Nursing informatics is a field of nursing that incorporates nursing, computer, and information sciences to maintain and develop medical data and systems to support the practice of nursing, and to improve patient care outcomes. Technologies that have evolved due to health care/nursing informatics include:
- Computerized provider order entry (CPOE)
- Electronic medical records (EMRs)
- Test results
- Progress notes
- Nursing notes
- Medication records
There are three "building blocks" of nursing communications-data, information, and knowledge. Data includes direct observations that do not need interpretation, such as:
- Patient's name
- Vital signs
- Disease history
Information is data that has been interpreted. Examples include:
- Prevalence of hospital-acquired infections, by care unit
- Percentage of patient care delays in outpatient clinics, by specialty
Knowledge is the amalgam of information to identify relationships that provide further observation to an issue. For example:
- The effect of nurse-patient ratios and patient outcomes
- Developing care protocols (i.e. anaphylactic reaction protocols, pressure ulcer protocols, etc.)
While nurses incorporate all three communication "building blocks" in their daily routines, the three concepts are also stored in computer programs and software to assist health care providers across the continuum to provide high-quality, safe patient care.
Nurse informaticists work to develop communication and information technologies in health care. They also serve as educators, researchers, software engineers, and chief nursing officers. Using the "building blocks" listed above, they help develop evidence-based policies and procedures for organizations.
Nurses need information to care for patients safely. They need to be able to access medical histories, medication lists, lab and imaging results, and physician/interdisciplinary team notes to get a complete picture of a patient's clinical status. They use this information to make decisions efficiently to improve patient care outcomes.
Nurse informaticists, as well as other health care informaticists (pharmacists, physicians, etc.), play a critical role in the continuous development and improvement of health care technology. Communication is inarguably one of the most important aspects of patient safety. The contribution of nurse informaticists in developing and improving technology such as electronic medical records and computerized provider ordering has been crucial in reducing medical errors, patient care delays, and health care costs.
For example, before CPOE, nurses would need to transcribe provider orders by hand. Hard-to-read handwriting and human error caused transcription inaccuracies, which in turn led to medication errors, delays, and omissions.
Today, software exists where providers simply click a button and the right medication, dose, and frequency is selected. Additionally, some programs cross-check orders against the patient's allergies and/or duplicate orders to further protect patient safety.
Nurses who have strong analytical and critical thinking skills, enjoy working with technology, and enjoy problem-solving and project management make excellent nurse informaticists.
Those considering the specialty of nurse informatics should, at a minimum, obtain a bachelor's degree in nursing (BSN). While an advanced-practice degree is not always required, it is highly recommended. Advanced-practice nurses are those who have completed a master's program in nursing (MSN) or doctoral degree program (DNP).
To advance to a master's degree or doctoral in nursing, a student must complete an accredited nursing program and obtain a BSN. Successful completion of the NCLEX-RN is needed for licensure. The length of time it takes to earn an MSN depends on the nurse's starting point:
- Nursing students enrolled in a BSN program complete in about four years
- RN to BSN takes about two years
- BSN to MSN takes about two years
- BSN to DNP takes three to four years
- MSN to DNP takes one to two years
There are both online informatics programs and classroom programs available to accommodate students. Both types have pros and cons depending on students' needs, therefore researching individual schools is encouraged.
Nursing Informatics Education Requirements and Training
Some graduate programs require nurses to gain a few years' clinical experience before enrollment. Some schools allow nurses to work concurrently during the program. Working as a unit-based technology support user (also known as a "super-user") or with the information technology (IT) team allows nurses to gain necessary technical skills needed to work as an advanced-practice nurse informaticist.
Master's degree programs require completion of general advanced-practice courses, as well as courses specific to nursing informatics. While courses and practicum may vary slightly, curriculum for the nursing informatics track may include:
- Statistics for evidence-based practice
- Database management
- Project management
- Clinical information systems
- Information security and privacy
- Informatics theory
Examination, Licensure, and Certification
Certification in informatics can be completed concurrently within the MSN/DNP program or obtained via independent study from the American Nurses Credentialing Center (ANCC) or other learning institutes. Eligibility for certifications obtained outside of an MSN/DNP program can differ, and students are encouraged to research requirements when choosing an educational institution.
The ANCC offers board certification for nursing informatics. Eligibility for certification include:
- Hold a bachelor's degree or higher
- Have practiced as a registered nurse full time for two years (or part time equivalent)
- Have completed 30 hours of continuing education in nursing informatics within three years before certification
- Have met one of the following practice hour requirements:
- Have practiced a minimum of 2,000 hours in informatics nursing within the prior three years
- Have practiced a minimum of 1,000 hours in informatics nursing in the last three years and have completed a minimum of 12 semester hours of credit in informatics courses that are part of a graduate-level nursing informatics program
- Have completed a graduate program in nursing informatics that includes a minimum of 200 hours of supervised practicum
Certification is by exam, and the credential is valid for five years.
Licensure and certification are different-certification means nurses are competent to perform in the field of nursing informatics; licensure means they are legally permitted to practice in their state of residence. State nursing boards list the requirements for testing and can vary from state to state. BSN, MSN, and DNP nurses, after meeting specified requirements, may apply to their state board for licensure.
Nurse informaticists play a critical role in not only developing health care technology but educating staff and evaluating the results of implementation. Other responsibilities and duties include:
- Assessing and analyzing health care technology needs
- Designing systems technology
- Testing systems technology
- Implementing the technology which also includes:
- Staff training
- Escalating issues as needed
- Assisting in the transition from one system's technology to another
- Evaluating the success of implementation; revising as needed
- Serving as project managers
- Assisting in ensuring organizations meet federal health care laws such as HIPAA
- Serving as a resource to staff
- Serving as a liaison between staff and information technology experts
- Assessing user requirements and developing solutions
- Serving as an educator to staff and new nurses
- Developing organizational policies and standards
- Researching different informatics topics that affect health care providers as well as patients
The expanding presence of computers and technology in health care has led to more crossover career opportunities-including nurse informatics. By combining technology and nursing, this specialty utilizes the skills needed to improve health care efficiency and enhance patient safety.
Nurse informaticists work in many different areas such as:
- Long-term care facilities
- Nursing schools
- Health care consulting firms
- IT companies
They are vital in assisting members of the health care team to integrate new information technology applications into daily work flows. This takes skill and patience as not everyone is accepting of change, especially in technology. Since health care technology is a rapidly evolving science, many health care practitioners still cling to "old school" methods and struggle with navigating computer systems. However, nurse informaticists are skilled in various approaches to education and can provide ongoing support to the most challenging and resistant learners.
Salary and Employment
According to PayScale, informatics nurses can earn between $56,372 and $97,367 annually with a median salary of $75,939. Salary can be dependent on additional degrees or certificates held, city and state of employment, experience, and the organization.
Nursing, in general, is a field that is growing substantially. The Bureau of Labor Statistics projects a 16 percent growth until 2024. Growth is primarily due to demand for health care services- an aging population, a significantly of nurses retiring, and recent health care legislation creates a higher demand to ensure patient care needs are met. Additionally, the top-paying states for registered nurses are:
While the Bureau of Labor Statistics does not track data specifically for nurse informaticists, it does project a 21% growth for computer systems analysts as a whole. If there is technology, then there is the opportunity-- especially in today's health care arena. Nurse informaticists have an advantage in this field, as more and more organizations seek to lower cost while improving care.