Integration of nursing informatics in a specialty organization

AWHONN informatics initiative 

The Association of Women's Health, Obstetric and Neonatal Nursing (AWHONN) is developing resources for informatics education and clinical decision-making tailored to the care of women and newborns. In this practice environment, there is an ongoing need for continuity of care across the childbirth continuum, and an increased integration of technology in the labor and delivery setting, operating room, and neonatal intensive care. As electronic fetal monitoring tools became computerized information systems, many perinatal nurses unexpectedly found themselves in informatics roles, charged with system selection, implementation, and maintenance. These nurses functioned with little skill preparation beyond on-the-job training and with specialty systems that were not integrated with institution-wide systems and frequently were not supported by the institutional information technology (IT) department. Consequently, nurses turned to AWHONN as a place to network and share information about perinatal systems. The organization's leadership recognized the need to incorporate IT in strategic planning and, in 2006, convened a Nursing Informatics Advisory Panel, guided by the imperatives of the national health informatics technology agenda and specifically by Building the Workforce for Health Information Transformation.1 The Advisory Panel goals included identifying gaps in NI information available to members, identifying AWHONN's role in NI, and making recommendations for strategic planning and product development. The panel report outlined recommendations to integrate informatics into education products, collaborate with the larger informatics community, and develop IT products.

AWHONN has accomplished a number of the panel's education recommendations. Outcomes include integrating informatics content into continuing education resources that members typically access, such as pre-convention workshops, individual convention sessions, and convention networking events. Content on informatics has been published in the organization's journals, including a clinical issue series on informatics in the Journal of Obstetric, Gynecologic and Neonatal Nursing (JOGNN) and a continuing IT column, Plugged-In, in Nursing for Women's Health.

Another outcome is AWHONN member participation in broader NI organizations and activities to collaborate and to promote representation of the specialty perspective. These activities include attending informatics conferences, presenting posters and papers, and serving on committees (including the Academy's Expert Panel on Nursing Informatics and the American Nurses Association Nursing Information Data Set Evaluation Center [NIDSEC]). Specialty organizations need to collaborate with the Technology Informatics Guiding Education Reform (TIGER) initiative,2 whose vision is to promote informatics competencies as a part of every nurse's skill set and to support IT-enabled nursing practice for quality care and safety. For example, one TIGER goal is to collaborate with nursing specialty organizations to disseminate the TIGER vision among members and to incorporate the TIGER vision and action steps into organizations' strategic plans.3 To achieve this goal, TIGER has recommended a list of actions nursing organizations can take, many of which AWHONN is implementing.4 AWHONN has shared the TIGER vision at annual leadership conferences and convention informatics networking events, has considered the TIGER vision in strategic planning, has members participating in TIGER collaborative teams, and has offered a number of informatics educational products.

AWHONN is developing an exciting specialty IT product (now in the beta testing phase); a women's health benchmarking database named the AWHONN EDGE: Extract Data Generate Evidence© (www.awhonnEDGE.org). This web-based tool collects, de-identifies, and aggregates data from the women's and newborns' electronic medical record of hospitals that contract with AWHONN (using extraction software). Data is collected on quality measures, such as length of stay, discharges, births, characteristics of births and more, for data-based decision-making. Data is analyzed into a number of reports (clinical, productivity, staffing) to trend statistics in individual or all participating institutions, to compare institutions of similar size or acuity (a number of hospital demographics are collected), and to generate evidence about clinical nursing practice in the specialty. This tool illustrates how the power of information technology can enable quality specialty care.

Challenges for academy members 

Academy members can promote the integration of nursing informatics in specialty organizations either as informatics experts or as informatics champions. Many AAN members participate in specialty organizations and can encourage their organization to collaborate with nursing-wide initiatives such as TIGER or can participate in TIGER themselves. Members of AAN can increase their own awareness by reading the informatics literature or attending an informatics conference. Members may be serving—or could consider serving—on the board of directors of specialty organizations to promote informatics in strategic planning. Members can follow the development of informatics competencies and adopt appropriate competencies for practice in the specialty that can then be integrated into standards, guidelines, and performance appraisals.5 Informatics content must be made available where specialty nurses typically access their professional development: in the organization's conferences and publications. Academy members can advocate for more educational opportunities within the specialties. We all have a role in ensuring that current specialty practice is not overlooked in the information technology transformation.