1 STANDARDS OF NURSING INFORMATICS PRACTICE
2 Nursing informatics (NI) is the specialty that integrates nursing science, computer science, and
3 information science to manage and communicate data, information, knowledge, and wisdom in
4 nursing practice. Nursing informatics facilitates the integration of data, information, knowledge,
5 and wisdom to support patients, nurses, and other providers in their decision-making in all roles
6 and settings. This support is accomplished through the use of information structures,
7 information processes, and information technology.
8 The goal of nursing informatics is to improve the health of populations, communities,
9 families, and individuals by optimizing information management and communication. These
10 activities include the design and use of informatics solutions and/or technology to support all
11 areas of nursing, including, but not limited to, the direct provision of care, establishing effective
12 administrative systems, managing and delivering educational experiences, enhancing life-long
13 learning, and supporting nursing research.
14 The nursing informatics standards of practice are organized using a general problem-solving
15 framework that closely resembles the familiar nursing process of assessment, diagnosis,
16 identification of outcomes, planning, implementation, and evaluation. The problem-solving
17 framework supports all facets of informatics practice, helps to identify and clarify issues, and
18 aids in the selection, development, implementation, and evaluation of informatics solutions.
19 These steps are not mutually exclusive and may overlap.
20 Informatics solution is a generic term used in this document to describe an application,
21 product, method, tool, workflow change or other recommendation an informatics nurse makes
22 after identifying and analyzing a need or an issue. An informatics solution may encompass
23 technology and non-technology products such as developing a database, purchasing a new
24 computer application, creating nursing vocabulary, designing informatics curricula, creating a
25 spreadsheet, tailoring an application to a particular environment, designing a designing a
26 research study to describe required informatics competencies, describing information flow in a
27 process redesign, creating newly re-engineered processes or creating a structure for
28 information presentation.
29 The standards of nursing informatics practice and the identified competencies apply to all
30 informatics nurses. The competencies for the informatics nurse specialist reflect the additional
1 expectations for this advanced level of practice.
2 Overarching Competencies for Nursing Informatics Practice
3 Three overarching competencies inherent in every aspect of nursing informatics practice apply
4 to each of the sixteen standards of informatics nursing practice.
5 The informatics nurse:
6 1. Incorporates theories, principles, and concepts from appropriate sciences into
7 informatics practice. Examples of theories could include information, systems, and change
8 theories. Principles and concepts could include project management, implementation
9 methods, workflow analyses, with process redesigns, organizational culture, or database
11 2. Integrates ergonomics and human–computer interaction (HCI) principles into informatics
12 solution design, development, selection, implementation, and evaluation.
13 3. Systematically determines the social, legal, regulatory and ethical impact of an informatics
14 solution within nursing and health care.
15 STANDARDS OF NURSING INFORMATICS PRACTICE
16 STANDARDS OF PRACTICE
18 STANDARD 1. ASSESSMENT
19 The informatics nurse collects comprehensive data, information, and knowledge
20 pertinent to the situation.
23 The informatics nurse:
24 Collects data, information, and knowledge in a systematic and ongoing process,
25 such as with a needs assessment to refine the issue or problem, or with workflow
26 analyses to examine current practice, workflow, and the potential impact of an
27 informatics solution on that workflow.
29 Involves the patient, family, nurse, other healthcare providers, and key
30 stakeholders, as appropriate, in holistic data collection.
32 Prioritizes data collection activities based on the immediate or anticipated needs
33 of the situation.
35 Uses appropriate evidence-based assessment techniques and instruments in
36 collecting pertinent data to define the issue or problem.
1 Uses analytical models and assessment tools that facilitate problem solving.
3 Synthesizes available data, information, and knowledge relevant to the situation
4 to identify patterns and variances.
6 Documents relevant data in a retrievable format.
8 STANDARD 2. PROBLEMS OR ISSUES
9 The informatics nurse analyzes the assessment data to determine the problems
10 or issues.
13 The informatics nurse:
14 Derives the problems, needs, or issues based on assessment data.
16 Validates the problems, needs, or issues with the patient, family, nurse, other
17 healthcare providers, and key stakeholders when possible and appropriate.
