Certifications, Informatics, & Innovations Special Issue March 2023

CERTIFICATIONS INFORMATICS INNOVATION

By Michele Wojciechowski

Reneé Hewitt

Louis Pilla

Julia Quinn-Szcesuil

Editor’s Notebook

Nurse-led innovation has the power to transform health and healthcare systems because nurses are trained to use critical thinking to define a problem and combine objective data with experience and teamwork to create solutions.

Innovation isn’t about developing a new app or gadget. It’s about creating a new model of care, safety practices, efficient processes, and social change to improve patient outcomes.

Nurses are primed to lead healthcare innovation because of the attributes that make them great nurses: creativity and the agility to provide high-quality, patient-centric care. This month, Minority Nurse focuses on certifications, informatics, and innovation.

• If you’re fairly new to the nursing field, you may not know much about certifications. Should you get one? How do you determine what’s right for you? Are they worth it? Michele Wojciechowski breaks down different certifications and how to find success in your nursing career with them.

• Have you ever wondered what a day in the life of a nursing informaticist involves? Reneé Hewitt profiles three nursing informaticists to get their insight into the field of nursing informatics.

• If you believe AI won’t affect your nursing practice, or it might influence your daily work some time far off in the future, you’ll have to reconsider that position. Louis Pilla discusses how AI is already impacting nursing.

• VR is often associated with gaming, but technology is quickly becoming a soughtafter educational tool that is incredibly adaptable to nursing. Julia Quinn-Szcesuil explores how VR opens new possibilities in nursing education.

“Were there none who were discontented with what they have, the world would never reach anything better.” –Florence Nightingale

—Reneé

A Primer in Nursing Certifications

Different Certifications and How to Find Success in Your Nursing Career With Them

By Michele Wojciechowski

Especially if you’re fairly new to the nursing field, you may not know much about certifications. Should you get one? How do you determine what’s right for you? Are they worth it?

We spoke with experts in the field to get their take on certifications and how they can help you.

Various Certifications

According to Alice Benjamin, APRN, MSN, ACNS-BD, FNP-B, CCRN, CEN, CV-BC, Chief Nursing Officer and Correspondent for Nurse.org, Clinical Nurse Specialist and Family Nurse Practitioner, and Critical-Care and Emergency Medicine Nurse, “There are over one hundred types of nursing certifications which you can find here. But a nurse must demonstrate a knowledge base and clinical experience— a certain amount of clinical bedside hours—within the area they are seeking certification in. So you can’t just sign up for any nursing certification,” she explains.

“Most employers require nurses to be certified in BLS (Basic Life Support) or ACLS (Advanced Cardiovascular Life Support),” says Andrea Bendig, MSN, BSN, RN, CM, DN, CDP, Owner and Founder of Wellness Strategies Group.

Often, nurses earn certifications specific to their particular area of practice. “The certification highlights an area or specialty that is typically above and beyond requirements for licensure and aligns with the work the individual is doing,” says Angela SilvestriElmore, PhD, APRN, FNP-BC, CNE, Associate Professor and Associate Dean for entry and

prelicensure at the University of Nevada, Las Vegas, School of Nursing. “Examples include the certified nurse educator or nurse practitioner, among many others. A certification body—separate from state boards of nursing—is the authority for granting certifications. Certifications also often have continuing education requirements to be maintained.

Why Earn One (or Two or Three)

There are many reasons why nurses should consider earning certifications. One, of course, is that they often will be paid more for jobs that require a particular certification. But there’s more to it than that. For example, earning one can also help with your professional development.

“It will increase their knowledge, improve patient outcomes, and make them more marketable for other jobs,” Benjamin says.

In addition, “Research has shown that nurses with more education provide better patient outcomes and fewer medical errors. So it’s not only ideal but important that nurses obtain specialty certification within the areas that work for the best patient outcomes,” explains Benjamin.

Erin Blakely, a Licensed Nursing Home Administrator and founder of Senior Golf Source and works as an active healthcare consultant, says nurses should know that many employers may pay for their continuing education.

“Being a nurse offers you some of the greatest benefits and flexibility from most professions. You can work in various environments—your

home, hospitals, doctors’ offices, nursing homes, schools, etc. The world is your oyster—especially in today’s job market,” Blakely says. “Certifications help you bridge the gap when you’re ready to make a career change—either to a different type of nursing skill or gain a promotion. If your certification is desired by your employer, it will likely increase your pay.”

How much it will increase your pay may vary. Benjamin says that some employers may offer incentives to get nurses to earn specialty nursing certifications. For example, they may provide financial incentives from the reimbursement for a review course and the test, a bonus, and/or a 2%–5% hourly salary increase. “At some organizations, a certification is required to climb the clinical ladder,” she says.

Another benefit of having one or more certifications is that clients trust them. “I feel confident knowing that I can make a difference, and as a business owner of a senior healthcare consulting company, it has been valuable in securing new clients,” says Bendig. “It has allowed me to be self-employed, develop a flexible schedule, and charge the rates I think are deserved, rather than working for an assisted living facility.”

