NURSING INFORMATICS • Data are discrete elements that have not been
The “science and practice (that) integrates nursing. its
information and knowledge, with information and
communication technologies to promote the health of people,
families, and communities worldwide. “
Nursing informatics is an established and growing area of
specialization in nursing. Nursing informatics is a specialty
that integrates nursing science, computer science, and
information science to manage and communicate data,
information and knowledge in nursing practice.
NURSE INFORMATICANS
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 INCLUDE:
Concept representation and standards to support evidence-
based practice, research, and education
Data and communication standards to build an interoperable
national data infrastructure
Research methodologies to disseminate new knowledge into
practice
Information presentation and retrieval approaches to support
safe patient centered care
Information and communication technologies to address inter-
professional work flow needs across all care venues
Vision and management for the development, design, and
implementation of communication and information technology
THEORIES OF NURSING INFORMATICS
Why do we need to study Nursing Informatics?
In the 21st Century, information is doubling every 5yrs, if not
tripling in quantity and quality.
Information is POWER.
Technology also facilitates the creative process in nurses,
affording amazing vehicles for patient education, teaching and
learning, and providing general health promotion and
prevention information on a global scale.
This can only become a common reality if nurses are
comfortable working with computers and advanced
technology while providing evidence-based care for their
clients.
The healthcare of our clients is largely dependent on
information.
Every action taken depends on previous information and
knowledge
INFORMATION THEORY
studies the transmission, processing, extraction, and
utilization of information.
builds not just on information theory, but uses concepts from
change theories, systems theory, chaos theory, cognitive
theory, and sociotechnical theory.
The theory of nursing informatics is based on Blooms
taxonomy and definition of data, information and knowledge.
These three entities are regarded as the core concepts of
informatics:
interpreted.
• Information comprises data that has some type of
interpretation or structure, and
• Knowledge is the synthesis of information. Using
taxonomy data are combined to produce information
and information is collected to produce knowledge.
GENERAL SYSTEM THEORY
General theory is a method of thinking about complex
structures such as an information system. In system theory
the focus is on the interaction among the various parts of the
system instead of individual parts, it is based on the premise
that the whole is greater than the sum of its parts.
General theory described that any change in one part of the
system will be reflected in other parts of the system. Computer
is a living example of the system any change in one area will
affect other sections.
The system is described as being either open or closed.
Open system; is continually exchanges information with the
environment outside the system itself or higher levels of
complexity in the system.
Closed system; is isolated from the environment and receive
no input from outside or disorganized breakdown of the
system.
NURSING SCIENCE
The vehicle, the knowledge base for understanding the
other 3 sciences.
The overarching goal for the use of the other 3science within
the sphere of nursing science.
CHAOS THEORY
Chaos theory, such as general systems theory, addresses an
entire structure without reducing it to the elemental parts. This
makes it useful with complex systems such as information
systems.
The idea behind this theory is that what may appear to be
chaotic actually has an order. It is based on the recognized
fact that events and phenomena depend on initial conditions.
Chaos theory is nonlinear. It allows us to question
assumptions that we normally might reach using linear
thought (Vincenzi, 1997). Seeing things reframed as a whole
can stimulate new thinking and new approaches.
COMPUTER SCIENCE
Gives us the hardware, the ability to program the hardware to
process nursing information.
It is the skills in using software and understanding how they
can work for processing nursing knowledge.
Nurses need to understand some basics
• Hardware
• Software
USABILITY THEORY
It uses information from both cognitive science and
sociotechnical theories.it involves the ease of use, users’
satisfaction that they have achieved their goals, and the
aesthetics of the technology.
The five goals of usability
1) It is easy for users to accomplish basic tasks the first time
they use the product.
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2) Once learned, the design permits users to quickly and
easily perform the needed tasks.
3) It is not used for a period of time; it is easy to reestablish CONTRIBUTION OF THEORIES TO INFORMATICS
one’s proficiency in using the product. 1) Nursing informatics: Convert data into information and
4) Users make very few errors, but any that they do make information to knowledge. Nurse add wisdom.
are easily remedied. 2) Sociotechnical theory and social informatics. Improve
5) The design is pleasant to use interaction between an information system and the
organizational culture.
LEARNING THEORIES 3) Change theory- Increase the chance of success in
• Learning theories are important in informatics as well as in implementing a system by attending to the reactions to the
