3. THE MAJOR THEORIES AND MODELS
SUPPORTING NURSING INFORMATICS
ARE AS FOLLOWS:
•GENERAL SYSTEMS THEORY
•CHANGE THEORY
•CYBERNETICS THEORY
•COGNITIVE LEARNING THEORY
•NOVICE TO EXPERT THEORY
•DIKW THEORY
4. GENERAL SYSTEMS THEORY
•Includes purpose, content and process,
breaking down the “whole” and analyzing
the parts.
•The relationship between the parts of the
whole are examined to learn how they
work together.
5. GENERAL SYSTEMS THEORY
•A system is made up of separate components.
The parts rely on one another, are interrelated,
share a common purpose, and together form a
whole.
•Input is the information that enters the system.
•Output is the end product of a system.
6. GENERAL SYSTEMS THEORY
•Output is the end product of a system.
•Feedback is the process through which the
output is returned to the system.
7. • Von Bertalanffy (1969, 1976) developed General System Theory,
which has the following assumptions:
a. All systems must be goal directed
b. A system is more than the sum of its parts
c. A system is everchanging and any change in one part affects
the whole
d. Boundaries are implicit and human systems are open and
dynamic.
8. TERM DEFINITION EXAMPLES
Input The energy & raw material
transformed by the
system.
Information, money, energy,
time, individual effort, & raw
materials of some kind.
Throughput The process used by the
system to convert raw
materials or energy from
the environment into
products that are usable
by either the system itself
or the environment.
Thinking, planning, decision-
making, constructing, sorting,
sharing, information, meeting
in groups, discussing, melting,
shaping, hammering, etc.
9. TERM DEFINITION EXAMPLES
Output The product or service which
results from the system’s
throughput or processing of
technical, social, financial &
human input.
Software programs, documents,
decisions, laws, rules, money,
assistance, cars, clothing, bills, etc.
Feedback Information about some aspect of
data or energy processing that
can be used to evaluate &
monitor the system & to guide it
to more effective performance.
How many cars were produced?
How many had to be recalled correct
errors?
How many mistakes were made?
Why were mistakes made?
HealthCareReportCard.com is an
example of how hospitals are doing
with certain diagnoses. Accreditation
reports are an example as are patient
satisfaction surveys, sales reports, and
test results.
10. Subsystem A system which is a part of a
larger system. They can work
parallel to each other or in a
series with each other.
The finance department,
the information system,
the managerial system,
the renal system,, the
political system, the
workflow system (such as
the conveyor belt), etc.
Static system Neither system elements nor
the system itself changes much
over time in relation to the
environment.
A rock
11. Dynamic System The system constantly changes the environment
& is changed by the environment.
A healthy young adult grows more
independent, interdependent, & self-
sufficient & self-directed in response to
stimuli from peers, family, school, work,
& recreational activities.
Closed systems Fixed, automatic relationship among system
components & no give or take with the
environment.
A rock is an example of the most closed
system. We may encounter families
that are isolated from the community &
the resistant to any outside influence.
12. Open Systems Interacts with the environment
trading energy & raw material for
goods & services produced by the
system. They are self-regulating, &
capable of growth, development
& adaptation.
Hospitals, families,
people, body systems,
banks, manufacturing
plants, governmental
bodies, associations,
business, etc.
Boundary The line or point where a system
or subsystem can be differentiated
from its environment or from
other subsystems. Can be rigid or
permeable or some point in
between. Systems or subsystems
will engage in boundary tending.
The nursing unit, the
occupational therapy
department, the
elementary school, a
person, an agency, or
business, a fence or wall,
roles, etc.
13. Goal The overall purpose for existence or the
desired outcomes. The reason for being.
Currently, many organizations put their
goals into a mission statement.
To educate students, to support
people during illness & restore
them to health, to make money,
to create social order, etc.
Entropy The tendency for a system to develop order
& energy over time.
Rules are made, policies &
protocols are written, approved
& communicated to staff; laws
are enacted & violators are held
accountable; a marathon runner
in training gradually is able to
run farther.
14. Negentropy The tendency of system to lose
energy & dissolve into chaos.