General Costs

According to Benjamin, the costs of earning certifications vary, depending on the specialty you’re seeking. The specialty certification review course and the test can cost anywhere from $400-$1,000.

Although your employer may pay for these costs, they also may reimburse you, which

means you need to lay out the money first.

The Details

Not all certifications are taught the same way. Silvestri-Elmore says that some are taught online, others are in-person, some are self-study, and certification by exam. “Certification courses can range from a few hours to months, depending on the focus area. To give an example, a basic life support certification will take about 8 hours, while a certification as an advanced practice nurse can take several months to complete,” she says.

“Nurses should consider how they feel they can obtain the best training,” adds Bendig. “For example, IV therapy certification is best in person. It’s impossible to practice securing peripheral IV access virtually.”

What if You Fail?

If you fail the exam for the particular certification you’re going for, don’t despair. Luckily, you can get another chance.

“Most certifications allow nurses to retake the exam if they fail. After their failed exam, most certifications provide nurses with general information on how they performed on the test. With that information, nurses can focus their studies,” says Benjamin. “Each certification has limitations on how often and soon a nurse retakes their test. For example, candidates may sit for the CCRN exam up to four times in 12 months.”

Challenges

Benjamin says that some of the greatest challenges nurses face when earning certifications include making sure they

have the time to study for the exam, finding a review course that will help them to prepare for the exam, and paying upfront for the review materials and exam while waiting to get reimbursed from their employers.

“I believe so many more nurses would seek certification if those barriers were removed, and their employers provided this as part of their staff development,” she says.

Another challenge for some nurses, says Silvestri-Elmore, is test-taking anxiety or learning disabilities, which can be significant barriers.

Sometimes, a barrier can be as simple as deciding which certification to earn. “The biggest challenge nurses have when considering certification is determining which is best for their career path. Nurses have so many options; they may need to work in a few different fields before discovering their passion,” says Bendig.

“I’ve been a nurse for 30 years, and I had the privilege of working in about five fields before I landed the specialty area where I feel I can have the biggest impact on improving patient outcomes.”

Rewards

Of course, better pay is one reward that would result from earning certifications. Again, though, there are other rewards as well.

“I found great value in the knowledge I gained, but I have to admit the increase in salary and doors opened for clinical ladder advancement were rewards that I found motivating,” says Benjamin.

“Knowledge is power. Having the added knowledge required to earn and maintain certification is beneficial for the services being provided,”

says Silvestri-Elmore. “It is also a proud moment when you achieve that milestone; it is a credential you can use from that point on.”

Michele Wojciechowski is a national award-winning freelance writer based in Baltimore, Maryland. She loves writing about nursing but comes close to fainting when she sees blood. She’s also the author of the humor book, Next Time I Move, They’ll Carry Me Out in a Box.

A Day in the Life: Nursing Informatics

by Reneé Hewitt

Nursing informatics is changing the way healthcare works, and it’s changing the way nurses interact with their patients.

We spoke with three nurse informaticists—a program chair of an MSN Nursing Informatics Program, a clinical informatics senior manager at a medical system, and a health informatics and digital strategy consultant—to get their insight into the field of nursing informatics.

A Day in the Life of a Program Chair of an MSN Nursing Informatics Program Ellie Hunt, DNP, RN-BC, CNE, CPHIMS, ACHIP™, is the program chair of the MSN Nursing Informatics program at Western Governors University (WGU).

my husband and I moved from Connecticut to North Carolina. I took that opportunity to go back to school for my MSN in Leadership and Informatics and become active in the North Carolina Nurses Association’s Council on Nursing Informatics (CoNI) to build a local nursing informatics network. After earning my MSN, I joined a vendor company’s research and development department designing electronic health records for outpatient settings. After several electronic health record product life cycle iterations, I became an informatics consultant. Consulting exposed me to a wide variety of technologies and informatics roles. As I was considering a doctorate in nursing (DNP) degree, I joined Western Governors University (WGU) and became a nurse educator. I learned that I loved teaching and sharing my knowledge with future informatics nurse specialists. At WGU, I helped launch the WGU MSN Nursing Informatics program and am now the program chair.

How do you prepare for a career in nursing informatics?

and abilities specific to nursing informatics.

What type of degree do you need to work in nursing informatics?

Nursing informatics as a specialty is interesting because you can start to work in an informatics role without any specific level of education. Entry-level job descriptions are often written for an MSN as preferred but not required. However, advancement within the specialty to a manager or director role is often associated with a master’s degree, such as the WGU MSN in Nursing Informatics. Senior leadership roles, such as CNIO, increasingly require a doctoral degree. The WGU MSN in Nursing Informatics degree provides over 500 clinical hours that can be applied toward a doctoral degree.

What inspired you to pursue this specialty?

What are the most critical attributes a nurse should have to work in informatics?

The most critical attributes applicable to all informatics roles include strong clinical skills, critical thinking, and systems thinking, which registered nurses learn in their prelicensure nursing program and hone through their clinical practice. A master’s in nursing informatics (MSN) strengthens clinical skills and develops the technical skills required of the advanced professional nurse. Additional traits include a willingness to adapt to change, self-learning, problem-solving, and acquiring technical skills related to their specific informatics job role.

