MATER DEI COLLEGE

COLLEGE OF NURSING
TUBIGON, BOHOL

COURSE NUMBER: NCM 110

COURSE TITLE: NURSING INFORMATICS

COURSE REQUIREMENTS online activities, quizzes, major exam

GRADING SYSTEM Major exam 50%

Activities 25%

Quizzes 25%

WEEK 1

1. Overview of Nursing Informatics

2. Definition of Nursing Informatics
3. Historical Perspective of Nursing Informatics

COURSE LEARNING OUTCOME:

- Apply knowledge of physical, social, natural and health sciences and humanities in nursing
informatics.

STUDENT LEARNING OUTCOMES:

- Introduce nursing informatics (NI) and clinical information system (CIS).

- Identify a brief historical perspective of nursing informatics.
- Explore lessons learned from the pioneers in nursing informatics.
- List the major landmark events and milestones of nursing informatics.

LEARNING CONTENT: Concepts, Principles and Theories in Nursing Informatics

INTRODUCTION TO NURSING INFORMATICS

Nursing Informatics is moving to the forefront of the nursing profession and nursing
information technology systems. Nurses are becoming computer literate and the nursing profession is
implementing practice standards for its clinical care and data standards for its nursing information
technology systems.

NI represents transition of data and data information and knowledge into action. NI
represents the practice, administration, community health, nursing education, and nursing research
applications. It also addresses other new applications such as international aspects or peripheral to the
field such as legal, consumer issues, or theoretical issues. This new edition also includes new content to
demonstrate how IT supports nurses to improve quality, ensure safety, measure outcomes, and
determine costs.

The Need for a Definition of Nursing Informatics

“Medical informatics” is used as an overarching term both to describe any informatics efforts
related to health care and also to describe a distinct specialty in the discipline of medicine.
Consensus has not been reached about whether medical informatics, especially as the term is
used in medicine, is the same discipline as what might more broadly be called health informatics.
Similarly, a lively debate in the literature underscores the disagreement about whether nursing
informatics and medical informatics are separate disciplines.
Furthermore, a definition of nursing informatics may be useful to other disciplines as they define
informatics practice within their own specialties. Finally, a definition for nursing informatics is
needed to help others, within and outside nursing, understand the legitimacy of the practice and
the general competencies of a nurse who specializes in informatics.

Definitions of Nursing Informatics

The authors reviewed work on definitions for nursing informatics. Other authors than those
considered here have published important work related to facets of nursing informatics, such as
defining requirements, designing nursing systems, and nurse– computer interaction. However,
the focus of this analysis is on overarching definitions for the nursing informatics domain. A
review of definitions of nursing informatics makes apparent three themes for analysis (revised
from those suggested by Turley)—information technology–oriented, conceptually oriented, and
role-oriented definitions.

Information Technology–oriented Definitions

The earliest series of definitions for nursing informatics highlighted the role of technology for what was a
new specialty in nursing. An early definition by Scholes and Barber stated that nursing informatics was
“the application of computer technology to all fields of nursing-nursing service, nurse education, and
nursing research.” Ball and Hannah modified an early definition of medical informatics, acknowledging
that all health care professionals are part of medical informatics. Therefore, nursing informatics was
“those collected informational technologies which concern themselves with the patient care decision-
making process performed by health care practitioners.” Shortly after this, Hannah continued and added
the concept of the nursing role within nursing informatics:

The use of information technologies in relation to those functions within the purview of nursing, and that
are carried out by nurses when performing their duties, therefore, any use of information technologies by
nurses in relation to the care of their patients, the administration of health care facilities, or the
educational preparation of individuals to practice the discipline is considered nursing informatics.

Saba and McCormick continue to stress the role of technology in nursing informatics as it supports the
functions of nursing. They provided this new definition:
The use of technology and/or a computer system to collect, store, process, display, retrieve, and
communicate timely data and information in and across health care facilities that administer nursing
services and resources, manage the delivery of patient and nursing care, link research resources and
findings to nursing practice, and apply educational resources to nursing education.

Conceptually Oriented Definitions

A shift from technology-focused definitions to more conceptually oriented definitions began during the
mid-1980’s. however this approach did not gain acceptance until nearly 1990.

Schwiran moved away from technology and stressed the need for a “solid foundation of nursing
informatics knowledge should have focus, direction, and cumulative properties.” She emphasized the
need for informatics research to be “proactive and model-driven rather than reactive and problem-
driven.”

Graves and Corcoran provided the first widely cited definition downplaying the role of technology and
incorporating a more conceptually oriented viewpoint:

A combination of computer science, information science, and nursing science designed to assist in the
management and processing of nursing data, information, and knowledge to support the practice of
nursing and the delivery of nursing care.

This definition broadened the horizon from technology and placed nursing informatics firmly within the
practice of nursing.

Turley analyzed previous nursing informatics definitions and then proposed a new nursing informatics
model. Turley’s major contribution was the addition of cognitive science to a model comprising the
original three sciences proposed by Graves and Corcoran. Cognitive science includes such topics as
memory, problem solving, mental model, skill acquisition, language processing, and visual attention.
These concepts can help informatics nurse specialists understand the decision-making and information
processing done by nurses and, subsequently, assist in the creation appropriate tools to support nursing
processes.

