2. THEORIES, MODELS AND FRAMEWORK
Nursing Informatics models is composed of 5
general models. 1st, Graves and Corcoran's model.
2nd, Schiwirian's model. 3rd, Turley's model. 4th,
Data Information Knowledge (D-I-K) model. And the
last is Benner's Novice to Expert model. The 2
specific informatics models are Philippine Health
Ecosystem model and Shift Left model.
3. According to GRAVES AND CORCORAN’S
MODEL (1989) that 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.
4. According to 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).
5. According to TURLEY’S
MODEL (1996), nursing
informatics is the intersection
between the discipline-
specific science (nursing) and
the area of informatics. And
in this model, there are 3 core
components of informatics,
namely Cognitive science,
Information science, and
Computer science.
7. Personal Health Dimension - personal health record
maintained and controlled by the individual or family;
nonclinical information.
Health Care Provider Dimension - promotes
quality patient care, access to complete accurate
patient data 24/7.
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.
PATIENT MEDICAL RECORD INFORMATION
MODEL (PMRI):
8. 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.
9. Perioperative Nursing Data Set
(PNDS):
universal language for perioperative
nursing practice and education;
standerdize documentation of
perioperative data in all perioperative
settings.
diagnosis based on NANDA,
interventions based on NIC, and
outcomes based on NOC.
10. SNOMED CT:
core clinical terminology
containing over 357,000
healthcare concepts
with unique meanings
and formal logic-based
definitions organized
into multiple
hierarchies.
11. Advanced Terminology Systems
The primary motivation for
standardized terms in nursing is the
need for valid, comparable data that
can be used across information
system applications to support
clinical decision-making and the
evaluation of processes and
outcomes of care.
12. The Vocabulary Problem
Reasons for the vocabulary problem in health
and nursing informatics:
• The development of multiple specialized terminologies has
resulted in areas of overlapping content, areas for which no
content exists, and large numbers of codes and terms.
• Existing terminologies are most often developed to provide
sets of terms and definitions of concepts for human
interpretation, which computer interpretation as only a
secondary goal.
The failure to achieve a single, integrated
terminology with broad coverage of the
healthcare domain.
15. Advantages of Advanced Terminology
Systems
Allow much greater
granularity through
controlled composition
while avoiding a
combinatorial explosion
of pre-coordinated terms
Facilitate two important facets of
knowledge representation for computer-
based systems that support clinical care:
(a) describing concepts, and (b)
manipulating and reasoning about those
concepts using computer-based tools
16. Motivated in part by a desire
to harmonize the plethora of
nursing terminologies around
the world and to integrate
with other evolving
terminology and information
and model standards.
Advanced Terminological Approaches
to Nursing
17. GALEN Program
Can be used in a range of ways, from directly
supporting clinical applications to supporting
the authoring, maintenance and quality
assurance of other kinds of terminologies.
18. SNOMED RT
• SNOMED Reference Terminology (TR) is a reference
terminology optimized for clinical data retrieval and
analysis
• Concepts and relationships in SNOMED are
represented using modified KRSS (Knowledge
Representation Specification Syntax) rather than GRAIL
• Concept definition and manipulation are supported
through a set of tools with functionality such as
Acronym resolution, word completion, term
completion, spelling correction, display of the
authoritative form of the term entered by the user, and
decomposition of unrecognized input
20. - Provide nurses knowledge of many
aspects organized for effective and
efficient healthcare delivery.
- Assists clinicians with data necessary
for decision-making and problem solving
- Must serve the organization and the patient in much the
same way an efficient healthcare delivery system involves
all appropriate departments in establishing healthcare
delivery processes
The Planning Phase
Begins once an
organization has
determined that an existing
need or problem may be
filled or solved by the
development of a CIS
The Clinical Information
System (CIS)
21. Clinical Information System
Committee Structure and Project
Staff
- The nursing administrator, in
conjunction with the information
system’s management team,
works to develop a committee
structure and participation to
best guarantee the success of
the project
Transition management is a
series of deliberate, planned
interventions undertaken to
assure successful adaptation/
assimilation of a desired
outcome into an organization.
(Douglas and Wright, 2003)
22. Project Team
Led by an appointed project manager and
includes a designated team leader for each of
the major departments affected by the system
selection, implementation, or upgrade proposed
Objectives:
- Understand the technology and its
restrictions, if any, of a proposed
system
- Understand the impact of
intradepartmental decisions
- Make decisions at the
intradepartmental level for the overall
good of the CIS within the
organization
- Become the key resource for their
application
23. The Key Role of the Nurse Administrator
The active involvement of the nurse executive is considered
a critical success factor of any CIS implementation or
upgrade.
The System Analysis Phase
- Second phase of developing a CIS
- Is the fact finding phase
- Foundational to the actual system design
Data Collection
- Collection of data reflecting the existing problem or goal.
- Refining of the project scope agreement
- Creation of a Workflow Document
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24. 1. data collected into logical sequencing of
tasks and subtasks performed by the end
users for each goal or problem area, it
includes:
- A list of assumptions about the process
- A list of major tasks performed
- A list of subtasks and steps accomplished
2. Sources:
- Written documents, forms, and flow
sheets
- Policy and procedure manuals
- Questionnaires
- Interviews
- Observations
25. Data Analysis
- Provides the data for
development of an
overview of the nursing
problem and or stated
goal defined in the
project scope
agreement
- Tools used:
Data flowchart
Grid chart
Decision table
Organizational chart
Model
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26. Data Review
Focuses on resolving the problem and
or attaining the goals defined in the
feasibility study based on the best
method or pathways derived from the
workflow documents and the
functional design.
Benefits Identification
The overall anticipated benefits
from the system are documented
in this step.
The benefits reflect the resolution
of the identified problem,
formulated and stated in
quantifiable terms
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