NURSING INFORMATICS

MODELS
General 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

DATA INFORMATION KNOWLEDGE

SCHIWIRIAN’S MODEL
(1986)
Nursing informatics involves identification of
information needs, resolution of the needs,
and attainment of nursing goals/objectives
 Patricia Schwirian – proposed a model intended
to stimulate and guide systematic research in
nursing informatics
 Model/framework that enables identification of
significant information needs, that can foster
research (somewhat similar to Maslow’s
hierarchy of needs)
 GOAL

USERS

TECHNOLOGY

RAW MATERIALS
(Nursing-related information)
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

INFORMATION
SCIENCE NURSING

COGNITIVE
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.
 KNOWLEDGE
COMPLEXITY

INFORMATION

DATA

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 to
cope with and manage many contingencies
 EXPERT

PROFICIENT

COMPETENT

ADVANCED
BEGINNER

NOVICE
Levels of Expertise
(Benner):
 Proficient – evolution through continuous
practice of skills, combined with professional
experience and knowledge; individual who
appreciates standards of practice as they apply
in nursing informatics
 Expert – individual with mastery of the concept
and capacity to intuitively understand the
situation and immediately target the problem
with minimal effort or problem solving
PHILIPPINE
PERSPECTIVE
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 lif 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
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
ORGANIZATIONS as
Resources
AMIA
NLN
HIMSS
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
health care information
technology standards of nursing
and advocacy of key innovations
in health care delivery and
administration