Identify a health information technology system, explain how it improves healthcare outcomes. Identify the organization you work for uses this system.

· Respond to discussion question in Moodle by week 3

· At least 400 words· At least  3 references within 5 years (APA style )

Integrating Health Information Technology

Safety into Nursing Informatics

Elizabeth M. BORYCKIa,1, Elizabeth CUMMINGSb, Andre W. KUSHNIRUKa

and Kaija SARANTOc
aUniversity of Victoria, Victoria, Canada

University of Tasmania, Tasmania, Australia

c University of Eastern Finland, Kuopio, Finland

Abstract. Nursing informatics competencies are constantly changing in response
to advances in the health information technology (HIT) industry and research
emerging from the fields of nursing and health informatics. In this paper we build
off the work of Staggers and colleagues in defining nursing informatics
competencies at five levels: the beginning nurse, the experienced nurse, the
nursing informatics specialist, the nursing informatics innovator and the nursing
informatics researcher in the area of HIT safety. The work represents a significant
contribution to the literature in the area of nursing informatics competency
development as it extends nursing informatics competencies to include those
focused on the area of technology-induced errors and HIT safety.

Keywords. Technology induced error, health information technology, safety,
patient safety, nursing, competencies, nursing informatics

1. Introduction

Nursing informatics competencies are one of the most important types of competencies
in a modernized health care system where the use of electronic health records, clinical
documentation systems, telehealth systems and patient portals in the hospital, home and
community are the norm. With the introduction of these technologies we have had a
significant reduction in the number of medical errors. We have also seen the
introduction of a new type of medical error (i.e. the technology-induced error) [1,2]. In
this paper we outline a framework for introducing the topic of technology-induced
errors and patient safety competencies involving health information technologies (HIT)
into nursing curricula. Patient Safety was addressed earlier as a relevant topic for
nursing during the 2003 Nursing Informatics post-conference, addressing the more
general aspects of safe healthcare [3]. The competency work described here builds off
Staggers and colleagues’ framework in defining nursing informatics competencies for
beginning nurses, experienced nurses, informatics specialists, informatics innovators,
and nursing informatics researchers [4]. This work represents a significant contribution
to the literature in the area of nursing informatics competency development as it

1 Corresponding author: Elizabeth Borycki; email: [email protected]

Forecasting Informatics Competencies for Nurses in the Future of Connected Health
J. Murphy et

Guest Editorial

Using Health Information Technology
to Support Evidence-Based Practice

The use of information technology is pervasive in our society,
a trend which is increasingly being reflected in healthcare en-
vironments with the rise in the use of electronic health records
(EHRs) and associated patient portals for patients to access
their health records. For example, in 2009, the U.S. govern-
ment provided $19 billion through the American Recovery and
Reinvestment Act to healthcare organizations with the goal of
promoting the uptake and use of EHRs (Blumenthal, 2009).
The rise in the use of personal devices and smart phone apps
to monitor health, together with the use of social media and
online forums to discuss healthcare issues, also is increasing.
This rise in the availability of technology, both in healthcare
settings and in the wider population provides unique oppor-
tunities for supporting evidence-based practice (EBP) across
healthcare settings. Evidence-based practice has been defined
as “a life-long problem-solving approach to the delivery of care
that integrates the best evidence from well-designed studies
and evidence-based theories (i.e., external evidence) with a clin-
ician’s expertise, which includes internal evidence gathered
from a thorough patient assessment and patient data, and a pa-
tient’s preferences and values” (Melnyk & Newhouse, 2014, p.
347). Arguably, the use of EBP and associated methods of sys-
tematically reviewing and appraising evidence for quality have
been made possible due to the ability of technology to support
the storage, annotation and retrieval of research studies quickly
and easily.

In the early days of EBP, a significant focus was on teaching
clinicians the information search, retrieval and appraisal skills
they required to be able to identify evidence they needed “at
the bedside.” However, a number of studies have consistently
highlighted how clinicians rely on other sources, such as peer
advice, to support their decisions mainly due to the number
of barriers encountered (e.g., such as time and resources avail-
able) in trying to access evidence electronically and interpret it
appropriately in a busy healthcare environment. One solution
to this problem is to develop functionality within EHR systems
to provide evidence-based advice and guidance to clinicians at
the point of care. For example, some systems use “info but-
tons” that are located in the EHR system (e.g., for instance in
the order entry module), which when clicked on by a clinician,
provide context specific information related to the location such
as the results of a PubMed search for a specific question re-
lated to the drug order (Bakken et al., 2008). However, while
overcoming some of the major barriers faced by clinicians in
accessing up-to-date clinical information, this solution does not
help clinicians in terms of guidance for care delivery.

Clinical gu

RECEIVED 10 March 2015
REVISED 28 July 2015

ACCEPTED 29 July 2015

Effects of health information technology
on patient outcomes: a systematic review

Samantha K Brenner,1,2,3,4 Rainu Kaushal,1,2,4,5,6 Zachary Grinspan,1,2,5,6

Christine Joyce,5,6 Inho Kim,6,7 Rhonda J Allard,9 Diana Delgado,8 and
Erika L Abramson1,2,5,6


Objective To systematically review studies assessing the effects of health information technology (health IT) on patient safety outcomes.
Materials and Methods The authors employed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement
methods. MEDLINE, Cumulative Index to Nursing Allied Health (CINAHL), EMBASE, and Cochrane Library databases, from 2001 to June 2012, were
searched. Descriptive and comparative studies were included that involved use of health IT in a clinical setting and measured effects on patient
safety outcomes.
Results Data on setting, subjects, information technology implemented, and type of patient safety outcomes were all abstracted. The quality of the
studies was evaluated by 2 independent reviewers (scored from 0 to 10). A total of 69 studies met inclusion criteria. Quality scores ranged from 1
to 9. There were 25 (36%) studies that found benefit of health IT on direct patient safety outcomes for the primary outcome measured, 43 (62%)
studies that either had non-significant or mixed findings, and 1 (1%) study for which health IT had a detrimental effect. Neither the quality of the
studies nor the rate of randomized control trials performed changed over time. Most studies that demonstrated a positive benefit of health IT on di-
rect patient safety outcomes were inpatient, single-center, and either cohort or observational trials studying clinical decision support or computer-
ized provider order entry.
Discussion and Conclusion Many areas of health IT application remain understudied and the majority of studies have non-significant or mixed
findings. Our study suggests that larger, higher quality studies need to be conducted, particularly in the long-term care and ambulatory care


Keywords: health information technology, adverse events, patient outcomes, systematic review

Effectively harnessing the potential of health information technology
(health IT) to improve patient safety, reduce harm, and improve patient
outcomes remains a unifying national goal among healthcare pro-
viders, patients, and regulators. For several decades, the use of com-
puter systems has been considered a potential mechanism to support
and im