NURSING

INFORMATICS
BSN III-E (GROUP 3)
 MEET THE TEAM!
ABRENZOSA, HYLENE LUBO, NICOLE
ANDRES, CATHERINE JOYCE MALANA, FATIMA NICOLE
ANDRADA, JENICA PAGELA, ZAIZA MAE
ANGULUAN, CHARLENE MAE QUIZZAGAN, MARY FAE
BINAG, KYLAEverest
MAE Drew RemyMAE
SERVITILLO, TRISHA
Cantu Holloway Marsh
DAO-AYAN, LOREIN AIRA TALBO, DIANNE
Ceo Of Ingoude
GARRO, PRECIOUS Company
TALENIO, CHARLEMAGNE
 CONTENT
01 DEFINITION OF DIKW (IN RELATION TO ADPIE)

02 DEFINITION OF NURSING PROCESS

03 THE SIMILARITIES OF DIKW TO THE NURSING PROCESS

04 DIKW THEORY AND NURSING INFORMATICS

05 EXAMPLES

06 REFERENCES
 DIKW
DIKW represents a hierarchical framework for understanding
information processing. (Decker, 2017)

Data – Information – Knowledge – Wisdom has evolved over the

years across a variety of disciplines and is one of the most
embraced in nursing informatics and “considered by some as the
canon of information science and knowledge management”
(Gackowski, 2012, p. 93) and one of the most widely recognized
theories in informatics (McDowell, 2021).
 DIKW ORIGINS
“Where is the Life we have lost in living?
Where is the Wisdom we have lost in Knowledge?
Where is the Knowledge we have lost in
Information?”

T.S. Eliot, The Rock (1934).

PYRAMID OF DIKW THEORY
This theory is often presented in the form of a
pyramid or hierarchy with data at the bottom WISDOM
and wisdom at the top, however, most point
out that the steps are not linear but
interwoven (Frické, 2009, 2019). KNOWLEDGE

INFORMATION

DATA
 DATA
DATA Data are considered the simplest and most basic element of
the theory, and come in many forms: numbers, letters,
images, sentences, and so on. Electronic health records are
rich in client data. “Indeed, the appeal of DIKW relates to its
fit with the way computers process information. In the
context of computerized systems, it is logical and necessary
to view data as value-free facts that are observable and
measurable in order for computerized information systems
to function.

Furthermore, the propositions that data are basic, discrete, DATA

“building blocks,” processed data and addition of context
creates information, and synthesizing information and
identifying patterns and relationships create knowledge are
features that can be programmed into computerized clinical
information systems” (Ronquillo, et al., 2016, p. E.11).
DATA>>>ASSESSMENT
 INFORMATION
In this theory, information emerges from data. “Information may
be thought of as “data plus meaning.” It can be derived by
processing data. Information represents the facts and ideas
that are available to be known within a certain context. When
data are put into a context and combinedwithin a structure,
information emerges” (Matney et al., 2011, p. 8). Information has
become so common and so profuse that our current era has
been dubbed “the information age” where “we over-invest in
information and under-invest in knowledge and wisdom”
(Mayer, 2005, p. 69).
Tunnel described information as “data that have been
transformed to have meaning for human beings by being
organized with specific relationships between the data.
Information adds value to a person’s understanding about
something. People use an IS to perform this transformation”
(2014, p. 45).
INFORMATION>>>DIAGNOSIS
 KNOWLEDGE
The third dimension of the DIKW is knowledge, a concept that has become both
elusive yet used continuously. “Knowledge has six key characteristics: it is
subjective as well as objective, it is context sensitive, it has both collective and
personal components, it has a tacit and explicit nature, it has a limited shelf life in
terms of usability and infinite shelf life as a piece of information, and it is
functional when you apply it and informational when you acquire it” (Hoppe, 2011, p.
155). Knowledge is a process of making meaning of information, “however, without
the dimensions of context, culture, tacitness, and time, this knowledge would be
little more than information” (p. 155).
“Explicit knowledge is what knowledge management systems (such as computer
decision support systems) seek to capture, codify, store, transfer, and share. Like
the transformation of data to information, the transformation of information to
knowledge in nursing and information systems can be conceptualized as a
continuum of increasing understanding. Knowledge is derived by discovering
patterns and relationships between types of information” (Matney et al., 2011, p. 8).
 KNOWLEDGE>>>PLANNING &
INTERVENTION:IMPLEMENTATION
 WISDOM
In the context of this theory, the following definition seems to be one of the most poignant and
applicable: “Wisdom or sapience is the ability to think and act using knowledge, experience,
understanding, common sense, and insight. Wisdom has been regarded as one of four cardinal
virtues; and as a virtue, it is a habit or disposition to perform the action with the highest degree
of adequacy under any given circumstance, and to avoid doing anything wrong. This implies a
possession of knowledge or the seeking of knowledge application to the given circumstance.
This involves an understanding of people, objects, events, situations, and the willingness as well
as the ability to apply perception, judgement, and action in keeping with the understanding of
what is the optimal course of action. It often requires control of one’s emotional reactions (the
“passions”) so that the universal principle of reason prevails to determine one’s action” (Bohle,
2016, p. 140).
According to Jennifer Rowley, “The wisdom hierarchy suggests that:
There is more data than information, than knowledge, than wisdom. Is this desirable
and acceptable, or simply a statement of the status quo?
The hierarchy with its broad base of data is safe, secure and stable.
Wisdom is only attained after much processing of data, information and knowledge,
and the process starts with data” (2007, p. 175).
 WISDOM
“We therefore define wisdom as: the capacity to put into action the most appropriate
behaviour, taking into account what is known (knowledge) and what does the most good
(ethical and social considerations). This leads to a simple relationship between knowledge
and wisdom. If knowledge is seen as “knowing how”, wisdom is “knowing why, what and how”
to do something” (Rowley, 2006a. p. 1250). Rowley and Slack (2009) pointed out that a
common theme in the literature on wisdom is its inherent link with action and judgement,
and the knowledge of what is good and right (ethics) which inform strategic decision-
making and making choices.
“Wisdom can thus be seen as a highly integrative, emotional and conscious, creative
process” (Hoppe et al, 2011, p. 587). “The path to wisdom is then knowing when to
differentiate, when to integrate, when to go after what one intends, and when to let go and
`flow’ with the challenges presented” (Kaipa, 2000, p. 157). Some would say wisdom is
developed over time in many nurses and is applied routinely during nursing practice. “In
nursing, wisdom guides the nurse in recognizing the situation at hand based on patients’
values, nurse’s experience, and healthcare knowledge. Combining all these components, the
nurse decides on a nursing intervention or action” (Topaz, 2013, p. 2).
WISDOM>>>EVALUATION
 DIKW INTEGRATION IN A GIVEN SCENARIO

