NCM 110: NURSING INFORMATICS

Theories, Frameworks, And Models

Jeezreel M. Orquina, RN, LPT

 Nursing Informatics
Models

 Graves and Corcoran’s model

 Schiwirian’s model

 Turley’s model

 Data Information Knowledge (D-I-

K) model
 Benner’s Novice to Expert model
 Nursing Informatics Models

 Specific Informatics Models

 Philippine Healthcare
Ecosystem model

 Shift Left Model

 GRAVES AND
CORCORAN’S MODEL

 (1989)
 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
 MANAGEMENT

D AT INFORMATION KNOWLEDGE
A
SCHWIRIAN’S
MODEL
(1986)
• Nursing informatics involves
identification of information needs,
resolution of the needs, and attainment of
nursing goals/objectives
• Patricia Schwirian – proposed a model
intended to stimulate and guide systematic
research in nursing informatics in 1986
• Model/framework that enables
identification of significant information
needs, that can foster research (some what
similar to Maslow’s hierarchy of needs)
 GOAL

USERS

TECHNOLOGY

RAW MATERIAL
(NURSING-REALATED INFORMATION
TURLEY’S MODELS
(1996)
 TURLEY’S MODEL
(1996)
Nursing informatics is the
intersection between the discipline-
specific science (nursing) and the area
of informatics

Core components of informatics:

 Cognitive science
 Information science
 Computer science
 COMPUTER
SCIENCE

INFORMATIO NURSING
N SCIENCE

COGNITIVE
SCIENCE
D ATA-
INFORMATION-
KNOWLEDGE
 DATA-INFORMATION-
KNOWLEDGE
NI is a MODEL
specialty that integrates nursing science,
computer science and information science to manage
and communicate data, information, knowledge
and wisdom into nursing practice (ANA)

 Nursing informatics is an evolving, dynamic

process involving the conversion of data
into information, and subsequently
knowledge
 Important Note: Processing of information does
not always result in the development of knowledge.
COMPLEXITY

KNOWLEDGE

INFORMATION

D AT
A

HUMAN INTELLECT
 BENNER’S LEVEL OF
EXPERTISE MODEL

 Every nurse must be able to continuously exhibit

the capability to acquire skills (in this case,
computer literacy skills parallel with nursing
knowledge), and then demonstrate specific skills
beginning with the very first student experience
 Levels of Expertise
(Benner):
 Novice– individuals with no experience
of situations and related content in those situations
where they are expected to perform tasks
 Advanced Beginner – marginally demonstrate
acceptable performance having built on lessons
learned in their expanding experience base; needs
supervision
 Competent– enhanced mastery and the ability
ot cope with and manage many contingencies
 Proficient– evolution through continuous
practice of skills, combined with professional
experience and knowledge; individual who
appreciates standards of practice as they apply in
nursing informatics
 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
 PHILIPPINE HEALTH CARE
ECOSYSTEM

 Nursing informatics is a huge network that

encompasses all the sectors of the health care
delivery system – government agencies, health
care facilities, practitioners, insurance companies,
pharmaceutical companies, academic
institutions, and suppliers
 the government, different nursing associations
and developmental agencies maintain and
balance the network
 INTEL’S SHIFT LEFT
MODEL

 Patient care shifts/progresses from a high

quality delivery of life through technology
with increased costs (right side) into
quality of life with minimal health costs
 Inverse relationship between quality of life
and cost of care/day
 PATIENT MEDICAL RECORD
INFORMATION MODEL (PMRI):
BASIS OF EHR

 The type and pattern of documentation in the

patient record will be dependent on 3 interacting
dimensions of health care:

 Personal health dimension – personal health record

maintained and controlled by the individual or
family; nonclinical information
 e.g. self-care trackers, directories of health care, and
other supports
 Health care provider dimension – promotes quality
patient care, access to complete accurate patient
data 24/7
 e.g. provider’s notes/prescription, clinical orders
decision support systems, practice guidelines

 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
 e.g. Ushahidi program
 *Important Terminologies
(Data Sets):

 ABC codes
 Perioperative Nursing Data Set
(PNDS)
 SNOMED CT
 International Classification for
Nursing
 Practice (ICNP)
 Patient Care Data Set (PCDS)
 NANDA
 LOINC
 ABC CODES

 m e c h a n i s m for coding integrative

health interventions by clinician
for administrative billing and insurance
claims
 i n c l u d e s complementary and alternative

medicine interventions and codes that

map all NIC, CCC, and Omaha system
interventions
 Perioperative Nursing Data
Set (PNDS)

 universal language for perioperative

nursing practice and education;
standardize documentation of
perioperative data in all perioperative
settings
 Diagnosis based on NANDA, interventions

based on NIC, and outcomes based on

NOC
SNOMED CT


core clinical terminology containing over
357,000 healthcare concepts with unique
meanings and formal logic-based
definitions organized into multiple
hierarchies
 International
Classification for
Nursing Practice
(ICNP)

integrated terminology for nursing
practice developed under sponsorship of
ICN

ICNP elements:
 Nursing phenomena (nursing diagnosis)

 Nursing actions (nursing interventions)

 Nursing outcomes
 Patient Care Data Set
(PCDS)

 terms and codes for patient problems,

therapeutic goals, and patient care orders

 developed by Dr. Judith Ozbolt

 American Medical
Informatics Association
(AMIA)
 authoritative body in the field of medical
informatics and frequently represents the United
States in the informational area of medical
informatics in international forums

 dedicated to the development and application of

medical informatics in the support of patient care,
teaching, research, and healthcare administration
 National League for
Nursing (NLN)
 Mission: To advance quality nursing education that
prepares the nursing workforce to meet the needs
of diverse populations in an ever-changing
healthcare environment
 Addresses faculty development and

educational research
*Educational Technology and Information
 Management Advisory Council (ETIMAC) – promote

effective use of technology in nursing education, as a

teaching tool and outcome for student-faculty learning
 Healthcare information and
management systems society
(HIMSS)

 assumes leadership role in the

technology standards of nursing and
advocacy of key innovations in
health care delivery and
administration
THE END
