1.

Graves and Corcoran’s Model (1989)

In 1989, Judith Graves and Sheila Corcoran published their article using the concepts of
data information and knowledge in defining nursing informatics as a scientific discipline.

This model describes nursing informatics as the proper management of knowledge and
it portrays that management processing is integrated within each element - starting from data as
it is processed into information and knowledge. It is designed to facilitate the practice of nursing
and the delivery of nursing care by assisting in the management and processing of nursing data,
information, and knowledge.

These perspectives emphasized the importance of taking the clinical decision-making

process into account when designing information systems. Designers may create solutions that
better address the needs of nurses during their clinical decision-making processes if they
understand how collected data is used in decision-making.
2. Schiwirian’s Model (1986)

The model is made up of four main elements that are arranged to form a pyramid with a
triangular base. The first element is the "raw materials," which is nursing-related information; the
second element is the “technology”, which is a computing system; the third element is
the “users”, who are nurses/students working within their personal and professional structures;
and the fourth element is the “goal” or objective that the three elements before it is aiming for.

The goal is placed at the top of the pyramid to emphasize the importance of the ultimate
goal of every NI activity and the fact that NI researchers must keep it in mind at all times. The
model shows that all of the elements' interactivity is bidirectional in nature; that is, one element
is not inherently a sequential precursor of the other, and changes in one element would almost
inevitably result in changes in at least one of the others.

This NI pyramid offers a flexible four-dimensional structure that is suitable for devising
and locating meaningful NI research. In terms of posing research questions or forming theories,
an investigator may enter the model at any stage and still see where his or her study fits into a
broader scheme of knowledge about NI. The model might have been used to direct thought
about nursing informatics concept and practice as well, as it was intended as a stimulus for
research in nursing informatics. Given the importance of research in informatics today,
Schwirian's focus on research was smart and wise.
3. Turley’s Model (1996)

According to this 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.

“Cognitive Science” is the interdisciplinary scientific investigation of the mind and

intelligence, refers to many kinds of thinking, including those involved in perception, problem
solving, learning, decision making, language use, and emotional experience; next is
“Information Science” which is a discipline that deals with the processes of storing and
transferring information, it attempts to bring together concepts and methods from various
disciplines in order to develop techniques and devices to aid in the collection, organization,
storage, retrieval, interpretation, and use—of information; the third is “Computer Science”, the
study of computers and computing, including their theoretical and algorithmic foundations,
hardware and software, and their uses for processing information, it focuses on how the
computer help nurses enter, organize, and retrieve information. The fields of sciences
mentioned, all contribute to nursing informatics, wherein “Nursing science” is the vehicle, it is
the knowledge base for understanding the other 3 sciences.
 Turley's main contribution was the incorporation of cognitive science to a model that
included Graves and Corcoran's initial three sciences. Memory, problem solving, conceptual
templates, skill learning, language processing, and visual attention are all subjects of cognitive
science. These ideas will assist informatics nurse specialists in understanding the decision-
making and information processes done by nurses and, subsequently, help in the creation of
appropriate tools to aid nursing processes. As a result, cognitive science is particularly useful to
informatics nurse specialists who focus on issues affecting users, such as decision making and
the design of computer interfaces for nurses.
4. Data-Information-Knowledge Model

Nursing informatics (NI) is a discipline that combines nursing, computer science, and
information science to handle and communicate data, information, expertise, and wisdom in
nursing practice.  NI is a complex, ever-evolving process that involves the transformation of data
into information, and then knowledge.

Data is discrete objective observations and/or facts. These bits of pieces are still raw,
and is insignificant unless they are collected and arranged in a certain manner which will now
give you an information. Information then is a collection of data, which can be used to answer a
certain question or describe a concept. Information makes the data meaningful valuable useful
and relevant. Next we have knowledge which builds on information and adds subjectivity to it.
Knowledge is more on the intellectual or cognitive ability of a person to possess and interpret
information. knowledge can be applied to aid in decision-making.

By collecting a lot of data, it can be mined for information, which then through analysis
and expertise can be further refined to knowledge.
5. Benner’s Level of Expertise Model

Every nurse must be able to demonstrate the ability to learn new skills (in this case,
computer literacy skills that are parallel to nursing knowledge) and then demonstrate those skills
starting with their first student experience.

According to Benner, there are 5 levels of expertise, the first stage is “Novice” who are
individuals with no experience of situations where they are expected to perform tasks; next is
“Advanced Beginner”, they marginally demonstrate acceptable performance having built on
lessons learned in their expanding experience and still needs supervision; the next stage is
“Competent”, they have enhanced mastery and the ability to cope with and manage many
unforeseen event; next is “Proficient”, whom have evolved through continuous practice of skills,
combined with professional experience and knowledge, these are individuals who appreciates
standards of practice as they apply in nursing informatics; and the last stage is “Expert” which
includes individuals with mastery of the concept and capacity to intuitively understand the
situation and immediately target the problem with minimal effort or problem solving.

Learners need different forms of instruction based on their current level. Novices, for
example, need very different training and support than experienced beginners, and so on.
Within the field of nursing informatics, this theory can be applied to the following: the
development of nursing informatics skills, competencies, knowledge and expertise in nursing
informatics specialists; It can also be applied to the development of technological system
competencies in practicing nurses working in an institution; and also to the education of nursing
students, from first year to graduation and; the transition from graduate nurse to the education
of nursing students, from first year to graduation and; lastly to the transition from graduate nurse
to expert nurse.
6. Intel Shift-Left Model

According to this model, patient care shifts or advances from high-quality delivery by
technology with higher costs (right side) to quality of life with low health costs (left side).

Rather than a focus on technology, the model suggests a set of principles that will
facilitate the evolution of health care and the previously described “shift to the left”. These
principles include; Shift the place of care to the least restrictive setting; Shift skills to patients
and caregivers and stop fighting the licensure and protectionism turf wars; Shift the time of care
so that it is proactive and not reactive; Shift payments from individual providers to teams of
providers of care and shift payments so that outcomes that reflect the use of a holistic approach
are achieved; Shift the technology used from specialized equipment to everyday life
technologies, but do it within a framework that does not start with technology. (Dishman, 2015)

The desire is to “shift left,” that is, to get more people on the end of the health continuum
with lower levels of chronic disease, lower levels of functional impairment, lower costs of health
care, and a higher quality of life
7. Patient Medical Record Information Model

Three interconnected dimensions of health care can influence the type and pattern of
documentation in the patient record. First is the “Personal health dimension”, it is a nonclinical
information system in which personal health record is kept and managed by the individual or
family.; Second is the “Health care provider dimension”, which facilitates high-quality patient
care by providing access to full, accurate patient data 24 hours a day, seven days a week, such
as provider notes/prescriptions, clinical orders, decision support systems, and practice
guidelines; and the third dimension is the “Population health dimension”, in which data on public
health and its influences to health. It aids stakeholders in recognizing and tracking health
threats, evaluating population health, creating and monitoring programs and services, and
conducting research.
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