Nursing informatics is currently the fastest growing area of professional nursing work. Integration of the principles of nursing practice and information and computer technology allows this area to solve specific issues related to patient safety. The problem of falls is relevant for all global institutions in the world and poses a serious threat to the well-being of patients, in particular older ones. Data report that 700,000 to 1 million hospitalized patients fall each year, leading to various injuries and may result in death (“Falls,” n. d.). The pending Nursing Practice and Research Information Management System (NPRIMS) project aims to collect and analyze information on nursing performance in preventing falls. The pending Nursing Practice and Research Information Management System (NPRIMS) project aims to collect and analyze information on nursing performance in preventing falls.
Informatics Project Overview
The Safety Issue Involved
The nursing informatics project analyzed in this work addresses the problem of falls, which are common in medical institutions. Falls among patients can lead to various injuries such as “fractures, head, and soft tissue trauma, which may lead to impaired rehabilitation, decreased independence, and premature death” (Choi & Choi, 2016, p. 103). Preventing falls of patients is one of the ways to increase the level of safety. To reduce the number of falls and related injuries, many hospitals have begun implementing computerized risk assessment systems and other preventive measures. However, in practice, there are no studies that assess the effectiveness of such initiatives.
The Stakeholders Involved
Patient safety concerns affect many people who have an interest in changing the situation. Healthcare stakeholders may be defined as “any person or party with an interest in the financing, implementation, or outcome of a service, practice, process, or decision made by another” (Cho, Lee & Kim, 2020, p. 3). Thus, falls in health care settings primarily affect patients, their families, and caregivers. Healthcare providers, including physicians, nurses, and professional associations, are also involved in solving the problem. The government presented by accrediting agencies and legislative bodies is another stakeholder in the area of patient safety.
The Intended Goals of the Project
The main goal of the project is to develop a prototype computer information system, Nursing Practice and Research Information Management System (NPRIMS). This system aims to record and analyze clinical data of nursing care associated with the prevention of falls among patients. The impact of this activity on the patient’s treatment outcomes is also assessed by the system. For research was selected “a nursing care protocol, the Fall and Fall-related Injury Prevention Protocol (FFIPP) for Veterans Admitted to Adult Day Health Care (ADHC) at Veterans Affairs (VA) Medical Center in Milwaukee, Wisconsin” (Choi & Choi, 2016, p. 104). The project includes four stages, including creating the expert nursing panel, construction of a computer algorithm, programming a prototype, and evaluation.
The Actual Outcomes of the Project
As a result, a prototype of the NPRIMS website has been created, which successfully calculates the basic statistics of fall prevention. The system provides various data on the indicators associated with the problem (for example, the percentage of falls or the risk assessments performed). These statistics are useful as they allow you to identify factors in nursing care that need to be improved to improve patient safety. What’s more, NPRIMS provides more granular reporting of crash types, allowing more specific prevention measures to be developed. However, the system does not provide information on injuries resulting from falls. Moreover, NPRIMS studies were conducted only within one hospital, which does not make the data valid for different healthcare settings.
Assessment through Informatics Model
Data, information, and knowledge are key aspects of nursing informatics practice. According to the Graves and Corcoran model, data is an objective description of a phenomenon without interpretation. Processing and analyzing data allows you to obtain information that can later be structured and organized. On the basis of the information, it is possible to identify and formalize relations that represent knowledge (American Nursing Association, 2015). Further research suggested adding the concept of wisdom to the model. This component can be defined as “the appropriate use of data, information, and knowledge in making decisions and implementing nursing actions” (Nelson, 2018). Thus, the integration of key aspects and professional values allows nurses to manage healthcare issues. Nursing informatics, in turn, uses nursing, computer, and information science to collect, analyze, and communicate data, information, knowledge, and wisdom (American Nursing Association, 2015). Thus, information and technology are applied to the management of the healthcare setting and the nursing decision-making process.
The described nursing informatics model seems to be relevant in the context of the project considered. First of all, the project uses data “related to clinical assessments, patient problems, interventions, and patient” (Choi & Choi, 2016, p. 104). The data were evaluated by a panel of experts of nurses and later structured using a computer algorithm. Thus, based on the selected data, information was synthesized representing various statistical models. The result was also evaluated by the expert panel nurses for suggestions and modifications. Further, on the basis of the algorithm, a web platform was developed that provides the received information to healthcare providers. Thus, based on the information received, they can generate knowledge for use in solving a specific healthcare issue. The results of working with the knowledge gained can then be used to generate wisdom as a result of the nursing research process.
