Optimization of a Graduate Nursing Informatics Practicum Program  

Nurse informaticists play a valuable role, serving as the liaison between clinical users and the build analysts. They are the workflow experts, using their clinical knowledge to ensure that technology is used to its fullest capability and lead efforts to continually optimize functionality while reducing the documentation burden.

Nursing informatics (NI) is the specialty that transforms data into needed information and leverages technologies to improve health and health care equity, safety quality, and outcomes. With the proliferation of electronic health records (EHRs) and use of technology in healthcare, the need for nurse informaticists has increased significantly. To meet this demand, there has been an increase in NI degree programs. In spite of this, opportunities for nurses to learn and experience the NI role outside of formal education are very rare. Many nurses are interested in learning more about the NI field but do not want to commit to an NI degree program without a better understanding of the role.

Our organization developed a year-long nursing informatics fellowship to provide nurses with an opportunity to learn about the NI role. The fellowship includes attending monthly classes, completing a project to optimize the EHR or a clinical workflow, and mentoring by a nurse informaticist. Fellows spend up to 8 hours a month attending classes and working on their project.

Fellows identified an idea for system or workflow optimization as part of the application process. The nurse informaticists work with the fellows to identify a project that each can successfully complete within the length of the program. Priority is given to projects that interested the fellow and aligned with their clinical expertise and operational/strategic goals. The fellows worked with their mentors and nursing leadership to determine the scope of their project and develop metrics for success. They completed the system development life cycle for their projects.

Fellows worked with build analysts to identify potential solutions and went through established governance committees for approval. They developed and implemented education and communication and provided support for their projects. Examples of projects include flowsheet optimization, implementation of barcoded blood administration for ambulatory care clinics, streamlining checklists, and reducing the burden of documentation.

At the end of their tenure, each fellow presented their projects and outcomes to the nursing department at a symposium. The presentation included the background and problem statement of their project, baseline data, goals, solutions, results and outcomes, lessons learned, and next steps.

Four cohorts have completed the NI fellowship to date. Fellows report that the program helped them grow professionally and gain insightful leadership and informatics experience. Each fellow completed a project benefiting the organization by optimizing the EHR and workflows, positively impacting patient care and improving clinician satisfaction. Creating a NI fellowship is an effective strategy to create meaningful change, accomplish more optimization project, and mentor future informaticists. The fellowship can be replicated in other organizations to help maximize use of technology and improve nursing interaction with the EHR, allowing them to provide efficient, high-quality, and safe patient care.