326 ■ III: ROLE FUNCTIONS OF DOCTORAL ADVANCED NURSING PRACTICE
Recently the TIGER Initiative Foundation issued a report, The Leadership
Imperative: TIGER’s Recommendations for Integrating Technology to Transform Practice
and Education , which identifies the growing need for nurse leaders to be prepared to
meet the challenges of a health care environment in which care will be “delivered
remotely through the use of mobile monitoring and innovative communications...
using online and electronic communication and telehealth strategies to enhance com-
munication among providers and between patients and providers. As a result, nurse
leaders’ accountability for patient- care oversight will extend well beyond the hospital
setting. To support these new models of care delivery, innovative nurse leaders will
be required to integrate an ever- expanding arsenal of health IT into practice” (TIGER
Initiative Foundation, n.d., p. 16). This goal will require educational preparation for the
doctoral APN to step into the role of an innovative nurse leader who is capable of lead-
ing an expanded interprofessional teams of nontraditional experts to achieve the goal of
a transprofessional approach to support innovation, redefine health care and improve
outcomes (O’Keefe & Griffin, 2013).
KNOWLEDGE MANAGEMENT COMPETENCIES
Knowledge management competencies are integral to health care and nursing practice
(Dreher, 2009a). While it is a growing expectation that nurses at all levels should possess
knowledge management skills, the doctoral APN must take a leadership role in efforts
to document and understand the impact of nursing care on the health of patients. It is
through the use of knowledge management systems that these important data can be
collected, stored, retrieved, and used to generate knowledge regarding nursing out-
comes and improve patient care and safety. Integral to these efforts is the EHR, as it
can provide a mechanism to record data collected at the point of care. The doctoral
APN must have a good understanding of knowledge management systems in order to
influence the design and management of these systems (Canadian Nurses Association
[CNA], 2006; Contino, 2004; Hsia, Lin, Wu, & Tsai, 2006; Staggers et al., 2002).
In addition, the doctoral APN must champion efforts to have a standardized nurs-
ing language system that is integrated with universal clinical care terminology. A stan-
dardized nursing language makes nursing data more visible within health systems and
can support the development of nursing knowledge (Coenen & Bartz, 2006). A standard-
ized nursing language can facilitate “better communication among nurses and other
health care providers, increased visibility of nursing interventions, improved patient
care, enhanced data collection to evaluate nursing care outcomes, greater adherence to
standards of care, and facilitated assessment of nursing competency” (Rutherford, 2008,
para 1). Without a standardized language, we will not be able to realize our vision of
a fully integrated health information system (HIS) that can support interdisciplinary
collaboration and data sharing across settings and can provide a way for the impact of
nursing care to be more visible and contribute more effectively to the body of knowl-
edge. The doctoral APN must be knowledgeable in health information technology (HIT)
and informatics and assume a leadership role to drive the transition to integrated sys-
tems that can support evidence- based practice, clinical decision making, improve out-
comes and fully reflect the impact of nursing practice on these outcomes. Until this is
fully realized, the impact of nursing care “will be unidentifiable for outcomes reporting
and therefore invisible” (Conrad, Hanson, Hasenau, & Stocker- Schneider, 2012, p. 450)
An essential part of knowledge management entails the gathering of information
and requires “information mastery” (Slawson, Shaughnessy, & Bennett, 1994). The main