Role-oriented Definitions

In the late 1980s, informatics nurse specialists were becoming more prevalent. Individuals were
bootstrapping themselves into jobs related primarily to the insertion of computer technology intno health
care settings.

As nursing informatics gained recognition as a specialty, the Council of Computer Applications in Nursing,
of the American Nurses Association, (ANA), provided a new definition for the field. The ANA expanded the
previous definitions by incorporating the role of the informatics nurse specialist into the earlier Graves
and Corcoran definition:

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
structure that support nursing; and identify and apply computer technologies for nursing.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC344585/#:~:text=Nursing%20informatics%20is%20the
%20specialty,and%20expansion%20of%20nursing%20knowledge.

SYNTHESIS:

The computer is the most powerful technological tool to transform the nursing profession prior
to the new century. The computer has transformed the nursing paper-based records to computer-based
records. Today and tomorrow, the computer and the Internet are essential for all settings where nurses
function- hospitals, ambulatory care center, health maintenance organizations, community health
agencies, academic institutions, research centers, and schools of nursing.

WEEK 2
COURSE LEARNING OUTCOME:

- Apply concepts, theories and principles of sciences and humanities in nursing informatics.

STUDENT LEARNING OUTCOMES:

- Discuss core concepts and the scope of practice of nursing informatics.

- Discuss different definitions and models of nursing and healthcare informatics.

LEARNING CONTENT:

A. Informatics Theory
 1. Theories
2. Models
3. Framework

Theories, models, & frameworks

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
➢ 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 element, depicting nursing informatics
as the proper management of knowledge – from data as it is converted into information
and knowledge

SCHWIRIAN’S MODEL (1986)

o Nursing informatics involves identification of information needs, resolution of the needs, and
attainment of nursing goals/objectives
o 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
(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
➢ 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
Mechanism for coding integrative health interventions by clinician for administrative billing and
insurance claims includes 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
o International Classification for Nursing Practice (ICNP)
o Integrated terminology for nursing practice developed under sponsorship of ICN ICNP elements:
o Nursing phenomena (nursing diagnosis)
o Nursing actions (nursing interventions)
o Nursing outcomes

Patient Care Data Set (PCDS)

Terms and codes for patient problems, therapeutic goals, and patient care order 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
WEEK 3
CONTINUATION OF TOPIC:
▪ Computer System
▪ Computer Hardware
▪ Computer Software System
Understanding the Computer System
Different components of a computer system

• Hardware
• Software
• Peopleware
Hardware - the physical, touchable, electronic and mechanical parts of a computer system.
A. Major hardware components of a computer system
System Unit- The main part of a microcomputer, sometimes called the chassis. It includes the
following parts: Motherboard, Microprocessor, Memory Chips, Buses, Ports, Expansion Slots
and Cards.
4. Primary storage- (internal storage, main memory or memory) is the computer's working
storage space that holds data, instructions for processing and processed data (information)
waiting to be sent to secondary storage. Physically, primary storage is a collection of RAM
chips.
Two (2) Types of Memory
ROM – (Read Only Memory) ROM is non- volatile, meaning it holds data even when the power
is ON or OFF.
RAM – (Random Access Memory) RAM is volatile, meaning it holds data only when the power
is on. When the power is off, RAM's contents are lost
B. Input Devices - Accepts data and instructions from the user or from another computer
system. Two (2) Types of Input Devices
1. Keyboard Entry
2. Direct Entry

2. Direct Entry – A form of input that does not require data to be keyed by someone sitting at a
keyboard. Direct-entry devices create machine-readable data on paper, or magnetic media, or
feed it directly into the computer’s CPU.
Three Categories of Direct Entry Devices

1. Pointing Devices - An input device used to move the pointer (cursor) on screen.  Mouse -
The most common 'pointing device' used in PCs. Every mouse has two buttons and most have
one or two scroll wheels.
 C. Output Devices - Any piece of computer hardware that displays results after the
computer has processed the input data that has been entered.

1. Computer Display Monitor- It displays information in visual form, using text and graphics. The
portion of the monitor that displays the information is called the screen or video display terminal.
5. Speakers - Used to play sound. They may be built into the system unit or connected with
cables. Speakers allow you to listen to music and hear sound effects from your computer

D. Ports - External connecting sockets on the outside of the computer. This is a pathway into
and out of the computer. A port lets users plug in outside peripherals, such as monitors,
scanners and printers
E. Cables and Wires Cables and Wires- A cable is most often two or more wires running side
by side and bonded, twisted or braided together to form a single assembly, but can also refer to
a heavy strong rope.
Software is the set of instructions (also called a program) that guides the hardware to operate
effectively.
Software can be split into two main types:
System Software
Application Software
2. Application Software – Designed to help the user to perform singular or multiple related
tasks.
Examples of application software are as follows:
A. Word processing software - Creates, edits, saves, and prints documents. Example: MS
Word, WordPerfect, Ami Pro, MacWrite.
B. Spreadsheet software - An electronic spreadsheet consisting of rows and columns is used to
present and analyze data. Example: MS Excel, Lotus 123, Quattro Pro.
C. Database management software - Used to structure a database, a large collection of
computer programs. Data is organized as fields and records for easy retrieval. Example: MS
Access, dBase, Fox Pro, Oracle.
D. Graphic software - Graphics programs display results of data manipulation for easier
analysis and presentation. Example: Macromedia Flash, Harvard Graphics, 3D Studio Max,
Adobe Photoshop