What does a nursing informaticist do daily?

Talk about your career path and how you ascended to your role in nursing informatics.

I started my nursing career in pediatric nursing. While working, I saw a posting for a volunteer opportunity representing pediatric nursing on the computerized provider order entry (CPOE) committee. That volunteering led to a full-time paid position, and I worked a happy 8 years with that health system in various informatics positions. Then,

Most people get started in nursing informatics as I did many years ago: by volunteering as a super-user or joining a technology committee at their organization. I always recommend networking through your professional organization or joining an informaticsspecific professional organization such as AMIA, HIMSS, ANIA, or one local to your area. Going back to school for your master’s in nursing informatics (MSN) is a great way to obtain the knowledge, skills,

I was interested in improving the care my pediatric patients were receiving. My early goal was to keep the patient at the center of my nursing practice by identifying ways to make my professional practice more efficient. That goal aligned very well with informatics skills in managing healthcare technology implementations, improving user experience, and integrating the data needed at the point of care into the clinical workflow. I continued my education with an MSN because I wanted to further ground myself in clinical skills and integrate technology into nursing practice. I also knew I wanted to earn my doctorate eventually, and I saw the MSN as a step toward a doctorate in nursing practice (DNP).

Daily activities vary widely for an informatics nurse specialist as daily tasks ultimately depend on the role’s job description. For example, what I do as a WGU nursing informatics educator vastly differs from what I did while consulting, working in a vendor’s R&D department, or working as an analyst in a large health system. I would suggest shadowing an informatics nurse or informatics nurse specialist in a job role you are considering to see if their daily activities appeal to you.

What do you like best about your job?

I love the flexibility within the role to pivot in a different informatics direction, the ability to work remotely, and, most importantly, the positive impact the role has on improved nursing practice and patient outcomes.

What is the difference between health informatics and nursing informatics?

Think of health informatics as an umbrella term with sub-specialties specific to the specialty, such as nursing informatics, medical informatics, pharmacy informatics, bioinformatics, and so on. In a health informatics role, you may be managing other clinical areas instead of, or in addition to, nursing. You might report to a department other than nursing, such as the information technology or finance departments. In a nursing informatics role, you typically report to nursing and have your practice focused on nursing data. Regardless, in any informatics role, you will collaborate within an interprofessional team, so good communication skills are a must.

How is informatics helping healthcare today?

Nursing informatics specialists sit at the intersection of technology and nursing practice, working collaboratively within an interprofessional team to improve nursing’s technology experience and indirectly impacting patient care and patient outcomes. For example, when I worked in direct care as a pediatric home care nurse or a staff nurse, I impacted patient outcomes directly through the care I provided. Throughout the rest of my career, I had more of an indirect impact. When I implemented CPOE, my role affected every pediatric clinician and patient in the health system. Then, when I worked at a vendor, my decisions impacted clinical practice and documentation at every one of their client sites. Now, as a nurse educator, I influence the

education obtained by WGU’s MSN Nursing Informatics 1000+ alums, positively impacting patient outcomes in their roles.

Does the Informatics Nurses Board Certification Exam offered by The American Nurses Credentialing Center (ANCC) for the RN-BC® credential help improve a nurse’s employment and salary potential?

Certifications validate a person’s knowledge to prospective employers and demonstrate a commitment to professional development. Depending on the certification, it can also provide insight into a person’s education and level of experience. There are several certifications that informatics nurses hold, including those offered by ANCC (RN-BC), HIMSS (CAHIMS, CPHIMS), and AMIA (ACHIP™). I hold all three of these and the NLN CNE® certification because I support the value of certification. I have personally found that it differentiates me as a professional nurse committed to continuous learning.

Is nursing informatics a high-demand career?

Informatics nurse specialists make a great addition to a well-functioning organization. I have personally seen job postings increasing, on sites such as LinkedIn, as organizations keep up with the increasing demand to integrate cuttingedge technology and data analytics at the point of care. With the shift toward value-based care, data analytics skills are increasingly valued in job candidates. The Future of Nursing 2020-2030 report called out population health informatics as an area of high growth potential. So yes, informatics is increasingly in demand.

What are the job prospects for nursing informatics?

Nursing informatics is an exciting specialty to consider if you are thinking about a role change, particularly if you want to work with data to innovate technology in patient care and enjoy collaborating within an interprofessional team.

A Day in the Life of a Clinical Informatics Senior Manager

Brooke Gaskins is a clinical informatics senior manager in information systems and technology at the University of Maryland Medical System. She has worked in the healthcare field for over 15 years. Brooke has progressed through various nursing areas on her journey into nursing informatics and is currently in a doctor of nursing program at the  University of Maryland School of Nursing (UMSON)

find a therapeutic treatment for schizophrenia and Alzheimer’s. During my time at the VA, I discovered my passion for nursing. My mentor and chief, Dr. Stephen Deutsch, organized a shadow day in the operating room where I could interact with surgical staff. I met with a nurse anesthetist and observed how she cared for the patient and manipulated the machines. She was patient in answering my questions, and this interaction set me on a new path.