19 Documents problems, needs, or issues in a manner that facilitates the
20 determination of the expected outcomes and plan.
22 STANDARD 3. OUTCOMES IDENTIFICATION
23 The informatics nurse identifies expected outcomes for a plan individualized to
24 the situation.
27 The informatics nurse:
28 Involves the patient, family, nurses, other healthcare providers, and key
29 stakeholders in formulating expected outcomes when possible and appropriate.
31 Considers associated risks, benefits, costs, current scientific evidence,
32 environmental factors, and expertise when formulating expected outcomes.
34 Defines expected outcomes in terms of the patient, patient values, ethical
35 considerations, environment, organization, or situation with such consideration as
36 associated risks, benefits and costs, and current evidence-based knowledge.
38 Includes a time estimate for attainment of expected outcomes.
40 Develops expected outcomes that provide direction for all key stakeholders.
42 Modifies expected outcomes based on changes in the status or evaluation of the
45 Documents expected outcomes as measurable goals.
1 Additional Competencies for the Informatics Nurse Specialist:
2 The informatics nurse specialist:
3 Identifies expected outcomes that incorporate scientific evidence and are
4 achievable through implementation of evidence-based practices.
6 Identifies expected outcomes that maximize quality, efficiency, and effectiveness
7 balanced with economy.
9 Supports the use of clinical guidelines, such as, but not limited to the integration
10 of clinical guidelines into practice, information system solutions, and knowledge
13 STANDARD 4. PLANNING
14 The informatics nurse develops a plan that prescribes strategies,
15 recommendations, and alternatives to attain expected outcomes.
18 The informatics nurse:
19 Develops a customized plan considering clinical and business characteristics and
20 the environmental situation.
22 Develops the plan in conjunction with the patient, family, nurse, other healthcare
23 providers, key stakeholders, and others, as appropriate.
25 Includes strategies within the plan that address each of the identified problems
26 and issues, which may include strategies for the synthesis of data, information,
27 and knowledge to enhance healthcare delivery.
29 Provides for continuity within the plan.
31 Incorporates an implementation pathway or timeline within the plan.
33 Establishes the plan priorities with the key stakeholders and others as
36 Utilizes the plan to provide direction to healthcare team members and other
39 Defines the plan to reflect current statutes, rules and regulations, and quality
42 Integrates current research and trends in the planning process.
44 Considers the clinical, financial, and social impact of the plan.
46 Uses standardized language, tools, and methodologies to document the plan.
2 Participates in the design and development of interdisciplinary processes and
3 informatics principles to address the situation or issue.
5 Contributes to the development and continuous improvement of organizational
6 systems that support the planning process.
7 Supports the integration of clinical, human, financial, and technical resources to
8 enhance and complete the decision-making processes.
10 STANDARD 5. IMPLEMENTATION
11 The informatics nurse implements the identified plan.
14 The informatics nurse:
15 Implements the plan in a safe and timely manner.
16 Documents implementation and any modifications, including changes or
17 omissions, of the identified plan.
18 Utilizes specific evidence-based actions and steps specific to the problem or
19 issues to achieve the defined outcomes.
20 Utilizes clinical, financial, technical, and community resources and systems to
21 implement the plan.
22 Collaborates with colleagues and other stakeholders to implement the plan.
24 Implements the plan using principles and concepts of quality, project, or systems
26 Fosters organizational systems that support implementation of the plan.
28 Incorporates new knowledge and strategies to initiate change in informatics and
29 nursing practices if desired outcomes are not achieved.
31 STANDARD 5A: COORDINATION OF ACTIVITIES
32 The informatics nurse coordinates activities.
35 The informatics nurse:
36 Coordinates implementation of the plan, including activities and resources
37 necessary to achieve desired outcomes.
39 Synthesizes data and information to prescribe necessary system and
40 environmental support measures.
42 Documents the coordination of the activities.
2 Competencies for the Informatics Nurse Specialist:
3 The informatics nurse specialist:
4 Provides leadership in the coordination of interdisciplinary informatics activities.
6 Coordinates system and community resources that enhance delivery of care
7 across continuums.
