Change and Innovation Theories in Nursing Informatics and impact on patient care Student`s name

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Abstract
There are change and innovation theories in nursing informatics, which have been analyzed and found to create an immense influence to the nursing department as well as the patient care. These theories, explain the basic processes in an effective working environment, and explain data, information, knowledge and wisdom as used to ensure that various processes in the organization are effective and efficient. The nursing informatics has been implemented and has been used to ensure that patients are attended, and their requirements attained, immediately there is a requirement.
Theories in Nursing Informatics
Nursing Informatics (NI) has been described as both a science and a system. This is based on the notion that science involves the acquisition of knowledge systematically and knowledge can be measured precisely. On the other hand, a system is an arrangement of working organisms that are coordinated. Therefore, NI can be explained as a combination of elements in the health care sector. These elements include nursing science, information science, and computer science among others.
The main aim of these elements is to assist in the various processes, which involve processing of nursing data, management, knowledge and information used to support the practices undertaken by the nursing department, administration, research and education. There have been past, present and future implications of Change and Innovation Theories in Nursing Informatics, which have also been fond to create an immense influence to the organization and departments related to patient care (Anderson & Willson, 2008).
The various theories have been found to examine diverse departments in nursing as well as their impact to the society. The theorists also analyze the various implications of changes relative to the experiences, the present and future. This has helped in ensuring that the various processes in the health care centers are improved.
Background
Nursing informatics is a term that might have been considered to draw blank stares, over a decade ago. After this, the field related to nursing informatics has been known to become one among the essential elements in the various processes in delivery of healthcare. As years roll out, there has been an increase in the levels at which nurses are demanded in the society. However, the nurses should have qualified specialization in nursing informatics and additional knowledge on nursing, which will be used to contribute to various processes involved in nursing practices in the various departments in the health care centers (Saba, 2001).
Nursing informatics was first recognized in 1992 as a specialty and also as a scope of practice. This was developed through the American Nurses` Association that was formed in 1994. The first exam for the nursing informatics in American Nurses Credentialing Center was in November, 1995. This created a good environment for the training of nursing informatics, and 2007, the nursing informatics that had been certified included 0.80% of all 22,159 nurses. However, this number has been found to increase with more development, change and innovation as well as advancements in the nation.
In the United States and other countries, the application of nursing informatics have involved research, education, leadership and nursing practices. This has been found to influence the diverse processes in the health care departments. There is a definition of nursing informatics that was adopted by the International Medical Informatics Association`s Interest Group on Nursing Informatics. This definition explains that nursing informatics is the integration of information management, information and nursing with communication technology and information processing to be able to support the health of individuals in various parts of the world (Anderson & Willson, 2008).
Since the time of President Bush in 2004, the interest in implementing information systems that could be used in clinical processes seemed to have escalated. The interest also necessitates widespread of the Electronic Health Records (EHRs) within ten years. The EHRs were to help in facilitating the processes involved in data processing and storage. It was also aimed at ensuring that the records of patients visiting the hospital were recorded, and could be accessed by all departments in the organization whenever it was needed.
The office of the National Coordinator was later on created, in response to the mandate from the President. This was found to influence the operations in the diverse departments as the HER usage led to numerous benefits being experienced in the organization and the society. There was also noted increased efficiency and quality in the processes involved in the provision of goods and services (Mills, 2004).
Theories in Nursing Informatics
There are diverse theories that have been developed to illustrate the diversity existing in nursing informatics. These theories include Change Theories, which involves Roger`s Diffusion of Innovation Theory and Lewin`s Change Theory, Information Theories, which are made up Blum`s Theory and Data-Information-Knowledge-Wisdom Continuum as well as the Cognitive Theory.
CHANGE THEORIES
The change theories are based on the fact that the systems used in computerization of information in the health care centers involve change. This is based on the changes that occur as the information moves to an environment that is paperless, from an environment that is based on paper. The changes involved in change theories depend on the previous system`s theory as well as the information system users (Lewin, 1951).
