NCM 110

Nursing Informatics

Kathy Angeles, RN, CPC

 Class Assessment

1. What do you know about nursing informatics?

2. How does nursing informatics affect the nursing
industry and the healthcare system?
3. What are some examples of nursing informatics?
4. What are the concerns that nursing informatics
poses?
5. Why do you think it is important to learn nursing
informatics?
 Week 1 - Topics

• Course Overview
• Overview of Computers and Nursing
• Computers and nursing
• Issues in informatics
• Informatics Theory
 Week 1 - Objectives

• Define nursing informatics

• Identify parts of a computer
• Identify the issues in informatics
• Discuss informatics theory
 Computers and Nursing

COMPUTER

Cambridge: an electronic machine that is used

for storing, organizing, and finding words,
numbers, and pictures, for doing calculations,
and for controlling other machines

Merriam-Webster: a programmable usually

electronic device that can store, retrieve, and
process data.
 Computers and Nursing

Britannica: A computer is a machine that can

store and process information. Most computers
rely on a binary system, which uses two
variables, 0 and 1, to complete tasks such as
storing data, calculating algorithms, and
displaying information. Computers come in
many different shapes and sizes, from
handheld smartphones to supercomputers
weighing more than 300 tons.
 Computers and Nursing

NURSING

Nursing is the diagnosis and treatment of

human responses and advocacy in the care of
individuals, families, groups, communities, and
populations in recognition of the connection of
all humanity. ANA (2021)
 Computers and Nursing

Nursing encompasses autonomous and collaborative

care of individuals of all ages, families, groups, and
communities, sick or well and in all settings. Nursing
includes the promotion of health, prevention of illness,
and the care of ill, disabled and dying people.
Advocacy, promotion of a safe environment, research,
participation in shaping health policy and in patient
and health systems management, and education are
also key nursing roles. (ICN, 2002)
 Informatics

INFORMATICS

• Combination of the terms information and

automatic / automation which means
automatic information processing.
• A science that combines domain science,
computer science, information science and
cognitive science.
 Nursing Informatics

HEALTHCARE INFORMATICS

• It is the integration of information science, health

science, computer science, and cognitive science.

• It is the derivative of the holistic objective of

medical practitioners, such as nurses, healthcare
providers, physicians, and healthcare staff.
 Nursing Informatics

NURSING INFORMATICS (NI)

NI is a specialty that integrates nursing

science with multiple information management
and analytical sciences to identify, define,
manage, and communicate data, information,
knowledge, and wisdom in nursing practice.
 Nursing Informatics

NI supports consumers, patients, nurses,

and other healthcare professionals in their
decision-making in all roles and settings to
achieve desired outcomes.
This support is accomplished through the
use of information structures, information
processes, and information technology.
 NI Definitions

Rognehaugh (rown-hoff)
“the use of any computer and information
technologies that support any nursing function
carried out by nurses in the performance of
their duties”

Hannah (1985)
“use of information technologies in relation to
those functions, within the purview of nursing
that are carried out by nurses when performing
their duties”
 NI Definitions

Graves and Corcoran (1989)

“a combination of computer science,
information science and nursing science
designed to assist in the management and
processing of nursing data, information and
knowledge to support the practice of nursing
and the delivery of nursing care.”
 NI Definitions

Hebda (1998)
Defines nursing informatics as “the use of
computer technology to support nursing,
including clinical practice, administration,
education, and research.
 NI Models

Schwirian’s Model (1986)

➢ Patricia Schwirian – proposed a model
intended to stimulate and guide systematic
research in nursing informatics in 1986.
➢ The framework that enables identification of
significant information needs that can foster
research.
 NI Models

Turley’s Model (1996)

• Nursing informatics is the intersection
between the disciple-specific science
(nursing) and the area of informatics
• Core components of
informatics
o Cognitive science
o Information science
o Computer science
 Concept

Origins of Nursing Information System

1977
• The first Nursing Information System
Conference was held in the United States
• Here nurses adapt computer processes to
enhance client care, education,
administration and management, and
nursing research.
 Concept

Origins of Nursing Information System

October 1995
• The first ANA certification examination in Nursing
Informatics was given.
• This creates the Nurse Informaticists – they are
responsible for interfacing between the client care
and information technology departments and
assisting with the development, implementation and
evaluation of initiatives in the clinical information
system.
 Concept

Origins of Nursing Information System

1999
• A study was formed to identify International
Standards for health information and their
adaptability in the Philippines referred to as
“Standards of Health Information in the Philippines,
1999 ver. (SHIP99).
 Concept

Origins of Nursing Information System

2003
• Master of Science in Health Informatics was
proposed to be offered by UP-Manila College of
Medicine (major in medical informatics) and the
College of Arts and Science (major in
bioinformatics) and was later approved to be
offered starting academic year 2005-2006.
 Concept

