1. Effken, Judith A. PhD, RN, FACMI, FAAN

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Nursing and Informatics for the 21st Century: An International Look at Practice, Trends and the Future, edited by Charlotte A. Weaver, Connie White Delaney, Patrick Weber, and Robyn L. Carr. Chicago, Ill: Healthcare Information and Management Systems Society, 2006. 524 pages, hardcover, $90.00.


Following recommendations of the Institute of Medicine and encouraged by recent federal initiatives such as the National Health Information Infrastructure (NHII), healthcare organizations are speeding up their implementation of electronic health records (EHRs) to enhance the delivery of safe, quality care. Frequently, nursing administrators are asked to lead these very expensive and complex information technology (IT) projects. For those nursing leaders who may feel less than optimally prepared for this challenge, this book will be enormously helpful. In contrast to most books on informatics, which are aimed at informatics professionals, this book targets nursing administrators. Among the more than 140 international contributors to the book are informatics experts from industry, hospitals and other agencies, research, and education, an ensemble that provides a wealth of practical information for nursing administrators that is immediately applicable.


The book's 34 chapters are divided into 6 sections. Section I (Revolutionizing Nursing: Technology's Role) is anchored by a chapter by Angela McBride. McBride begins by defining informatics, which she describes as integral to the achievement of nursing's practice, safety, and quality goals. Because one of the key benefits of the EHR is decision support, subsequent chapters in this section describe how informatics is being used to support nurses' clinical reasoning.


Few projects are as complex-or as expensive-as implementing an EHR throughout a healthcare system. Section II (New Roles and Leadership Opportunities) examines many of the new informatics-related roles for nurses that are needed for EHR or other IT implementation. One chapter defines the skills CNEs need to manage these projects, suggesting, for example, the need to merge business planning and a learning organization with a participative, interdisciplinary leadership style. Although the challenges of IT projects might seem to be overwhelming, readers may be comforted that it is not so much technological knowledge but the nursing administrator's own core knowledge (leadership, change management, and business decision making) that is critical to the success of these innovations. Additional chapters delineate the challenges inherent in comparable executive roles in industry, as well as in other informatics roles increasingly filled by nurses, including that of chief information officer (CIO).


Section III (Nursing Education and Information Technology) highlights how information technology is being used to transform nursing education. Topics in this section range from the need for integrating informatics competencies at all levels of the nursing curriculum to specific examples of how faculty are using technology creatively to teach nursing skills and support teaching in general. As in other chapters, this section emphasizes the need for close collaboration among practitioners, educators, and industry in developing and implementing these innovations.


Section IV (Innovation Applied Through Informatics) focuses on the use of IT to collect and repurpose data for reimbursement, organizational analysis, decision support, and evidence-based practice. The 5 chapters in this section describe the use of cutting edge IT and standardized terminology to provide nurse administrators with the timely, accurate data needed to make informed operational decisions, evaluate the effectiveness of various operational and clinical strategies, and meet strategic objectives in an increasingly complex healthcare environment.


Section V (The Electronic Health Record Initiatives Across the Globe) explores EHR initiatives around the globe through case studies. Nursing administrators will appreciate the chapters on how IT can be used to bring research to the point of care to support evidence-based practice-and how the EHR can provide data to build the research evidence for practice. As one of the authors puts it, in the future, nurses should reach for information tools that facilitate evidence-based practice as quickly as they reach for a pen or a stethoscope.


Section VI (The Near Future and Nursing) projects the impact of biomedical informatics on our clinical information systems and nursing knowledge, and the critical role that nursing informatics plays in the NIH roadmap. Finally, the authors predict that empowering patients is likely to not only change the way we provide them with health information but also may ultimately transform our entire healthcare system.


Nursing administrators will find the book not only readable but also an invaluable and practical reference. Although it may seem a bit expensive, it is well worth the price!!


Judith A. Effken, PhD, RN, FACMI, FAAN


Assistant Professor, University of Arizona College of Nursing, Tucson