Nursing Informatics is a specialty that integrates nursing science, computer science,

and information science.

➢ Nursing Informatics Models

• General Models
o Graves and Corcoran's model
o Schwerin's Model
o Turley's Model
o Data Information Knowledge (D-I-K) Model
o Benner's Novice to Expert Model
• Specific Informatics Models
o Philippines Healthcare Ecosystem Model
o Shift Left Model
o Patient Medical Record Information Model (PMRI)
➢ Nursing Informatics Theories

o Nursing informatics theory (Information theory)

o Sociotechnical theory and social informatics
o Change theory
o General system theory
o Chaos theory
o Cognitive science theory
o Usability theory
o Learning theories.

➢ Nursing Informatics Frameworks

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Nursing Informatics Models

Graves and Corcoran's Model (1089)

• Nursing informatics as linear progression, from data into information and
knowledge.
• Designed to assist in the management and processing of nursing data,
information and knowledge to support the practice of nursing and delivery of
nursing care
 2. Schiwirian's Model (1986)

Patricia Schiwirian
• proposed the model intended to stimulate and guide systematic research in nursing
informatics.

⎯ The model is similar to Maslow’s hierarchy of needs.

⎯ Contains four primary elements arranged to form a pyramid with a triangular base.
o These elements are:
▪ (1) The raw material, which is nursing related information;
▪ (2) The technology, which is a computing system;
▪ (3) The users, who are nurses/students within the context of their personal
and professional systems; and
▪ (4) The goal or objective toward which the three preceding elements are
directed.

2. Turley's Model (1996)

⎯ Nursing informatics is the intersection between the discipline- specific science

(nursing) and the area of informatics.
⎯ It encompasses computer science, information science and cognitive science within
the domain of nursing science.

Core Components:
1. Cognitive science
a. Use and position of computer and computer science as central definition.
2. Information science
a. Focus on conceptual issue that represent nursing knowledge and information
3. Computer Science
a. Focus on how the computer help nurses enter, organize, and retrieve
information
Nursing science

- The vehicle, the knowledge base for understanding the other 3 sciences (information science,
computer science, and cognitive science).

Computer Science

- It is where the hardware is found, the ability to program the hardware to process nursing
information.

Information Science

- The ability to access information, research, and knowledge.

Cognitive Science
- Helps to develop computing systems that work best with how humans process information,
creating more seamless human-systems integration.

4. Data, Information, and Knowledge Model

- a concept of synthesizing data to have meaningful information to produce the knowledge

necessary to have the right wisdom to make informed clinical decisions with regards to patient
care.
Data- discrete entities that are described objectively without interpretation.
Information- reflects interpretation, organization or structuring of data result of processing of data.
Knowledge- emerges from the transformation of information or information synthesized so that
relationships are identified and formalized.

Processing of information does not always result in the development of knowledge.

5. Benner's Level of Expertise Model
Dr Patricia Benner introduced the concept that expert nurses develop skills and
understanding of patient care over time through a sound educational base as well as a multitude
of experiences.
LEVELS OF NURSING EXPERIENCE
5 levels of nursing experience as;

1. Novice

- Beginner with no experience

- Taught general rules to help perform tasks.
- This stage, new nurses are taught simple, objective attributes that are easily identified.
2. Advanced beginner

-
Demonstrates acceptable performance
-
Has gained prior experience in actual situations to recognize recurring meaningful
components.
- as an individual who has been involved in enough real-world situations that the
recurrent component is easily identified
- Still needs assistance and support in the clinical area by setting priorities to ensure that
important patient needs do not go unattended.
3. Competent

- Nurse with 2-3 years’ experience on the job in the same area or in similar day-to-day
situations
- More aware of long-term goals.
- able to prioritize tasks at hand by utilizing past experiences.
4. Proficient

- Perceives and understands situations as whole parts

- More holistic understanding improves decision-making
- Learns from experiences what to expect in certain situations and how to modify plans
5. Expert

- No longer relies on principles, rules, or guidelines to connect situations and determine

actions
- Much more background of experience
- Has intuitive grasp of clinical situations
- Performance is now fluid, flexible, and highly-proficient

B. Specific Informatics Models

1. Philippine Healthcare Ecosystem Model
- Nursing informatics is a huge network that encompasses all the
sectors of the health care delivery system

❖ Government agencies
❖ Healthcare facilities
❖ Practitioners
❖ Academic institutions
❖ Suppliers
2. Intel's Shift Left Model
- Patient care shifts/progresses from a high-quality delivery of life through technology with increased
costs (right).
Shift left
- It means more than just self-service or web submission (automation).
- It is about better service and achieving better business results.

3. Patient Medical Record Information Model (PMRI): Basis of HER

The type and pattern of documentation in the patient record will be dependent on 3 interacting dimensions of
health care:

1. Personal Health Dimension - personal health record maintained and controlled by the
individual or family; nonclinical information.
❖ Example:
Self-care trackers, directories of health care, and other supports.
2. Healthcare Provider Dimension - promotes quality patient care, access to complete accurate
patient data 24/7.
❖ Example:
Provider's prescription, clinical orders decision support systems, practice guidelines.
3. Population Health Dimension - information on the health of the population and the influences
to health.
❖ Example:
Ushahidi program
- is an open source software application which utilizes user-generated reports to collate
and map data.

Theories that lend support to

Informatics
1. Nursing Informatics Theory (Information Theory)

• Can quantify the expected amounts of total and redundant information contained in a given
clinical data type.

 DATA
 INFORMATION
 KNOWLEDGE
 WISDOM
2. Sociotechnical Theory and Social Informatics

• Developed in the middle of the last century when it became evident that not all
implementations of technology were increasing productivity.
• The impact of technology implementation on an organization.

3. Change Theory
• A new experience that creates a change that affect workers.
a. A. Roger's diffusion of innovation theory (Unplanned change)
- Examines the patterns of acceptance that innovations follow as they spread
across the population of people who adopt it.
a. Social Change
b. Individual Change
b. Lewin's Change Theory (Planned Change)
- a ‘planned change’ guide that consists of three distinct and vital stages:
a. Unfreezing Stage
b. Moving to a New Level or Change Stage
c. Refreezing Stage
4. General System Theory

- Described that any change in one part of the system will be reflected in other parts of the
system.
2 Types of General System Theory:
1. OPEN SYSTEM
- It is the continuous exchanges of information with the environment outside the system itself or
higher levels of complexity in the system.
2. CLOSED SYSTEM
- It is isolated from the environment and receive no input from outside or disorganized
breakdown of the system.
5. Chaos Theory
- It is nonlinear.
- Explains how a complex and unpredictable system behaves.

6. Usability Theory

- It involves the ease of use, user's satisfaction that they have achieved their goals, and the aesthetics
of the technology.
- It is about how humans interact with technology.

7. Learning Theories
- main guide for educational systems planning in the classroom and clinical training included in
nursing.
 Framework in nursing Informatics
A. INFORMATICS RESEARCH ORGANIZING MODEL

- Judith A. Effken, PhD (2003) proposed the framework.

- Emphasized all elements of nursing's metaparadigm including the system,
nurse, patient, and health.

B. NURSE- PATIENT TRAJECTORY FRAMEWORK.

- Gregory L. Alexander (2007) proposed the framework.
- Described the relationships between the virtual information system and the real
world that it affects.
- Visualized along two separate and distinct nurse and patient trajectories.