lOMoARcPSD|14033774
lOMoARcPSD|14033774
1
1
▪
▪
▪
NURSING INFORMATICS
NCM 110: Nursing Informatics
Handout No. 5
Is the “science and practice that integrates nursing, its
information and knowledge, with information and a. Information Theory – studies the transmission,
communication technologies to promote the health of
processing, extraction and utilization of information.
people, families and communities worldwide.”
• Builds not just on information theory, but uses
Nursing informatics is an established and growing area
concepts from change theory, systems theory, chaos
of specialization in nursing.
theory, cognitive theory and sociotechnical theory.
Nursing informatics is a specialty that integrates nursing
• The theory of nursing informatics is based on
science, computer science, and information science to
Bloom’s Taxonomy and definition of date,
manage and communicate data, information and
information and knowledge. These three entities are
knowledge in nursing practice.
regarded as the core concepts of informatics:
Nurse Informaticians – work as developers of
communication and information technologies, educators,
researchers, chief nursing officers, chief information officers,
software engineers, implementation consultants, policy
developers and business owners, to advance healthcare.
CORE AREAS OF NURSING INFORMATICS
i.
Data – discrete elements that have not been
interpreted. ii. Information – comprises data
that has some type of interpretation or
structure
iii. Knowledge – synthesis of information. Using
taxonomy data are combined to produce
information and information is collected to
produce knowledge.
1. Concept representation and standards to support
evidence-based practice, research and education.
b. General Systems Theory – method of thinking about
complex structures such as an information system.
2. Data and communication standards to build an
interoperable national data infrastructure.
3. Research methodologies to disseminate new knowledge
• In system theory, the focus is on the interaction
into practice.
among the various parts of the system instead of
4. Information presentation and retrieval approaches to
individual parts. It is based on the premise that the
support safe patient care.
whole is greater than the sum of its parts.
5. Information and communication technologies to address
• General theory described that any change in one
inter-professional work flow needs across all care
part of the system will be reflected in other parts
venues.
of the system. Computer is a living example of the
6. Vision and management for the development, design
system any change in one area will affect other
and implementation of communication and information
sections.
technology.
• The system is described as being open or closed:
.
THEORIES OF NURSING INFORMATICS
i. Open System – continually exchanges
information with the environment outside the
Why do we need to study nursing informatics?
system itself or higher levels of complexity in
the system.
st
▪ In the 21 century, information is doubling every 5
ii.
Closed System – isolated from the
years, if not tripling in quantity and quality.
environment and receive no input from
▪ Information is power.
outside or disorganized breakdown of the
▪ Technology also facilitates the creative process in
system.
nurses, affording amazing vehicles for patient
education, teaching and learning, and providing
general health promotion and prevention information on Nursing Science – the vehicle, the knowledge base for
understanding the other 3 sciences. The overarching goal for
a global scale.
the use of the other 3 sciences within the sphere of nursing
▪ This can only become a common reality if nurses are
science.
comfortable working with computers and advanced
technology while providing evidence based care for
c. Chaos Theory – such as general systems theory,
their clients.
addresses an entire structure without reducing it to the
▪ The health care of our clients is largely dependent on
elemental parts. This makes it useful with complex
information.
systems such as information systems.
▪ Every action taken depends on previous information
and knowledge.
lOMoARcPSD|14033774
NURSING INFORMATICS
1
1
•
•
NCM 110: Nursing Informatics
Handout No. 5
ii. Identify and retrieve information. iii.
The idea behind this theory is that what may
Evaluate information for relevance, iv.
appear to be chaotic actually has an order. It is
Integrate information into practice.
based on the recognized fact that events and
v. Evaluate the effect of the information on
phenomena depend on initial conditions.
problem
or issues.
Chaos theory is nonlinear. It allows us to question
assumptions that we normally might reach using
linear thought (Vincenzi, 1997). Seeing things Information Literacy – competence in this area are critical
reframed as a whole can stimulate new thinking and to safe nursing practice.
1
new approaches.
Information Management – nurses are faced with
significant amount of information in a given day (information
Computer Science – gives us the hardware, the ability to overload). Nurses need to know how to make sense of it – in
program the hardware to process nursing information. It is a way that is knowledge. In a way that informs practice and
the skill in using software and understanding how they can decision making.
work for processing nursing knowledge.
Hardware – physicality of technology
Dames, Jan Remedios B.
Cognitive Science – Cognitive science is the missing link
between science and our brains and minds are explored.”
d. Usability Theory – uses information from both cognitive (Mast Rain and McGonagall, 2008). Core Concepts: critical
science and sociotechnical theories. It involves the ease thinking, decision making, problem solving.
of user’s satisfaction that they have achieved their
NURSES AS KNOWLEDGE WORKERS
goals, and the aesthetics of the technology.
