Theories, models, & frameworks

Chapter 17: Theories, Frameworks, And

ModelsBy: Minette Din

BSN2A

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

Nursing Informatics Models

Specific Informatics Models

Philippine Healthcare Ecosystem model

Shift Left Model

GRAVES ANDCORCORAN’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

SCHWIRIAN’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 in 1986

• Model/framework that enables identification of significant information needs, that can foster research (some what similar to Maslow’s hierarchy of needs)

GOAL

USERS

TECHNOLOGY

RAW MATERIAL(NURSING-REALATED

INFORMATION

TURLEY’S MODELS (1996)

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

COGNITIVE SCIENCE

NURSING

DATA-INFORMATION-KNOWLEDGE

DATA-INFORMATION-KNOWLEDGE MODELNI 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.

DATA

INFORMATION

KNOWLEDGE

CO

MP

LE

XIT

Y

HUMAN INTELLECT

BENNER’S LEVEL OFEXPERTISE 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):

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 CAREECOSYSTEM

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 LEFTMODEL

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 RECORDINFORMATION 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 NursingData 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

InternationalClassification 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

American MedicalInformatics 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 forNursing (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 InformationManagement Advisory Council (ETIMAC) –

promote effective use of technology in nursing education, as a teaching tool and outcome for student-faculty learning 

Healthcare information andmanagement systems

society (HIMSS)

assumes leadership role in the technology standards of nursing and advocacy of key innovations in health care delivery and administration

THE END