtful, judicious, and practical. Nurses need to apply their knowledge to patients
situations and rely on their knowledge, integrated with evidence-based practice, to enhance patient care. Wisdom
uses knowledge and experience to heighten common sense, perceptions, and the ability to think critically and use
sound clinical judgment. Knowledge and wisdom
are not synonymous, because knowledge includes others thoughts and information, whereas wisdom is focused
on ones own mind and the synthesis of ones own experience, insight, intuition, understanding, and knowledge.
Wisdom could be thought of as the foundation of the art of nursing.
PERSONAL IMPORTANCEThe focus of this new Everyday Informatics column is to help nurses understand and
implement the concepts of nursing informatics and optimize patient care by using health care technology.
Examples of concepts and topics that will t within this column include electronic health records (EHR) personal
health records, electronic access to care (eg, telehealth), terminologies and taxonomies (eg, the Perioperative
Nursing Data Set3 language), virtual environments, social networking and professional boundaries, simulation,
robotics, databases and database management, analytics, dashboards and benchmarking, accessibility, privacy,
meaningful use, and optimization. Innovative ideas and questions of how perioperative nurses embrace the rapid
advancement of technology and retain the art of the practice at the same time generates content for this column.
The team members who will be writing this column with me are Kathy Hunter, Toni Hebda, and Carolyn Sipes. I
asked them each to say why they believe nursing informatics is important. Their responses are included here.
Monitoring PatientsKathy Hunter: Years ago, when I was working full time nights in the Maryland Shock-Trauma

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Unit, we had computer display units in every patient cubicle that were connected to patient monitoring equipment.
Laboratory data were provided directly from the trauma laboratory. Vital signs
Nursing informatics provides the tools and capabilities necessary to enrich the data, information, knowledge, and
wisdom pathway and, therefore, literally puts the information and knowledge nurses need at their ngertips.
AORN Journal j 325
September 2014 Vol 100 No 3 EVERYDAY INFORMATICS
data were collected from the monitors. Critical parameters could be automatically calculated or requested as
needed. Any parameters one wanted could be graphed in combination on demand. There also were programs for
collecting nursing data (ie, assessments). This system was pretty primitive compared with those available today,
but even then I could see the value of having the collected data displayed across timedwatching trends was a big
part of nurses ongoing monitoring. Entering the data was worth theeffort because theinformation we received
helped keepingup with patients oftenrapid physical changes.
It was this realizationthat rst got me involved in what is now called informatics.
Implementing EHRsCarolyn Sipes: During the past 11 years, I have worked as a consultant with several health
systems, both nationally and internationally. Even today, I see the same issues arise with EHR implementation
regardless of whether they are large or small implementations, or whether they are national or international
implementations. The one consistent theme throughout all of these implementations is the lack of communication
and understanding between what information technology department personnel think should be implemented for
clinical staff members versus what the nurses and other clinical staff members really need to complete their day-
to-day tasks. Health systems are becoming better at recognizing the need and value of the nurse informaticist who
can facilitate the process and communication between the two specialties.
In the past, and even today, one of the key risks for project failure in an EHR implementation is when it is the sole
responsibility of the information technology department to design a system for clinical users without their input
into what is required for them to successfully complete their
work. Today, the informaticist functions in the role of a facilitator for information technology and clinical staff
members as well as performs many other roles. On some projects, informaticists might work as analysts, or work
to interpret and assist with a workow design and implementation, or collect and analyze data that might be used in
a managers monthly dashboard report. They provide shoulder-to-shoulder support for clinical staff members
during the go-live phase of the implementation. The role for the informaticist is expanding even further as
organizations recognize the value a nurse informaticist can bring.
An example that emphasizes the value of an EHR and role of the nurse informaticist was when both the Cleveland
Clinic and a competitor were implementing the same EHR system. A patient had tests and radio-graphs performed
at one facility, and a physician told me how he had cancelled tests and radiographs he had ordered for the patient
because the tests had already been run at the competing hospital. Working with the nurse informaticist who
facilitated the communication between the two hospitals, he said he trusted their results and would use those
instead. The philosophy of using a national EHR system and adding the skills of a nurse informaticist who
understands the functions of both has saved many health care dollars.
Supporting Nurses WorkToni Hebda: Nurse informatics supports the work that nurses do. It allows quick access to
information when and where it is needed by the people who need it to facilitate the delivery of safe, effective
patient care, support administrative decisions, and enhance the education of nursing students, health care
consumers, and the public through the use of well-designed and well-used technology. Nurse informatics provides
the tools to make nursing
Informaticists provide shoulder-to-shoulder support for clinical staff members during the go-live phase of
electronic health record implementation.
326 j AORN Journal
EVERYDAY INFORMATICS http://www.aornjournal.org
Web End =www.aornjournal.org