I enrolled at the UMSON and obtained a master of science in nursing with a clinical nurse leader specialty. After graduation, I began working for TEKsystems, providing “at the elbow” support for Cerner and Azyxxi for MedStar Health. I enjoyed this experience and began contemplating whether becoming a nurse anesthetist was the right path. Upon passing the NCLEX-RN, I obtained a position as a nurse in the Neuro IMC at the  University of Maryland Medical Center. Ultimately, I returned to the University of Maryland School of Nursing to obtain a graduate certificate in nursing informatics.

Talk about your career path and how you ascended to your role in nursing informatics.

After graduating from George Washington University, I begin working as a psychology technician at the Veterans Affairs Medical Center. I coordinated medication studies and performed bench research to

During this time, I joined a newly formed team to assist in adopting Epic, the electronic medical record. This was an exciting time as this was the beginning of a 10-year journey where we implemented Epic across University of Maryland Medical Systems. I have been with the Department of Clinical Informatics for over 12 years. I have served as a clinical informaticist, principal trainer, and now as a leader within the department.

How do you prepare for a career in nursing informatics?

There are many avenues to get into the field of nursing informatics. My journey was far from linear. Many of my colleagues have a clinical degree in nursing and have served on clinical councils as subject matter experts for their specific specialty areas. You can volunteer as a “Super User” for your department, serving as an expert in workflows, disseminating information to team members, and providing feedback on the design, build, and usability of the electronic medical record. In addition, you can join a professional organization such as American Nursing Informatics Association (ANIA) or the Healthcare Information and Management System Society (HIMSS) to develop relationships in the field and broaden your knowledge on the best use of information technology and management systems.

What type of degree do you need to work in nursing informatics?

Generally, you need a bachelor’s degree in a clinical field. However, many working in this field hold advanced degrees such as an MS, MSN, or DNP and/or have obtained their Informatics Nursing Certification through ANCC or HIMSS.

What inspired you to pursue this specialty?

While providing “at the elbow” support, I was exposed to the IT side of healthcare. I enjoyed helping healthcare professionals navigate electronic medical records. Sharing tips and tricks of the system allowed them to document faster and spend more time

with their patients. I found this rewarding which lead me to discover nursing informatics and ultimately my passion.

What are the most critical attributes a nurse should have to work in informatics?

The most important attributes are clinical experience and knowledge of clinical workflows. The ability to relate to a clinician and speak their language is invaluable. Often we bridge the gap between clinical language and IT lingo. Critical thinking is also essential. We analyze requests for the system build and determine the best solution based on workflows, technical feasibility, and clinical need. A nurse informaticist must be knowledgeable of the system and clinical workflows to make recommendations for build and ultimately provide a product that is easy to use and intuitive.

What does a nursing informaticist do daily?

Some of the typical daily responsibilities and tasks include:

• Master EHR application and organizational workflows

• Advocate for nursing practice and quality care

• Organize and participate in discovery, validation, reengineering, content, training and optimization

• Lead meetings to facilitate decisions on clinical documentation, security, orders, and training

• Workflow analysis, planning, development, user support, documentation, and reporting to support the implementation and execution of system applications

• Manage communication and coordination of clinical/operational service line

• Assist in the development and implementation of strategic initiatives that will enable employees to develop competence in the use of computer software and systems

• Contribute to the design and maintenance of systems to support multidisciplinary team functioning and continuity of services within the hospital

• Actively participate in projects for clinical or business applications in the healthcare environment

• Participate in training development and delivery, go-live and elbow support, testing activities, and reporting

• Collaborate with multidisciplinary team members to assess, redesign and continually improve effectiveness and productivity of clinical and business programs

• Support innovation in healthcare practice, care delivery systems, and healthcare business operations by staying current with emerging trends and literature in healthcare informatics and care delivery

• Disseminate and incorporate research findings into informatics and EHR efforts

What do you like best about your job?

The best part of my job is building relationships and collaborating with end-users to help meet our organizational goals. Another aspect of my job is coaching and mentoring team members. It is rewarding to support my team members to grow, develop, and reach their full potential.

What is the difference between health informatics and nursing informatics?

Health informatics is the intersection of information science, computer science, cognitive science, and healthcare. Information technology is used to organize and analyze the patient’s health record to improve healthcare outcomes. Nursing informatics is a subset of health informatics that combines technology and patient care. Nurse informaticists are uniquely positioned since they have clinical and technical knowledge. They bridge the gap between healthcare professionals and technology to improve patient care, quality, and safety.

How is informatics helping healthcare today?

The American Recovery and Reinvestment Act (ARRA), specifically the Health Information and Technology for Economic Clinical Health (HITECH) Act, encourages the use of an electronic health record (EHR). Providers are incentivized to use an EHR through the Meaningful Use program. This provides informatics the opportunity to enhance the delivery of care through data collection, storage, and extraction. We use these data to improve health outcomes, drive and inform practice, reduce medical errors, and advance patient education.

