Trends in Publication of Nursing Informatics Research
Abstract
We analyzed 741 journal articles on nursing informatics published in 7 biomedical/nursing informatics journals and 6 nursing journals from 2005 to 2013 to begin to understand publication trends in nursing informatics research and identify gaps. We assigned a research theme to each article using AMIA 2014 theme categories and normalized the citation counts using time from publication. Overall, nursing informatics research covered a broad spectrum of research topics in biomedical informatics and publication topics seem to be well aligned with the high priority research agenda identified by the nursing informatics community. The research themes with highest volume of publication were Clinical Workflow and Human Factors, Consumer Informatics and Personal Health Records, and Clinical Informatics, for which an increasing trend in publication was noted. Articles on Informatics Education and Workforce Development; Data Mining, NLP, Information Extraction; and Clinical Informatics showed steady and high volume of citations.
Introduction
Information technologies were identified as key factors in achieving improved patient safety and quality of care and the published literature is starting to confirm this role(1–3). Biomedical informatics, including nursing informatics, is a fast moving field that is heavily influenced by healthcare policy and clinical practice. Professional and/or academic organizations have been dedicating substantial effort to facilitate nursing informatics research and training that address current needs. For example, many nursing education programs offer training opportunities specialized in nursing informatics and also mandate an introductory nursing informatics class to all students as part of their core curriculum(4–7). The Nursing Informatics Working Group (NIWG) at AMIA addresses various issues in policy, research, and educational aspects of nursing informatics. The NIWG also offers two award programs to recognize noteworthy research presented in the annual AMIA symposium to encourage participation of nurse scholars (8). Scientific journals are a venue for dissemination of research to a large community of readers. The proportion of peer-reviewed articles published in a certain area of research (and their citations) can provide interesting insights on topic trends in informatics(9,10). Although it may not constitute a perfect measure, the number of citations is considered a de facto standard for measuring the impact of a scientific publication. Based on this idea, we have previously analyzed the publication and citation volumes in biomedical informatics that were published relatively recently (2009-2012) in the J Amer Med Inform Assoc (JAMIA) to better understand research topic trends for biomedical informatics in general.
We conducted a similar analysis to describe the trends in published nursing informatics research by analyzing the articles published on selected major informatics and nursing journals during the past 9 years. We also compared the active research areas reflected in these articles against the nursing informatics research agenda proposed by nursing informatics leaders(11–13). Through this analysis, we aimed at (1) checking the trajectory of published nursing informatics research for the past 9 years, and (2) identifying potential gaps in particular research areas.
It is noteworthy that Clinical Workflow and Human Factor is among the most frequently published and cited themes in nursing informatics research. This is not surprising considering the large amount of time that nurses spend working with clinical information system, especially EMRs(23). This research trend may also imply that nurses can make significant contributions to mitigating various EMR usability issues. In July of 2013, the Office of National Coordinator (ONC) hosted a meeting with stakeholders to discuss usability issues in EMRs. Representatives from a healthcare informatics professional group, an EMR certification agency, and the American Medical Association were invited and had a chance to provide testimonials. Common criticism was that designs and workflows of many EMRs largely focused on meeting the Meaningful Use (MU) requirements rather than usability(24–26). These testimonials addressed the usability issues commonly faced by various healthcare professionals. Also not many MU core/menu objectives are directly related to nursing documentation. Nonetheless it would be beneficial to actively seek nursing perspectives on the usability issues, considering that nurses are the major workforce for documenting and generating clinical data, as well as being heavily involved in the research on usability and workflow aspects of clinical information systems. The findings of this study may not reflect the most comprehensive and accurate trends of nursing informatics research due to several limitations. Firstly, the operational definitions of nursing informatics research we adopted were arbitrary: research related to informatics published in nursing journals OR research done by a researcher affiliated with a nursing institution and published in an informatics journal. Ideally, nursing informatics research should be defined as any scholarly work that investigated informatics aspects relevant to nursing research, practice
and education. However, operational definitions that could be readily applicable to literature search were unavailable. Use of crude definitions of nursing informatics research may have caused either the inclusion of nonnursing informatics articles or exclusion of nursing informatics articles. Secondly, we collected articles from a small subset of informatics and nursing journals. For example, we excluded conference papers with no citation information and specialty nursing journals, where many practical applied informatics articles are published, as they can be most beneficial to practicing nurses. Thirdly, although we used CPM to minimize the bias introduced by publication dates, CPM is still not completely free from the bias given that trends captured in the early age of articles might drastically change later. Finally, even if we found AMIA themes were robust and clear enough to label the articles collected for this study, there were cases that the authors struggled with assigning proper themes. Like in many studies that involve with human annotation of concepts, this study also
carries subjectivity and inconsistency issues in theme assignment.