Change in systems may either be planned or can be unplanned in some instances. A planned change involves implementing of events that are aimed at achieving a certain goal, which leads to an outcome that has already been predicted. On the other hand, unpredictable outcome can only be as a result of an unplanned change.
Changes that are considered to create an impact to the nursing services are brought about by a change agent. The change agent can be an individual working with the nurses, a staff nurse or even a nurse leader. The change theories are applied in the nursing department, to bring about planned changes. However, research indicates that all the change theories cannot be applied to fit all the situations in a nursing department. Therefore, the nurse leaders and the nurses should have the skills and knowledge about the changes theories, which will help them in selecting the right theory to be implemented in the organization (Lewin, 1951).
Lewin`s Change Theory-Planned Change
The two types of change theories are made up of planned and unplanned change theories. These are the Lewin`s Change Theory and Roger`s Diffusion of Innovation Theory respectively. The change theory that is commonly used in the nursing department is the planned theory, which is the Lewin`s Change Theory. Kurt Lewin`s change theory has been found to be involving three stages namely: refreezing stage, moving stage and the unfreezing stage. The existence of Lewin`s theory is dependent on resistant and driving forces.
The resistant forces are nurses or employees in the organization, and are considered to be proposing the notions related to change, whereas the driving force is made up of the agents of change who push the other employees towards change in the organizational plan. However, this theory can only be successful if the dominant force in the nursing department is the driving force (Lewin, 1951).
The processes involved in Lewin`s Change Theory include unfreezing, moving and refreezing. Unfreezing involves making use of procedures that can assist in the reinforcement of the involvement of an individual in the variations taking place in the organization. This also involves processes that will enable the decisions of individuals in the organization to be respected and also ensure that there is a continuous flow of communication. Thus, the problems experienced relative to individuals being committed to the groups that are against change is immensely reduced.
The process described as moving in Lewin`s Change Theory helps in ensuring that the planned change is not interrupted, but instead implemented even in circumstances where anxieties are found to be high and needs to be dealt with immediately. However, this will require that the organization ensures that the new systems have been tested before implementation, and users of the same systems trained (Lewin, 1951).
Lewin also illustrates that refreezing involves procedures that enable the implemented system and the planned change become a norm in the organizational performance. Therefore, the human resource management in the organization should ensure that employees in diverse departments feel in control of the processes considered new and also feel confident of the variations that have been introduced and implemented. A support group and a help system should also be implemented by the organization managers, to ensure that the various problems of the employees are solved whenever there is a need (1951).
Roger`s Diffusion of Innovation Theory-Unplanned Change
Roger`s diffusion of innovation theory is an unplanned change. This theory analyses the patter existing in the acceptance of innovation and follows as the pattern spreads across the population of individuals who decide to adopt and implement it. This theory was developed by Everette Rogers, after analyzing the theory developed by Lewin. This enabled Rogers to modify the existing theory and create a theory that had five steps. The five stages in this theory included interest, awareness, implementation, evaluation and adoption. Projects that were considered to be long term implemented the application of this theory.
The five stages in this theory explained the adopters of the modification made in the planned theory. The adopters were further sub-divided into five groups, namely innovators, early adopters, early majority, late majority and the laggards. A graph designed, explained the difference in the percentage of the adopters. The results indicate that the innovators constituted 2.5%, early adopters 13.5%, early majority 34%, late majority 34% and the laggards 16% (Anderson & Willson, 2008).
The innovators readily adopted the innovation and are classified and a group that is considered troublesome and not able to the innovation to other individuals. On the other hand, the early adopters are leaders considered having opinions that are respectable, and majorly act as the innovation promoters. The early majority are antagonistic to risk of the innovations (Anderson & Willson, 2008).
However, the early majority are also ready to make investments that are safe. Late majority has been known to be adopting the innovation. This is based on the notion that the late majority does not see the use of innovation, therefore, use peer pressure to act. The laggards, on the other hand, are suspicious about change and innovation. The laggards are also considered as being stubborn and also grasp the weaknesses that other individuals in the society have failed to identify.
