nursing informatics Flashcards
Integration of healthcare sciences, computer science, information science, and cognitive science to assist in the management of healthcare information.
• A subdiscipline of informatics..
Health informatics
“The use of computers technology to support nursing, including clinical
practice, administration, education, an d research.”
Hebda (1998)
“The development and evaluation of applications, tools, processes, and
structures which assist nurses with the management of data in taking care of patients or supporting the practice of nursing.”
American Nurses Association (ANA)
goals of N.I
1.improve the health of population, i,f,c
2. establishing effective administrative systems managing
3. delivering educational experiences
4.supporting life long learning
5z supporting nursing research
“The application of computer technology to all fields of nursing-nursing service, nurse education, and nursing research.”
(Scholes and Barber, 1980)
Nursing informatics is a combination of nursing science, information science, and computer science to manage and process nursing data, information and knowledge to facilitate the delivery of health care.
Graves & Corcoran (1989)
The scientific field that deals with biomedical information, data and knowledge-their storage, retrieval, and optimal use for problem-solving and decision-making.
Shortliffe & Perreault
recognized as a specialty for registered nurse by
American Nurses Association in 1992
computers can’t but humans can
- perceive data and information
- abstract data and information
3.make decision that involve values and risk preferences
scope of informations
- • Data, information, knowledge and wisdom
• Communication and information management
• Types, capabilities, and limitations of technology
• Legal and ethical considerations of information
discrete entities that are described objectively without interpretation,
Data
data that are interpreted, organized, or structured
Information
information that is synthesized so that relationships are identified and formalized
Knowledge
appropriate use of data, information and knowledge in making decisions and implementing nursing actions.
wisdom
non-repetitive, non-routine work consuming considerable levels of cognitive activity (Drucker, 1993).
knowledge work
nursing informatics can be applied to all areas of nursing practice which include
clinical practice
administration
education
research
Nursing informatics general models
- graves and corcoran
- schiwirian
- turley
- data information knowledge
- benner’s novice to expert model
2 specific informatics models
- philippine health ecosystem model
2.shift left model
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.
graves and corcoran’s model
nursing informatics involves identification of information needs, resolution of the needs, and attainment of nursing goals/objectives.
proposed a model intended to stimulate and guide systematic research in nursing informatics, model/framework that enables identification of significant information needs, that can foster research (somewhat similar to Maslow’s hierarchy of needs).
schiwiran’s model
nursing informatics is the intersection between the discipline-specific science (nursing) and the area of informatics. And in this model, there are 3 core components of informatics, namely Cognitive science, Information science, and Computer science.
turley’s model 1996
benner’s level of expertise model
novice
advanced beginner
competent
proficient
expert
patient medical record information model (pmri)
1.personal health dimension
2. health care provider dimension
3. population health dimension
personal health record maintained and controlled by the individual or family: nonclinical information.
personal health dimension
promotes quality patient care, access to complete accurate patient data 24/7.
health care provider dimension
helps stakeholders identify and track health threats, assess population health, create and monitor programs and services, and conduct research.
Population health dimension
semiotic triangle
term
concept
object
examines the pattern of acceptance that innovations follow as they spread across population of people who adopt it
Roger’s diffusion of innovation theory (unplanned change)
describes the processes that occur in a planned change into 3 stages.
Lewin’s Change theory (planned change)
Lewin’s Change theory (planned change) 3 stages
Changing
Refreezing
Unfreezing
Blum’s theory 3 group
- data is processed
- information is processed
- knowledge is processed
Cognitive science includes mental models, skills acquisition, perception and problem solving that adds an understanding of how the brain perceives and interprets a computer screen.
cognitive theory
informatics compentencies
level of competency
beginning nurse
experienced nurse
informatics nurse specialist
informatics innovator
informatics compentencies 3 areas
computer literacy
informatics knowledge
informatics skills
Roles of the Informatics Nurse
Specialist
•Project Management
• Consultation
• Education
• Research
• System Development
• Decision Support/Outcomes Management
• Policy Development
• Entrepreneur
Electronic Patient Records:
Development Constraints
• Need for standards in clinical terminology
• Concerns about data privacy, confidentiality and security
• Data entry challenges
• Integration of records and other information resources
Information Needs and Tools for
Practice
• Sound Clinical Decision Making
• Evidence Based Practice
• Standardized Vocabularies
• Clinical Information Systems
Research Priorities
Brennan, Zielstorff, Ozbolt, & Strombom, 1998)
Standardized language/vocabularies
Technology development to support practice/ patient care
Data base issues
Patient use of information technologies
Using telecommunications technology for nursing practice
Putting technology into practice
Systems evaluation issues
Information needs of nurses and other clinicians
Nursing intervention innovations for professional practice
Professional practice issues
Assumptions to be
Challenged
• Organization of electronic systems
- Desktop metaphor
- EMR
• Chronological structure
• Set of processes to be supported by technology
nursing and the computer historical perspective
- six time periods
- four major nursing areas
- standard initiatives
- significant landmark events
Six time periods
I. Prior to 1960’s
II. 1960’s
III. 1970’s
IV. 1980’s
V. 1990’s
VI. Post 2000
4 major nursing areas significance of nursing informatics
clinical practice
administration
education
research
Healthcare Information and Management systems Society was founded
1961
Development of one of the first hospital
Information system in California
1965
First Conference on Management Information System
1973
First National Conference on Computer
Technology in Chicago
1981
First Nursing Computer Journal is published.
1984
graduate program in Nursing Informatics is introduced in Maryland university
1989
establishment of electronic library
1993
first International Nursing Informatics
Teleconference held in Australia
1995
JCAHO identified clinical information system as a way to improve safety and recommends that hospitals adopt technology.
2002
Health Insurance Portability and Accountability
Act was enacted
2003
Establishment of the National Health Information Coordinator.
2004
Advantages of N.I
• shared data;
• centralized control;
disadvantages of redundancy control;
• improved data integrity;
• improved data security, and database systems; and,
• flexible conceptual design.
Disadvantages of NI
• a complex conceptual design process;
• the need for multiple external databases;
• the need to hire database-related employees;
• high DBMS acquisition costs;
• a more complex programmer environment;
• potentially catastrophic program failures;
• a longer running time for individual applications; and,
• highly dependent DBMS operations.
Informatics nurse specialist
- Project manager
• Educator
• Product developer - Decision support/outcomes manager
• Systems analyst
• Consultant
• Programmer - Advocate/policy developer
• Web developer
• CIO, CEO, CNO
• Entrepreneur
• Researcher - Sales and marketing