Does the Informatics Nurses Board Certification Exam offered by The American Nurses Credentialing Center (ANCC) for the RN-BC credential help improve a nurse’s employment and salary potential?

A recent survey by HIMSS found that nurses can increase their earning potential by obtaining the certification. This is also true for nurses

who further their education by earning a graduate or doctorate degree.

Is nursing informatics a high-demand career?

Yes, we are in high demand. Most hospitals and outpatient clinics use an electronic medical record and require a team of informaticists to support the needs of the end-users and facility.

What are the job prospects for nursing informatics?

The job prospects for nursing informatics are good. Many career paths for nurse informaticists include clinical informaticists, chief information officers, educators, faculty members, nursing informatics specialists, project managers, researchers, system analysts, support analysts, system administrators, and trainers.

A Day in the Life of a Health Informatics and Digital Strategy Consultant

Linda Harrington, PhD, DNP, RN-BC, CNS, UXC, FHIMSS, FAMIA, is an independent health informatics and digital strategy consultant, adjunct faculty at Texas Christian University, and the Technology

Today editor for AACN

Advanced Critical Care, a peerreviewed journal published by the American Association of Critical-Care Nurses.

Talk about your career path and how you ascended to your role in nursing informatics.

I was formerly a health system VP for Advancing Nursing Practice. My responsibilities included nursing quality, safety, evidence-based practice, research, shared governance, advanced practice, co-chair of the critical care service line with a physician, and nursing informatics. I had demonstrated experience and expertise in all of those but informatics. Having that level of responsibility for nursing informatics and seeing the increasing role of technology in the industry, I decided to look for a formal education program in nursing informatics. I felt lucky to live in an age where my choices were not restricted by geographic locations because, at the time, there were no graduate programs in informatics in the state of Texas. I looked around the country for the best programs, spoke with informatics nurses and leaders, and was fortunate to be accepted at Duke. In short, the career path was an assignment for the responsibility of nursing informatics as a health system executive, hitting the ground running and learning all I could to lead, set strategy, achieve goals, and so forth. This was not a unique career path 15 years ago.

Talk about your role as the co-chair for the recently released American Nurses Association, Nursing Informatics: Scope and Standards of Practice.

I served on the second edition of the scope and standards in 2015. So, when the notice went out about the recent third edition, I knew what I was getting into, immediately applied,

and was asked to be co-chair. The work involved biweekly meetings, plus small group work in between those meetings reviewing current literature, sharing work experiences and knowledge, and drafting content, followed by reviews and discussions of the work by small groups within the larger group of about 30 informatics nurse specialists, creating a draft of the scope and standards, sending the draft out for public comment, reviewing and addressing public comments, and then creating the final draft which goes to the copy editor and ultimately to print. It was both very tedious and time-consuming over 2 years or more. Unfortunately, we were slowed down somewhat on this edition due to the pandemic. As co-chair, I worked with the other cochair and the ANA staff, ensuring that the processes moved forward to the final quality product.

How do you prepare for a career in nursing informatics?

This varies depending on where you are in your career, from being new to informatics to wanting to develop in an informatics specialty to further developing a subspecialty. Formal education is an excellent place to start. As mentioned, we have many more programs than we did 15 years ago, with more faculty teaching who have practiced informatics and continue their learning journey. Nurses should examine potential schools that will give them solid preparation, both didactic and practicum. Look at the faculty and their informatics experience, and compare curricula.

What type of degree/education do you need to work in nursing informatics?

There are master’s degrees and, increasingly, DNP programs preparing nurses to work in informatics. As nurses look for informatics degrees, it is important to appreciate that just as the healthcare industry is rapidly transforming in the digital age, so are educational programs, meaning some are further along in how well they prepare graduates. There are also certificate programs in nursing informatics, some from highly regarded institutions with well-established programs and organizations. And I would be remiss if I didn’t mention continuing education which we all need as healthcare rapidly advances.

What inspired you to pursue this specialty?

I grew up in the so-called “high tech, high touch” critical care, and my husband was in IT, later studying biomedical informatics and working in healthcare informatics. So, technology was always comfortable for me, part of our family discussions. As a nurse, I always appreciated the good things it did and was frustrated by issues with use and wanted them fixed. So, as I mentioned earlier, I pursued the specialty when I was assigned an informatics role. My informatics specialty is in design, usability, and safety, which has broad implications. I’ve used it to improve infusion pumps, electronic health records, workflows, and other technologies. More recently, I’ve been studying a subspecialty in AI as I see that as a big part of our future.

What are the most critical attributes a nurse should have to work in informatics?

From a personal perspective, first and foremost, you must have excellent listening and observation skills and attention to detail and logic. Those using technology or needing data-driven solutions have a lot of important information that directly impacts solutions. From a practice perspective, there is a term dual-domain expert, meaning having expertise in two areas, such as nursing and informatics. If you are going to work in nursing informatics, you need a solid foundation in nursing on which to build your informatics expertise. And while you will be very busy continuing to learn informatics as it evolves, don’t abandon your professional practice association, which in my case is AACN, as it will keep you abreast of what’s going on in that side of the domain.