9 STANDARD 5B: HEALTH TEACHING AND HEALTH PROMOTION
10 The informatics nurse employs strategies to promote health and a safe
14 The informatics nurse:
15 Identifies the need to integrate health content and learning resources into
16 healthcare systems that address such topics as healthy lifestyles, risk-reducing
17 behaviors, developmental needs, activities of daily living, and preventive self-
20 Participates in the design, development, implementation, and evaluation of health
21 promotion materials and health teaching methods appropriate to the situation and
22 the patient’s developmental level, learning needs, readiness, ability to learn,
23 language preference, and culture.
25 Seeks opportunities for feedback and evaluation of the effectiveness of the
26 educational content and teaching strategies used for the continuing education
27 and professional development programs necessary to implement the plan.
29 Additional Competencies for the Informatics Nurses Specialist:
30 The informatics nurse specialist:
31 Synthesizes empirical evidence on risk behaviors, learning theories, behavioral
32 change theories, motivational theories, epidemiology, and other related theories
33 and frameworks when designing health information and patient education.
35 Designs health information and patient education appropriate to the patient’s
36 developmental level, learning needs, readiness to learn, and cultural values and
39 Evaluates health information resources, such as the Internet, within the area of
40 practice for accuracy, readability, and comprehensibility to help patients, family,
41 healthcare providers, and others access quality health information.
43 STANDARD 5C: CONSULTATION
44 The informatics nurse provides consultation to influence the identified plan,
45 enhance the abilities of others, and effect change.
1 Competencies for the Informatics Nurse
2 The informatics nurse:
3 Synthesizes data, information, theoretical frameworks and evidence when
4 providing consultation.
6 Facilitates the effectiveness of a consultation by involving the stakeholders in the
7 decision-making process.
9 Communicates consultation recommendations that influence the identified plan,
10 facilitate understanding by involved stakeholders, enhance the work of others,
11 and effect change.
13 The informatics nurse specialist:
14 Develops recommendations and strategies to address and resolve complex
15 issues and problems.
17 Establishes formal and informal consultative relationships that can also provide
18 professional development and mentorship opportunities.
20 STANDARD 6. EVALUATION
21 The informatics nurse evaluates progress towards attainment of outcomes.
24 The informatics nurse:
25 Conducts a systematic, ongoing, and criterion-based evaluation of the outcomes
26 in relation to the structures and processes prescribed by the plan and the
27 indicated timeline.
29 Includes key stakeholders and others involved in the plan or situation in the
30 evaluative process.
32 Supports the integration and use of evidence-based methods, tools and
33 guidelines linked to effective outcomes.
35 Evaluates the effectiveness of the planned strategies in relation to the attainment
36 of the expected outcomes.
38 Uses ongoing assessment data to revise the problems and issues, the outcomes,
39 the plan, and the implementation and evaluative processes as needed.
41 Disseminates the results to key stakeholders and others involved in the plan or
42 situation as appropriate.
44 Documents the results of the evaluation.
46 Additional Competencies for the Informatics Nurse Specialist:
1 The informatics nurse specialist:
2 Uses the results of the evaluation analyses to make or recommend process or
3 structural changes including policy, procedure or protocol documentation, as
6 Synthesizes the results of the evaluation analyses to determine the impact of the
7 plan on the affected patients, families, groups, communities, and institutions,
8 networks, and organizations.
10 STANDARDS OF PROFESSIONAL PERFORMANCE
12 STANDARD 7. EDUCATION
13 The informatics nurse attains knowledge and competency that reflects current
14 nursing and informatics practice.
17 The informatics nurse:
18 Participates in ongoing educational activities related to appropriate knowledge
19 bases and professional issues.
20 Demonstrates a commitment to lifelong learning through self-reflection and
21 inquiry to identify learning needs.
22 Seeks experiences that reflect current practice in order to maintain skills and
23 competence in informatics practice and role performance.
24 Acquires knowledge and skills appropriate to the specialty area, practice setting,
25 role, or situation.
26 Maintains professional records that provide evidence of competency and life long
28 Seeks experiences and formal and independent learning activities to maintain
29 and develop clinical and professional skills and knowledge.
