Importance of Nursing Informatics in Nurses Daily Practice

Importance of Nursing Informatics in Nurses Daily Practice Introduction Data is the basic and the fundamental concept that this study focus on. Since there is no information can be acquired without availability of data (Ahsan and Shah, 2006). The data that we are talking about in this context is the clinical data, which is the data that gathered about patients in practice by clinicians (Millar et al., 2009). Pressure ulcer (PU) data is one of these data that collected by nurses in clinical settings, these involve all the elements of PU data, like; prevalence, incidence, risk assessment, ulcer grading, and prevention data. Data is a concept being of high interest in the discipline of nursing informatics. (Graves and Corcoran, 1989) define nursing informatics as a combination of computer science, information science and nursing science to assist in the management and processing of nursing data, information and knowledge, to support the practice of nursing and delivery of nursing care. So, the nursing informatics as a speciality begins with the basic concept data, as the present research did. Indeed, nursing informatics can be applied in four areas, that are summarised in the word CARE; clinical, administration, research and education areas (Hannah et al., 2006). In this study, the nursing informatics concepts chosen to be applied in a clinical oriented subject, which is PU. PU as one of the important clinical areas has been selected due to the importance of this problem, in term of its size and the costs of preventing and treating such problem, from one side, and due to limited numbers of previous works that relate the concept of nursing informatics to PU field, from other side. More specifically, this research has related the concept of nursing informatics on PU data. Nursing informatics deal with the data, that processed to support nursing care, and PU data is one of these data that should be processed to support the delivery of patient care. In this thesis, the recording of PU data in recording systems, either paper or electronic was explored, and the uses of these data in these records were identified. As has been recommended, more researches are needed to realize what need to be recorded in the recording systems and how this will be used (Urquhart et al., 2009). Personal motivations toward the research The researchers interest in this subject arose from the importance of nursing informatics in nurses daily practice. The nursing informatics specialists have a special role in using the information technology (IT) to enhance the safety, effectiveness, and quality of health care (Murphy, 2010). It is acknowledged that all providers of healthcare assumed to be skilled in exercising the IT to make decisions that lead to better care (Saba and McCormick, 2006). PU topic investigated due to its great importance. As a nurse used to work in clinical practice caring for PU patients, and observing the magnitude of the physical and psychological impacts of this problem on patients and their families life, the researcher decide to choose this area to be studied. Noticing many patients die because complications of this problem is an enough motivation to start digging in this area. First, to understand how PU data is recorded and used in practice, in effort to understand the difference between recording this data on paper and electronic record. Then, to realise the size of this problem in the researcher country Jordan, to make a reference data for health policy makers to adopt prevention programs in Jordan, there is no one in action yet. Statement of the problem PU is one of the health problems that are very common and prevalent, without accurate portrait of PU data, the problem will continue to grow. Nurses in clinical practice collect and record large volume of PU data every day. This data should be recorded and used appropriately in practice. Taken into considerations that recording and utilising of patients data is the fundamental role of any healthcare provider (Millar et al., 2009). Further, and in the second study, urgent identification of prevalence and prevention data in Jordan is necessary, especially that there is no previous works have been located. So, the primary focus of this study was on the problem of PU, identifying its size, the preventive measure provided to PU patients, and how its data recorded and utilised in practice. Overall Research Aim The overall research aim is to explore how PU data are recorded and utilised in clinical settings. This is the overall aim of the study, with many other secondary objectives for each study and method of the research, but all these objectives are come under the main aim of the study. The objectives of each method will be presented in the methodology chapter (chapter 3). Definition of terms From the general aim of the study, the reader can note that many terms have been used in formulating the aim. The following represent the operational definitions of each term presented in the study aim: PU data: raw facts that related to PU concept, like prevalence, risk assessment, ulcer grading, and prevention data. For instance; a prevalence rate for a specific ward is 5%, Waterlow risk assessment score is 10, patients PU grade is 4, and patient repositioned on his bed every 2 hours. All these are clinical data related to the PU problem. PU Data recording: recording and documenting of PU data that specified above into patients medical record, either this record held on paper or electronic format. PU Data utilization: the uses of the collected and recorded PU data in practice, what they are make of this data, what they are benefit from it. Clinical settings: the different care settings that usually collect, record and used patients clinical data, including PU data. Most commonly, it is composed from primary and secondary settings. Background to the study problem Scope of the problem European Pressure Ulcer Advisory Panel (EPUAP), are group has been lunched to guide all Europe nations in preventing and treating PUs. They define PU as: an area of localised damage to the skin and underlying tissue caused by pressure, shear, friction and or a combination of these (EPUAP, 1998). These ulcers, regardless of their basis, represent negative outcomes for patients; these negative outcomes may include pain (Reddy et al., 2003, GÃ ¼nes, 2008), longer hospital stays, where it can add about 7 days to a hospital admission (Anthony et al., 2004), decreased quality of life (Price, 1998, Neil and Munjas, 2000), and increased the spending of care provider time and costs (Alterescu, 1989, Clough, 1994, Severens et al., 2002a, Bennett et al., 2004). PUs have been regarded as the most physically debilitating complications in the twentieth century (Burdette-Taylor and Kass, 2002), and it is the third most costly problem after cancer and cardiovascular diseases in the Netherlands (Shahin et al., 2008). In fact, there are many complications for PUs, including infection, sepsis, and osteomyelitis (Thomas, 2001). It has been found that more than half (51%) of long term care patients with PUs have Methicillin-Resistant Staphylococcus Aureus (MRSA) infection (Capitano et al., 2003). Furthermore, PUs are linked with two-fold rates of increased mortality, regardless of the origin of the ulcer (Brem and Lyder, 2004). This is consistent with Landi et al (Landi et al., 2007) study, who investigated the connection between PU and the risk of one year all reasons mortality in a community of very elder people, and found a significant difference between the PU group and non-PU group in mortality rate, 29% vs. 14% (p