What does a nursing informaticist do daily?

It’s as varied as where you practice as a registered nurse. Similarly, it depends on whether you are practicing as a generalist, specialist, or subspecialist and what area of healthcare you are working in. That may be on the delivery side of healthcare, from hospitals to telehealth and all places in between, or for a vendor developing a new product or advancing a current product. You might work for a lawyer to evaluate the role of technology in a practice dispute. You may work in data science, artificial intelligence (AI), and robotics. Some informatics nurses teach or research, some work as IT analysts, and others as policymakers. Informatics nurses

work in many areas meeting many needs which define what they do daily.

What do you like best about your job?

Making a difference. There is a lot of press about the burdens and burnout of nurses. Data and technology can help improve that or make it worse. Informatics nurses leverage it to make nursing practice and patient outcomes better.

What is the difference between health informatics and nursing informatics?

There are many different types of informatics. These include nursing informatics, medical informatics, health informatics, healthcare informatics, biomedical informatics, and clinical research informatics, among others. I’ve witnessed the growth in the number and types of informatics and the evolution of the definitions over the last few decades as the role of health information technology has dramatically expanded. Fundamentally, they are about improving health. They are just focused on different areas. The American Nurses Association, Nursing Informatics: Scope and Standards is the authoritative source on the definition of nursing informatics as “the specialty that transforms data into needed information and leverages technologies to improve health and healthcare equity, safety, quality, and outcomes” (2022).

How is informatics helping healthcare today?

Informatics is filling a growing need as healthcare rapidly transitions into the digital world. But, unfortunately, we have been “data rich and information poor” for far too long.

And the increase in the widespread use of technology in healthcare has not yielded the outcomes we initially hoped to achieve. We now have better computing power, analytics, data capture, and other tools and processes that informatics nurses use to make it happen.

Does the Informatics Nurses Board Certification Exam offered by The American Nurses Credentialing Center (ANCC) for the RN-BC credential help improve a nurse’s employment and salary potential?

I would point nurses to the HIMSS 2020 Nursing Informatics Workforce Survey for that information. They do the survey every 3 years, and the findings are always informative and interesting. For example, there is an item in the 2020 survey specific to salary by certification reporting that 56% of nurse informaticists who hold informatics certification earn over $100,000 a year.

You can read the full report at:  https://www.himss.org/sites/ hde/files/media/file/2020/05/15/ himss_nursinginformaticssurvey2020_v4.pdf

Is nursing informatics a high-demand career?

Just as the role has evolved, so has the demand for the increasing specialties and subspecialties needed. The Health Information Technology for Economic and Clinical Health (HITECH) Act which became law in 2009, ignited the rapid proliferation of electronic health records (EHRs) across the industry. Back then, many nurses were hired as informaticists to help train end users. My experience suggests that most needed formal education in nursing informatics, and many needed direct experience. It

reminds me of how I first got into nursing informatics. It was easy to see the need and demand would go beyond any initial training. I look back at the three editions of the American Nurses Association, Nursing Informatics: Scope and Standards of Practice in 2008, 2015, and 2022, and see the evolution from generalists to adding specialists to subspecialists as indicative of the continuing growth in need and demand.

Is there anything else you’d like to share about the field of nursing informatics?

Yes. It is important to know that nursing informatics needs minority nurses. Their knowledge and advocacy are vital to what we do and those we serve, patients, nurses, healthcare providers, vendors, policymakers, and more. A simple example is pulse oximeters which can be less accurate for some people of color. It seemed like a surprise to many during COVID, but the research on this has been around for decades.

Another example is that as we increasingly use data in AI solutions, we need to ensure we are using the right data for everyone. We need minority nurses to help identify data elements also to help prevent biases in AI data so that we get the right solutions for all individuals. We need to get this right, and we can’t do it right without minority informatics nurses and leaders.

So, I hope people are informed and encouraged by what I’ve said, and anyone interested will take steps to learn more. Here are a couple of ideas on where you might start.

• Visit the American Nursing Informatics Association (ANIA) website at  www. ANIA.org Other excellent informatics associations exist, but that’s where I’d start. Look around the site and eventually stop in “Chapters” on the menu across the top of the page. Connect with them and ask

if you can attend a meeting. Some are still holding them virtually. Look under “Practice” to identify learning opportunities. Also, make a note of “Jobs”—be sure and use the search function and input the word “informatics” to find jobs specific to informatics nursing.

• Shadow an informatics nurse where you work, keeping in mind that informatics nurses have different roles.

Reneé Hewitt is the editor and content strategist for Minority Nurse. When enjoying life unplugged from the digital world, you’ll find her on a trail taking wildlife photos or birdwatching.

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Will AI Impact Nursing? It Already Does

by Louis Pilla

If you believe artificial intelligence (AI) won’t affect your nursing practice, or it might influence your daily work some time far off in the future, you’ll have to reconsider that position. AI is already affecting nursing, and you’re probably using it today.

