Module 1.

Foundations of Nursing Informatics

Informatics
▪ “Informatics” was derived from the French word
“informatique,” referring to computer science
▪ A branch of information science, and of computer
science, that focuses on the study of information
processing, and particularly as respect to systems
integration and human interactions with machine and
data.
▪ It deals with the analysis and discrimination of data
through the application of computers.
▪ Informatics is the science of how to use data, information and knowledge to improve human health and
the delivery of health care services
▪ Studies the representation, processing, and communication of information in natural and engineered
systems
▪ It is the human part of the IT equation, making computer software and hardware relatable, and
accessible.
▪ With the right hardware (construction materials) and software (knowledge), engineers (people) can
create a building that is structurally sound.
▪ It has computational, cognitive and social aspects.
▪ The central notion is the transformation of information whether by computer or communication.

Scientific Domains in Informatics

▪ It is a multidisciplinary science drawing from varied theories and knowledge applications.
▪ It is the science that combines the following domains in Science: Computer Science, Information
Science and Cognitive Science
▪ Domain in Science focus on scientific knowledge, skills, and scientific attitudes and values.
- Computer Science
✓ Concerns the study of natural systems
✓ Study of computers and computational system.
✓ The principal areas of studies are: artificial intelligence, computer systems and networks,
security, database systems, human computer interaction, vision and graphics, numerical
analysis, programming languages, software engineering, bioinformatics and theory of
computing.
- Information Science
✓ It is the discipline that investigates the properties and behavior of information, the forces
governing the flow of information, and the means of processing information for optimum
accessibility and usability.
✓ It is concerned with the body of knowledge relating to the origination, collection,
organization, storage, retrieval, interpretation, transmission, and utilization of information
- Cognitive Science
✓ The interdisciplinary scientific investigation of the mind and intelligence.
✓ Concerns with the analysis of computation, and design of computing systems
✓ It encompasses the ideas and methods of psychology, linguistics, philosophy, computer NCM 110: Nursing Informatics
science, artificial intelligence. It how the mind works, functions, and behaves in connection
to the informatics.

Health Informatics
▪ It applies the principles of computer and information science to the advancement of life sciences
research, health professions education, public health, and patient care
▪ This multidisciplinary and integrative field focuses on health information technologies (HIT), and
involves the computer, cognitive, and social sciences.
▪ The AMIA defines health informatics as “the field devoted to informatics from multiple consumer or
patient views. These include patient-focused informatics, health literacy and consumer education”
▪ It emphasizes “information structures and processes that empower consumers to manage their own
health
✓ Example health information literacy, consumer-friendly language, personal health records, and
Internet-based strategies and resources” 1
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College of Science – Nursing Department
 ▪ Health informatics, defined by the U.S. National Library of Medicine, is “the interdisciplinary study of
the design, development, adoption, and application of IT-based innovations in healthcare services
delivery, management, and planning

Nursing Informatics (NI)

▪ According to American Nurses Association, Nursing
informatics has been traditionally defined as a
specialty that integrates nursing science, computer
science, and information science to manage and
communicate data, information, knowledge, and
wisdom in nursing practice.
▪ The definition of nursing informatics was initially
theoretical-based, technology-focused until ANA
came up with its own definition that was thought of
then as comprehensive:

Based from ANA “A specialty that integrates nursing science, computer science, and information science in
identifying, collecting, processing, and managing data and information to support nursing practice,
administration, education, and research and to expand nursing knowledge. The purpose of nursing informatics
is to analyze information requirements; design, implement and evaluate information systems and data
structures that support nursing; and identify and apply computer technologies for nursing.” (ANA, 1992)

▪ Nursing Informatics has been officially named a specialization in nursing by the American Nurses
Association (ANA) since 1992 and has been integrated into most important educational standards and
initiatives, including that of the American Association of Colleges of Nursing (AACN).
▪ The certification for nurse informaticist was approved by the American Nurse Credentialing Center
during 1995.
▪ NI supports nurses, consumers, patients, the interprofessional healthcare team, and other stakeholders
in their decision-making in all roles and settings to achieve desired outcomes.
▪ The core phenomena of nursing informatics are: nurse, patient, health and environment.
▪ It is designed to make use of healthcare data through the entire healthcare system, with the goal of
improving patient care and outcomes
▪ NI represents the transition of data, data information and knowledge into action.
▪ It represents the practice, administration, community health, nursing education, and nursing research
applications.
▪ It includes other new applications such as international aspects or peripheral to the field such as legal,
consumer issues, or theoretical issues.
▪ The IT supports nurses to improve quality, ensure safety, measure outcomes, and determine costs.
▪ NI is basically a career field that places emphasis on devising solutions to improve information
communications and management in nursing for the purposes of reducing costs, enhancing patient
care quality, and improving efficiency.
▪ The three "building blocks" of nursing communications through informatics — data, information, and
knowledge.
▪ Data includes direct observations that do not need interpretation, such as:
✓ Patient's name ✓ Vital signs
✓ Age ✓ Disease history NCM 110: Nursing Informatics
▪ Information is data that has been interpreted. Examples include:
✓ Prevalence of hospital-acquired infections, by care unit
✓ Percentage of patient care delays in outpatient clinics, by specialty
▪ Knowledge is the amalgam of information to identify relationships that provide further observation to an
issue. For example:
✓ The effect of nurse-patient ratios and patient outcomes
✓ Developing care protocols (i.e. anaphylactic reaction protocols, pressure ulcer protocols, etc.)

Application of Nursing Informatics

▪ Nursing informatics can be applied to all areas of nursing practice, which includes clinical practice,
administration, education and research.
▪ Nursing Clinical Practice (Point of Care Systems and clinical information System)
✓ Work list to remind staff of planned nursing interventions
✓ Computer generated client documentation 2
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College of Science – Nursing Department
 ✓ Electronic Medical Record (EMR) and Computer – Based Patient Record (CPR)
✓ Monitoring devices that records vital signs and other measurements directly into the client
records (Electronic Medical Records)
✓ Computer – generated nursing care plan and critical pathways
✓ Automated billing for supplies or procedures with nursing documentations
✓ Reminders and prompts that appears during documentation to ensure comprehensive charting
▪ Nursing Administration (Health Care Information Systems)
✓ Automated staff scheduling
✓ E-mail for improved communication
✓ Cost analysis and finding trends for budgeting purposes
✓ Quality assurance and outcome analysis
▪ Nursing education
✓ Computerized record – keeping
✓ Computerized – assisted instruction
✓ Interactive video technology
✓ Distance learning: Web based courses and degree programs
✓ Internet resources: CEU’s and formal nursing courses and degree programs
✓ Presentation software for preparing slides and handouts: PowerPoint and MS word
▪ Nursing Research
✓ Computerized literature searching – CINAHL, Medline and Web sources
✓ The adoption of standardized language related to nursing terms – NANDA
✓ The ability to find trends in aggregate data, that is data derived from large population groups –
statistical software

1. What is the difference between nursing informatics and health informatics?

2. Using nursing informatics / or this innovative technology, how does nurses incorporate all the three
building blocks of nursing communication in their daily routine activities in the clinical setting?
3. How will you apply nursing informatics in the concept of education, research, nursing administration
and clinical practice?
4. Using nursing informatics / or this innovative technology, how does nurses incorporate all the three
building blocks of nursing communication in their daily routine activities in the clinical setting?