The disorganization after a hurricane, a rigid, frightened
family produces a child who is unable to think
independently or leave home, a new business has no
forms or protocols for handling consumer complains
Control or cybernation The activities & processes used to
evaluate input, throughput &
output in order to make
corrections.
Pilots use instrument panels & devices to constantly
evaluates & make course corrections: teachers grade
papers & give students grades or exams; parents
measure their children’s height & weight & may adjust
the child’s diet; healthcare agencies use TQM or Quality
Assurance programs; employee health nurses review
records to see who needs immunization updates
Equifinality Objectives can be achieved with
varying inputs & in different ways.
A nursing assistant assigned to empty catheter bags on
a unit could begin in the middle of the hall, on the right
side, on the left side, at the front or back of the hall &
still end up with all the bags emptied. A traveler could
take the interstate or back country roads & still arrive at
their destination. The traveler could go by train, plane,
bus or a car & still arrive at desired location.
15. BASIC PRINCIPLE OF A SYSTEM
APPROACH
1. A system is greater than the sum of its parts.
Requires investigation of the whole situation
rather than one (1) or two (2) aspects of a
problem.
2. The portion of the world studied (system)
must exhibit some predictability.
16. BASIC PRINCIPLE OF A SYSTEM
APPROACH
3. Though each sub-system is a self-contained
unit, it is part of a wider and higher order.
4. The central objective of a system can be
identified by the fact that the other objectives
will be sacrificed in order to attain the central
objective.
17. BASIC PRINCIPLE OF A SYSTEM
APPROACH
5. Every system, living or mechanical, is an
information system. Must analyze how
suitable the symbols used are for information
transmission.
6. An open system and its environment are
highly interrelated.
18. BASIC PRINCIPLE OF A SYSTEM
APPROACH
7. A highly complex system may have to be
broken into subsystem so each can be
analyzed and understood before being
reassembled onto a whole.
8. A system consists of a set of objectives and
their relationships.
19. BASIC PRINCIPLE OF A SYSTEM
APPROACH
9. A system consists of a set of objectives and
their relationships.
10. When subsystems are arranged in a series
, the output of one is the input for another;
therefore, process alterations in one requires
alterations on other subsystems
20. BASIC PRINCIPLE OF A SYSTEM
APPROACH
11. All systems tend toward equilibrium,
which is a balance of various forces within and
outside of a system.
12. The boundary of a system can be redrawn
at will by a system analyst.
13. To be viable, a system must be strongly
goal-directed, governed by feedback, and have
the ability to adapt to changing circumstances.
21. CHANGE THEORY
• Was developed by Kurt Lewin- considered the Father of Social
Psychology.
• Most influential theory of Kurt Lewin.
• Three-stage model of change: unfreezing-change-refreeze.
• “a dynamic balance of forces working in opposing directions.”
• Change Theory has three major concepts: driving forces, restraining
forces, and equilibrium.
22. Driving forces are those that push in a direction that causes
change to occur. They cause a shift in the equilibrium towards
change.
Restraining forces are those forces that counter the driving
forces. They hinder change because they push the patient in
the opposite direction. They cause a shift in the equilibrium
that opposes change.
23. Equilibrium is a state of being where driving forces equal
restraining forces, and no change occurs. It can be raised or
lowered by changes that occur between the driving and
restraining forces.
24. THREE STAGES: UNFREEZING,
CHANGE, AND REFREEZING
• Unfreezing is the process which involves finding a
method of making it possible for people to let go of an
old pattern that was somehow counterproductive.
• The change stage, which is also called “ moving to a
new level” or “movement.”
• Refreezing stage is establishing the change as the new
habit.
25. MAJOR ASSUMPTIONS
• People grow and change throughout their lives. This growth
and change are evident in dynamic nature of basic human
needs and how they are met.
• Change happens daily. It is subtle, continuous and
manifested in both everyday occurrences and more
disruptive life events.
26. MAJOR ASSUMPTIONS
• Reactions to change are grounded in the basic human needs
for self-esteem, safety and security.
• Change involves modification or alteration. It may be
planned or unplanned.