Conclusion
We conducted a descriptive analysis of nursing informatics articles published in the past 9 years to understand
overall trends in publication of nursing informatics research in the peer-reviewed literature and to identify the
research areas that may be relatively under-represented. Overall, we found that published nursing informatics
research covered a broad spectrum of research topics in biomedical informatics and is aligned with high priority
research agenda items advocated by the nursing informatics community. Despite limitations related to relatively
narrow coverage of journals, the findings allow us to initiate a dialogue with journal editors and the nursing
informatics community at large about the differences in maturity of research in each of the themes, and potentially guide authors and readers on which venue currently provides the highest number of articles related to a given theme.
แนวโน้มในการเผยแพร่สารสนเทศวิจัยพยาบาลบทคัดย่อเราวิเคราะห์บทความสมุด 741 ในพยาบาลสารสนเทศเผยแพร่ใน 7 ทางชีวการแพทย์/พยาบาลสารสนเทศและสมุด 6 พยาบาลรายวันจากปี 2005 ถึงปี 2013 เริ่มเข้าใจแนวโน้มประกาศพยาบาลวิจัยสารสนเทศ และระบุช่องว่าง เรากำหนดรูปแบบการวิจัยบทความแต่ละประเภทรูป AMIA 2014 และตามปกตินับอ้างอิงโดยใช้เวลาจากการเผยแพร่ พยาบาลวิจัยสารสนเทศครอบคลุมสเปกตรัมกว้างของหัวข้อวิจัยทางชีวการแพทย์คอมพิวเตอร์โอลิมปิกทั้งหมด และพิมพ์หัวข้อดูเหมือนจะสอดคล้องกับวาระวิจัยสำคัญที่ระบุ โดยพยาบาลที่ดีชุมชนสารสนเทศ รูปแบบวิจัย ด้วยปริมาณสูงสุดของงานพิมพ์ได้ลำดับ งานทางคลินิก และ ปัจจัยมนุษย์ ผู้บริโภคสารสนเทศ และ ประวัติสุขภาพ และ สารสนเทศทางคลินิก ซึ่งระบุมีแนวโน้มเพิ่มขึ้นในการเผยแพร่ บทความเกี่ยวกับสารสนเทศศึกษาและพัฒนาบุคลากร ข้อมูลการทำเหมืองแร่ NLP การสกัดข้อมูล และสารสนเทศทางคลินิกแสดงให้เห็นว่าระดับเสียงสูง และมั่นคงของอิงแนะนำInformation technologies were identified as key factors in achieving improved patient safety and quality of care and the published literature is starting to confirm this role(1–3). Biomedical informatics, including nursing informatics, is a fast moving field that is heavily influenced by healthcare policy and clinical practice. Professional and/or academic organizations have been dedicating substantial effort to facilitate nursing informatics research and training that address current needs. For example, many nursing education programs offer training opportunities specialized in nursing informatics and also mandate an introductory nursing informatics class to all students as part of their core curriculum(4–7). The Nursing Informatics Working Group (NIWG) at AMIA addresses various issues in policy, research, and educational aspects of nursing informatics. The NIWG also offers two award programs to recognize noteworthy research presented in the annual AMIA symposium to encourage participation of nurse scholars (8). Scientific journals are a venue for dissemination of research to a large community of readers. The proportion of peer-reviewed articles published in a certain area of research (and their citations) can provide interesting insights on topic trends in informatics(9,10). Although it may not constitute a perfect measure, the number of citations is considered a de facto standard for measuring the impact of a scientific publication. Based on this idea, we have previously analyzed the publication and citation volumes in biomedical informatics that were published relatively recently (2009-2012) in the J Amer Med Inform Assoc (JAMIA) to better understand research topic trends for biomedical informatics in general.We conducted a similar analysis to describe the trends in published nursing informatics research by analyzing the articles published on selected major informatics and nursing journals during the past 9 years. We also compared the active research areas reflected in these articles against the nursing informatics research agenda proposed by nursing informatics leaders(11–13). Through this analysis, we aimed at (1) checking the trajectory of published nursing informatics research for the past 9 years, and (2) identifying potential gaps in particular research areas.It is