Module 2. Nursing Informatics as a Nursing Specialization

Nursing
▪ The American Nurses Association defines nursing as “The protection, promotion, and optimization of
health and abilities, prevention of illness and injury, facilitation of healing, alleviation of suffering through
the diagnosis and treatment of human response, and advocacy in the care of individuals, families,
groups, communities, and populations”
▪ The focus of nursing is on human responses to actual or potential health problems and advocacy for
various clients. These human responses are varied and may change over time in a single case.
▪ Nurses must possess both technical and interpersonal skills.
✓ Technical skills to manage equipment and perform procedures
✓ Interpersonal skills to interact appropriately with people NCM 110: Nursing Informatics
✓ Cognitive skills to observe, recognize, and collect data; analyze and interpret data; and reach
a reasonable conclusion that forms the basis of a decision.
▪ The heart of all of the skills lies the management of data and information.
▪ Nursing science focuses on the ethical application of knowledge acquired through education, research,
and practice to provide services and interventions to patients to maintain, enhance, or restore their
health and to acquire, process, generate, and disseminate nursing knowledge to advance the nursing
profession.
▪ Nursing is an information – intensive profession.
▪ The steps of utilizing information, applying knowledge to a problem, and acting with wisdom form the
basis of nursing practice science.

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College of Science – Nursing Department
Healthcare Informatics
▪ It is defined by the Office of the National Coordinator for Health Information Technology (ONC) as “the
application of information science and technology to acquire, process, organize, interpret, store, use,
and communicate medical data in all of its forms in medical education, practice and research, patient
care, and health management.”
▪ It is also known as “medical informatics.
▪ There are many sub-areas of healthcare informatics, including nursing, dental, radiology, nutritional,
veterinary, consumer, and health information management.
▪ Medical Informatics studies the organization of medical information, the effective management of
information using computer technology, and the impact of such technology on medical research,
education, and patient care.
▪ The field explores techniques for assessing current information practices, determining the information
needs of healthcare providers and patients, developing interventions using computer technology, and
evaluating the impact of formulated interventions
▪ The focus is on administration concerns, such as those surrounding data security and technology
compliance standards and analyzes data and how it can affect the operations of the hospital or health
system

Nursing Informatics
▪ It is the intersection between nursing care, technology, health information systems, and the data used
in health care settings.
▪ According to Hebda, “nursing Informatics” is the use of computer technology to support nursing,
including clinical practice, administration, education, and research.
▪ Nursing informatics is a field of nursing that incorporates nursing, computer, and information sciences
to maintain and develop medical data and systems to support the practice of nursing, and to improve
patient care outcomes.
▪ The International Medical Informatics Association (IMIA) defines nursing informatics as the “science
and practice that integrates nursing, its information and knowledge, with management of information
and communication technologies to promote the health of people, families, and communities
worldwide.”
▪ The application of nursing informatics knowledge is empowering for all health care practitioners in
achieving patient-centered care
▪ Technologies that have evolved due to health care/nursing informatics include:
- Computerized provider order entry - Test results
(CPOE) - Progress notes
- Electronic medical records (EMRs) - Nursing notes
▪ Nursing informatics is a field dedicated to delivering high-quality patient care through efficient
management of data and technical systems.
✓ Using data, an informatics nurse can analyze trends, monitor for any consistent errors, and
implement new, more efficient systems.
▪ Informatics brings advanced technology to the daily work of nurses
▪ The focus is on patient care, specifically by optimizing the technology used by nurses and examines
how technology—such as electronic medical records and patient monitoring—affects care nursing and
other healthcare professionals can provide

Nurse Informaticist NCM 110: Nursing Informatics

▪ The nurse informaticist is a qualified nurse, with nursing experience – which gives her the background
of the procedures, processes, and challenges of everyday nursing and patient care – together with
advanced knowledge of technology and information systems.
▪ They work as developers of communication and information technologies, educators, researchers, chief
nursing officers, chief information officers, software engineers, implementation consultants, policy
developers, and business owners to advance health care.
▪ The nurse informaticist acts as a go-between in identifying, developing and introducing informatics tools
and processes that support the nursing process within a particular health care setting
▪ The ANA distinguishes between an informatics nurse specialist and informatic nurse
▪ Informatic Nurse Specialist
✓ Is a registered nurse with a formal graduate qualification in informatics or a related field or
certification and practical experience in using computers in patient care settings
✓ Is a nurse who works to combine the utilization of healthcare technologies and the delivery of
healthcare 4
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College of Science – Nursing Department
 ✓ Their job involves integrating nursing with computer science and technologies in order to cut
costs, boost efficiency, and improve patient care quality
▪ Informatics Nurse
✓ Is a nurse who has experience in informatics but without graduate education in the subject.
✓ Is a nurse who combines their clinical skills with a knowledge of technology, computers, and
data.
▪ Nursing informaticists focus on improving patient outcomes and patient safety.
▪ Their goal is to use technology and data analysis to help nursing and other healthcare professionals
deliver high-quality patient care
▪ Informaticists take on complex tasks like using health data to analyze patient care outcomes or train
nursing staff in new patient care technology
▪ Roles and Responsibilities
✓ Analyzing patient care data and using the results to improve outcomes
✓ Tracking the success of patient care programs
✓ Researching or designing new technology for your healthcare facility
✓ Testing new technology
✓ Training staff on the use of new technology
✓ Answering staff questions about medical technology
✓ Monitoring the results of using the new technology
✓ Serving as a liaison between nursing staff and technology development departments
✓ Managing hospital or facility-wide projects
▪ The American Medical Informatics Association defines the nurse informaticist’s core areas of work as:
✓ Concept representation and standards to support evidence-based practice, research and
education
✓ Data and communication standards to build an interoperable national data infrastructure
✓ Research methodologies to disseminate new knowledge into practice
✓ Information presentation and retrieval approaches to support safe patient-centered care
✓ Information and communication technologies to address interprofessional work flow needs
across all care venues
✓ Vision and management for the development, design and implementation of communication
and information technology
✓ Definition of health care policy to advance the public’s health
▪ The American Nurses Association, listed several functions of the INS / NIS
✓ Theory development. The NIS contributes to the scientific knowledge base of nursing
informatics
✓ Analysis of information needs. The identification of information that nurses’ need to in order to
accomplish their work; client care, education, administration, and research
✓ Selection of computer system. They guide the user in making informed decisions related to the
purchase of computer system
✓ Design of computer systems and customizations. The NIS collaborate with users and computer
programmers to make decisions about how data will be displayed and accessed
✓ Testing of computer systems. Systems must be checked for proper functioning before they are
made available for use in patient care
✓ Training users of computer systems. Users need to be trained in how the system work, the
importance of accurate data entry, and how the system will benefits them, and more importantly
how it will improve patient outcomes NCM 110: Nursing Informatics
✓ Evaluation of the effectiveness of computer system. The unique role of the NIS makes them
the ideal person to evaluate the effectiveness of the computer system
✓ Ongoing maintenance and enhancement. The NIS make sure the computerized system
functions properly and explores possible enhancement to the system that will better serve the
users and the patients
✓ Identification of computer technologies that can benefit nursing. The NIS must keep abreast of
the changes in the fields of computers and information technology, including new hardware
and software that will benefit the nurse and patient.
▪ NI is important to nursing and health care because it focuses on representing nursing data, information,
and knowledge.
▪ Nursing Informatics: Scope and Standards of Practice, NI meets the following needs for health
informatics
✓ Provides a nursing perspective
✓ Showcases nursing values and beliefs 5
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College of Science – Nursing Department
 ✓ Provides a foundation for nurses in NI Produces unique knowledge
✓ Distinguishes groups of practitioners
✓ Emphasizes the interest in nursing
✓ Provides needed nursing language and word context
▪ In 2008, the ANA published a revised scope and standards of nursing informatics practice. There were
three overarching standards of practice:
✓ Incorporate theories, principles, and concepts from appropriate sciences into informatics
practice.
✓ Integrate ergonomics and human–computer interaction (HCI) principles into informatics
solution design, development, selection, implementation, and evaluation.
✓ Systematically determine the social, legal, and ethical impact of an informatics solution within
nursing and health care