Scenario: A nurse in a hospital ward notices a patient suddenly collapse

and become unresponsive.
DATA: Witnessed Collapsed

The nurse quickly assesses the patient, finding no pulse and no breathing.
They recognize these as critical signs of cardiac arrest.

Information: No Pulse or Breathing

 DIKW INTEGRATION IN A GIVEN SCENARIO

Drawing on their training and knowledge, the nurse initiates cardiopulmonary

resuscitation (CPR) by delivering chest compressions and rescue breaths,
following the established CPR protocol.
Knowledge: CPR Protocol

After several rounds of CPR, the nurse decides to activate the automated
external defibrillator (AED) based on their wisdom gained from experience.
The AED advises a shock, which the nurse administers. This action reflects
the wisdom of knowing when to escalate treatment.

Wisdom: AED Activation

 NURSING PROCESS
Nursing process is a critical thinking
process that professional nurses use to
apply the best available evidence to
caregiving, promoting human functions,
and response to health and illness
(American Nurses Association, 2010).
 CHARACTERISTICS OF
NURSING PROCESS

•Cyclic
•Dynamic in nature
•Client-centered
•Universally Applicable
• Uses critical thinking and clinical Reasoning
STEPS IN THE NURSING
PROCESS

•Assessment
•Diagnosis (Nursing D.)
•Planning
•Implementation
•Evaluation
 ASSESSMENT

Assessment is the first step and involves

critical thinking skills and data collection;
subjective and objective. Subjective data
involves verbal statements from the
patient or caregiver .Objective data is
measurable, tangible data such as vital
signs, intake and output, and height and
weight. (Tammy J. Toney Butler, Jennifer
M. Thayer, 2023)
 DIAGNOSIS
•According to NANDA, nursing diagnosis is defined as a
clinical judgment about responses to actual or potential
health problems on the part of the patient, family, or
community.

- Based on the analysis of the collected patient data.

• A nursing diagnosis encompasses Maslow's Hierarchy of

Needs and helps to prioritize and plan care based on
patient-centered outcomes.
 PLANNING

Provides direction for nursing interventions. When the nurse, any

supervising medical staff, and the patient agree on the diagnosis,
the nurse will plan a course of treatment that takes into account
short and long-term goals. Each problem is committed to a clear,
measurable goal for the expected beneficial outcome.
 IMPLEMENTATION

It involves action or doing and the actual carrying out of nursing

interventions outlined in the plan of care.

Actions associated with a nursing care plan include monitoring the

patient for signs of change or improvement, directly caring for the
patient or conducting important medical tasks such as medication
administration, educating and guiding the patient about further health
management, and referring or contacting the patient for a follow-up
 EVALUATION

This final step of the nursing process is vital to a positive patient

outcome. Whenever a healthcare provider intervenes or implements
care, they must reassess or evaluate to ensure the desired outcome
has been met. Reassessment may frequently be needed depending
upon overall patient condition. The plan of care may be adapted based
on new assessment data. (Butler et al. 2023)
 INTEGRATING NURSING PROCESS - EXAMPLE

Scenario: In a busy hospital's intensive care unit (ICU) in Tuguegarao, a

nurse is caring for a patient admitted with severe pneumonia.

• Assessment (Data Collection): The nurse collects data on the patient's vital signs,
oxygen saturation level (SpO2), lung sounds, lab results (such as elevated white
blood cell count), and the patient's difficulty in breathing.

