Theories, Frameworks,

And Models
 Nursing Informatics
Models

 Graves and Corcoran’s model

 Schiwirian’s model

 Turley’s model

 Data Information Knowledge (D-I-K)

model
 Benner’s Novice to Expert model
 Nursing Informatics Models

 Specific Informatics Models

 Philippine Healthcare Ecosystem

model

 Shift Left Model

 GRAVES AND
CORCORAN’S MODEL

 (1989)
 Nursing informatics as the linear progression - from

data into information and knowledge

 Management processing is integrated within each

elements, depicting nursing informatics as the proper
management of knowledge – from data as it is
converted into information and knowledge
 MANAGEMENT

D ATA INFORMATION KNOWLEDGE

SCHWIRIAN’S
MODEL
(1986)
• Nursing informatics involves identification
of information needs, resolution of the
needs, and attainment of nursing
goals/objectives
• Patricia Schwirian – proposed a model
intended to stimulate and guide systematic
research in nursing informatics in 1986
• Model/framework that enables identification
of significant information needs, that can
foster research (some what similar to
Maslow’s hierarchy of needs)
 GOAL

USERS

TECHNOLOGY

RAW MATERIAL
(NURSING-REALATED INFORMATION
TURLEY’S MODELS
(1996)
 TURLEY’S MODEL
(1996)
Nursing informatics is the intersection
between the discipline-specific science
(nursing) and the area of informatics

Core components of informatics:

 Cognitive science
 Information science
 Computer science
 COMPUTER
SCIENCE

INFORMATION
NURSING
SCIENCE

COGNITIVE
SCIENCE
D ATA-INFORMATION-
KNOWLEDGE
 DATA-INFORMATION-
KNOWLEDGE MODEL
NI is a specialty that integrates nursing science,
computer science and information science to manage
and communicate data, information, knowledge and
wisdom into nursing practice (ANA)

 Nursing informatics is an evolving,

dynamic process involving the conversion of
data into information, and subsequently
knowledge
 Important Note: Processing of information does
not always result in the development of knowledge.
COMPLEXITY

KNOWLEDGE

INFORMATION

D ATA

HUMAN INTELLECT
 BENNER’S LEVEL OF
EXPERTISE MODEL

 Every nurse must be able to continuously

exhibit the capability to acquire skills (in this case,
computer literacy skills parallel with nursing
knowledge), and then demonstrate specific skills
beginning with the very first student experience
 Levels of Expertise
(Benner):
 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 or problem
solving
 PHILIPPINE HEALTH CARE
ECOSYSTEM

 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
 the government, different nursing
associations and developmental agencies
maintain and balance the network
 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
 PATIENT MEDICAL RECORD
INFORMATION MODEL (PMRI):
BASIS OF EHR

 The type and pattern of documentation in the

patient record will be dependent on 3 interacting
dimensions of health care:

 Personal health dimension – personal health

should maintained and controlled by the
individual or family; nonclinical information
 e.g. self-care trackers, directories of health care,
and other supports
 Health care provider dimension – promotes
qulity patient care, access to complete accurate
patient data 24/7
 e.g. provider’s notes/prescription, clinical
orders, decision support systems, practice
guidelines
 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
 e.g. Ushahidi program
 *Important Terminologies
(Data Sets):

ABC codes
Perioperative Nursing Data Set (PNDS)
SNOMED CT
International Classification for Nursing
Practice (ICNP)
Patient Care Data Set (PCDS)
NANDA
LOINC
 ABC CODES

 m e c h a n i s m for coding integrative health

interventions by clinician
for administrative billing and insurance
claims
 i n c l u d e s complementary and alternative

medicine interventions and codes that map

all NIC, CCC, and Omaha system
interventions
 Perioperative Nursing
Data Set (PNDS)

 universal language for perioperative nursing

practice and education; standardize
documentation of perioperative data in all
perioperative settings
 Diagnosis based on NANDA, interventions

based on NIC, and outcomes based on NOC

SNOMED CT

 core clinical terminology containing over

357,000 healthcare concepts with unique
meanings and formal logic-based definitions
organized into multiple hierarchies
 International
Classification for
Nursing Practice (ICNP)

 integrated terminology for nursing practice

developed under sponsorship of ICN

ICNP elements:
 Nursing phenomena (nursing diagnosis)

 Nursing actions (nursing interventions)

 Nursing outcomes
 Patient Care Data Set
(PCDS)

 terms and codes for patient problems,

therapeutic goals, and patient care orders

 developed by Dr. Judith Ozbolt

 Associations and
Organizations in
Healthcare Informatics
 American Medical
Informatics Association
(AMIA)
 authoritative body in the field of medical
informatics and frequently represents the United
States in the informational area of medical
informatics in international forums

 dedicated to the development and application of

medical informatics in the support of patient care,
teaching, research, and healthcare administration
 National League for
Nursing (NLN)
 Mission: To advance quality nursing education that
prepares the nursing workforce to meet the needs
of diverse populations in an ever-changing healthcare
environment
 Addresses faculty development and educational

research
*Educational Technology and Information
 Management Advisory Council (ETIMAC) – promote

effective use of technology in nursing education, as a

teaching tool and outcome for student-faculty learning
 Healthcare information and
management systems
society (HIMSS)

 assumes leadership role in the

technology standards of nursing and
advocacy of key innovations in health
care delivery and administration
THE END
