Nursing Information Systems Survey

Nursing training Systems SurveyStudy of Nursing Information Systems (NIS) in teaching hospital of Zahedan University of Medical SciencesLeila Erfannial Msc1,Yo make use off Mehdipour PhD 1,Afsaneh Karimi Msc 1,Ayeshe Zargoni Bs 1,Nahid Mehrabi Msc 2ABSTRACTPurpose Nurses are one of the biggest providers in wellness industry that effect directly on health wait on quality and outcomes. Nurses need correct randomness in correct time to take hold an effective service for patient and other fellow member of health society. Nursing entropy form (NIS) is sub brass of hospital data system that can attend to nurse to set about better performances. The main goal of this employment is evaluation of breast feeding data system in teaching hospital of Zahedan according hackneyed criteria.Materials and Methods This research is based on a descriptive sink in sectional study that has assumee on 2013.Nursing randomness system of 4 teaching hospital in Zahedan were evaluated. For inf o gathering, we use a checklist that its reliability and rigor was verified.Results According our result, NIS of our study has met 42.19% of priority in general scopes, 72.33% for nursing information trim, none of them had classification system standards. They had 45% of nursing info register priorities and 61.12% of say requirement was met.Conclusion According our system weakness in general aspects, data register and data classification, we propose educational package such as workshops, classes and bulletin for nurses in hospitals toward optimal using of NIS. In other hand , provide nurses with enough hardware requirements , management supervision on using system , provide NIS systems by nursing classification standards and contribution of nurses in selection and implementation of this system is suggested.Keywords nursing information system hospital information system nurseINTRODUCTIONThere is an increasing growth in information production in divers(prenominal) sciences and theqnics, so the management of these volumes of information is very difficult. Information technology is a useful tool for management and useful application of this information. Health industry has faced with increasing rate of information generation that are multiple and complicated in nature1. So health information technology can help this high-demanded industry to manage information. Health information systems are both(prenominal) kinds of tools that integrate and communicate patient data and information and also can lick the data and make some new information2.Nurses are one of the biggest providers in health industry that effect directly on health service quality and outcomes. Nurses need correct information in correct time to have an effective service for patient and other member of health society3. Nursing information system (NIS) are subsystem of hospital information system that can help nurse to have better performances, more nursing knowledge and make available data and information for nurses to have a role in health policy making and also decision making around health society and patients4. Furthermore, NIS can participate in hospital information process so lead to a better communication between health wish well team in hospital 5 .Margaretconclude that using NIS in hospital has a positive effect on information quality that provide by nurses6 .Ammenwerth state that NIS lead to better and more complete documentation of patient information and also better quality of information process5 .Toolabi in her study conclude that optimization of hospital information system would lead to a significant development in nursing care average and better communication between nurses , patient and health care team and consequently patient more fairness to health system ,health work and nurses, more patient family satisfaction and at the end , decrease patient claims7.Zahedan, the capital city of a province in southeast of Iran uses hospital information system in teaching hospital. Nursing information system is one this system module that use in these hospitals. So the introductory objective of this study is to evaluate Nursing information system according standard indexes in four sections general stipulation of systems, nursing data set , nursing nomenclature and classification stipulation , documentation registration and drawing specification of systems.MATERIALS AND METHODSThis research is based on a descriptive print sectional study that has done on 2013.nursing information system of 4 teaching hospital in Zahedan were evaluated. For data gathering, we use a checklist that its reliability and hardship was verified.Checklist has 5 section at whole section 1 has some questions approximately the system, vendor and some general information just closely NIS module, section 2 was close general specification of nursing information system. The questions has two answers yes or no.this section involve 23 question about patient care proce ss,11 about ward management process, 10 about communication process and 1 question research and education process.in section 3 , we have some questions about nursing data set that involve 5 question about nursing care data specification, 15 about patient data specification and 14 about service providing data specifications. Section 4 has some question about nursing nomenclature and classification data specification with 25 questions and in section 5 nursing data, registration and reporting requirements were evaluated by 6 questions about personnelreport, 14 questions about clinical report and 3 about financial report.The researchers attended in hospitals and by deep interviewing and also direct observation of systems, gather information and register in checklists. Supervisor of hospital, health information technologist and some professional nurse who uses NIS and familiar with the potential of system was interviewed furthermore, during interview the researchers can observe the NIS a nd its functions.After gathering information, we use descriptive statistics to analytic view our data by using Excel 2010 tables.RESULTSAccording our study, general specification of our NIS was evaluated in 5 aspects and 4 hospitals.(table 1)At whole, the frequency of patient care process data specification was 44/56%, ward management data specification was 31.81%, communication process data specification 47.5% and education and research data specification was 50% in our society research.Nursing data set was evaluated in 4 aspects in 4 hospitals nursing care data set , patient data set, service data set (table 2)According our study , nursing care data set specification was 40% , patient data set specification was 71.66% and service data set specification was 84%.None of our NIS , has nursing classification standards specification data.Data registration and reporting specification data was evaluated in 4 aspects.