Evolution of the Specialty

▪ Computer technology has transformed the industrial age to the information age.
▪ Florence Nightingale was the first nursing informatics specialist as she developed pie charts to illustrate
causes of deaths in 1855. This information was carried forward to demonstrate the need to reduce
unsanitary conditions in not only field hospitals but in all military hospitals
1950’s
▪ Computers and computerized equipment were becoming an important part of the health care and began
influencing the nursing profession
▪ The very early pioneer of using computer in nursing practice is Harriet Werley, a nurse researcher at
Walter Reed Army Research Institute, consulted with IBM in the late 1950s to explore computer use in
health care. Ms. Werley recognized the need for a minimum set of data to be collected from every
patient, so that comparisons could be made, and thus set the stage for the development of informatics.
1960’s
▪ Computers were beginning to be used in healthcare. For example, the United States began to use
computer systems to process standardized reimbursement forms with the passage of the Medicare
legislation in 1966
▪ The nursing profession began to embrace and utilize informatics principles.
▪ During the 1960's a nurse created an obstetrical computer-assisted nursing simulation exercise (Saba,
2001)
1970’s
▪ Informatics was coined in the 1970’s from the French term informatique in reference to advancing
computer technology.
▪ The "informatics movement" was felt throughout all disciplines of health care both nationally and
internationally
▪ Nursing stations were studied and identified to be central to patient care and deemed fundamental in
the creation of health information systems (HIS).
▪ The adoption of some of the first HIS and Electronic Medical Records (EMR) occurred in the 1970's
▪ By 1974 the first nursing informatics papers were presented at the Medical Informatics Conference in
Sweden
▪ Five papers were presented on a variety of topics including: general description of informatics impact,
computer education of health care workers, the design of nursing care protocols for hospital information
systems (HIS), advancing real-time cardiac monitors, and computerized medication systems
▪ In the early 1970's, workshops were being offered on how to use computer systems in home care NCM 110: Nursing Informatics
▪ In the US, computers were used to calculate the cost of home care visit
▪ Canadian Organization for the Advancement of Computers in Health (COACH) was found in 1975
COACH works to develop professional guidelines for utilizing computers in health care
1980’s
▪ The size of personal computers (PC) became smaller while their capabilities increased. These
technological advancements created high expectations for the benefits of nursing informatics
▪ Nursing informatics originated in 1980’s to refer to computer technology, computer system, data
processing
▪ During the 1980’s there were significant financial investments and a big educational push to educate
nurses in informatics.
▪ International Medical Informatics Association (IMIA) formally recognized nursing as integral.
▪ In 1982 the IMIA-Nursing Informatics Special Interest Group (IMIA/NI-SIG) was formed. IMIA/NI-SIG
holds conferences every 3 years with the mandate to promote informatics education, collaboration, and
support of NI development (Saba, 2001). 6
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College of Science – Nursing Department
 ▪ In 1985, computer technology classes were being offered at undergraduate and graduate levels
▪ In 1988, the first graduate program in Nursing Informatics at the University of Maryland School of
Nursing with a focus on understanding nursing informatics systems and science
▪ The Computers in Nursing journal was founded
▪ In 1980’s most Canadian hospitals had some form of computer information system for entering data
▪ 1989 the International Council of Nurses (ICN) approved an initiative to develop a common NI language
▪ During this period, many mainframes HISs emerged with nursing subsystems. These systems
documented several aspects of the patient record; namely, order entry emulating the Kardex, results
reporting, vital signs, and other systems that documented narrative nursing notes via word-processing
packages.
1990’s
▪ In 1992 the American Nursing Association (ANA) recognized nursing informatics as nursing specialty
▪ In 1995 the first NI credentialing exam was offered by the ANA
▪ In 1995 Nursing Informatics certification became available through the American Nurses Credentialing
Center (ANCC)
▪ University of Utah offered a graduate program for Nursing Informatics focused on the transformation of
data into clinical decision-making.
▪ In 1998 the Canadian Nurses Association (CNA) created the National Nursing Informatics Project which
sought to develop Canadian competencies and strategies
▪ In 1998 New York University School of Nursing offered a nursing informatics graduate track
▪ Nursing Minimal Data Set was created as a way to ensure nursing data was included within the
Canadian Institute of Health Information (CIHI) national database
▪ In 1999 the International Council of Nurses (ICN) created a program to expand the scope of practice
and advance nursing knowledge worldwide
2000’s
▪ The CNA continued to support informatics development through the publication of documents
▪ In 2001 the Canadian Nursing Informatics Association (CNIA) was founded with the aspiration to be
the voice for Nursing Informatics in Canada
▪ In 2003 The University of Arizona College of Nursing offered the first doctorate in nursing with the option
of study being healthcare informatics
▪ In 2003, CIHI published the Roadmap Initiative
▪ In 2006, the CNA launched NurseONE to develop a national strategy for nursing informatics
▪ Clinical information systems became individualized in the electronic patient record (EPR) and patient
specific systems considered for the lifelong longitudinal record or the electronic health record (EHR).
▪ Information technologies continued to advance with mobile technology such as with wireless tablet
computers, personal digital assistants (PDAs), and smart cellular telephones.
▪ The development and subsequent refinement of voice over Internet protocol (VolP) promises to provide
cheap voice communication for health care organizations.

