Kennedy, M. (November, 2018). Nursing Data Standards: Triangulating the Development of Industry-Level Competencies In Digital Healthcare. Online Journal of Nursing Informatics (OJNI), 22(3). Available at http://www.himss.org/ojni
Over the last several years, the Canadian nursing informatics community has accelerated focus on the recognition, establishment, and adoption of nursing data standards. A national symposium has hosted leaders from across Canada to collaborate on strategic advancement within practice domains (clinical practice, administration, research, policy, and education) and to foster key enabling industry partnerships (Nagle & White, 2017). This collaborative work has energized the informatics community and is inspiring a new generation of informatics professionals to advocate for nursing data standards as they navigate burgeoning digital health environments and seek to proactively manage the volume of health data generated through numerous data streams.
As digital health environments continue to evolve both in terms of breadth and complexity, calls for the inclusion of nursing data standards in vendor systems have escalated in priority and urgency. Data science and artificial intelligence have contributed to the expanding recognition that clinical intelligence and analytics are heavily dependent on data standards as a foundational element for evidence-informed decision making and planning. As healthcare organizations across Canada anticipate clinical system upgrades, this is clearly an opportune time to improve data quality and information management by integrating nursing data standards into new system versions. Many vendors are actively incorporating various nursing data standards into their products.
At the same time as this industry level activity is occurring, nursing faculty are increasingly challenged to include informatics courses in their curricula. It is worth noting that there is a lengthy history of significant variance in the availability and scope of informatics courses in both undergraduate and graduate healthcare programs. However, much work has been accomplished in the past 10 years, with entry-level competencies being published and included in program accreditation processes (CASN, 2012). Despite the progress, gaps in undergraduate and graduate level education continue to persist and have implications beyond entry to practice.
During a recent discussion about data standards and an impending clinical system upgrade, a nurse executive expressed that she was completely unfamiliar with informatics and questioned whether nurses were needed for the upgrade. Given the prevalence and priority of digital health solutions, the ubiquitous nature of technology and digital health applications, and the unequivocal necessity of providing quality data to inform decisions, it is imperative that nursing leaders are strong, compelling advocates. They must be able to demonstrate knowledge and effectively lobby for the inclusion of nursing data standards and other improvements that directly impact patient care and professional practice.
The time has come to ask ourselves if there is a better way to foster the development of industry-level informatics competencies among nurse leaders (including understanding why nursing data standards are essential). Nursing as a discipline must recognize the need for industry-level knowledge and skills and go about developing these in a deliberate, systematic manner. It is simply inadequate to target only formalized academic education to position the entire nursing workforce with appropriate skills. It is imperative to decisively partner with nursing leadership associations and groups to cultivate the development of core knowledge and essential competencies among existing and future nursing leaders. There is an urgent need for nursing executives who are informed and able to provide credible leadership in digital environments where decisions about functional requirements, data standards, information management and utilization, vendor and solution selection, and data analytics require nursing contributions. In short, it is finally time for nursing to step up and perform as industry partners that are armed with knowledge and voice rather than being passive consumers of solutions designed, configured and implemented by others. Nurse leaders in Canada and internationally are doing tremendous work to foster nursing informatics competencies and needs such as data standards, but this work requires all nurses to be aligned and aware.
Much work remains to be done; however, it is possible that industry-level competencies can be developed across the nursing discipline through strategic partnerships and clear accountability. A national strategy is needed to partner with educators to foster undergraduate students and with leadership/executive organizations such as colleges of health leaders and other leadership institutes to embed core competencies (including fundamentals such as data standards) as requirements for executive certification. We have the opportunity to triangulate the development of informatics competency development using a strategic, collaborative and clear-eyed approach to the minimum expectation we have for nurses entering the practice of nursing, as well as for nursing executives. The question is, does the political will exist to enact this?
Canadian Association of Schools of Nursing (CASN) (2012). Nursing informatics entry-to-practice competencies for registered nurses.Ottawa, ON: Author. Retrieved from http://www.casn.ca/2014/12/nursing-informatics-entry-practice-competencies-registered-nurses-2/
Nagle, L. & White, P. (2017). Proceedings from the National Nursing Data Standards Symposium. Author: Toronto, Canada.