LESSON 1: Concepts, Principles and Theories

in Nursing Informatics

Informatics
Theory
 01 THEORIES

MODELS
02
TOPICS

03 FRAMEWORK
 Introduction

Nursing informatics is an established and growing

area of specialization in nursing. Informatics nurses
are key persons in the design, development,
implementation, and evaluation of technologies and
in the development of the specialty’s body of
knowledge.
Theories
 Theories that lend support to Informatics

*The core concepts of informatics:

 Data
1. Nursing  Information

informatics theory  Knowledge

(Information theory)  Wisdom

Theories that lend support to Informatics

are discrete, objective facts or elements that

have not been interpreted (Clark, 2009) or
are out of context that they are at atomic
level. Data are describe objectively without
interpretation. They are the building blocks
DATA of meaning but lack context, and hence are
meaningless.
 Theories that lend support to Informatics

is data that has some type of

interpretation or structure; that is, it has
a context; is derived from combining
different pieces of data (Clark, 2009). A
INFORMATION set of data, such as vital signs when
interpreted over a period of time is
information.
 Theories that lend support to Informatics

is the synthesis of information with

relationship identified and formalized or
it is information collected to produce
knowledge.
For example, interpreting a set of vital signs
KNOWLEDGE over a period of time and deciding on an
action based on this information
combined with nursing knowledge and
experience.
.
Theories that lend support to Informatics

is achieved through evaluating knowledge

with reflection. Knowing when and how
to use knowledge to situation (ANA,
2008). It requires people to combine
their knowledge, values, and experience

WISDOM with three types of data.

For example, wisdom would interpreting
vital signs in a post surgical patient as
indicative od an infection and taking the
appropriate action.
.
 Theories that lend support to Informatics

• Sociotechnical theory developed in the middle of

2. Sociotechnical theory
and social informatics
• To this end, it focuses on interactions of an
the last century when it became evident that not
all implementations of technology were
increasing productivity. The overall focus is the
impact of technology implementation on an
organization.
organization between information management
tools and techniques and the knowledge, skills,
attitude, values and needs of its employees as
well as the rewards and authority structures of
the employer (Wade & Schneberger, 2005).
 Theories that lend support to Informatics

• Computerization of information is a new experience that

create a change that affect workers, this change may be
3. Change unplanned represented by Rogers change theory of
diffusion and innovation address how change occurs in
theory society and individual.

• And may be planned represented by Lewins’s Change

theory who talks about stages in moving people from
comfortable state before the change, and finally back to a
comfort with the change.
 Rogers’s Diffusion of innovation theory
(Unplanned Change)
Innovators (12.5%): people who adopt the innovation.
Early adopters (13.5%): they are respectable opinion leaders who function
as promoters of the innovation.
Social Changes Early majority (34%): people who are averse to risks but will make safe
investment.
Late majority (34%): make up another group of adopters, they need to be
sure that the innovation is beneficial, they adopt the innovation not
because they see a use of it, but because of peer pressure.
Laggards (16%): they are suspicious about the innovation and change, they
see their resistance as rational and must be certain that the innovation
will not fail before they are willing to adopt it.
 Rogers’s Diffusion of innovation theory
(Unplanned Change)

First Stage: knowledge of an innovation in which the potential adopter

gains an understanding of how the innovation operates.
Second stage: persuasion is based on the perception of the relative
Individual changes advantages of the innovation, computability with existing norms and its
observability. At this stage, individual forms an opinion about the
innovation (negative, neutral, or positive).
Third stage: the individual uses his opinion to make a decision (adapt or
reject the innovation).
Fourth stage: implementation (if decision is positive).
Fifth stage: confirmation (when reinforcement of the decision is sought).
 Lewins Change Theory:
(Planned change)
Lewin divided his theory into three(3) stages
1. Unfreezing
2. Moving
3. Refreezing

1. Unfreezing stage
This stage is based on the idea that the human behavior is supported by a driving
forces and restraining forces that create
equilibrium. When a driving force toward change occurs, a countering
retraining force develops to allow the maintenance of equilibrium. Thus, to
unfreeze, it is necessary to reduce the retraining forces and allow the driving
forces to become dominant.
 2. Moving stage
In this stage the panned change is implemented. This isnot a comfortable period, anxieties are high and if they
are not successfully dealt with, the change may be unsuccessful.
This stage occur in the wrong direction if the system has many problems that don’t supported by
administration, so it important to gain the support of administration in the planning process, involve users
that the system serves them, test the system before implementation, provide adequate training and deal
with any implementation problems immediately.

3. Unfreezing stage

In this stage, the planned change becomes the norm, people involved need to feel confident with the
change and feel in control of the procedures involved in the new methods.
 Theories that lend support to Informatics

• General Theory is a method of thinking about complex

4. General structures such as an information system. In system theory
the focus is on the interaction among various parts of the
Theory system instead of individual parts, it is based on the
premise that the whole is grayer than the sum of its parts.
• General theory described that any change in one part of
the system will be reflected in other parts of the system.
Computer is an example that any change in one area will
affect other sections.
.
 Theories that lend support to Informatics

5. Chaos • Chaos theory, such as general systems theory,

addresses an entire structure without reducing to
Theory the elemental parts.
• The idea behind this theory is that what may appear
to be chaotic actually has an order. It is based on
the recognized fact that events and phenomena
depend on initial conditions.
 Theories that lend support to Informatics

• It is the study of the mind and intelligence (Thagard,

2010) and how this information can be applied. It is

6. Cognitive
interdisciplinary, includes philosophy, artificial
intelligence, neuroscience, linguistics and anthropology
and is a part of social informatics.
Science Theory• It focus on how the brain perceives and interprets a screen
(Turley, 1996). In addition, cognitive science addresses
the amount of information that an individual can absorb
and use constructively.
• Cognitive Theory can aid an informatics nurse specialist
in understanding the information processing done by a
nurse in decision making, thus facilitating the design of
tools to support these processes (Staggers & Thompson,
2002).
 Theories that lend support to Informatics

It uses information from both cognitive science and

sociotechnical theories. It involves user’s satisfaction that
they have achieved their goals, and the aesthetics of

7. Usability technology.
*****The Five Goals of Usability*****

Theory 1. Its is easy for users to accomplish basic tasks the first time
they use the product.
2. Once learned, the design permits users to quickly and easily
perform the needed tasks.
3. It is not used for a period of time, it is easy to reestablish
one’s proficiency in using the product.
4. Users make very few errors, but any that they do are easily
remedied.
5. The design is pleasant to use.
 Learning Theories are important in
8. Learning informatics as well as in all nursing
endeavors. Users must be taught to use a
Theory system, and use of these theories can
decrease the time for training as well as
the time for learning.
 MODELS &
FRAMEWORK
 A. General Theories

Graves and Corcoran’s model

Schiwirian’s model
Turley’s model
Data Information Knowledge (D-
I-K) model
Benner’s Novice to Expert 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
 SCHIWIRIAN’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
 Model/framework that enables
identification of significant information
needs, that can foster research (somewhat
similar to Maslow’s hierarchy of needs)
 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
DATA-INFORMATION-KNOWLEDGE MODEL

NI is a 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.
 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 to cope with and manage
many contingencies
 Levels of Expertise (Benner):
 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
 B. General Theories

Philippine Health Care

Ecosystem
Intel’s Shift Left Model
Patient Medical Record
Information System
 1. 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
2. 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
 3. 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
 THANKS!

GOD BLESS YOU!

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