Methodologies & Theories Flashcards
What are the foundations of NI?
- Computer science
- Information science
- Nursing science
- Nursing process
- Cognitive science
What is the definition of computer science?
- It is the study of algorithms for solving computation problems (Saba & McCormick 2105)
- It is a branch of engineering that studies the theoretical foundations of information and computation and their implementation and application in computer systems (McGonigle & Mastrian, 2018)
What are the computer’s major functions?
- Input
- Output
- Processing
- Storage
What are the computer science subfields?
- Artificial intelligence
- Graphics and visualization
- Computer networks and systems
- Database & knowledge management
- Algorithms & computation theory
- Communication & signal processing
- Microelectronics, photonics & optical communication
What is the definition of Information Science?
**The science of information, studying the application and usage of information and knowledge in organizations and the interfacing or interaction between people, organizations, and information system.
An extensive, interdisciplinary science that integrates features from cognitive science, communication science, computer science, library science, and social sciences.
What are the components of Information science?
Blum’s Model of Information 1986
- Data-discrete
- Information (DIKW)
- Knowledge
- Wisdom (highest level-applying knowledge w/compassion
Data
Naming
Collecting &
Organizing
Information
Organizing &
Interpreting
Knowledge
Interpreting,
Integrating, &
Understanding
Wisdom
Understanding,
Applying, &
Applying w/compassion
The relationship of data, information, knowledge, & wisdom (Nelson 2002)
Constant flux
What is the definition of Nursing Science?
McGonigle & Mastrian, 2015
*The ethical application of knowledge acquired through education, research, and practice to provide services and interventions to patients in order to maintain, enhance, or restore their health; to advocate for health, and to acquire, process, generate, and disseminate nursing knowledge to advance the nursing profession.
What are the components of the nursing process?
(ADOPIE) A=assessment D=diagnosis O=outcome identification P=planning I=Implementation E=evaluation
What is the definition of cognitive science?
- Much of the learning cannot be observed or predicted, in that, the individuals is processing information based on experiences, associations and subjective interpretation
- Cognitive process influence learning
(aptitude, compacity to learn, learning styles, attitude)
What are the concepts/theories supporting practice?
- Data, information, knowledge, wisdom (DIKW)
- Organizational behavior
- Communication theory
- Systems theory
- Learning styles
- Change managment
What is Graves & Corcoran Conceptual Framework (1989)?
Management & Processing
Data————–>Information—————->Knowledge
Linear progression from data to knowledge. Missing wisdom. This framework was borrowed from Blum
What is organizational behavior?
*The study and application of knowledge about how people, individuals, and groups act in organizations.
Done through a system approach:
1. Hawthorne experiment (telephone factory-lights turned up so employees would be more productive & effective---but really it was they felt they were being watched) 2. Motivational theory
What are behavioral theories?
Group dynamics Change Organizational behavior Organizational theories Teaching/learning Cognitive Novice to expert
What are the stages of Tuckman’s behavioral theory?
Used when starting up a group:
Forming: building commonalities
Norming: towards consensus, opportunity to lead
Storming: focused on goals, manage process, integrating
Performing:
In which stage of Tuckman’s theory do you have conflict resolution?
Storming
What is the communication theory?
(Shannon-Weaver Model, 1949)
Foundational theory based on this theory
Noise
channel source---->encoder---------------->decoder---->receiver | | Message | | | |
What are the primary factors in good communication?
- Frequency of communication
- Candor (honesty) of the communication
- Content of the communication
- Emotional impact of the communication
Systems theory
Ludwig Bertalanffy & others (1950s)
.Concepts:
a. system
b. environment
c. input
d. output
e. feedback
Closed (inpermiable) vs. open systems (influenced by
outside)
Communication: information & feedback
Life and tension: life is about disequilibrium, stress creates
higher life
Systems theory
A set of interrelated interacting parts within a boundary.
System is more than the sum of its parts due to those interrelationships
For ex: NI group came to boot camp-we didn’t know each other, introduced to each, groups formed, better today
What is group dynamics?
- The scientific study of all aspects of groups
- Group dynamics is the field of study within the social sciences that focuses on the nature of groups
- Increasingly, group dynamics are becoming of particular interest because of online, social interaction made possible by the internet.
Change Theory
Lewin (1947)
Foundation change theory
Concepts:
Unfreezing-letting go of old habits
Movement
Refreezing-new habits formed
Driving and restraining forces (force field analysis)
Change Theory steps
Lippitt (1958)
- diagnosing the problem (U)
- assessing motivation and capacity for change (U)
- assessing change agent’s motivation & resources (U)
- selecting progressive change objectives (M)
- choosing appropriate change-agent role (M)
- maintenance of change (R)
- termination of helping relationship (R)
Change Theory - ADKAR model
Hiatt (2003)
A=awareness of the need for change D=desire to support and participate in change K=knowledge of how to change A=ability to implement the change R=reinforcement to sustain the change
Innovation Diffusion Theory
Rogers (1962) Diffusion of innovation bell
Innovators Early adopters ***those you want on the team*** Early majority Late majority Laggards
Change management processes
- sequence of steps or activities that a change management team or project leader follow to apply change management to a change in order to drive individual transitions and ensure the project meets its intended outcomes
i. e. ADKAR
Teaching/Learning
Assumptions
a. self-concept b. experience c. readiness to learn d. time perspective e. orientation towards learning
- *Malcolm Knowles -adult learning theories
- *Patricia Benner - learning & skill
Learning principles
- meaningfulness assists learning
- Only so much input can be handled at one time
- Timing of learning is critical
- Participation and practice support retention
- Conceptual learning is enhanced w/concrete examples
Learning Principles
- Taking in new material through more than one modality can facilitate learning
- Learning is enhanced when the teaching method includes cognitive, affective, and psychomotor domains in concert
- Learning takes place intentionally and unintentionally
- Learning is contagious
Adult Learning Theory-
Malcolm Knowles
- Adults are self-directed
- Adults have accumulated a number of life experiences and cognitive structures. These are used to interpret new learning
- Adults are practical and loof for immediate application of learning
- Adults are more interested in learning how to solve problems than in retention of facts
- Adult learners expect to be treated with respect and to have their previous learning acknowledged
Adult Learning Theory-
Malcolm Knowles
- Ask the students to provide examples from their experience and use these to explain how the new system will function
- Orientation to a new system should occur no more than-weeks prior to implementation
- Use real-life examples that can be expected to occur on the clinical unit.