all nursing endeavors. Users must be taught to use a system, change.
and use of these theories can decrease the time for training 4) General system theory Contribute to the understanding of the
as well as the time for learning. complexity of an information system.
5) Chaos theory: Improve the design of an information system
INFORMATION SCIENCE 6) Cognitive science theory. Improve the ability of user to gain
The ability to access information, research, and knowledge. knowledge from an information system.
It includes the ability to evaluate the quality of the information. 7) Usability theory: Improve ease of use and satisfaction with an
As well as the applicability. information system.
5 COMPONENT OF INFORMATION LITERACY 8) Learning theories: Teach use of a system and design or select
1) Acknowledge awareness of a need for information literacy. computer-aided instruction.
2) Identify and retrieve information.
GENERAL MODELS OF NURSING INFORMATICS
3) Evaluate information for relevance.
4) Integrate information into practice.
GRAVES AND CORCORAN’S MODEL (1989)
5) Evaluate the effect of the information on problem or issues.
Nursing informatics as the linear progression - from data into
INFORMATION LITERACY information and knowledge. (Data, information and
Competencies in this area are critical to safe nursing practice knowledge in sequential boxes with one-way arrows pointing
from data to information to knowledge.
INFORMATION MANAGEMENT
SCHIWIRIAN’S MODEL (1986)
Nurses are faced with significant amount of information in a
given day. Patricia Schwerin – proposed model of nursing informatics
intended to stimulate and guide systematic research in this
Nurses need to know how to make sense of it – in a way that
discipline.
is knowledge.
The model provides a framework for identifying significant
In a way that informs practice and decision making
information needs, which in turn can foster research.
COGNITIVE SCIENCE
TURLEY’S MODEL (1996)
Critical thinking
Review the literature and found themes (Core components of
Decision making informatics):
Problem solving 1) Cognitive science: use and position of computer and
• “Cognitive science is the missing link between computer science as central to definition.
• science and our brains and minds are 2) Information science: focus on conceptual issues that
• explored” Mast rain and McGonagall, 2008. represent nursing knowledge and information
• Core concepts 3) Computer Science: focus in on how the computer help nurses
enter, organize, and retrieve information
NURSES AS KNOWLEDGE WORKERS CORE CONCEPTS
Data: apiece of information DATA, INFORMATION, AND KNOWLEDGE MODEL
Information: results from processing data Data – discrete entities that are described objectively w/out
interpretation
Knowledge: comes from transformation of information.
- include some value assigned to a variable
This knowledge can be processed to generate decisions
Information – reflects interpretation, organization or
- that can be known as wisdom.
structuring of data result of processing of data (which occurs
NURSES AS KNOWLEDGE WORKERS when raw facts are transformed through the application of
context to give meaning)
Data gathers: gather basic data in patient care, or about
patient outcomes. Knowledge – emerges from the transformation of information
or Information synthesized so that relationships are identified
Information users: interpretation of data that is organized into
and formalized.
meaningful information-for patient care, quality assurance,
infection control. BENNER’S LEVEL OF EXPERTISE MODEL
Knowledge users: comparing data of your patient with 1) Novice
knowledge nursing has. - Individuals with no experience of situations and related
Knowledge builder: aggregating data for patterns that either content in those situations where they are expected to
compare to what is already known or builds new nursing perform tasks
knowledge. 2) Advanced Beginner
The processing of information doesn’t always result in the - marginally demonstrate acceptable performance
development of knowledge. having built on lessons learned in their expanding
Further, knowledge is necessary to the processing of data and experience base; needs supervision.
information. 3) Competent
- enhanced mastery and the ability to cope with and
Knowledge itself may be processed to generate decisions and
manage many contingencies.
new knowledge.
4) Proficient

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- evolution through continuous practice of skills,
combined with professional experience and knowledge;
individual who appreciates standards of practice as
they apply in nursing informatics.
5) 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.

SPECIFIC INFORMATIC MODELS

PHILIPPINE HEALTHCARE ECOSYSTEM MODEL

Nursing informatics is a huge network that encompasses all
the sectors of the health care delivery system – government
agencies, healthcare facilities, practitioners, insurance
companies, pharmaceutical companies, academic
institutions, and suppliers.
the government, different nursing associations and
developmental agencies maintain and balance the network.

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 healthcare:
1) 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
2) Health care provider dimension
- promotes quality patient care, access to complete
accurate patient data 24/7e.g. provider’s
notes/prescription, clinical orders decision support
systems, practice guidelines.
3) 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.

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