INFORMATION THEORIES
Blum`s Theory
Blum`s Theory was developed by Blum in the year 1986. Blum stated that the functions of the computer could be categorized into three main parts. These parts included the data processing, information processing and knowledge processing. This was explained by a structure that illustrated the flow of data, information, knowledge and wisdom from one communicating device to another (Lewin, 1951).
Data was defined to be a source of raw facts and figures that could be used to provide information. The data was manipulated to produce meaningful and useful information that could also be used to create knowledge. Knowledge was described by Blum as the information that has been analyzed and synthesized. Knowledge was then used to derive wisdom, which was found to be the basis for operations in the various departments in the organization. This is based on the idea that wisdom was to establish and achieve the laid down goals and objectives in the organization.
Data-Information-Knowledge-Wisdom Continuum
Graves and Corcoran developed the theory of Data-Information-Knowledge-Wisdom Continuum basing on the nursing informatics, which includes knowledge, information and data as illustrated by Blum. Graves and Corcoran explained that the level of complexity of information is based on the interaction that is impacted to ensure that it is attained. Graves and Corcoran also explained the various meanings of the words data, information, knowledge and wisdom (Gaumer, 2007).
The explanation discussed that data are elements that are plainly recorded and is not interpreted, but rather viewed the way it has been collected from a field study. On the other hand, information is explained as data that are based on an individual`s behavior, attitude and capacity. Knowledge is information that has been composed in a way considered as organized. The meaning of wisdom was added by Nelson and Joos, and is explained to consider the use of values, in the various processes involved in decision making.
COGNITIVE THEORY
Cognitive sciences have been found to include problem solving, perception, acquisition, skills and mental models, which are used to add understanding of how the brain interprets and perceives a computer screen. Therefore, cognitive theory uses this notion to provide philosophies that can be used to create systems, which concentrate on the tasks that are at hand, rather than requiring tasks that are cognitive.
These tasks that are considered cognitive are used to deal the interface of computers. This has immensely helped the health informatics to understand the various processes involved in decision making. This has also helped in ensuring that a better design is implemented for the tools that are used in programs. These programs have also influenced the operations in the various departments positively (Mills, 2004).
Implications of Change and Innovation
Change and Innovation have significantly influenced the operations in the health centers. This is based on the notion that the various processes can be planned, by the implementation of Lewin`s Change Theory. This has helped in ensuring that the various departments work as expected and planned, which has also helped in ensuring that the laid down goals and objectives of the organization are attained.
The first model that was considered viable was the one developed by Lewin. This model clearly illustrated the implications of change and innovation in nursing informatics. In this case, change was characterized as an imbalanced state between restraining and driving forces. Research indicates that, if there was a situation that could enable these forces to be balanced, then there would be no changes that could take in the various operations in diverse departments in the organization as well as the systems that have been implemented (Anderson & Willson, 2008).
However, it has been analyzed that in every context, change is inherent and is also considered as a concept that is relative. Research indicates that despite the fact that the nature of a phenomenon is stable, the phenomenon is also subject to change, and the change exists in a notion that is predictable. The changes that occur in the organization should be planned to guarantee that there is effectiveness and efficiency in the various processes undertaken by individuals in the various departments.
Change and innovation have been analyzed and found to be complicated, messy and disruptive. This is based on the fact that even the plans that had been laid down successfully cannot occur as predicted if change and innovation are implemented, in the various operations, in an organization. However, it has been found that real change in diverse organizations is enormously political and intensely personal (Nadler, 1998).
Change has been analyzed as a process that entail not only ways and structures but carrying out activities, but also perception, expectations and performance of all parties involved in the processes. It has also been noted that despite the fact that change is unpredictable and widespread, it is still manageable. However, change is characterized as being risky when it involves diverse departments in the society and the organization.
Various organizations that were found to implement other emergent models in the operations of the organization have been found to shift and implement the use of planned change model by Lewin. This has been found to influence the standard of operations as well as the time taken to cover certain requirements of the society by the organizational managers. This has also been found to impact the rate of growth and development of the nation where the organizations are situated (Lewin, 1951).
Change and innovation in the organization has been found to require policies, which should be implemented to ensure that the organization is successful in ensuring that the requirements of the customers are attained. These strategies should be used in the theories that involve both the unplanned and planned changes. This is based on the fact that, not all instances can be done successfully with the application of only one theory.