Software – processes that functions inside of the computer
•
The 5 goals of usability:
▪
Core Concepts:
i. Data – a piece of information
It is easy for users to accomplish basic tasks
ii. Information – results from processing data
the first time they use the product.
iii. Knowledge – comes from transformation of
ii. Once learned, the design permits users to
information
quickly and easily perform the needed tasks.
iii. It is not used for a period of time, it is easy
to reestablish one’s proficiency in using the ▪ This knowledge can be processed to generate decisions
– that can be known as wisdom.
product.
iv. Users make very few errors, but any that
Data Gatherers – gather basic data in patient care, or
they do make are easily remedied.
about patient outcomes.
v. The design is pleasant to use.
i.
e. Learning Theory – are important in informatics as well Information Users – interpretation of data that is organized
as in all nursing endeavors. Users must be taught to use into meaningful information for patient care, quality
a system, and use of these theories can decrease the assurance, infection control.
time for training as well as the time for learning.
Knowledge Users – comparing data of your patient with
Information Science – the ability to access information, knowledge nursing has.
research, and knowledge. It includes the ability to evaluate
the quality of the information as well as the applicability. Knowledge Builder – aggregating data for patterns that
either compare to what is already known or builds new
nursing knowledge.
• The 5 component of information literacy:
i.
Acknowledge awareness of a need for ▪
information literacy.
▪
The processing of information doesn’t always result in
the development of knowledge.
Further, knowledge is necessary to the processing of
data and information.
lOMoARcPSD|14033774
1
1
▪
NURSING INFORMATICS
NCM 110: Nursing Informatics
Handout No. 5
i.
Cognitive Science – use and position of
computer science as central to definition.
ii. Information Science – focus on conceptual
issues that represent nursing knowledge and
information.
iii. Computer Science – focus in on how the
computer help nurses enter, organize, and
retrieve information.
Knowledge itself may be processed to generate
decisions and new knowledge.
CONTRIBUTION OF THEORIES TO INFORMATICS
1. Nursing Informatics – convert data into information
and information to knowledge. Nurse add wisdom.
2. Sociotechnical Theory and Social Informatics –
improve interaction between an information system and
d. Data Information, and Knowledge Model
the organization culture.
3. Change Theory – increase the chance of success in
implementing a system by attending to the reactions to
• Data – discrete entities that are described
the change.
objectively without interpretation (includes some
4. General Systems Theory – contribute to the
values assigned to a variable).
understanding of the complexity of an information
• Information – reflects interpretation, organization
system.
or structuring of data result of processing of data
5. Chaos Theory – improve the design of an information
(which occurs when raw facts are transformed
system.
through the application of context to give meaning)
6. Cognitive Science Theory – improve the ability of user
• Knowledge – emerges from the transformation of
to gain knowledge from an information system.
information or information synthesized so that
7. Usability Theory – improve the ease of use and
relationships are identified and formalized.
satisfaction with an information system.
8. Learning Theories – teach use of a system and design
e. Benner’s Level of Expertise Model
21
or select computer-aided instruction.
GENERAL MODELS OF NURSING INFORMATICS
•
•
a. Graves and Corcoran’s Model (1989)
Nursing informatics as the linear progression – from
data into information and knowledge. Data
information and knowledge in sequential boxes
with one-way arrows pointing from data to
information to knowledge.
b. Schiwirian’s Model (1986)
•
•
•
•
•
Novice – individuals with no experience of
situations and related content in those situations
where they are expected to perform tasks.
Advanced Beginner – marginally demonstrate
acceptable performance having built on lessons
learned in their expanding experience base.
Needs supervision.
Competent – enhanced mastery and the ability to
cope with and manage many contingencies.
Proficient – evolution through continuous practice of
skills, combined with professional experience and
knowledge. Individual who appreciates standards
of practice as they apply in nursing informatics.
Expert – individual with mastery of the concept and
capacity to intuitively understand the situation and
immediately target the problem with minimal effort
of problem solving.
Patricia Schwerin – proposed model of nursing
informatics intended to stimulate and guide
systematic research in this discipline.
The model provides a framework for identifying
SPECIFIC INFORMATICS MODELS
significant information needs, which in turn can
foster research.
a. Philippine Healthcare Ecosystem Model
c. Turley’s Model (1996)
Review the literature and found 3 themes or the
core components of informatics:
•
Nursing informatics is a huge network that
encompasses all the sectors of the health care
delivery system – government agencies, health
care facilities, practitioners, insurance companies,
pharmaceutical companies, academic institutions
and, suppliers.
lOMoARcPSD|14033774
1
1
•
NURSING INFORMATICS
NCM 110: Nursing Informatics
Handout No. 5
The government, different nursing associations and
developmental agencies maintain and balance the
network.
b. Intel’s Shift Left Model
•
•
Patient care shifts progresses from a high quality
delivery of life through technology with increased
costs (right side) into quality of life with minimal
health costs.
Inverse relationship between quality of life and cost
of care/day.
c. Patient Medical Record Information Model (PMRI):
Basis of HER
The type and pattern of documentation in the patient
record will be dependent on 3 interacting
dimensions of health care:
i.
Personal Health Dimension – personal
health record maintained and controlled by
the individual or family. Non-clinical
information.
E.g.
Self-care
trackers,
directories of health care and other supports.
ii. Health Care Provider Dimension –
promotes quality care, access to complete
accurate patient data 24/7. E.g. Provider’s
notes/prescription, clinical orders, decision
support systems, practice guidelines.
iii. Population Health Dimension – information
on the health of the population and the
influences to health, helps stakeholders
identify and track health threats, assess
population health, create and monitor
programs and services and conduct research.
13