Nursing Informatics in the Philippines: The major milestone of nursing informatics in the Philippines
▪ The participation of PNA in the development of “Standards for Health Information in the Philippines
(SHIP) in 1999
▪ The formation of the Master of Science in Health Informatics (MSHI) which began in 2005
▪ The formation of the Philippine Nursing Informatic Association (PNIA) in 2010 as a sub – specialty
organization of the PNA for nursing informatics.
▪ The Philippine Medical Informatics Society (PMIS) and its founders had strong influence in the NCM 110: Nursing Informatics
development of health informatics in the Philippines. It was officially registered under the securities and
Exchange commission in 1996
▪ In 2008, Nursing Informatic course in the undergraduate curriculum was defined by CHED
memorandum order 5 Series of 2008. Then was later revised and included as Health Informatics course
in CHED memorandum order 12 series of 2009. This was first implemented in the summer class of
2010
▪ 2009, Mr. Kristian Sumabat and Ms. Mia Alcantara – Santiago both graduate students of Master of
Science in Health Informatics at UP Manila started to create the nursing informatics organization.
▪ 2020 UPCN started the first batch of nurses to have their post – graduate course un Teaching Nursing
Informatics at the University of the Philippines – Manila Campus.

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Tarlac State University
College of Science – Nursing Department
Philippine eHealth Strategic Framework
▪ Recognizing the critical role of ICT in the timely accessibility of safe and quality healthcare, a concerted
effort to push for policies began in the early 2000s among stakeholders led by the Department of Health
and the Department of Science and Technology.
▪ Through the Joint National Governance on eHealth, the DOH and DOST, guided by the resolutions
from the World Health Assembly (WHO-ITU), developed the Philippine eHealth Strategic Framework
and Plan (PeHSFP).
▪ The eHealth vision for the country:
“By 2020 eHealth will enable widespread access to health care services, health information and securely share
and exchange patients’ information in support to safer, quality health care, more equitable, and responsive
health system for all the Filipino people by transforming the way information is used to plan, manage, deliver
and monitor health services”.
▪ The plan foresees the integration of ICT in delivering all healthcare services through safer and quality
care for all health consumers; ensuring better-informed decisions for healthcare providers; and the
ability to conduct effective program development, implementation & monitoring.
▪ To achieve the Philippines' eHealth vision, specific eHealth components were defined, including:
✓ Governance ✓ Infrastructure
✓ Legislation, policy, and compliance ✓ Human Resource
✓ Standards and interoperability ✓ eHealth Solutions
✓ Strategy and Investment
▪ eHealth is integrated into the current healthcare delivery system, including health science education
and continuing professional development. Current initiatives to strengthen eHealth in the country can
be explored in ehealth.ph.
▪ Challenges to the implementation of eHealth and health/nursing informatics in the country
✓ We haven't achieved the targets for eHealth integration in Philippine healthcare due to the
prevailing limitations with resources, policies, infrastructure, and user/consumer uptake;
continued evaluation, monitoring, and update are needed to ensure an equitable and
responsive health system for Filipinos.
▪ Because of the pandemic, eHealth has emerged to have the most significant potential to ensure access
to healthcare services, given the high risk for cross-infection. Policies have pushed for its
comprehensive integration. One of which is Senate BIll 1618 or "Philippine eHealth Systems and
Services Act".

Nursing Informatics is currently a vital topic for nursing, which will gain in importance as the 21st century
progresses. Experts predict that it will not only be an important core component of all nursing education and
practice, but that it will also become a crucial nursing specialty. A nursing informatics specialty integrates
nursing science, computer science, and information science in identifying, collecting, processing, and managing
data and information to support nursing practice, administration, education, research, and the expansion of
nursing knowledge. The rapidly changing health care delivery system is creating a pressing need for nurses
with advanced knowledge and skills to provide leadership for reshaping nursing and health care in communities
and health care organizations. The informatics nurse specialist serves as a translator between nurse clinicians
and computer services personnel (program analysts, programmers, data base managers, hardware/software
vendor and others). Graduates of a certificate program in Nursing Informatics have the knowledge and skills to NCM 110: Nursing Informatics
lead informatics projects in a wide range of clinical, educational, and business settings. Graduates of degree
specializations in Nursing Informatics will be the leaders of tomorrow in this quickly growing specialty area of
Nursing. Over the past thirty or so years, the field of nursing informatics has evolved, slowly but surely. Within
this evolution, roles and responsibilities for nursing experts have subsequently evolved as well. These roles can
be confusing at times, since several names and titles are used to identify similar positions within the informatics
field. Some examples include: Nursing informatics Specialist, Chief of Nursing informatics, Director of Nursing
Informatics, Clinical Information System Coordinator, Director of Clinical Systems, CIO or Chief Information
Officer, and so on. Just as confusing is the diverse way that Nursing Informaticians become educated as
experts. From self-directed learning through to graduate school study, the means to become educated in these
roles is still evolving. As well, nursing informatics roles can exist within all fields of nursing whether practice,
administration, research or education. Several initiatives are underway to standardize nursing informatics
education and to promote the acceptance of nursing informatics specialists in healthcare, research, and
education. 8
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College of Science – Nursing Department
 1. The readings illustrate the diverse ways that various organizations are attempting to standardize
nursing informatics education and practice, especially related to specialties in the area. However, there
is a lack of uniformity across states, countries, and internationally. In your view, what is the best way to
support both standardization AND individual choice in the development of nursing informatics specialty
competencies?
2. What do you think are the role of nursing informatics? What are the explicit and implicit responsibilities
of nurse informaticians?
3. Discuss the opportunities and critical need for nursing informaticians to work collaboratively with other
health informaticians?
4. Identify strategies that nurses can adopt to prepare themselves educationally for nursing informatician
roles
5. Write a personal plan to help you decide how you prefer to further your education in the growing
specialty of Nursing Informatics.
6. Reflect on how you can cultivate nursing informatics expertise

Module 3. Introduction to Information, Information Science, and Information Systems

Concepts on Information

Data
▪ This are the raw facts
▪ Example: If the nursing attendant tell you that patient Juan’s temperature is 38.7c. You processed data
(38.7c) to information that 38.7c is the patient’s temperature
▪ Types of data
✓ Alpha data – refer to letters
✓ Numeric data – refers to numbers
✓ Alphanumeric data – refers to letters and numbers (patient’s name, identification numbers,
medication record numbers)
✓ Audio data – refers to sound, noises, or tones (monitor alerts or alarms, taped or recorded
messages and other machine sounds)
✓ Image data – includes graphics and pictures (graphic monitor displays or recorded ECG, Xray,
MRI, CT scan)
✓ Video data – refers to animations, moving pictures, or moving graphics (ultrasound,
echocardiogram) to learn how to operate a technology tool such as pumps or monitoring systems.
▪ The form does not matter in analyzing data
▪ It is important in analyzing data is the integrity and quality of the data.
▪ Data Integrity
✓ Refers to the whole, complete, correct, and consistent data
✓ It can be compromised through human error, viruses, worms, hardware failures or crashes,
transmission errors, and / or hackers entering the system.
Information technologies help to decrease these errors by putting safeguards in place such
as backing up files on a routine basis, error detection for transmissions, and developing user
interfaces that helps nurses / healthcare practitioners enter the data correctly
▪ High quality data – refers to data that are relevant and accurately represent corresponding information
concepts
▪ Data is considered dirty when there are errors in the database such as duplicate, incomplete, or NCM 110: Nursing Informatics
outdated records.

