Page 370 - Encyclopedia of Nursing Research

NuRSING INFORMATION SySTeMS n 337

primarily to support charge capture, admin- requirements needed to support the nursing
istrative, and operational transactions. With process including performance, flexibility,
the increased introduction of computer and connectivity, as well as user–machine N
technology in the health care industry, com- interface, hardware, and data security and
puter developers of the early hospital, med- integrity requirements. They also believed it
ical, and patient care information systems essential that the system would promote effi-
began to expand their systems to include ciency and effectiveness of care by support-
subsystems that addressed the documenta- ing decision making by the nurse (Zielstorff
tion of nursing care. Then, the challenge was et al., 1993). Androwich et al. (2003) empha-
how to best computerize the existing paper- sized that the information systems of the
based methods of documenting nursing care future must go beyond meeting basic infor-
in health care facilities to support nursing mation needs to support practice. They
practice and patient care. Developers began envision data, information, and knowledge
by computerizing the standardized nursing available to the nurse as needed to inform
care protocols or plans that focused on med- every present clinical encounter and to pro-
ical diagnoses, surgical procedures, or dis- vide and generate new knowledge to improve
ease conditions. With the introduction of the future encounters. Nursing Information and
microcomputer, NIS emerged as stand-alone Data Set evaluation Center identified four
systems for a specific nursing application for dimensions of nursing data sets and the sys-
different aspects of nursing administration, tems that contain them: nomenclature (the
practice, education, research, and commu- terms used), clinical content (the “linkages”
nity health. Such systems were designed by among terms), clinical data repository (how
nurses who were becoming proficient in their the data are stored and made available), and
design. Today, nurses continue to be involved general systems characteristics (American
in the design and development of NIS mod- Nurses Association, 2010).
ules to support capture of nursing data at the NIS modules can be found in all areas
point for care. However, the focus has shifted where nurses function and in all settings
from replicating existing paper processes to where nurses provide patient care including
practice redesign and leveraging informa- hospitals, community health agencies, man-
tion technology to support effective and safe aged care organizations, ambulatory care
patient care and to promote transformation facilities, and other settings. NIS modules
of clinical data into information and knowl- in nursing administration are used primar-
edge (Androwich et al., 2003). ily for the administration of nursing ser-
In 1996, the American Nurses Asso- vices and the management of nursing units.
ciation established the Nursing Information For the administration of nursing services,
and Data Set evaluation Center to develop these information systems are designed to
and disseminate standards pertaining to generate information focusing on budget,
information systems that support nursing personnel, and resource management. The
practice and to evaluate voluntarily sub- focus is on the specific applications needed
mitted information systems against those to run a nursing department effectively and
standards. A number of models for view- efficiently, such as staffing, scheduling, uti-
ing information systems have been pro- lization, productivity, quality assurance, and
posed. One model, developed by Graves and discharge planning. To achieve full reim-
Corcoran, focuses on the design of an NIS bursement for care provided, information
as the framework that represents the man- systems are now required to meet criteria
agement processing of data, information, for “meaningful use” and include electronic
and knowledge. Zielstorff, Hudgings, and documentation and data exchange across
Grobe (1993) identified early system design organizations (Westra, Subramanian, Hart, &