- When explaining a new system, ask the student what they already know about the new system
Novice to Expert -
Patricia Benner
*Nursing expertise/how nurses gain experience
- 5 levels of experience in Benner’s theory:
- Novice
- Advanced beginner
- Competent
- Proficient
- Expert
Novice to Expert Concepts
Patricia Benner
- Nurses develop skills through education and experience
- It is possible to learn knowledge and skills without ever learning theory
- Development of knowledge in applied disciplines such as medicine and nursing is composed of the extension of practical knowledge (know-how) through research understanding of the “know-how” of clinical experience
- Nursing skills as experience are pre-requisite to becoming expert
Management Science
- Theoretical, technical, and applied economic aspects of business administration and management
- Decision making using statistical and mathematical tools and surveys
- The application of quantitative techniques to solve complex problems
Workflow tools that support practice
-Flowcharts
-Value stream mapping (Six SIGMA) patients path to improve service and minimize delays
_Swim Lanes
-Gantt charts
Six Sigma Phases
Focuses on eliminating defects & process improvement
*developed by Motorola
Icon Meaning
Ear Define
Thermometer Measure
Magnifying Glass Analyze
Hammer/wrench Improve
Graph ControlSix Sigma Phases
Focuses on eliminating defects & process improvement
*developed by Motorola
Icon Meaning
Ear Define
Thermometer Measure
Magnifying Glass Analyze
Hammer/wrench Improve
Graph ControlRules, Regulations, and Requirements
- Regulatory, reimbursement, and accreditation requirements
- Legal issues
- Security, privacy, and confidentiality
- Ethical practices
- Policies and procedures
Regulatory, Reimbursement, & Accreditation Requirements
- Revenue Cycle
- Joint Commission
- Centers for Medicare & Medicaid (MU/PI)
- Health Information Technology for Economic & Clinical Health Act (HITECH)
**Documentation drives reimbursement
What is Meaningful Use?
Using a certified health record (EHR) technology to:
1. improve quality, safety, efficiency, and reduce health disparities 2. Engage patients and family 3. Improve care coordination and population and public health 4. Maintain privacy and security of patient health information
Accountable Care Organizations
Def: a group of health care providers who give coordinated care, chronic disease management, and thereby improve the quality of care patients get. The organization’s payment is tied to achieving health care quality goals and outcomes that result in cost savings.
ex: continuity of care
Care transitions
Medical home
Legal Issues
- Malpractice
- Scope of practice
- Propriety Data Misuse
Security, Privacy, Confidentiality
**Health Insurance Portability & Accountability Act (HIPAA)*
1996
2013 updated with fines for infractions
Threshold: need to report to government if 500+ are exposed
Security
- Audit trails-record who had access and what they did
- Intrusion and infections (threats, preventions, & remedies…ex: firewalls, viruses, and protections)
- User security (ex: biometrics, pw protection, tokens, authentication)
- System security, device access control protecting from unauthorized access, time out)
- Information system disaster preparedness (ex: natural and manmade threats, recovery plans, back-ups)
- Defining and assigning role-based or system access
Privacy and Confidentiality
HIPAA-health insurance portability accountability act 1996 & 2013
Privacy Rule: Federal protection for PHI with some disclosure
Security Rule: Administrative, physical, & technical safeguards for confidentiality, integrity & availability of electronic health information
HITECH 2009 (Health Information Technology for Economic and Clinical Health)
- Seeks to improve US healthcare delivery & patient care via IT investment
- Provide assistance & technical support to providers, help with coordination with states
- Programs support connectivity for public health, workforce training for MU for EHRs
- Reports on HIPAA compliance by DHHS
- Authorized CMS to provide incentive payments to physicians & hospitals that use EHR technology
Ethical Practices
Data Management Practices
- Collection
- Storage
- Manipulation
- Dissemination
Ethical Practices
Legal Issues
- eICU
- Malpractice
- Liability
- Patient data misuse
- Proprietary data misuse
Code of Conduct
Proper practices
Overview of responsibilities and behavior
Set of rules
Ethics
- Protection of patient, provider and enterprise interests
- Protecting proprietary information
- Code of ethics (IMIA, ANA)
Ethics References
- ANA (2015): American Nurses Association
Guide to the Code of Ethics for Nurses with Interpretive
Statements - IMIA (2016): International Medical Informatics Association
The Code of Ethics for Health Information Professionals
Policy and Procedure Review
- Clinical documentation
- Downtime
- CPOE
- Barcode scanning