Information
▪ Is the processed data that has meaning
▪ As a health care practitioner, we are constantly processing data and information in order to provide the
best care possible for our patients.
▪ Characteristics of valuable and quality information: accessibility, security, timeliness, accuracy,
relevancy, completeness, flexibility, reliability, objectivity, utility, transparency, verifiability, and
reproducibility.
▪ Right users
✓ The authorized user who has the right to obtain the data and information of the patient
✓ Security of patient data is considered
▪ Utility / Timely information
✓ Processed data that are available when it is needed for the right purpose and at the right time. 9
Tarlac State University
College of Science – Nursing Department
 ▪ Accurate information
✓ Free of errors in the data and information.
▪ Flexible information
✓ Information that can be used for variety of purpose
▪ Reliable information
✓ Comes from reliable or clean data and authoritative and credible sources
▪ Verifiable information
✓ The user can check to verify or prove that the processed data in correct
▪ Process of acquiring information: Nurse receives information from our computer (output), through our
vision, hearing, or touch (input), and we respond (output), to the computer (input)
▪ Knowledge
✓ It is the awareness and understanding of a set of information and ways that information can be
made useful to support a specific task r arrive at a decision.
✓ It is the awareness and understanding of a set of information and ways that information can be
made useful to support a specific task or arrive at decision.

Information Science
▪ It has evolved over the last 50 or more years as a field of scientific inquiry and professional practice.
▪ It is studying the application and usage of information and knowledge in organizations and the
interfacings or interaction between people, organizations, and information systems.
▪ It is an extensive, interdisciplinary science that integrates features from cognitive science,
communication science, computer science, library science, and social sciences.
▪ It is primarily concerned with the input, processing, output, and feedback of data and information
through technology integration with a focus on comprehending the perspective of the stakeholders
involved and then applying information technology as needed.
▪ It is a response to technological determinism.
▪ Determinism
✓ The belief that technology develops by its own laws, that it realizes its own potentials, limited only
by the material resources available, and must therefore be regarded as an autonomous system
controlling and ultimately permeating all other subsystems of society.
▪ It is an interdisciplinary, people – oriented field that explores and enhances the interchanges of
information to transform society, communication science, computer science, cognitive science, library
science, and social sciences.
▪ It deals with obtaining, gathering, organizing, manipulating, managing, storing, retrieving, recapturing,
disposing of, distributing, or broadcasting information.

Information Processing
▪ According to Claude E. Shannon who is considered as the father of information theory defined
information processing as the conversion of latent information into manifest information.
✓ Latent information – not yet realized or apparent
✓ Manifest information – obvious or clearly apparent
▪ Information science enables the processing of information, this processing links people and technology.
▪ Information science and computation tools are extremely important in enabling the processing of data,
information, and knowledge in health care.
▪ The hardware, software, networking, algorithms, and the human organic information system work
together to create meaningful information and generate knowledge. NCM 110: Nursing Informatics

1. Why it is important that the data we (nurses / informatic nurse) process into information must be of high
quality and integrity?
2. Why it is imperative that we (informatic nurses) have clean data if we want quality information?
3. Why does security is a major challenge while providing open and easy access for the right user in
obtaining patient’s data?
4. How do you acquired information using technologies? How this will affect your care to your patient?
5. In the health care, how many times does the nurses interact with IS (information science)? Are they at
the bedside, handheld or station based?
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 Module 4. Computer Science and the Foundation of Knowledge Model

▪ Computer technology has shown in what has been called the “Information Age”
▪ Information age – starts when data, information, and knowledge are both accessible and manipulatable
by more people.

Computer
▪ It is an electronic information – processing machine that serves as a tool to manipulate data and
information
▪ It accepts data inputted via a variety of devices, process data through logical and arithmetic rendering,
store the data in memory components, and output data and information to user.
▪ It is a universal machine since it is considered as general – purpose and symbol – manipulating device
that can perform any task represented in specific program
▪ It is based on scientist John Von Neumann’s model of a processor – memory – input – output
architecture.
▪ It is the most powerful technological tool to transform the nursing profession prior to the new century.
▪ It transformed the nursing paper-based records to computer-based records.
▪ “Computer” is an all-encompassing term referring to information technology (IT), computer systems,
and when they are used in nursing information systems (NISs), nursing applications, and/or nursing
informatics (NI).
▪ “NI” has emerged as new term encompassing these technologies enabling nurses to manage health
care and patient care more efficiently and effectively and, at the same time, make nurses more
accountable.
▪ Computers in nursing care are used to manage information in patient care, monitor the quality of care,
and evaluate the outcomes of care.
▪ Computers and networks are now used for communicating (sending/receiving) data and messages via
the Internet, accessing resources, and interacting with patients on the World Wide Web.