27. KURT LEWIN (1962) DEVELOPED THE
CHANGE THEORY, WHICH IDENTIFIES
THE FOLLOWING SIX COMPONENTS
1.Recognition of the area where change is needed.
2. Analysis of a situation to determine what forces
exist to maintain the situation and what forces are
working to change it.
3.Identification of methods by which change can
occur.
28. KURT LEWIN (1962) DEVELOPED THE
CHANGE THEORY, WHICH IDENTIFIES
THE FOLLOWING SIX COMPONENTS
4. Recognition of the influence of group mores or
customs on change.
5. Identification of the methods that the reference
group uses to bring about change.
6. The actual process of change.
29. Kurt Lewin’s Model of Change
1. Unfreezing. Is the recognition of the need for change and the
dissolution of previously help patterns of behavior.
2. Movement. Is the shift of behavior toward a new and more healthful
pattern. (Also called the “change stage”)
3. Refreezing. Is the long – term solidification of the new pattern of
behavior.
Unfreeze
Change
Refreeze
30. CYBERNETICS THEORY
• Is a transdisciplinary approach for exploring
regulatory systems their structure, constraints, and
possibilities.
• Norbert Weiner defined cybernetics in 1948 as
“the scientific study of control and communication
in the animal, machine, and society”.
31. CYBERNETICS THEORY
• The essential goal of the broad field of cybernetics is to
understand and define the functions and processes of systems
that have goals and that participate in circular, casual chains that
move from action to sensing to comparison with the desired goal,
and again to action.
33. • Cybernetics includes the study of feedback, black boxes and derived
concepts such as communication and control in living organisms,
machines and organizations including self-organization.
• Concepts studied by cybernetics includes, but are not limited to:
learning, cognition, adaptation, social control, emergence,
convergence, communication, efficiency, efficacy, and connectivity.
• The word cybernetics comes Greek word “Kubernetes” means
“steering” and “governor” in Latin.
34. MAJOR CONCEPTS
• Cybernetics introduces the concept of circularity and
circular casual systems.
• Systems are defined by boundaries.
• Every system has a goal.
• System acts, aims toward the goal.
• Environment affects aim.
35. MAJOR CONCEPTS
• Information returns to system – “feedback”.
• System measures difference between state and goal.
• Detects ‘error’
• System corrects action to aim toward goal.
• Cycle repeat.
36. SCOPE & APPLICATION OF
CYBERNETICS
•Basis of modern communication
systems.
•Application in cognitive science for
modelling of learning.
•Application in management science.
37. CONCLUSION
•Cybernetics is applicable in any discipline
relying on feedback processes including health
sciences, sociology and psychology, which are
based on communication process.
38. COGNITIVE LEARNING
THEORY
• The Cognitive Learning Theory explains why the brain is the most
incredible network of information processing and in the body as
we learn things. This theory can be divided into two specific
theories: the Social Cognitive Theory (SCT), and the Cognitive
Behavioral Theory (CBT).
39. A. SOCIAL COGNITIVE THEORY
3 Variables:
•Behavioral factors
•Environmental factors (extrinsic)
•Personal factors (intrinsic)
41. SOCIAL COGNITIVE THEORY
ILLUSTRATION (PAJARES, 2002)
• In the person-environment interaction, human beliefs, ideas and
cognitive competencies are modified by external factors such as a
supportive parent, stressful environment or a hot climate. In the
person-behavior interaction, the cognitive process of a person
affect his behavior, likewise, performance of such behavior can
modify the way he thinks.
• Lastly, the environment-behavior interaction, external factors can
alter the way you display the behavior. Also your behavior can
affect and modify your environment.
42. BASIC CONCEPTS
Social Cognitive Theory includes several basic concepts that can
manifest not only in adults but also in infants, children and adolescents.
OBSERVATIONAL LEARNING
learning from other people by means of observing them is an
effective way of gaining knowledge and altering behavior.
REPRODUCTION
the process wherein there is an aim to effectively increase the
repeating of a behavior by means of putting the individual in a
comfortable environment with readily accessible materials to motivate
him to retain the new knowledge and behavior learned and practice
them.