noteworthy that Clinical Workflow and Human Factor is among the most frequently published and cited themes in nursing informatics research. This is not surprising considering the large amount of time that nurses spend working with clinical information system, especially EMRs(23). This research trend may also imply that nurses can make significant contributions to mitigating various EMR usability issues. In July of 2013, the Office of National Coordinator (ONC) hosted a meeting with stakeholders to discuss usability issues in EMRs. Representatives from a healthcare informatics professional group, an EMR certification agency, and the American Medical Association were invited and had a chance to provide testimonials. Common criticism was that designs and workflows of many EMRs largely focused on meeting the Meaningful Use (MU) requirements rather than usability(24–26). These testimonials addressed the usability issues commonly faced by various healthcare professionals. Also not many MU core/menu objectives are directly related to nursing documentation. Nonetheless it would be beneficial to actively seek nursing perspectives on the usability issues, considering that nurses are the major workforce for documenting and generating clinical data, as well as being heavily involved in the research on usability and workflow aspects of clinical information systems. The findings of this study may not reflect the most comprehensive and accurate trends of nursing informatics research due to several limitations. Firstly, the operational definitions of nursing informatics research we adopted were arbitrary: research related to informatics published in nursing journals OR research done by a researcher affiliated with a nursing institution and published in an informatics journal. Ideally, nursing informatics research should be defined as any scholarly work that investigated informatics aspects relevant to nursing research, practiceand education. However, operational definitions that could be readily applicable to literature search were unavailable. Use of crude definitions of nursing informatics research may have caused either the inclusion of nonnursing informatics articles or exclusion of nursing informatics articles. Secondly, we collected articles from a small subset of informatics and nursing journals. For example, we excluded conference papers with no citation information and specialty nursing journals, where many practical applied informatics articles are published, as they can be most beneficial to practicing nurses. Thirdly, although we used CPM to minimize the bias introduced by publication dates, CPM is still not completely free from the bias given that trends captured in the early age of articles might drastically change later. Finally, even if we found AMIA themes were robust and clear enough to label the articles collected for this study, there were cases that the authors struggled with assigning proper themes. Like in many studies that involve with human annotation of concepts, this study alsocarries subjectivity and inconsistency issues in theme assignment.ConclusionWe conducted a descriptive analysis of nursing informatics articles published in the past 9 years to understandoverall trends in publication of nursing informatics research in the peer-reviewed literature and to identify theresearch areas that may be relatively under-represented. Overall, we found that published nursing informaticsresearch covered a broad spectrum of research topics in biomedical informatics and is aligned with high priority
research agenda items advocated by the nursing informatics community. Despite limitations related to relatively
narrow coverage of journals, the findings allow us to initiate a dialogue with journal editors and the nursing
informatics community at large about the differences in maturity of research in each of the themes, and potentially guide authors and readers on which venue currently provides the highest number of articles related to a given theme.
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