Nursing Informatics

The development of information and communication technologies have affected the data and information management activities in the field of nursing. Opportunities for the application of information and communication technologies become more widespread when faced with the nursing community demands for a quality service so that the nurses should provide direct care time (direct care) to patients is longer and quality. Technology helps nurses reduce documentation time and divert it to direct care.

Integration of nursing activities with the management of data and information has led to the terminology of nursing informatics. Overseas, nursing informatics thrive in all nursing activity, both in the field of services, education and nursing research.

Definition
Nursing informatics is the integration of nursing, information and information management with information processing and communication technologies to support health efforts (ICN, 2006).

Nursing informatics is defined by the ANA (American Nursing Ascociation) as the development and evaluation of applications, tools, process that helps nurses manage data in implementing care to the clients or in support of nursing practice (ICN, 2006).

Nursing informatics can not be separated from the use of computer technology to support the practice, administration, education and nursing research. Nursing informatics can be applied to all areas of nursing, including practice, administration, education and research. The following are examples of applications of nursing informatics in the areas of clinical practice of nursing: work list to remind nurses to plan nursing interventions, computerized nursing documentation, electronic medical record and computer-based patient records, monitoring vital signs and financial billing information (billing) (Marin et al., 2000).

Computer-Based Nursing Information Systems
Information management in an organization includes three interrelated areas of information systems, information management and information technology. Information technology is a tool used to process the data and information (Marin et al., 2000). The development of information and communication technologies influence both directly and indirectly to nursing care (Oyri et al., 2006).

Nursing information systems when applied to a small scope can be done manually, but when the data and information from the scope of nursing which is greater the more complex will require a computer to improve the effectiveness and efficiency of information management (Marin et al., 2000).

Nursing activities related to data and information in large numbers, therefore a computer is indispensable in modern nursing service. Nurses use computers to store patient data, add data, create and record re-plan the development of nursing to the records (progress notes) and follows the progress of the patient (Ioanna et al., 2007).

There are several advantages the use of computers in nursing information system according to Ioanna et al. (2007), namely:

1. Improve and facilitate access to information.
2. Reduce redundancy of data entry.
3. Decrease the time needed for nursing documentation.
4. Increase the time nursing care directly to clients.
5. Facilitate data collection for research.
6. Improve communication and reduce the risk of error.
7. Work for decision making.

Minimum Standards of Nursing Data
Nursing data are the basis of nursing informatics that is necessary for a computerized nursing information system. Data is a tool for recording nursing nursing process of assessment, diagnosis, planning, implementation and evaluation. Nursing data are complete and accurate information can be used to produce highly useful information (Marin et al., 2000).

Nursing information generated from the data analysis process that has been collected and organized in such a way that shows the processing of nursing information systems data into information terimpan in the database. Such information is needed for decision making and maintain the quality of nursing care (Marin et al., 2000).

Nursing Information System requires a complete and accurate data so that must meet minimum data standards (Nursing Minimum Data Set / NMDS) (IMarin et al., 2000). NMDS is useful for:

1. Allows comparison clinics based on population, setting, geography and time.
2. Describe the nursing care of clients and their families at both institutional and non institutional setting.
3. Demonstrating the trend (trend) of nursing care.
4. Stimulate nursing research based on data already available.
5. Provide nursing care that facilitates data and affect aspects of clinical, administrative and policy decision making.

NMDS (Nursing Minimum Data Set) consists of three categories which contains 16 groups of data elements are:
1. Elements of nursing: problem or nursing diagnosis, intervention, outcome criteria and intensity of nursing care.
2. demographic elements: personal identification, birth date, gender, race and culture (tribe) and shelter.
3. Elements of care: institutional code of service, medical record number, registered nurse number, entry date, exit date, Disposition patient charts and billing estimates the cost of care.

NMDS was first developed by Werley in 1988 and developed into a Nursing Management Minimum Data Set (NMMDS) by Delaney and Huber in 1996. Next NMDS has been applied internationally to the i-NMDS (international NMDS) in some countries such as Belgium, Canada, New Zealand, Korea, Netherlands, Spain, Switzerland, Thailand, Britain and the U.S. (Marin et al., 2000).