43. SELF EFFICACY
the course wherein the learner improves his newly knowledge
or behavior by putting it into practice.
EMOTIONAL COPING
good coping mechanisms against stressful environment and
negative personal characteristics can lead to effective learning,
especially in adults.
45. B. BEHAVIORAL COGNITIVE THEORY
Cognitive Behavioral Theory describes the role of cognition
(knowing) to determining and predicting the behavioral pattern
of an individual. This theory was developed by Aaron Beck.
The Cognitive Behavioral Theory says that individual tend to form
delf-concepts that affect the behavior they display. These
concepts can be positive or negative and can be affected by a
person’s environment.
46. THE NOVICE TO EXPERT
THEORY
• A construct theory first proposed by Hubert and Stuart Dreyfus
(1980) as the Dreyfus Model of Skill Acquisition, and later applied
and modified to nursing by Patricia Benner (1984) provides a very
useful and important theory that clearly applies to nursing
informatics.
47. • Within the field of nursing informatics, this theory can be applied
to:
1. the development of nursing informatics skills, competencies,
knowledge and expertise in nursing informatics specialists;
2. The development of technological system competencies in
practicing nurses working in an institution;
3. The education of nursing students, from first year to graduation
and;
4. The transmission from graduate nurse to expert nurse.
48. NOVICE TO EXPERT
The currently accepted five levels
of development within the
Novice to Expert theoretical
model are illustrated in the
image, as presented by Benner
(1984). They start from the
bottom rung at the Novice level
and move upward through
Advanced Beginner, Competent,
Proficient, and Expert levels.
49. DISTINGUISHING FEATURES
• Two personal characteristics that distinguish the
successful to the expert level seem to be
1. Deliberate practice and
2. The willingness to take risks, to go beyond the
norm.
50. TAKING RISKS – This continuous climb to the expert
level is not without perceived risks- it requires
people to move beyond the status quo of mere
competence through the levels of Proficiency, then
Expertise.
51. • Some common themes are evident as a person
successfully progresses through the novice to expert
levels:
1. As progression occurs, the person tends to
move away from relying on rules and explicit
knowledge to learning to trust and follow their
intuition and pattern matching.
52. • Some common themes are evident as a person successfully
progresses through the novice to expert levels:
2. Better cognitive filtering occurs, where problems are
no longer a huge confusing collection of data but instead
become a complete and unique whole where some bits are
much more relevant than others.
3. The person also moves from being a detached
observer of a problem to an involved part of the system itself,
accepting responsibility for results, not just for carrying out
tasks.
53. NOVICE TO EXPERT LEVEL
NOVICE – A novice does not know anything about the subject
he/she is approaching and has to memorize its context-free
features. The novice nis then given rules for determining an
action on the basis of these features.
ADVANCED BEGINNER – An advanced beginner is still
dependent on rules, but as he/she gains more experience
with real-life situations, he/she begins to notice additional
aspects that can be applied to related conditions.
54. COMPETENT - The competent person grasps all the relevant rules and
facts of the field and is, for the first time, able to bring his/her own
judgment to each case. This is the stage of learning that is often
characterized by the term – problem-solving.
PROFICIENT – Characterized by the progress of the learner from the
step-by-step analysis and solving of the situation to the holistic
perception of the entirety of the situation.
EXPERT – An expert’s repertoire of experienced situations is so vast
that normally each specific situation immediately dictates an intuitively
appropriate action.
55. THE DIKW THEORY
• When raw data is collected, it gets mixed up and the view
seems jumbled. The DIKW Model by Fricke (2018) on Russell
Ackoff (1989) describes how the data can be processed and
transformed into information, knowledge, and wisdom.
• The DIKW Hierarchy compromises the following:
“D” = Data
“I” = Information
“K” = Knowledge
“W” = Wisdom
57. DATA – First step in DIKW model.
Collection of raw data is the main requirements for coming up a
meaningful result in the end. Any measurements, logging, tracking,
records, and many others are all considered as data.
INFORMATION – the data that has been given a meaning by
defining relational connections. The word “meaning” represents
processed and understandable data that may or may not be a useful
piece of content from the organization perspective.
