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