31 Additional Competencies for the Informatics Nurse Specialist:
32 The informatics nurse specialist:
33 Uses current research findings and other evidence to expand knowledge,
34 enhance role performance, and increase knowledge of professional issues.
36 STANDARD 8. PROFESSIONAL PRACTICE EVALUATION
37 The informatics nurse evaluates one’s own nursing and informatics practice in
38 relation to professional practice standards and guidelines, relevant statutes,
39 rules, and regulations.
42 The informatics nurse’s practice reflects the application of knowledge of current practice
43 standards, guidelines, statutes, rules, and regulations.
2 The informatics nurse:
3 Engages in self-evaluation of practice on a regular basis, identifying areas of
4 strength as well as areas in which professional development would be beneficial.
5 Obtains informal feedback regarding one’s own practice from peers, professional
6 colleagues, key stakeholders, and others.
7 Participates in systematic peer review as appropriate.
8 Takes action to achieve goals identified during the evaluation process.
9 Provides rationales for practice beliefs, decisions, and actions as part of the
10 informal and formal evaluation processes.
12 STANDARD 9. QUALITY OF PRACTICE
13 The informatics nurse systematically enhances the quality and effectiveness of
14 nursing and informatics practice.
17 The informatics nurse:
18 Demonstrates quality by documenting the application of the nursing process in a
19 responsible, accountable, and ethical manner.
21 Uses the results of quality improvement activities to initiate changes in nursing
22 and informatics practice and in the healthcare delivery system.
24 Uses creativity and innovation in nursing and informatics practice to improve care
27 Incorporates new knowledge to initiate changes in nursing and informatics
28 practice if desired outcomes are not achieved.
30 Participates in quality improvement activities. Such activities may include:
31 Identifying aspects of practice important for quality monitoring.
32 Using indicators developed to monitor quality and effectiveness of
33 nursing and informatics practice.
34 Collecting data to monitor quality and effectiveness of nursing and
35 informatics practice.
36 Analyzing quality data to identify opportunities for improving nursing
37 and informatics practice.
38 Formulating recommendations to improve nursing and informatics
39 practice or outcomes.
40 Implementing activities to enhance the quality of nursing and
41 informatics practice.
42 Engaging in the development, implementation, and evaluation of
1 policies, procedures and/or guidelines to improve the quality of
3 Participating on interdisciplinary teams to evaluate clinical care or
4 delivery of health services.
5 Participating in efforts to minimize costs and unnecessary
7 Analyzing factors related to safety, satisfaction, effectiveness, and
8 cost/benefit options.
9 Analyzing organizational systems for barriers
10 Implementing processes to remove or decrease barriers within
11 organizational systems.
13 Obtains and maintains professional certification if available in the area of
16 Designs quality improvement initiatives.
18 Implements initiatives to evaluate the need for change.
20 Evaluates the practice environment in relation to existing evidence, identifying
21 opportunities for the generation and use of research.
23 STANDARD 10. COLLEGIALITY
24 The informatics nurse interacts with and contributes to the professional
25 development of peers and colleagues.
28 The informatics nurse:
29 Shares knowledge and skills with peers and colleagues as evidenced by such
30 activities as presentations at formal or informal meetings and professional
33 Provides peers with feedback regarding their practice and/or role performance.
35 Interacts with peers and colleagues to enhance one’s own professional nursing
36 practice and/or role performance.
38 Maintains compassionate and caring relationships with peers and colleagues.
40 Contributes to an environment that is conducive to the education of healthcare
43 Contributes to a supportive and healthy work environment.
45 Additional Competencies for the Informatics Nurse Specialist:
1 The informatics nurse specialist:
2 Participates on interdisciplinary professional teams that contribute to role
3 development and, directly or indirectly, advance nursing, informatics practice,
4 and health services.
6 Mentors other registered nurses and colleagues as appropriate.
8 STANDARD 11. COLLABORATION
9 The informatics nurse collaborates with key stakeholders and others in the
10 conduct of nursing and informatics practice.
13 The informatics nurse:
14 Communicates with key stakeholders regarding the practice of nursing and
17 Communicates with key stakeholders regarding the role of nurses and nursing
18 within the domain of healthcare informatics and patient care delivery.