AI is “already being used in nursing practice. It’s going to be used more and more, and it has the potential to save nurses time,” says Jenny Alderden, PhD, RN, associate professor, school of nursing, Boise State University. “A lot of bedside nurses are already seeing AI within their practice,” agrees Kendra Ripp, DNP, CPHQ, RN, vice president of clinical services at Nice Healthcare.

This article discusses some of the ways you’re probably using AI in your practice and the benefits it can bring. But first, let’s define AI.

Understanding AI

In a 2022 position statement on the ethical use of AI in nursing practice, the American Nurses Association (ANA) notes that AI involves using algorithms to drive the behavior of different agents, such as software programs, machines, robotics, games, and other hardware devices. Several different technologies, such as machine learning, deep learning, natural language processing, robots, neural networks, and rule-based expert systems, fall under the umbrella of AI, according to a recent article in AACN Advanced Critical Care by health informatics and digital strategy consultant Linda Harrington, PhD, DNP, RN-BC, CNS, UXC, FHIMSS, FAMIA.

However it’s defined and used, AI categorically will not

replace nurses and will likely benefit them. That’s especially the case when staff shortages, high patient acuity, and overwhelming workloads continue to stress the profession.

AI is “likely to augment the work of nurses--it’s never going to replace the nurses,” says Alderden. A critical care nurse for 20 years, she conducts research into AI supported by an impact research grant from AACN.

“AI is likely to augment the work of nurses, but it absolutely cannot replace nurses because it cannot critically think,” says Ripp of Nice Healthcare, a nurse practitioner-founded firm that provides in-home and virtual primary care. “It cannot understand the human factors going on with individual patients.” The ANA position statement strongly agrees, stating that “AI does not replace a nurse’s decisionmaking, judgment, critical thinking, or assessment skills.”

AI as Your Assistant Regard AI as your nursing assistant, suggests Alderden. “AI is our copilot. It’s our assistant, and we’re the pilot. You can consider it and then do what you will with it. Sometimes what AI recommends will be very appropriate. Sometimes it won’t. We always need the person to make the final decisions, but AI can be an assistant.”

As more is learned about AI, nurses need to understand that this technology is built to support care, not to replace the care that nurses provide, says Ripp, who serves as chair for the ANA Innovation Advisory New Models of Care committee. “These models need human validation. They’re

only as smart as the inputs and must continue to be validated. If we don’t have clear data, and if we don’t have validation, there’s not much that you can do with the model. So we still need folks who can ensure that the nursing practice and the care being delivered to patients doesn’t necessarily change.”

Noting the significant impact of the COVID pandemic on staffing levels and patient care, Ripp suggests that AI could broaden access to care. “Nursing leaders are trying to look at how we can implement AI to help augment and improve the care that we’re giving, not necessarily replace humans but help to expand what we can do with our current staffing,” she says.

AI in Action

You may use AI in clinical decision support systems and medical devices today. For example, an AI-enabled clinical decision support system—perhaps embedded in your organization’s EMR—might suggest that, based on the symptoms being entered for a patient’s assessment, “here’s the likely pathway for care,” notes Ripp.

With so much data being collected in hospital systems, humans could find it hard to consider and analyze all that data, notes Ripp. AI can help to “collate that data and help inform the care in a way that you’re able to analyze it more quickly to enhance the care that you’re providing.”

“... AI can predict what’s going to happen, it can reduce the nursing workload and free up the nurse for the hundred other things that she needs to do and for direct patient care,” says Alderden.

Detecting Subtle Differences

AI can also be a boon for patient monitoring and surveillance. The technology could, for example, recognize signs of sepsis very early, before a clinician might, notes Alderden.

“AI can sometimes detect problems with a patient before anyone on the healthcare team can because it can detect subtle differences. Like, the vital signs are trending worse. Maybe the patient is deteriorating,” says Alderden.

“If we’re on that fast and get antibiotics on board, we can save their life. Whereas if we let the sepsis go for 6 or 7 hours until human brains, physician or nurse, could detect those changes, the patient would have a longer time to deteriorate, and the sepsis would be more entrenched,” notes Alderden.

AI can also optimize workflow, freeing time and allowing nurses to spend more of their day on higher-level tasks and critical thinking. For example, an EMR with AI, notes Alderden, could look at how nurses document and optimize workflow by automating repetitive tasks.

In addition, AI can help with medication management, notes Alderden. “AI algorithms can help pharmacists and nurses ensure that patients are given the medications at the right time and dosage.”

AI can also assist nursing by enhancing communication and collaboration. “We haven’t quite seen it yet,” notes Alderden, “but there’s a lot of work toward communication and coordination. So much of what nurses are doing with patients is coordinating with

that AI may work behind the scenes to assist your practice and improve patient care.

“Artificial intelligence is going to have a profound impact on the future of practice,” says Alderden. “It kind of already

ouis Pilla is a seasoned publishing expert with over 20 years of experience providing content and digital products to healthcare audiences.

Augusta University is proud to be an equal opportunity employer welcoming applicants from underrepresented groups, including individuals with disabilities and veterans

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Virtual Reality Opens New Possibilities in Nursing Education

By Julia Quinn-Szcesuil

Although virtual reality (VR) is often associated with gaming, technology is quickly becoming a sought-after educational tool that’s especially adaptable to nursing.

