Nursing Information Systems

Nursing Information System (NIS)

Definition

Nursing Information System is a part of a health care

information system that deals with nursing aspects,
particularly the maintenance of the nursing record.

CEN/TC 251 /PT001 Medical Informatics-Vocabulary

First Draft Working Document
Objectives of a Nursing Information System:
1. An integrated view of patient data (e.g. integrate nurses
and physician orders in the patient care plan)
2. Data available from different locations (including bedside entry)
3. Control of correctness, validity, safety and confidentiality
of information
4. Communication with related services
5. A user-friendly interface: easy to learn, fast to use, help
functions included and homogeneous in appearance
6. Planning support activities
 Functions of a Nursing Information
System

A conceptual information model based on four important main

functions in the clinical and administrative nursing practice.

These main tasks in the nursing care process are the following:

1. Patient care processes

2. Ward management processes
3. Communication processes
4. Education and research processes
 1. Patient care processes
Anything done to/for the patient. It can vary from medical treatments
(administering medication, fixing bandages, giving a bath) to diagnostic
observations. It is the basis for gathering operational information

• Patient registration (nurse anamnesis)

• Examinations and observations (nursing diagnosis)
• Treatments and medication scheduling
• Nurse medical record charting
• Dietary registration
• Patient acuity/classification (prospective)
• Workload assessment
• Patient administration (discharge, transfer)

Main actor: nurses

 2. Ward management processes
Activities related to the well functioning of the ward unit, to the
effective use of the available resources in achieving the specific
planned objectives.
It transforms operational information into management-oriented
information to assist in the decision-making process.
• Quality assurance
• Nursing ward unit activity overviews
• Staff scheduling (human resources)
• Personnel management
• Care planning (nurse charting)
• Inventory management and supplies
• Financial management (budjet, patient billing)
• Infection control

Main actor: nurses manager

 3. Communication processes
All activities concentrated on communications about a patient
(orders, appointments, talking to the family) and other
work-related subjects
• Orders (medication, treatments) are integrated in the care plan
• Appointment and scheduling
• Data review (order status, medical results)
• Information transfer to nurses who are coming on duty
• All kinds of messages
Main actor: nurses

4. Education and research processes

Documentation of routine functions and procedures
 NIS Committee
The NIS committee generally includes the following:

* A nursing representative from administrators to uphold the nursing

department’s commitments
* A nursing representative from each of the major health care departments,
programs, or units in the hospital
* A clinical nurse specialist/advanced practice nurse
* A systems nurse
* A staff physician
* A computer consultant
* A systems analyst
* Other appointed members
 Health care facility

Other Nursing department

departments
Management
Information
Nursing information System (MIS)
system committee department
• Nursing
administration’s
Infromation
representative
system
• Nursing units’
committee
representatives
• Systems nurse
• Computer consultant/
systems analyst

Project staff
Organizational chart depicting an NIS committee
Phases of implementing and upgrading an NIS are:

1. Planning phase
2. Analysis phase
3. Design phase
4. Development phase
5. Implementation phase
6. Evaluation phase
7. Upgrade phase
 1. Planning phase
The planning phase involves the following steps:

1. Define problem and/or stated goal

2. Conduct feasibility study
- State objectives
- Determine scope
- Determine information needs
- Decide whether to proceed
- Negotiate the project definition agreement
- Write the project definition document
3. Allocate resources
 2. Analysis Phase

1. Collect data 2. Analyse data

- written documents - data flowchart
- questionnaires
- grid chart
- interviews
- decision table
- observantions
- organizational chart
- model
3. Review Data

4. Identify Benefits
 3. Design Phase

The design phase is dividedinto two parts:

1. Functional design
• personnel 2. Implementation design
• time frame • design inputs
• cost and budget • design outputs
• facilities and equipment • design files and databases
• data manipulation and output • design controls
• operational considerations
• human-computer interactions
• system validation plan
 4. Development phase

The Development phase includes the following:

1. Select Hardware
2. Develop software
3. Test system
4. Document system
- user’s manual
- operator’s manual
- maintenance manual
 5. Implementation Phase

The implementation phase includes a detailed description of

the system that specifies not only all hardware and software
components but implementation, training, operation, and
maintenance procedures as well.Includes the following steps:

1. Train users
2. Install System
3. Manage and Maintain System
 6. Evaluation Phase (1)
The following criteria are considered essential in selecting a
nursing information system and can be used as a basis for
evaluation:

• Applications • Simplification of reports

• Overall system performance • Database access
• Evaluation features • Hardware and software
• Ease of system use reliability
• Configuration or programming • Connectivity
• System cost
performance
• Security
 6. Evaluation Phase (2)

Methods and tools for evaluating a system’s functional

performance include:

* Record review
* Time study
* User satisfaction
* Cost-benefit analysis
 7. Upgrade Phase
Some of the important considerations in upgrading a system
include the following new technologies:

• Bedside/point-of-care terminals
• Workstations
• Multimedia presentations
• Desicion support systems
• Artificial intelligence
• Neural networks
• Integrated systems architecture
• Interfaced networks
• Open architecture
 Future trends
The next decade will require expanded system capabilities.
They will include:
• Databases and database management systems
• Workstations
• Data acquisition and retrieval
• Text processing
• Advanced image processing and storage
• Data-exchange and vocabulary standards
• System communications and network infrastracture
• Linkages to secondary databases