Thus, the described project implementation process corresponds to the theoretical model of nursing informatics, which is based on key principles. The process includes obtaining and structuring patient data, their subsequent processing and synthesis of information, interpretation of information, and the formation of knowledge and the potential generation of wisdom. Moreover, the project uses nursing science, which is to provide the highest quality patient care and improve their outcomes. It also integrates computer and information science to make the best use of data in nursing practice.
Standards of Practice
The standards of practice for nursing informatics encompass many aspects which are combined to deliver high-quality nursing care. These standards include many factors such as professional activity, work with information, ethical aspects, research, education, communication, and others (Al-Hawamdih &Ahmad, 2017). Evaluation of the submitted project in terms of standards of nursing informatics practice is to consider the integration of these aspects. First of all, the project provides nurses with a tool for the correct collection and assessment of information. Nurses can also identify problems and opportunities for health issue improvement. In terms of planning and outcomes, the project also meets the standards, as it allows nurses to set a specific goal and implement the project according to it. From the perspective of health teaching and health promotion, the project also has prospects since, on the basis of the information received through it, nurses can conduct educational work with patients.
Thus, the standards of practice for nursing informatics have been followed in the implementation of this project. It uses data to improve patient care and safety. Moreover, experts with a high level of education and extensive experience in clinical activities took part in the implementation of the project, which integrates the principles of nursing science. The project aims to overall improve patient safety in the healthcare setting and may be applicable to other healthcare issues in the future.
Impacts of Regulatory Constraints
From the point of view of compliance and integrity management, the project complies with regulatory restrictions since it does not involve the use of personal and confidential patient data. To a greater extent, the program is aimed at tracking the performance of medical personnel, which requires the project to pay attention to the protection of medical personnel data. From a quality and performance improvement perspective, the project is most effective as it provides nurses with an opportunity to generate reports on patient outcomes and quality of care. Safety, security, and environmental health promotion involve human-computer interaction to minimize statistical errors that can occur when generating and analyzing information. The project uses an expert panel of two nurses who validate the data and its structuring to design the most accurate and efficient system. Thus, the risk of computational errors is minimal since the data and methods of their analysis are verified by experienced nurses. Thus, the project is value-based and aimed at improving the quality of patient care and safety. which corresponds to regulations and does not meet restrictions.
Ethical and Legal Practices
The Code of Ethics for Nurses recognizes that the primary concern of a nurse is caring for patients and working to improve the quality of care provided. In an informatics setting, a nurse may not be involved in direct patient care but rather actively participate in the development of care delivery systems. From an ethical perspective, the project complies with all provisions of this Code, as it is fully aimed at solving one of the problems related to patient safety. From a legal point of view, this project may have problems with data confidentiality and protection. The system developed within the framework of the study is based on a web resource, which makes it sufficiently vulnerable to hacking and data misuse. This aspect also addresses ethical concerns related to the integrity of patients’ and healthcare providers’ data. However, the safety of patients is the primary goal of healthcare, which is controversial in terms of data protection in relation to this project.
Transmission of Data
The project aims to improve the productivity of nurses in preventing falls for patients. Thus, the project fully copes with the accurate transmission of data to internal stakeholders. Moreover, the result of the nurses’ activity based on the use of this system has a direct result on the satisfaction and outcomes of patients. The system also provides capabilities for recording and analyzing performance indicators and the dynamics of risk assessment and prevention of falls. Thus, the project can also be used for the administration and management of the activities of medical personnel. However, the system provides limited opportunities for nursing research, as it does not take into account data on injuries sustained by patients as a result of falls. Thus, the project provides more practical than theoretical value for healthcare setting.
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Choi, J., & Choi, J. E. (2016). Enhancing patient safety using clinical nursing data: A pilot study. In W. Sermeus et al. (Eds.), Nursing Informatics (pp. 103-107). IMIA and IOS Press. Web.
Falls. (n. d.). Agency for Healthcare Research and Quality. Web.
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