Computer System
▪ It is a collection of entities (hardware, software and liveware) that are designed to receive, process,
manage and present information in a meaningful format.
▪ Components of Computer System
✓ Computer hardware - Are physical parts/ intangible parts of a computer. (Example: Input
devices, output devices, central processing unit and storage devices)
✓ Computer software - also known as programs or applications. They are classified into two
classes namely - system software and application software
• System software is a program designed to run a computer's hardware and applications
and manage its resources, such as its memory, processors, and devices
• Application software (App) is a kind of software that performs specific functions for the
end user by interacting directly with it. The sole purpose of application software is to
aid the user in doing specified tasks
✓ Liveware - is the computer user. Also known as the human ware. The user commands the
computer system to execute on instructions. (Example: Web browsers like Firefox, and Google
Chrome, as well as Microsoft Word and Excel)
▪ Hardware – it is the physical part of the computer and its associated equipment. Computer hardware NCM 110: Nursing Informatics
can comprise many different parts, these includes:
✓ Input devices. Used to enter data: keyboard, mouse, trackball, touch screen, light pen,
microphone, bar code reader, fax modem card, joystick, and scanner
✓ Output devices. Used to view and hear processed data: video monitor screens, printers,
speakers, and fax.
✓ Central Processing Unit (CPU). “Brain” of the computer: Its three components are:
1. Arithmetic Logic Unit. The number “crunching”
2. Memory. It is the storage area in which program instruction (code) reside during execution
• Read – only memory (ROM). It is permanent; it remains when the power is off.
Start – up instruction for the computer is an example of ROM
• Random access memory (RAM). It is temporary storage area for program
instruction and data that is being processed, it is only active while the computer is
turned on. Located on motherboard not part of the CPU. 11
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 3. Control Unit. Manages instruction to other parts of the computer, including input and output
devices “traffic cop”
▪ Secondary Storage. It provides space to retain data in an area separated from the computer’s memory
after the computer is turned off. These include hard disk drives, floppy disk, tape, zip drives, optical
drives and CD – ROM drives
▪ Computer categories:
✓ Supercomputer
• It is a computer with a high level of
performance compared to a general-
purpose computer. Performance of a
supercomputer is measured in floating-
point operations per second (FLOPS)
instead of million instructions per second
(MIPS).
• It contains tens of thousands of processors
and can perform billions and trillions of
calculations or computations per second.
• Some supercomputers can perform up to a
hundred quadrillion FLOPS.
• Information moves quickly between
processors in a supercomputer (compared
to distributed computing systems) therefore,
they are ideal for real-time applications.
• Supercomputers are used for data-intensive and computation-heavy scientific and
engineering purposes such as quantum mechanics, weather forecasting, oil and gas
exploration, molecular modeling, physical simulations, aerodynamics, nuclear fusion
research and cryptoanalysis
✓ Mainframes.
• Large computers capable of processing
several million instructions per second.
• Are high-performance computers with large
amounts of memory and processors that
process billions of simple calculations and
transactions in real time.
• The mainframe is critical to commercial
databases, transaction servers, and
applications that require
high resiliency, security and agility.
• It supports organizational functions, therefore have been the traditional equipment in
hospitals.
✓ Minicomputer.
• It is a scaled down version of the mainframe
• Minicomputers are mini computers that were
first launched in 1960 and are utilised in a
wide range of corporate and scientific
applications NCM 110: Nursing Informatics
• It utilized to control the manufacturing
processes
• It used for optimization and are composed of
a double processing unit for any evaluation
and manipulation.
• It used for process control, a variety of
administrative tasks, and financial
performance, all of which are primarily
related to industry tasks
• Commonly found in hospital and HMO’s

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 ✓ Microcomputer (PCs).
• Microcomputers, on the other hand,
are personal computers which are
used for a wide range of tasks and
were first developed in 1970
• It utilized for a variety of educational,
presenting, and entertainment
reasons
• It composed of a single processing
unit for optimization and evaluation
• It is used for word processing,
management of the database,
spreadsheet programs, graphics, and
general office applications, which can
be completed quickly and easily
✓ Laptop or Notebook. Handled and personal digital Assistants (PDAs)
▪ Networks
✓ It is a combination of hardware and software that allows communication and electronic transfer
of information between computers
✓ Hardware may be connected permanently by wire (Ethernet), or temporarily by wireless
communication, and modems / telephone lines.
✓ This allows the sharing of computer and software resources, through the use of the network.
✓ Network is operated with the client / server technology
▪ Server
✓ Stores files and programs that are accessed by the client on the network.
✓ When you access the Internet from home, you the client (your computer), requests files from a
Server (another computer), you see the results displayed on your screen through a browser. You
may also access a network in your clinical practice: you the client, accesses a patient record on
the floor from a server, which stores the patient record.
▪ Types of Networks. They range from small (home network) to very large (Internet)
✓ Home Networks. Within a home
✓ Local Area networks (LAN). Networks within an area, location or business. The university
connects all its computer on a LAN
✓ Wide Area Networks (WAN). Several LAN connected together.
▪ Internet. Many WAN connected together around the globe to give us the internet that we use today.
✓ Simply "the Net," is a worldwide system of computer networks -- a network of networks in which
users at any one computer can, if they have permission, get information from any other computer
✓ It was conceived by the Advanced Research Projects Agency (ARPA) of the U.S. government in
1969 and was first known as the ARPANET
✓ It is a globally connected network system facilitating worldwide communication and access to
data resources through a vast collection of private, public, business, academic and government
networks
✓ It is governed by agencies like the Internet Assigned Numbers Authority (or IANA) that establish
universal protocols.
✓ Intranet – private company networks that are protected from outside access Kaiser HMO and its
clinics and hospital are an example NCM 110: Nursing Informatics
✓ Extranets – several intranets connected together; Kaiser maintains extranet a network connected
with its suppliers.
▪ Selection Criteria for Computer Equipment: When selecting a computer or related hardware, the
following should be taken into consideration:
✓ The type of applications required. Some people need word processing, while others may need
database or spread sheet software
✓ The program execution time and computer capacity needed to process job. Complex joins require
more processor speed and memory
✓ Storage Capacity Needs are determined by the amount of information that must be kept and the
length of time that it must be retained.
✓ Backup Options. When information is critical to conduct daily business, another backup system
may be need if the primary one fails.
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 ▪ Operating Systems.
✓ A collection of programs that manage all of the computer’s activities, including the control of
hardware, execution of software, and management of information.
✓ It provides a user interface by which the individual interacts with the computer.
✓ Types includes: Test based commands, graphical user interfaces, and object – oriented interface.

Roles of Support Personnel

▪ Support for computer systems and networks is extremely important in order to maintain system
functionality.
▪ Support includes:
✓ Planning system upgrades
✓ Instillation of upgrades for operating system and various applications
✓ Troubleshooting
✓ User education and training
▪ Superuser
✓ This person has additional experiences over the average employee and serves as a local
resource person. In hospital setting, this is user who knows the clinical area and the computer
system
▪ Microcomputer Specialist
✓ It provides PC information and training. Has special training and degree in computer science or
a related area.
▪ Analyst.
✓ They are frequently clinicians who become involved in system selection and training. Many have
learned their role on the job and further their education by taking computer or information science
classes.
▪ Programmer
✓ Writes codes, computer instructions; they often lack the clinical experience. For this reason, the
analysts are responsible for communicating user needs to programmers.
▪ Network Administrator. T
✓ They are responsible for the planning, management and expansion of network.
▪ Director, information Service.
✓ These individuals have a board view of the needs of the institution and the design,
implementation, and evaluation of information systems.
✓ Responsibilities includes: planning, policy development, budgeting, information security, and
overall management of the information system.

1. Discuss how technology affects nursing practice

2. Discuss the benefit of Nursing Technology
3. What are your ideas / insights about how hardware and software could be developed to make it easier
for nurses to use or to improve patient care?
4. You are the nurse assigned to a young 32-year mother of two young children who was recently
diagnosed with Gestational Hypertension, Chlamydia, Tuberculosis, UTI, hemophilia, sickle cell
anemia, iron deficiency anemia, DM. She has taken a medical leave of absence from the law firm where NCM 110: Nursing Informatics
she works as a paralegal assistant. Although she has reported adhering to her diet and medication
regimen, she has had two recent admissions to the hospital in the past month with a flare-up of her
disease. She states she is using Wikipedia for her health care information and is using Aloe Vera as a
supplement without consulting her healthcare provider. Using electronic tool, devise a teaching plan for
this patient. Please pick at least two that would be appropriate for this patient. What website would you
recommend for her to use for online information? What do you think her health literacy is at?
5. What are your ideas / insights about how hardware and software could be developed to make it easier
for nurses to use or to improve patient care?