19 Collaborates in creating a documented plan focused on outcomes and decisions
20 related to the management of data, information, and knowledge for the delivery
21 of healthcare services.
22 Partners with others to effect change and generate positive outcomes through
23 knowledge of the plan and situation.
24 Documents plans, communications, rationales for plan changes, and
25 collaborative discussions.
26 Additional Competencies for Informatics Nurse Specialist:
27 The informatics nurse specialist:
28 Partners with others to enhance health care, and ultimately patient care, through
29 interdisciplinary activities such as education, consultation, management,
30 technological development, or research opportunities.
32 STANDARD 12. ETHICS
33 The informatics nurse integrates ethical provisions in all areas of practice.
36 The informatics nurse:
37 Uses the Code of Ethics for Nurses with Interpretive Statements (ANA, 2001) to
38 guide practice.
40 Uses nursing and informatics principles and methodologies in a manner that
41 preserves and protects patient autonomy, dignity and rights.
43 Employs informatics principles, standards, and methodologies to establish and
44 maintain patient confidentiality within legal and regulatory parameters.
2 Evaluates factors related to privacy, security, and confidentiality in the use and
3 handling of data, information, and knowledge.
5 Promotes active engagement of community members in the oversight and
6 management of the exchange of health information.
8 Serves as a patient advocate assisting patients in developing skills for self
11 Contributes to resolving ethical issues of patients, colleagues, or systems as
12 evidenced in such activities as participating on ethics committees.
14 Reports illegal, incompetent, or impaired practices.
16 Seeks available resources as needed when formulating ethical decisions.
18 Demonstrates a commitment to practicing self-care, managing stress, and
19 connecting with self and others.
21 Additional Competencies for the Informatics Nurse Specialist:
22 The informatics nurse specialist
23 Participates on multidisciplinary and interdisciplinary teams that address ethical
24 risks, benefits, and outcomes.
26 Informs administrators or others of the risks, benefits, and outcomes of programs
27 and decisions that affect healthcare delivery.
29 STANDARD 13. RESEARCH
30 The informatics nurse integrates research findings into practice.
33 The informatics nurse:
34 Utilizes the best available evidence, including research findings, to guide practice
37 Actively participates in research activities at various levels appropriate to the
38 nurse’s level of education and position. Such activities may include:
39 Identifying clinical, nursing, and informatics problems or issues
40 specific to nursing research
41 Participating in data collection such as surveys, pilot projects, and
42 formal studies.
43 Participating in a formal committee or program.
44 Sharing research activities and/or findings with peers and others
45 Conducting research.
1 Critically analyzing and interpreting research for application to
3 Using research findings in the development of policies, procedures,
4 and standards of practice in patient care.
5 Incorporating research as a basis for learning.
7 Additional Competencies for the Informatics Nurse Specialist:
8 The informatics nurse specialist:
9 Contributes to nursing knowledge by conducting or synthesizing research that
10 discovers, examines and evaluates knowledge, theories, criteria, and creative
11 approaches to improve health care.
13 Formally disseminates research findings through activities such as presentations,
14 publications, consultation, and journal clubs.
16 STANDARD 14. RESOURCE UTILIZATION
17 The informatics nurse considers factors related to safety, effectiveness, cost, and
18 impact on practice in the planning and delivery of services to achieve expected
22 The informatics nurse:
23 Evaluates factors such as safety, effectiveness, availability, cost and benefits,
24 efficiencies, and impact on practice, when choosing practice options that would
25 result in the same expected outcome.
27 Assists stakeholders in identifying and securing appropriate and available
28 services to address identified needs and implement and complete the plan or
29 other activity.
31 Assigns or delegates tasks based on the knowledge, skills and abilities of the
32 individual, complexity of the task, and predictability of the outcome.
34 Assists stakeholders in becoming informed consumers about the options, costs,
35 risks, and benefits of the plan and its associated activities.
37 Additional Competencies for the Informatics Nurse Specialist:
38 The informatics nurse specialist:
39 Develops innovative solutions and applies strategies to obtain appropriate
40 resources for nursing initiatives.