There are diverse tasks that should be carried out by organizational managers in a case where there should be effective adaptation to change. This calls for redesigning and redefining the processes in the organization and adapting to specific cultural and geographical settings. The workforce should also be retrained, to ensure that the individuals in the various departments are ready for change on how to relate to global customers and collaborators, the knowledge and skills required as well as the work that should be carried out. This will help in ensuring that implementing the change will create an impact, which will be aimed at ensuring that the organization is helpful to the society (Gaumer, 2007).
Change and innovation also require that the needs of the organization are reshaped relative to the culture that had been applied before. The other areas in the organization that will need redefinition include appraisal measurements, reward systems and structures. The procedures involved in management and leadership styles should also be shifted to ensure that they adapt to the changes. There should also be refining of the way in which stakeholders, suppliers and customers relate in the organization.
Therefore, successful adaptation to change and innovation in an organization entails an understanding of how to rebuild and convert from old legacies and complexities and be able to generate new designs that can be related and fitting to the changes and innovation. Research indicates that change and innovation necessitates that the organizations managers are expected to move into everyday work setting from incorporate advances in information technology, retraining and empowering employees and also moving beyond processes that are considered antiquated in the organization (Nadler, 1998).
Role of the Nursing Informatics Specialist
Informatics nurse has been known as a specialist working in the health care organization and helps in integrating information science, computer science and nursing science. The nurse informatics specialists also ensure that there is facilitation of processes involved in integration of knowledge, information and data in the organization. This is to ensure that the providers, nurses and patients in the organization are supported in the diverse procedures applied in decision making relative to the settings and roles in the organization.
Nursing informatics has been associated with the application of Clinical Decision Support System (CDSSs), which is considered as a key application compelled by information technology. The CDSSs have been associated with the advancements that have been experienced in the diverse departments in the health care organizations and science that is applied in the nursing informatics departments (Anderson & Willson, 2008).
Thus, the nursing informatics specialists can get access to information in the health care related to current treatment, vital signs and trauma history, which has been summarized by use of graphics that depict trends through the use of a computer system. This has made the operations by the nursing informatics specialists quick, which helps in ensuring that a large number of patients can be attended in the health care center. This has also influenced the growth and development processes of the organization and the nation, which has also ensured that the living standard of individuals in the various communities is increased.
Nursing informatics specialist assists in ensuring that there is an advanced use of the CDSSs by the nurses in the various departments in the health care organization. This has been found to improve subsequent patient outcome, which helps in ensuring that the services offered are also advanced. Research indicates that qualified nursing informatics in an organization are effective as they ensure that the various processes in the departments are made easy and the standard of operation in increased (Gaumer, 2007).
Nursing informatics specialists also help in ensuring that there is adequate processing and management of knowledge, information and data in the organization. This entails ensuring that processing of information is done and provided to the patients immediately it is required. This has helped in ensuring that the information contained in the systems provided by the nurses is managed. This has been found to create an immense impact to the organizational performance and effectiveness.
Impact of Informatics on Nursing Practice
Informatics has been used to improve the practices that are carried out by the nurses. Nurses attend to patients and ensure that there are records that are managed to ensure that the health of the patient is trailed. Nursing informatics have ensured that there are measures put in place, to ensure that patients are attended to quickly and in more advanced ways, to ensure that have good services and attention provided to them.
The introduction of nursing informatics in the organization has also helped in ensuring that there are new methods of storing data and information in the various departments. This involves storing data in the computers, which makes it easy to access whenever it is needed by the nurse, to attend a patient. This has made the procedures in the nursing departments more advanced and effective (Anderson & Willson, 2008).
Nursing informatics has also enabled the managers to ensure that the communication and transfer of information in the various departments in the health care center is made quick. This is based on the notion that the information in the health care systems can be accessed by authorized personnel in the various departments of the organization. The employees can also get to communicate through the system without necessarily having to move from one location to the other physically (Saba, 2001).