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 Module 5. Disciplines with Influence on Nursing Informatics

Cognitive, Computer and Information Science

▪ Disciplines such as cognitive science, computer science, and information science are some of the first
thought of basic sciences.

Cognitive Science
▪ It involves the study of the mind and a person’s intelligence.
▪ It covers the sciences of psychology, philosophy, sociology, artificial intelligence, anthropology and
data.
▪ Cognitive science is one’s ability to understand, comprehend and appreciate concepts, theories and
ideas.
▪ When one speaks of nursing informatics and its meta-structures of data, information, knowledge and
wisdom and how these are managed and processed to enhance safe and quality care, it just makes
sense that cognitive science ranks high up there when speaking of information processing and
management, one of major functions of nurses and nurse informaticists.

Computer Science
▪ It is the science that primarily focuses on the hardware and software of informatics and technology,
e.g., computer screens, keyboards, servers, scanners, computer programs and applications.

Information Technology
▪ It refers to the study of information, its storage, organization, retrieval, processing, management, and
security.
▪ One’s gender, race, socio-economic status, educational level, etc., are just some of the social
determinants of health and illness.
▪ We can now determine or predict using nursing informatics concepts and theories what illnesses one
will have algorithmically and through population health, not just using the old way we used to, which
was to rely on past personal and family medical history.
▪ Genetics and genomics are also part of nursing informatics, it enables health workers to identify genetic
biomarkers that can predispose individuals to certain illness or assist in identifying certain medications
that will work better with certain illnesses.
▪ Taxonomies or the study of various types of classificatory systems/ organism is also useful in nursing
informatics. Some examples of taxonomies are:
✓ North American Nursing Diagnosis Association (NANDA) which is the classification scheme for
all actual and potential nursing diagnoses that is use in the profession.
✓ Nursing Interventions Classification and Nursing Outcomes Classifications (NIC and NOC),
refer to the exhaustive listing of nursing interventions and outcomes used in nursing.
✓ The use of NANDA, NIC and NOC demonstrates to every nurse another way how knowledge
in the discipline of nursing can be classified for easy organization, management, retrieval and
use.

Theories and Concepts in Nursing Informatics

▪ There are also many theories and concepts that can be applied to NI as a body of knowledge. There
are the general systems, communications, learning, and change theories. NCM 110: Nursing Informatics

General System Theory

▪ It is one of the oldest theories that explain that systems are complex and intricate, yet hold
commonalities that can be explained and applied to almost any type.
▪ Systems can be physical structures (education, healthcare, financing, etc.), manual (patient care,
exercise, patient’s hygiene, etc.) or those that are electronic or computerized (electronic medical
records, computerized provider order entry, automated medication dispensing, etc.).
▪ The theory emphasizes the interactions of the various parts of systems, instead on the individual parts.
▪ The premise is that the whole is greater than the sum of its parts.
▪ There are three main components to a system: input, throughput and output.
✓ Input – is where raw data enters the system
✓ Throughput – involves the processes involved in managing the information
✓ Output – is the resulting end-product of the processed information.
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 ▪ For example, when we look at a hospital system, the admission and registration processes and how
they relate to the wait time, patient satisfaction and the quality of care are just some of the interactions
that are looked at in this particular system. The input would be the flow of patients and gathering their
information to be able to register them and generate a patient care record. The throughput would be
the processes involved in transforming the information gathered from the patient during the registration
and being able to process this into particular parts of the patient care record. And the output would be
a completely generated medical record that can be placed on queue for the healthcare provider to see
the patient. If there is a problem in any of these elements, the entire system will be affected. The fact
that systems generate a tremendous amount of data that need organizing, managing, processing,
retrieving and using, safe and quality patient care are consequently affected.
▪ In terms of the three main components according to the general systems theory, an aberration in one
can detrimentally affect the others.
▪ Assumptions in the general systems theory that need mentioning:
✓ The whole is greater than the sum of its parts
✓ There is a purpose for the system that needs to be achieved
✓ There are structures, functions and tasks within the system that are meant to be carried out
efficiently and effectively in order to achieve the purpose of the system
✓ The structure also follows the function, with specifications and attributes designed to meet the
expectations
✓ There is dynamic homeostasis or the capability to maintain stability or equilibrium
✓ There is entropy or the tendency to break into its smallest parts
✓ There is also negentropy or the likelihood to grow big and complex
✓ The system has the capability for specialization or the ability to be unique and differentiate from
the whole
✓ There is also reverberation which makes changes cut across the entire system

Communication Theory
▪ It provides a conceptual and visual model that
is easily understood to demonstrate its
relationship to nursing informatics and the work
of nurses.
▪ Nurses spend a great amount (about 90%) of
their work schedule communicating, whether
verbally, written, or behavioral cues. Whether it
is manual communication or electronic, this
model remains a good framework to explain
how things can go well, or worse.
▪ Information is a two-way process. There is a sender, encoder, channel, decoder and receiver.
▪ The information can come from either sender or receiver, and it can be simple, short and direct; or it
can be complex, multi-faceted, and interactive.
✓ The sender is the source of the information.
✓ The information is first encoded using some form of medium, depending on how the information
is being sent.
- It can be written on a sheet of paper, typed using an electronic medium, lights of varying speed
and length (Morse Code), sign, etc.
✓ It goes through a channel, which again is dependent on how the information is sent. NCM 110: Nursing Informatics
- The channel can be through hand delivery, snail or electronic mail, by TV or computer
broadcast, etc.
✓ The information will be decoded or interpreted before it gets to the receiver.
- If it is written or typed and received by hand delivery, snail or electronic mail, it needs to be
read.
- If it is via sign language through broadcast TV or streamed, it needs to be interpreted
✓ Once decoded the receiver is able to receive the information and the internal interpretation
occurs.
▪ As in the general systems theory, a problem in one or more of the steps in the process can derail the
process of sending, receiving and interpreting the message.