(table 3)DISCUSSIONInformation technology making a great service for n urses to perform their tasks8. According our result, by using NIS in all hospital, nurses can receive patient demographic data from admission,discharge,and transmission (ADT) system of hospitals and also can register of diametric request such as science lab tests, radiology and pharmacy services. And also they can observe laboratory and radiology results. But none of NIS support nursing evidence based and frosty variances from normal patterns. According Ammenwerthstudy, after using information systems, nurses report more quickly patient data documentation, better information monitoring and progress in patient information legibility5. Kossman state that electronic health record implementation in hospital lead to decrease inter-department communication and promote critical thinking between nurses9.Making electronic communication between different parts of hospital is one of the most important capabilities of hospital information systems. According our study, by using nursing inform ation system, in all hospital, nurses can schedule the admission of patients in their wards. Nurses in hospitals can access to information in all place of hospital. In hospital Cand D , nurses can transmit all information by NIS when changing their shifts. According Hinsonstudy , using NIS would lead to the time increasethat nurses reach on patient direct care (10.66%) ,verbal communication 19.33% decrease and mean time for reviewing data 8.9% increase10.Standard NIS needs nursing concepts standards and nursing data standards3. Without co-ordinated nursing language , internal data integration and external connection of information would disappear when information are shared and also there would be some problem for clinical decision support.in other hand , nursing information are unstructured generally , so if we dont use a standard unified language , the retrieval of information would be difficult11.Result of our study show that, none of NIS in Zahedan hospital use standard nursi ng classification. This issue is very similar to Ahmadi research, they suggest standard nursing classification system for standardization of nursing data and concept to facilities retrieval of information that register in nursing information system12.All NIS in our study, register patient demographic data , nursing diagnostic data and data about service provided by nurses can record ECG data.in hospital C and D , patient vital signs and input-output liquid balance data , can come in to the terminal near patient bed. Anderson state that a standard nursing data set should involve nursing diagnostic data , nursing discourse , nursing outcome and intensity of nursing services and declare , by using such standard data set , management of nursing service cost , supporting of resources that allocated to the nurses , nursing knowledge developed and at the end nursing nursing profession would be promoted13.Making different reports is one of basic management capability of nursing informatio n system that can provide valuable information about personnel productivity, budget management and nursing workload management in different shifts14. In hospital A,B and D , NIS making schedule for personnelshifts. All NIS , can make clinical reports such as laboratory and pathology report and reports about admitted or discharged patients. In Ahmadi study, reporting specification data was met 20.4%,63.5% and 85.2% in personnel , clinical and financial reports4.CONCLUSIONNurses have a great role in health care systems so documentation of their services would be very easy by using nursing information system.so if we want to implement an effective NIS , at first , we should implement a powerful HIS as an infrastructure for any hospital ward subsystem. Nurses are the biggest grouping of NIS users , so nurses data processor literature promotion , has an important role in success and acceptance of NIS. So educational workshop and classes for nurses in hospital would be helpful to make b etter utilization of nursing information system also increasing inter-hospital communication between nurses and health information technologist would have a helpful tool for transmitting professional knowledge between these groups. Using nurses knowledge and skills in all phase electronic system development and implementation and courage electronic health systems developer to use this knowledge in their production is an essential item for successfulness of NIS and systems like that.Since we dont have any guinea pig nursing standard classification and nomenclature , prepare , provide an standard unified system according national requirements is another important factor for implementation and usage of NIS and at whole , establishment some professional workshop that has different different profession such as nursing , health information technology , policy making and so on , to start and monitored special effort about nursing information system requirement , development and implementa tion is very important.ACKNOWLEDGEMENTSThe authors are grateful to nurses and health information technologist of educational hospital affiliated to Zahedan University of medical sciences who loving participated in this study.REFERENCES1.Bitaraf E, Riazy G. comprehensive hospital information system. iranian ministry of health,care and education 2006.2.Yoder-wise PS. Leading and Managing in Nursing. second ed St. Louis Mosby 1999.3.Organization PAH, Organization WH. BuildingStandard-BasedNursing Information Systems. Washington PAHO Library Cataloguing in Publication Data 2000.4.Ahmadi M, Habibi Koolaee M. Nursing Information Systems in Iran. HAKIM. 20105.Ammenwerth E, Rauchegger F, Ehlers F, Hirsch B, Schaubmayr C. Effect of a nursing information system on the quality of information processing in nursing An evaluation study using the HIS-monitor instrument. International journal of medical informatics. 201180(1)25-38.6.Verkerke M. Information Quality of a Nursing Information Systemde pends on the nurses A combine quantitative andqualitative evaluation. international journal of medical informatics 20128166273.7.Toolabi T, Vanaki Z, Memarian, improving hospital information system in cardial care unit, yafteh. 201214(5)83-928.Sadeghi R. Informatics applying in nursing education, research and care. Iranian Quarterly of Education Strategies. 20125(3)199-2069.Kossman SP. Perceptions of impact of electronic healthrecords on nurses work. healthtechnology information. 2006122337-41.10.Hinson DK, Huether SE, Blaufuss JA, Neiswanger M, Tinker A, Meyer KJ, et al., editors. Measuring the impact of a clinical nursing information system on one nursing unit. Proceedings of the Annual Symposium onComputer Application in Medical Care 1993 American Medical Informatics Association.11.BowlesKH. the barriers and benefits of nursing information system. computer in nursing. 199715(4)191-6.12.Ahmadi M, Rafiee F, Hosseini F, Habibi kolaee M. information and structure requirements for nu rsing data classification in computerized systems. hayat. 201117(1)16-2313.Anderson B, Hannah KJ. A Canadian nursing minimum data set a study priority. Canadian journal of nursing administration. 19926(2)7-13.14.Sadoughi F, Ghazisaeid M, Mehraji M, Kimiafar Kh. health information management technology. first edition ed. Tehran Jafari 2011.Table1.frequency percentage of NIS general data specification in different hospitalDCBA17/52%95/86%73/21%39/17%Patient care process63/63%36/36%09/9%18/18%Ward management process50%90%30%20%Communication process100%100%00Education and research processTable2.frequency percentage of nursing data set in different hospital.DCBA60%100%00Nursing care data set60%33/93%60%33/73%Patient data set85/92%57/78%57/78%71/85%Provided services data setTable3.frequency percentage of reporting data specification in different hospital.DCBA33/33%0100%33/83%Personnel report71/85%28/64%28/64%71/35%Clinical report0100%100%0Financial report