THEORIES, MODELS,

AND FRAMEWORKS
CHAPTER 17
OBJECTIVES:
• Relationship between
healthcare informatics and
nursing informatics.
• Models of nursing and NI
• NI as a distinct specialty
• Key aspects of EHR
• Terminologies for nursing
• Organizational resources
 INTRODUCTION

Learning is based on recognition

of patterns, variances, builds, on
previous experiences and
knowledge, and involves
analogies.

Theories, models, framework can

guide learning for students and
the faculty.
 FOUNDATIONAL
DOCUMENTS GUIDE NI
PRACTICE
• ANA (2001) – Published the code of ethics for
nurses w/ interpretative statements; a
complete revision of previous ethics which
guides nurses in practice. (education,
administration, research)
• Nursing social policy statement, 2nd edition
(2003)- definition of nursing:
 « the protection, promotion,prevention of
illness and injury, alleviation of suffering through
the diagnosis and treatment of human response
and advocacy in the care of individuals, families,
communities, and populations.  »
 FOUNDATIONAL
DOCUMENTS GUIDE NI

PRACTICE


 ANA( 2004) – nursing as a cognitive

profession.
 -This cognitive work begins
with the critical thinking and
decision process that occur
before nursing action begins.
 INFORMATICS AND
HEALTHCARE INFORMATICS
INFORMATICS- a science that combines a


domain science, computer science,

information science, and cognitive
science.


HEALTHCARE INFORMATICS- application of



informatics in the area of healthcare. HI

is a subdiscipline of informatics.


MEDICAL INFORMATICS- subdomain of



healthcare informatics.
HEALTHCARE INFORMATICS
 NURSING INFORMATICS
• 1985 definition of Kathryn Hannah:
 « the use of information technologies in
relation to any nursing functions and
actions of nurses »
• Graves and Corcoran:
 « NI is a combination of computer
science designed to assist in the
management and processing of nursing
data, inforamtion, and knowlegde to
support practice of nursing and delivery of
nursing care. »
 Nsg Informatics as a
Specialty
Earl 1992, the ANA established
nursing informaticsas a distinct
specialty in nursing with a distinct
body of knowledge.
Scope of Nursing Informatics

include:
 developing and evaluating
applications, tools, process, and
strategies for managing data and
support decision-making
 MODELS FOR NURSING
INFORMATICS
 Models
 are representation
of some aspect of the
real world;


 Show particular
perspectives of a
selected aspect and
may illustrate
relationships.
 DATA, INFORMATION,
KNOWLEDGE
 ARE IDENTIFIED AS
CURRENT METASTRUCTURES
OR OVERARCHING CONCEPTS
FOR NURSING INFROMATICS
WITH SPECIFIC DEFINITIONS
 Example:
 Data- Bp: 120/80
 Information: Normal
 Knowledge: information
that is synthesized so that
relationships are identified and
formalized.
 REGISTERED NURSES AS
KNOWLEDGE WORKERS


Knowledge work – is the exercise
of specialist knowledge and
competencies. Futurist predict that
in the second millenium the primary
domestic product of the united
states will be knowledge and related
knowledge services.



ELECTRONIC HEALTH
RECORD
Also associated with the terms:


EMR- Electronic medical record

EPR- Electronic patient record

CMR- computerized medical record

CPR- computer- based patient

record

 EHR



«  Any information related to the past, present, and
future physical/mental health, or condition of an
individual. »
 (ASTM-American Society for Testing and
Materials)


 NCVHS- National Committee on Vital and Health

Statistics; indentified record infromation as a
model for the specific content necessary for the
EHR.


 NHII- National Health Information Infrastructure

 TERMINOLOGIES

• NIC- Nursing Intervention Classification

• NOC- Nursing Outcome Classification
• CCC- Clinical Care Classification
• Omaha System
• PNDS- Perioperative Nursing Data Set
• SNOMED CT
• ABC Codes
• PCDS- Patient Care Data Set
• LOINC- Logical Observation Identifiers Names and
Codes
• ICNP- International Classification for Nursing
Practice
• NMMDS- Nursing Management Minimum Data Set
 NIC

 Contains 514 nursing

internventions that describe the
treatments nurses perform,
updated linkages with NANDA
diagnoses, and core
interventions identified for 44
specialty practice areas.
 NOC

 Contains 330 research-based

outcomes to provide
standardization of expected
patient, caregiver, family, and
community outcomes for
measuring the effect of nursing
interventions.
 CCC

 A research-based
nomenclature designed to
standardize the terminologies
for documenting nursing care in
all clinical care settings.
 Omaha System

 Was released in November 2004;

Originally developed in home
health practice, now included in
all setting.


 It includes an assessment
component, an intervention
component, and an outcome
component.
 ICNP

Combinatory terminology for

nursing practice developed by
the international nursing
community under sponsorship of
the ICN.
ICN facilitates cross-mapping of

local terms and existing

vocabularies and financial
resources.
 NMMDS

 Includes terms to describe the

context and environment of
nursing practice, includes terms
for nursing delivery unit/service,
patient/client population, care
delivery method, personnel
characteristics, and financial
resources.
 ORGANIZATION AS
RESOURCES

 Many organizations have

emerged to provide information
resources and value-
adddedmembership benefits
that support those individuals
interested in healthcare and
nursing informatics.

 ORGANIZATIONS

AMIA- American Medical Informatics

Association
HIMSS- Healthcare Information and

management Sytems Society (innovations in

healthcare delivery, EHR, and wireless
healthcare computing)
NLN- National League for Nursing(Advance

quality of Nsg educ)

SHS- Society for Health Systems (continuing

education of professionals for productivity

and quality improvement in healthcare
delivery.