• Diagnosis: Based on the assessment data, the nurse identifies the nursing
diagnosis: "Impaired Gas Exchange related to pneumonia, as evidenced by low SpO2
and abnormal lung sounds."
 INTEGRATING NURSING PROCESS - EXAMPLE

Planning: The nurse develops a plan that includes administering prescribed

antibiotics, monitoring the patient's SpO2, administering oxygen therapy, and
educating the patient on deep breathing exercises.

Implementation: They start the antibiotics, provide oxygen therapy at the

prescribed rate, and encourage the patient to perform deep breathing exercises
as planned.

Evaluation: The nurse continuously monitors the patient's SpO2 and lung
sounds. Over time, as the patient's SpO2 improves,
 SIMILARITIES OF DIKW
TO THE NURSING PROCESS

DIKW and the nursing process both involve

collecting data and connecting the collected
data to form information, translate the
information into knowledge, and get wisdom to
resolve issues.

It requires judgment to understand values,

patterns, and relations..
 SIMILARITIES OF DIKW
TO THE NURSING PROCESS

Both are designed to make informed clinical

decisions with regards to patient care.

Like the actions that occur within the nursing

process, DIKW concepts in the healthcare
process depend on data use, information sharing,
knowledge to be applied, and wisdom to evaluate
the accuracy of information and the appropriate
selection of interventions needed for a nursing
care plan.
SIMILARITIES OF DIKW AND NURSING PROCESS

Data, when processed and organized, becomes

DIKW Information. Information, when interpreted and
contextualized, becomes Knowledge. Knowledge,
when applied wisely, leads to Wisdom.

The nursing process consists of five steps:

Assessment, Diagnosis, Planning, Implementation, and NURSING PROCESS
Evaluation (ADPIE). These steps are followed in a
logical sequence to provide patient-centered care.
SIMILARITIES OF DIKW AND NURSING PROCESS

DIKW Encourages critical thinking skills to interpret and

transform data into meaningful insights.

Promotes critical thinking in clinical practice by guiding

nurses to analyze data, identify problems, and NURSING PROCESS
implement evidence-based interventions.
 DIKW THEORY &
NURSING INFORMATICS
The American Nurses Association (ANA) In 2015, the ANA further expanded their
included the DIKW theory in their 2008 definition to “Nursing informatics is the
definition of Nursing Informatics: specialty that integrates nursing science
“Nursing informatics (NI) is the specialty with multiple information and analytical
that integrates nursing science with sciences (a listing of sciences that integrate
with NI includes, but is not limited to:
multiple information management and
computer science, cognitive science, the
analytical sciences to identify, define,
science of terminologies and taxonomies
manage, and communicate data,
[including naming and coding conventions],
information, knowledge, and wisdom in information management, library science,
nursing practice. NI supports nurses, heuristics, archival science, and
consumers, patients, the mathematics”) to identify, define, manage,
interprofessional healthcare team, and and communicate data, information,
other stakeholders in their decision- knowledge, and wisdom in nursing practice.
making in all roles and settings to NI supports nurses, consumers, patients, the
achieve desired outcomes. This support interprofessional healthcare team, and other
is accomplished through the use of stakeholders in their decision making in all
information structures, information roles and settings to achieve desired
processes, and information technology” outcomes. This support is accomplished
through the use of information structures,
(p.1).
information processes, and information
technology” (ANA, 2015, p. 1).
 Bruce Bulm (1986a) is credited by Graves and Corcoran
Judith Graves and Sheila Corcoran
(1989) as being the first to apply the data-information-
(1989) are credited as being the first knowledge dimensions to medical informatics. Bulm
nurses who tied together the first (1986b) described these dimensions in the context of
three DIKW dimensions, data- clinical information systems in the following way:

information-knowledge in the
context of nursing informatics. “This
framework for nursing informatics
Data. These are the uninterpreted
relies on a taxonomy and definition items given to an analyst or problem
of the central concepts of data, solver, such as the signals processed
information and knowledge put by an electrocardiograph or an
forward by Blum (1986), who defines imaging device.
data as discrete entities that are Information. This is a collection of data
described objectively without elements organized (or interpreted) to
convey meaning to the user, such as
interpretation, information as data
an automated medical record or a flow
that are interpreted, organized or
sheet.
structured and knowledge as Knowledge. This is the formalization of
information that has been the relationships, experience, rules
synthesized so that and so forth by which information is
interrelationships are identified and formed from data, such as si
formalized” (p. 228).
The DIKW theory is just that – a theory. However, it does help nurses and other professionals to
articulate how we use data, information, and knowledge within our practice and how they can
support the development and application of wisdom within the context of healthcare.
“Alternatively, perhaps DIKW can be viewed as a vision or goal for nursing informatics: a depiction
of nursing informatics as a vehicle in the movement toward nursing praxis. In this view, we would
then be directed to taking up DIKW as a means of understanding nursing informatics, inclusive of
both computerized clinical information systems and nurses as users, since nursing praxis would
require both components” (Ronquillo, et al., 2016, p. E.16). The theory helps to articulate the
technological aspects of nursing informatics while creating a wide space for the ingenuity of the
human nurses themselves.
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SNAHS Department
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