Putting Data in Nurses' Hands

Gienna Shaw, for HealthLeaders Media , February 21, 2012

This article appears in the February 2012 issue of HealthLeaders magazine.

Although the title of chief nursing informatics officer or nurse informaticist isn't exactly commonplace, data is increasingly becoming a part of nurses' day-to-day working lives. Typically the largest employee population, nurses also have the most frequent direct contact with patients. And so getting data into their hands can have a big impact on patient care. 

"Every nurse needs to be able to understand the power of data, because nurses are knowledge workers. We have always collected data and information. So we need to understand the data that's at our fingertips. It's something that every staff nurse should be able to do," says Toni Hebda, PhD, RN, BSN, MNEd, MSIS, a professor in the master of science nursing degree program at Chamberlain College of Nursing, which has campuses in seven states and is headquartered in Downers Grove, IL.

"For us to be adept at what we need to do, we need to be able to work with the technology and use it at the optimal level so that we can reap the benefits, both for our work methods, as well as patient safety and improved outcomes," she says.

Still, some say adding a chief nursing information officer to the executive team is another example of C-suite bloat.

And Hebda agrees that not every department in the hospital needs a chief informatics officer. But she adds that it is a mistake to think that informatics should be solely the domain of doctors.

"From a political standpoint, a lot of people still prefer to reference 'medical informatics,'" Hebda says. "And some people innocently think that just encompasses everything within the healthcare profession," although in industry-speak that phrase refers to physicians. "There are many areas within healthcare or medical informatics that represent the different disciplines," she says.

That attitude isn't an issue at the 330-licensed-bed Catholic Medical Center in Manchester, NH, says Mercedes Fleming, the organization's manager of nursing systems and support.

"I've mostly worked at community hospitals. And honestly my experience is that at community hospitals the nurse has tremendous autonomy. And the doctors here are actually accustomed to nursing taking a leadership role in caring for the patient. I'm not saying we operate outside our scope of practice. But we do keep a pretty close watch over what is going on with our patients. That's really nothing new for us," she says.

Resources and responsibilities

CMC started its nursing informatics work in 2007 with a clinical documentation system—it used a knowledge-based charting program that merges evidence-based practice and clinical practice guidelines.

"It dramatically improved the quality of the documentation and put all nurses on the same page in terms of caring for the patients," she says. "It moved all nurses to that same level of care."

The program, a product by Grand Rapids, MI–based software firm Elsevier CPM, measures patient outcomes by asking nurses to determine the patient's condition—if it is improving, declining, or stable.

"That was a higher level of practice than we had employed prior to that time," she says.

Then the hospital decided to make its nurses experts in a number of different systems, starting with computerized physician order entry.

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2 comments on "Putting Data in Nurses' Hands"

Jackie Larson - Avantas (2/22/2012 at 12:19 PM)
This article tackles a lot of issues. On one hand, it speaks to a greater issue of departmental silos. In my company's world of healthcare labor management we provide our clients with a lot of tools and dashboards to monitor staffing levels, productivity, etc., but sometimes these tools are used only by financial analysts, put into reports and are forgotten – not the point of having access to real-time data. The point of real-time data is to empower staff and managers to make adjustments to correct the course – before variances become trends that hurt the bottom line. To the point about making staffing recommendations for the next shift based on acuity, hospitals should already have the expansion and contraction capacity built into their contingency resources to account for normal fluctuations in volume or acuity. This really isn't an issue of needing a technology to tell you what you already know. It is an issue of having sound labor management plans that allow you to adjust, system-wide, to the ebb and flow of patient care. If your inpatient unit scheduling is based off accurate, census projections (predictive analysis), not budgeted census, your staffing levels will be more accurate to begin with, making those last minute acuity adjustments nonevents. Providing nurses with data is not hard to do. What a lot of organizations struggle with is empowering nurses to do something with the data they have access to.

Karen Hahn, MBA, BSN, RN (2/21/2012 at 12:01 PM)
This article further substatiates the nurses vital role as end users of EMR to the success of the organizations and meeting their goals and requirements for HIT .




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