However, to ensure that the nursing practices are improved in the organization, the managers should ensure that the employees are trained to use the new systems and made to adapt to change and innovation that has been introduced in the organization. This will in ensuring that the employees in the various departments work effectively and efficiently. This will help in ensuring that the various processes in the organization are carried out perfectly, and performance in the organization is also advanced.
Impact of Informatics on Patient Care Delivery
Patient care has been found to be influenced by health care informatics. A survey that was once carried out indicates that eighty percent of the nurses illustrated that, effect of health care informatics on patient care delivery created positive outcomes. This clearly explains that the implementation of health care informatics in the organization can be used to develop an environment where patients can be effectively and efficiently attended. This will also ensure that the requirements of individuals in the different communities, in the nation, are also achieved successfully (Lewin, 1951).
Health care informatics has been found to improve the efficiency of operations in the health care centers. This is based on the fact that technology introduction in any organization helps in making work easier. Therefore, use of technology has enabled the nurses to access the information needed from any department. This has ensured that the tasks carried out in the various departments in the organization are carried out quickly. Technology has also ensured that there is improved efficiency, timely access of patient information that is relevant and has also helped in reducing errors.
This has helped in ensuring that the services offered to the patients are carried out quickly and effectively. A situation where data and information have to be searched manually has been compared with the introduction of technology, and researchers indicate that technology has provided an environment where all the needs of the organization in the diverse departments can be accessed easily. This has necessitated efficiency and effectiveness in the operations of the organization (Nadler, 1998).
However, there are challenges that have been experienced with the introduction of health care informatics in the organizational performance, in the nursing departments. These challenges include limited access to applications and information, regular system failures and lack of training. New system introduction in any organization, requires that the change is accepted by the employees and also the managers should ensure that there is provision of training for individuals who will be influenced by the change and innovation.
The organizational managers should ensure that the workers in diverse departments are trained. This will help in ensuring that the various processes in the different departments are made effective. This will also influence the performance of the organization. This is based on the notion that, if the employees are not trained on the use of the new systems and technology in the organization, the change and innovation intended to improve the operations of the employees will not be achieved (Anderson & Willson, 2008).
The organization managers should also ensure that the systems are serviced to ensure that there is no failure. Failure in the machines illustrates that the processes will be slowed down, and customers will not be contented with the services from the organization. This can only be ensured by the human resource managers that the service providers are available in the organization so that in case of a breakdown, the issues can be dealt with instantly. This will help in ensuring that the processes in the organization are not disrupted, thus becoming effective in ensuring that the requirements of the society are attained.
Conclusion
Nursing informatics has been explained by diverse theories of change and innovation. These theories illustrate the various processes involved in the systems implemented in the nursing departments. The theories also explain the difference that exists between data, information, knowledge and wisdom as used in diverse applications, in the operations of the nursing informatics.
Nursing informatics have been analyzed and found to influence the operations in the diverse departments in a health care center. It has helped in ensuring that the services and products provided to the patients are advanced and aimed at ensuring that the requirements of the individuals in the society are attained. This has helped to ensure to that processes involved in growth and development of the organization are maintained and used to influence the nation economically.
Therefore, nursing informatics should be implemented in the organization, to ensure that there is improved effectiveness in the operations, in the various departments. This will help in ensuring that the organization develops, and the patients become contented with the services being offered to them.
References
Anderson, J. A. & Willson, P. (2008). Clinical Decision Support Systems in Nursing: Synthesis of the Science for Evidence-based Practice. CIN: Computers, Informatics, Nursing 26(3), 151-158.
Gaumer, G. L., et. al. (2007). Use of Information Technology by Advanced Practice Nurses. Comput. Inform.Nurs., 25(2), 344-352.
Lewin, K. (1951). Theory in Social Science. New York: Harper & Row.
Mills, M. E. (2004). A growing role in system development. Healthcare Information Management Systems, 4(3), 320-331.
Nadler, D. A. (1998). Champions of change: How CEOs and their companies are mastering the skills of radical change. San Francisco: Jossey-Bass.
Saba V. (2001).Nursing informatics: yesterday, today and tomorrow. 2(1), 177-187.

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