59. KNOWLEDGE - Third level of DIKW model. Knowledge means the
appropriate collection of information that can make it be useful.
It is a deterministic process. When someone “memorizes”
information due to its usefulness, then it can be said that they have
accumulated knowledge.
WISDOM – Fourth level and last step of DIKW Hierarchy. It is a
process to get the final result by calculating through extrapolation
of knowledge. It considers the output from all the previous levels of
DIKW Model and process them through special types of human
programming.
60. COMPUTER SYSTEM
1. COMPUTER HARDWARE
Refers to the physical parts of the computer. It allows the
user to enter data into the computer, performs the actions of the
computer’s processing and produces the computer output.
(Koizer, 2016) The size, shape, and type varies depending on the
purpose of the computer. The essential components of computer
hardware are the central processing units (CPUs) and the
different types of input and output devices that may also vary
from one or more types.
61. 2. COMPUTER HARDWARE SYSTEM
The CPU is in the box that compromises the computer hardware
necessary to process and store data. The power supply, disk drives,
chips, and connections for all other computer hardware (also known as
peripherals) are also located with the CPU. The performance of the CPU
or the determinant of how fast the CPU’s performance is known by
three components:
1.) CPU processor cores and clockspeed, which is typically measures in
gigahertz
2.) The amount of random-access memory (RAM)
3.) The speed of data location or transfer rate of the disk drives.
62. 3. OPEN SOURCE AND FREE SOFTWARE
Software are the instructions being given to the hardware to
perform certain tasks. They are classified based on availability and
shareability as to free and open-source software and propriety or
closed software.
Free and open-source software (FOSS) allows users and
programmers to edit, modify or reuse the software’s source code.
This gives developers the opportunity to improve program
functionality by modifying it.
63. System Software helps the user, hardware, and
application software to interact and function
together.
Application Software are what users regularly
engage with the most of the time.
64. 4. DATA ASSESSMENT
Data Quality Assessment (DQA) is the process of
scientifically and statistically evaluating data in order to determine
whether they meet the quality required for projects or business
processes and are of the right type and quantity to be able to
actually support their intended use. It can be considered a set of
guidelines and techniques that are used to describe data, given an
application context, and to apply processes to assess and improve
the quality of data.
65. DQA processes are aligned with the best practices and a set of
prerequisites as well as with the five dimensions of data quality.
• Accessibility
• Accuracy and reliability
• Serviceability
• Methodological soundness
• Assurances of integrity
66. 5. PERSONAL, PROFESSIONAL, AND EDUCATIONAL
INFORMATICS
Personal Informatics
Information services, often accessible via a mobile device,
that search, sort, mine, correlate or otherwise filter information for
a person based on their preferences, transaction logs, location,
social networks and other personal data.
Health informatics professionals use their knowledge of
healthcare, information systems, databases as and information
technology security to gather, store, interpret and manage the
massive amount of data generated when care is provided to
patients.
67. Educational Informatics
is an emerging sub-disciplines of education and
informatics that “incorporate[s] new technologies and
learning strategies to enhance the capture,
organization, and utilization of information within the
field of education.”
68. Graves and Corcoran'smodel (1989; 1995)
According to this model, nursing informatics as the
linear progression, from data into information
and knowledge.
69. GravesandCorcoran'smodel (1989; 1995)
MANAGEMENT
DATA INFORMATION KNOWLEDGE
Management
processin
g
is integrated within
each
elements, depicting nursing informatics as the
proper management of knowledge, from data as it
is converted into information and knowledge.
70. Schiwirian'smodel (1986)
According to this model, nursing informatics involves
identification of information needs, resolution the
needs, and attainment of nursing goals/objectives.
Patricia Schiwirian proposed a model intended to stimulate
and guide systematic research in nursing informatics,
model/framework that enable identification of significant
information needs,that canfosterresearch
72. Turley'smodel(1996)
Nursing informatics is the intersection between the
science (nursing) and the area of
discipline-specific
informatics
And in this model, there are 3 core components of informatics,
namely Cognitive science, Information science, and Computer
science.