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Change Theories
▪ The three major concepts: driving forces, restraining forces, and equilibrium.
✓ Driving forces are those that push in a direction that causes change to occur. They facilitate
change because they push the patient in a desired direction. They cause a shift in the
equilibrium towards change.
✓ Restraining forces are those forces that counter the driving forces. They hinder change
because they push the patient in the opposite direction. They cause a shift in the equilibrium
that opposes change.
✓ Equilibrium is a state of being where driving forces equal restraining forces, and no change
occurs. It can be raised or lowered by changes that occur between the driving and restraining
forces.
▪ There are three stages in this nursing theory: unfreezing, change, and refreezing.
▪ Unfreezing stage
✓ It is the process which involves finding a method of making it possible for people to let go of an
old pattern that was somehow counterproductive.
✓ It is necessary to overcome the strains of individual resistance and group conformity.
✓ It creates some form of conflict that makes the scenario conducive to questioning the status
quo Once the imbalance is created, it is somewhat easier to influence change or to encourage
resistors to consider and embrace the change
✓ The three methods that can lead to the achievement of unfreezing.
1. Increase the driving forces that direct behavior away from the existing situation or status quo.
2. Decrease the restraining forces that negatively affect the movement from the existing
equilibrium.
3. Finding a combination of the first two methods.
▪ Change stage
✓ Also called “moving to a new level” or “movement,”
✓ Moving is when the actual change occurs
✓ It involves a process of change in thoughts, feeling, behavior, or all three, that is in some way
more liberating or more productive.
▪ Refreezing stage
✓ It is establishing the change as the new habit, so that it now becomes the “standard operating
procedure.”
✓ Without this final stage, it can be easy for the patient to go back to old habits.
▪ Example: when introducing computer applications to healthcare staff and professionals, this is often
helpful since it is a long process and there is more time to pump up the driving forces and weaken the
restraining forces by holding many meetings, open town hall discussions of the pros and cons of the
change. There is more opportunity to hear both sides and weigh the advantages and disadvantages.

Nursing Informatics Models

▪ Models are representations of some aspect of the real world.
▪ It is important to remember that different models reflect different view - points
▪ Informatics theory builds not just on information theory, but uses concepts from change theories,
system theory, chaos theory, cognitive theory, and sociotechnical theory.
▪ 5 General Models in Nursing Informatics
✓ 1st: Graves and Corcoran's model.
✓ 2nd: Schiwirian's model. NCM 110: Nursing Informatics
✓ 3rd: Turley's model.
✓ 4th: Data Information Knowledge (D-I-K) model.
✓ 5th: Benner's Novice to Expert model.
▪ According to Graves and Corcoran’s Model (1989), nursing informatics is a linear / sequential
progression, from data into information and knowledge. Management processing is integrated within
each element, depicting nursing informatics as the proper management of knowledge, from data as it
is converted into information and knowledge.
▪ According to Schiwiran’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
▪ According to Turley’s Model (1996), 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. 17
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▪ In the 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. Nursing informatics is an evolving, dynamic process involving the
conversion of data into information, and subsequently knowledge.
➢ The conceptual framework underpinning the science and practice of Nursing Informatic centers
on the core concepts of data, information, knowledge, and wisdom, also known as the DIKW
paradigm
1. Data
✓ It includes direct observations that do not need interpretation, such as: Patient’s name,
Age, Vital signs, Disease history.
✓ The smallest components of the DIKW framework.
✓ They are commonly presented as discrete facts; product of observation with little
interpretation.
✓ These are the discrete factors describing the patient or his/her environment. For
information to be valuable, it must be accessible, accurate, timely, complete, cost-effective,
flexible, reliable, relevant, simple, verifiable, and secure.
2. Information
✓ It is data that has been interpreted. It is thought of as “data + meaning”.
✓ Information is often constructed by combining different data points into a meaningful
picture, given certain context.
✓ Information is a continuum of progressively developing and clustered data; it answers
questions such as “who,” “what,” “where,” and “when.
✓ Examples include: Congestive heart failure, unspecified” and living status “living alone” has
a certain meaning in a context of an older adult. Prevalence of hospital-acquired infections,
by care unit. nPercentage of patient care delays in outpatient clinics, by specialty
3. Knowledge
✓ It is the information to identify relationships that provide further observation to an issue.
✓ Knowledge is the awareness and understanding of a set of information and ways that
information can be made useful to support a specific task or arrive at a decision.
✓ For example: The effect of nurse-patient ratios and patient outcomes. Developing care
protocols (i.e. anaphylactic reaction protocols, pressure ulcer protocols, etc.)
4. Wisdom
✓ An appropriate use of knowledge to manage and solve human problems.
✓ Wisdom implies a form of ethics or knowing why certain things or procedures should or
should not be implemented in healthcare practice.
✓ Wisdom guides the nurse in recognizing the situation at hand based on patients’ values,
nurse’s experience, and healthcare knowledge.
▪ Benner’s level of Expertise Model, said that 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.
➢ According BERNER, there are 5 levels of expertise: Novice, Advance Beginner, Competent,
Proficient, and Expert
✓ 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. NCM 110: Nursing Informatics
✓ Competent – enhanced mastery and the ability to 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.

1. How can you apply communication to a clinical nursing scenario/ situation that might be mitigated by a
nursing informatics concept, theory, or technology?
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 Module 6. Concept in Informatics: Project Management

▪ As nurses, we are often asked to participate in projects, with our contributions varying in degrees and
scope.
▪ These projects that we participate in can be aligned with the steps used in Project Management.
▪ A potential requirement for students taking Nursing Informatics is a group project on a nursing
informatics-mediated process, system, or tool where students will use PM steps and concepts.

Project Management
▪ It is a systematic and organized process of managing and implementing projects toward completion.
▪ It includes the planning, organizing, and managing of all the activities and efforts involved in
accomplishing a successful project.
▪ A project is a one-time activity that produces a specific output and or outcome, for example, a building
or a major new computer system.
▪ This is in contrast to a program, which
✓ An ongoing process, such as a quality control program
✓ An activity to manage a number of multiple projects together.
▪ Examples of projects are planning for a flu vaccination fair, adopting an electronic health record in
private practice, rolling out the use of a patient portal, etc.
▪ Project management includes developing a project plan, which involves
✓ Defining and confirming the project goals and objectives
✓ How they will be achieved
✓ Identifying tasks and quantifying the resources needed
✓ Determining budgets and timelines for completion.
▪ It also includes managing the implementation of the project plan, along with operating regular
'controls' to ensure that there is accurate and objective information on 'performance' relative to the
plan and the mechanisms to implement recovery actions.
▪ Projects done in nursing is carried out using the steps of project management.
Projects such as quality improvement, evidence-based initiatives, identifying the peak time that
patients come to the ED or the outpatient clinic, identifying causes of falls, etc., are managed in
a project management format to a certain extent.
▪ Two other important steps in project management are creating a budget and a schedule. Example
Project Plan.

Projects
▪ It has a specific, time-sensitive purpose.
▪ It has a beginning and a finite end.
▪ It requires resources that need to be managed efficiently.
▪ It needs to be completed at a particular time.
▪ A project team implements the project.

Project Team
▪ Consist of members with varying skills, knowledge, and values but come together to complete the
project
▪ The team leader does not need to be an expert on the nature of the project NCM 110: Nursing Informatics
▪ Important qualities of a leader include:
✓ management and organizational skills
✓ being a motivator
✓ result-oriented
✓ empathetic
✓ people-person
✓ consensus builder
✓ uses critical thinking
✓ problem solver
✓ ability to function despite pressure
✓ time and cost constraints
✓ being mindful of all stakeholders
✓ knowledge of technical skills
✓ excellent communicator (written and verbal) 19
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 NCM 110: Nursing Informatics

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