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D. informatics theory


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all about nursing informatics

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D. informatics theory

  2. 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. 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. 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. 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.
  6. 6. Novice Advanced Beginner Competent Proficient Expert BENNER’S LEVEL OF EXPERTISE MODEL
  7. 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. 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. 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. 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. 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. 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.
  13. 13. The Semiotic Triangle Object Concept Term
  14. 14. Components of Advanced Terminology Systems Terminology Model Representation Language Computer- Based Tools
  15. 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. 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. 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. 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
  19. 19. Implementing and Upgrading Clinical Information Systems
  20. 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. 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. 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. 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 VV
  24. 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. 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 V V
  26. 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 V