42 Secures organizational resources to ensure a work environment conducive to
43 completing the identified plan and outcomes.
45 Develops evaluation methods to measure safety and effectiveness for
46 interventions and outcomes.
2 Promotes activities that assist stakeholders, as appropriate, in becoming
3 informed about costs, risks, and benefits of care or of the plan and solution.
5 Standard 15. Advocacy
6 The informatics nurse advocates for the protections and rights of patients,
7 healthcare providers, institutions and organizations, and for issues related to
8 data, information, knowledge and health care.
11 The informatics nurse:
12 Supports patient access to their own personal health information within a
13 reasonable timeframe.
15 Promotes patient awareness of how their personal health data and information
16 may be used and who has access to it.
18 Supports the individual’s right and ability to supplement, request correction of,
19 and share their personal health data and information.
21 Evaluates factors related to privacy, security, and confidentiality in the use and
22 handling of health information.
24 Promotes awareness and education of the healthcare consumer with regard to
25 appropriate data collection, information sharing, information access, and
26 associated issues.
28 Supports patient involvement in their own care, facilitated by access to personal
29 healthcare data.
31 Promotes active engagement of community members in the development,
32 oversight, and management of health information exchange.
34 Educates clinicians, patients and communities about the rights, responsibilities,
35 and accountability involved in the collection, use, and exchange of healthcare
36 data and information.
38 Incorporates the identified needs of the patient, family, healthcare provider,
39 organization, and key stakeholders in policy development, program and services
40 planning, and systems design.
42 Integrates advocacy into the implementation of policies, programs and services,
43 and systems for the patient.
45 Evaluates the effectiveness of advocating for the patient, family, healthcare
46 provider, organization, and key stakeholders when assessing the expected
2 Demonstrates skill in advocating before providers and stakeholders on behalf of
3 the patient, community, or population.
5 Strives to resolve conflicting expectations from patients, families, communities,
6 populations, healthcare providers, and other stakeholders.
8 Additional Competencies for the Informatics Nurse Specialist:
9 The informatics nurse specialist:
10 Demonstrates skill in advocating on behalf of the patient, key stakeholders,
11 programs, and services before public representatives and decision-makers.
13 Exhibits fiscal responsibility and integrity in policy development and advocacy
14 activities and processes.
16 Serves as an expert for patients, peers, other healthcare providers, and other
17 stakeholders in promoting and implementing policies related to the management
18 of data information, and knowledge.
20 STANDARD 16. LEADERSHIP
21 The informatics nurse provides leadership in the professional practice setting
22 and the profession.
25 The informatics nurse:
26 Engages in teamwork as a team player and a team builder.
28 Works to create and maintain healthy work environments in local, regional,
29 national, or international communities.
31 Displays the ability to define a clear vision, the associated goals, and a plan to
32 implement and measure progress.
34 Demonstrates a commitment to continuous, life long learning for self and others.
36 Teaches others to succeed by mentoring and other strategies.
38 Exhibits creativity and flexibility through times of change.
39 Demonstrates energy, excitement, and a passion for quality work.
40 Willingly accepts mistakes by self and others thereby creating a culture in which
41 risk-taking is not only safe, but expected.
42 Inspires loyalty through valuing of people as the most precious asset in an
44 Directs the coordination of the plan across settings and among caregivers and
1 other stakeholders.
2 Serves in key roles in the work setting by participating on committees, councils,
3 and administrative teams.
4 Promotes advancement of the profession through participation in professional
7 Assumes leadership roles within organizations representing nursing informatics
8 professional practice within the healthcare domain.
10 Additional Competencies for the Informatics Nurse Specialist:
11 The informatics nurse specialist:
12 Serves in key leadership roles defining the vision, strategy and tactical plans
13 related to the management of data, information, and knowledge.
15 Works to influence decision-making bodies to improve patient care, health
16 services, and policies through such things as the adoption of data standards.
17 Promotes communication of information and advancement of the profession
18 through writing, publishing, and presentations for professional or lay audiences.
19 Designs innovations to effect change in practice and outcomes.
20 Provides direction to enhance the effectiveness of the interdisciplinary team and
21 key stakeholders.