Colleen Nevins , DNP, RN, CNE, associate professor emeritus at the  California State University Channel Islands  (CSUCI) Nursing Program, and  Jaime Hannans, Ph.D., RN, CNE, and associate professor of nursing at CSUCI, run the Extended Reality (XR) at CI for Nursing and were introduced to a new product in 2018 that presented a use for VR they hadn’t seen in other places. Instead of a body function application or the kind of computer-based situation in which students watch and then choose answers they had seen in VR up to that point, this new product allowed nursing students to step into the shoes of the person seeking care. “It was a different type of simulation, and we knew it would be impactful for students,” says Nevins.

State University Channel Islands Nursing Program

“This was immersive,” says Hannans. “It changes how students see a disease process.” For instance, a VR module for macular degeneration can limit the vision field of the person wearing the headset. “Students are impacted differently,” she says. “It changes how you think about how would I eat my meal if I can’t see it or how would I find a call light or even fill out forms. It’s powerful, allowing that immersive experience.”

VR also opens up the number and type of experience nurses can train in. For example, based on location alone, clinicals aren’t always reliable for working with diverse populations and conditions. So while nursing schools can’t control clinicals, they can control the VR scenarios to help round out the experiences.

And VR is a risk-free environment to make and correct mistakes. “The virtual experience often offers something the real world/clinical instruction does not, a space that nursing students can learn/relearn different scenarios for remediation

of mistakes,” says Tsu-Yin Wu, PhD., RN, FAAN, director of the Center for Health Disparities Innovation and Studies (CHDIS), director of the  Healthy Asian Americans Project (HAAP), and professor and Ph.D. Program Director at  Eastern Michigan University’s School of Nursing “Students can play a scenario repeatedly with more time doing critical thinking, finetuning their responses, and learning best practices. These features can come from VR but may not be easily done from traditional clinical instruction.”

nurses and is a part-time faculty member of the Department of Medical Illustration at Augusta University. “It doesn’t happen often, but it can be devastating,” she says. And while healthcare professionals can’t physically prepare for such a dangerous and anxiety-producing situation, the scenario can be taken into a virtual reality setting where students can engage and learn. “All of your senses are involved,” she says. “You know you can pull off the headset, but you feel like you are there.”

In addition to VR helping show nurses patient scenarios, it also helps with situations where hands-on experience isn’t always possible. “Fire in the OR is a simulation by Health Scholars removing the elements of danger to their safety,” says  Lynsey Steinberg, MSMI, CMI, a board-certified medical illustrator who helps design the VR experiences for

Using VR in a nursing curriculum helps round out the classroom and clinical experiences without replacing either. A distinct benefit is that with some sensitive or complex topics, the VR experience can be shared by many people online and then stopped at various points for discussion, says Nevins. For example, students progressing through VR labs in end-of-life care and gendertransitioning scenarios might find some of the material

Jaime Hannans, Ph.D., RN, CNE, and associate professor of nursing at the California

Colleen Nevins, DNP, RN, CNE, associate professor emeritus at the California State University Channel Islands Nursing Progra

Tsu-Yin Wu, PhD., RN, FAAN, director of the Center for Health Disparities Innovation and Studies (CHDIS), director of the Healthy Asian Americans Project (HAAP), and professor and Ph.D. Program Director at Eastern Michigan University’s School of Nursing

Lynsey Steinberg, MSMI, CMI, a board-certified medical illustrator who helps design the VR experiences for nurses

intense, says Nevins. “These are sensitive and difficult topics to talk through.” Hannans agrees. “We were screen sharing, and we could pause for a discussion in the group,” she says. “In the end, it was valuable to work in these small groups and hear the students’ own experiences.”

Sometimes, VR can fill in gaps where training is needed but not possible. “It is inappropriate to train individuals in a hospice care facility with patients dying,” says Steinberg. “But using VR in helping people inside an experience helps nurses to experience the emotions. You can

be in the experience to better prepare yourself for the real world before you go into the real world.” The heightened responses that gamers appreciate make VR beneficial for nursing students.

And because VR is new, longterm studies about its efficacy in real healthcare settings don’t offer long-term findings yet. But predictions are hopeful. “I think when you see and feel something impactful, it reminds you and guides you,” says Nevins. “It increases your empathy and compassion.”

Wu also uses VR to help with diversity efforts, with a particular focus on Asian American

communities. “This VR case helps nurses to equip themselves with knowledge of barriers and health challenges

Asian Americans are experiencing, skills and competency of providing culturally-relevant communication messages, and resources to address misconceptions and barriers,” she says. “The VR experience promoted effective discussion with students and actively engaged them in real-world situations by using simulation-based learning.”

The possibilities for VR are exciting. “When you put on a headset, you’re put into a place you have never been

before,” says Steinberg. “It’s a new place, environment, and a 360-degree experience. You just stepped into a whole new world. The potential is almost limitless if you can think of anything for creative problemsolving technologies.”

Julia Quinn-Szcesuil is a freelance writer based in Bolton, Massachusetts.