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contributions to health care delivery visible, support research, and allow virtual real-time decision making through
the use of analytics, which is a method that allows the discovery and communication of meaningful patterns in
large unorganized data sets. Nursing informatics is an exciting area of specialization that focuses on working
smarter, not harder.
Editors note: The second edition of the Perioperative Nursing Data Set (PNDS) was superseded by the third edition
(PNDS 3) in 2011. The PNDS 3 terminology is only distributed through AORN and AORN Syntegrity licensed
vendors. For questions about PNDS 3 implementation intothe EHR and electronic perioperative record solutions,
please contact the AORN Syntegrity team via e-mail at mailto:[email protected]
Web End [email protected] . AORN Syntegrity is a registered trademark of AORN, Inc, Denver, CO.
References
1. http://refhub.elsevier.com/S0001-2092(14)00675-9/sref1
Web End =McGonigle D, Mastrian K. Nursing Informatics and the http://refhub.elsevier.com/S0001-
2092(14)00675-9/sref1
Web End =Foundation of Knowledge. 3rd ed. Burlington, MA: Jones http://refhub.elsevier.com/S0001-
2092(14)00675-9/sref1
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2. http://refhub.elsevier.com/S0001-2092(14)00675-9/sref2
Web End =Hebda TL, Czar P. Handbook of Informatics for Nurses &http://refhub.elsevier.com/S0001-
2092(14)00675-9/sref2
Web End =Healthcare Professionals. 5th ed. Upper Saddle River, NJ: http://refhub.elsevier.com/S0001-
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3. http://refhub.elsevier.com/S0001-2092(14)00675-9/sref3
Web End =Petersen C, ed. Perioperative Nursing Data Set. 3rd ed. http://refhub.elsevier.com/S0001-
2092(14)00675-9/sref3
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Dee McGonigle, PhD, RN, CNE, FAAN, ANEF, is the chair of virtual learning environments and professor of graduate
programs at Chamberlain College of Nursing, Columbus, OH.
Dr McGonigle has no declared afliation that could be perceived as posing a potential conict of interest in the
publication of this article.
Kathy Hunter, PhD, RN-BC, CNE, is the dean, MSN Indirect Care Tracks, Chamberlain College of Nursing, Columbus,
OH. Dr Hunter has no declared afliation that could be perceived as posing a potential conict of interest in the
publication of this article.
Carolyn Sipes, PhD, RN-BC, CNS, APN, PMP, is an associate professor, MSN Program Online, Chamberlain College
of Nursing, Columbus, OH. Dr Sipes has no declared afliation that could be perceived as posing a potential conict
of interest in the publication of this article.
Toni Hebda, PhD, RN-BC, MSIS, CNE, is a professor, MSN Program Online, Chamberlain College of Nursing,
Columbus, OH. Dr Hebda has no declared afliation that could be perceived as posing a potential conict of interest
in the publication of this article.
AORN Journal j 327

DETAILS

Subject: Bioinformatics; Nursing

Publication title: AORN Journal: The Official Voice of Perioperative Nursing; Denver

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Volume: 100

Issue: 3

Pages: 324-327

Publication year: 2014

Publication date: Sep 2014

Publisher: John Wiley &Sons, Inc.

Place of publication: Denver

Country of publication: United States, Denver

Publication subject: Medical Sciences--Nurses And Nursing

ISSN: 00012092

Source type: Scho larly Journals

Language of publication: English

Document type: NWS, Journal Article

DOI: http://dx.doi.org/10.1016/j.aorn.2014.06.012

ProQuest document ID: 1622584425

Document URL: https://search.proquest.com/docview/1622584425?accountid=194530

Copyright: © 2014 AORN, Inc

Last updated: 2014-12-04

Database: Nursing &Allied Health Database

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 Bibliography
Citation style: APA 6th - American Psychological Association, 6th Edition

McGonigle, D., Hunter, K., Sipes, C., & Hebda, T. (2014). Why nurses need to understand nursing informatics. AORN
Journal, 100(3), 324-327. doi:http://dx.doi.org/10.1016/j.aorn.2014.06.012

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