Jennifer has taught Nursing in ADN, BSN, and MSN programs and has a Master's degree in Nursing Education.
The evolution of the specialty of nursing informatics is a relatively short one. When first introduced, nursing informatics focused mainly on the technology that made up the field of nursing, and very little about its users, nurses, and those who benefitted from the technology, patients. As a result, the definitions became information technology-oriented definitions.
As the decades progressed, the specialty of nursing informatics shifted focus to a more conceptual framework. Researchers sought to anticipate the need for technology, versus reacting to a problem that arises from technology. With conceptually-oriented definitions in mind, theorists evolved the definition of nursing informatics to include nursing information and goals as well as users. However, even with a more updated definition of nursing informatics, the changing times called for another changing definition.
As healthcare, nurses, and other specialties entered the 1990s, it was clear that technology had pushed and changed the path of healthcare and would continue to do so. In addition, a new emphasis was placed on decision-making processes and the impact on patient care. As the specialty looked at the impact informatics had on these aspects, it was clear that a more focused definition was needed to hone in on the specific roles within the field of nursing informatics. Role-oriented definitions began to emerge and focus more on the nursing informatics specialist instead of the specialty itself.
Now that we've introduced each one, let's check out each of them in a bit more depth.
Information Technology-Oriented Definitions
Information technology-oriented definitions are just as they sound; they are the early definitions of nursing informatics that focused on the information technology that was used itself. Early authors of these definitions include Scholes, Barber, Hannah, Saba, McCormick and Zielstorff. These authors focused on a technology-oriented view of nursing informatics that severely downplayed the role of a nursing informatics specialist as well as patient interaction. The lack of emphasis on patients in relation to nursing informatics was customary of the times.
During the early decades of nursing informatics, patients were still playing a more passive role in their own health. With the dawn of technology, such as the Internet and smartphones, patients were able to take more control of their healthcare needs and become more active players in their care. This again changed the way technology was used in healthcare and the need for it. In addition, the technology-oriented definitions do not adequately explain the role in which the nurse, bedside or specialist, assumes when using technology in practice.
The shift from information technology-oriented definitions to conceptually-oriented definitions began around the 1980s. During this time, it was authors such as Schwirian and Turley that made a call for action, to change the focus of nursing informatics definitions from technology-based to purpose-based. They defined, along with others such as Graves and Corcoran, that the focus of these definitions should be on the purpose of the technology and model-driven rather than problem-driven.
During this time, new research models and theories were developed that placed nurses, the users of the technology, and patients, the receivers of the technology, at the center of the definition. Suddenly, the delivery of patient care was just as important. With an increased awareness of patient care blooming during this time, it also called for the relationship between research, clinical decision-making, and technology to be explored more in-depth as well.
Towards the end of the decade, Turley did not propose a new definition of nursing informatics, but an entirely new nursing informatics model. The model included cognitive science in order to shape a new definition. Cognitive science would allow nursing informatics specialists the change to explore the behaviors and logic behind decision-making processes related to nursing informatics.
Where Turley left off, this opened the door for role-oriented definitions to take shape in the late '90s. The American Nurses Association began providing definitions of nursing informatics that incorporated the role of the nursing informatics specialist. For the first time, the practice of nursing informatics was acknowledged within a definition and contributed to the creation of certification examination/specialty, though the ANA's definition had to undergo a few revisions in order to provide information on the role of the nurse informatics specialist. The result was, for the first time, both technology-oriented and conceptually-oriented definitions were blended together.
Despite a more detailed definition that encompasses patient care, nurses, and the role of the nurse informatics specialist, the definition of nursing informatics is still evolving. The current definition still underemphasizes the role that patients play when using technology. In addition, the role that research and evidence-based practice plays in nursing informatics is also neglected. These are two hot topics in the world of nursing and healthcare in general and should be addressed in future definitions.
The shift in definitions over the years mimicked the shift in healthcare and the increased trend of patient-focused care. The definitions for nursing informatics were forced to evolve from a focus on the technology that shaped it to the users that used it, and finally, landing on a definition that focuses on the actual practice of nursing informatics. It is no wonder that the definition will be forced to evolve as nursing informatics continues to grow and change with healthcare.
In addition, with the advent of evidence-based practice, new evidence will hopefully emerge that will provide insight into the changes, challenges, and impact nursing informatics has created, so that a future definition can also evolve.
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