Origins of Nursing Information System

2006
• Creation of TIGER (Technology Informatics Guiding
Educational Reform)
o HIMSS (Healthcare Information and Management
Systems Society)
• Created to identify knowledge/information
management best practices and effective
technology capabilities of nurses.
 Concept

Origins of Nursing Information System

2008
• The Nursing Informatics course in the
undergraduate curriculum was defined by the
Commission on Higher Education (CHED).
Memorandum Order 5 Series of 2008, later revised
and included as a Health Informatics course in
CHED Memorandum Order 14 Series of 2009, and
first implemented in the summer of 2010.
 Concept

Origins of Nursing Information System

2009
• Mr. Kristian R. Sumabat and Ms. Mia Alcantara-
Santiago, both nurses and graduate students of
Master of Science in Health Informatics at the
University of the Philippines, Manila began
drafting plans to create a nursing informatics
organization.
 Concept

Origins of Nursing Information System

2010
• They began recruiting other nursing informatics
specialists and practitioners to organize a group
which later became the Philippine Nursing
Informatics, a sub-specialty organization of PNA for
nursing informatics.
• Philippine Nursing Informatics Association (PNIA)
 Concept

Framework of Nursing Informatics

➢ Data – discrete entities that are described

objectively without interpretation.
➢ Information – as data, however is interpreted,
organized or structured.
➢ Knowledge – as information that has been
synthesized so that interrelationships are identified
and formalized… this results to decisions that
guides practice.
163/112 8/10 97 37 99 26
 Concept

➢ Health and nursing information science studies

how health care data is acquired, communicated,
stored, managed, and processed into information
and knowledge.

➢ This knowledge is useful

to nurses in decision-
making at the operational,
tactical, and strategic
planning of levels of
health care.
 Concept

Computer System

1. Computer Hardware
2. Computer Software System
3. Open Source and Free Software
4. Data Assessment
5. Personal, Professional and Educational
Informatics
 Concept

Computer System

• A network of computers, users, programs, and

procedures in an organization – assists the
healthcare team with decision-making and
communication.
 Concept

Computer System- which?

❑ general system used to manage information across
various sectors

❑ tailored to meet the specific needs of healthcare

institutions, focusing on improving patient care and
operational efficiency

• Two (2) most common types of Computer Systems:

1. Management Information System
2. Hospital Information System
 Concept

Computer System
Computer Hardware
• Hardware is the physical part of the computer and
its associated equipment. Computer hardware can
comprise many different parts, these include:
1. Input devices
2. Output devices
3. Central Processing Unit (CPU)
 Concept

Computer System

• Read-only memory (ROM) is permanent; it

remains when the power is off. A start-up instruction
for the computer is an example of ROM.

• Random access memory (RAM) is a temporary

storage area for program instructions and data that
is being processed; it is only active while the
computer is turned on. (Located on the
motherboard not part of CPU).
 Concept

Computer System

• Control Unit: manages instructions to other parts

of the computer, including input and output devices
“traffic cop”.

• Solid-state drive (SSD) is a solid-state storage

device that uses integrated circuit assemblies to
store data persistently, typically using flash
memory, and functioning as secondary storage in
the hierarchy of computer storage.
 Concept

Computer System

Secondary Storage
• Provides space to retain data in an area separate in
an area computer’s memory after the computer is
turned off, these include; hard disk drives, floppy
disks, tape, zip drives, optical drives and CD –
ROM drives. And also there are many storage
drives that are available like flash drive, external
hard drive etc.
Issues in informatics
 Issues in informatics

Like many other disciplines, nursing informatics

faces many challenges while in its infancy stage.
However, the contents of the curriculum were adapted
from international materials which do not match the
local needs. Lack of certification and credentialing
programs in post-graduate levels are also absent with
the scarcity of local nursing informatics experts. This
new field has yet to gain acceptance and recognition
in the nursing community as a sub-specialty.
 Issues in informatics

Development of training, certification and credentialing

programs are in the pipeline for the Philippine Nursing
Informatics Association. Future partnerships with local
and international nursing and health informatics
organizations have started as well.
 Issues in informatics

Other programs are expected to be slowly

delivered with PNIA's CORE X strategic platform
which stands for Competency, Organization,
Recognition, Experience, and Expertise.
It is also a major thrust to support the use of health
information standards in the Philippines and to have
nursing informatics specialists in every hospital in the
country.
Informatics Theory
 Informatics Theory

Foundations of NI
• Core phenomena
• Data, information, knowledge, and wisdom and
the transformations
• NI models
• Representations of some aspect of the real
world
• Particular perspectives of a selected aspect and
may illustrate relationships
• Evolve as knowledge, different models reflect
different viewpoints
 Informatics Theory

Theories Supporting Nursing Informatics

Nursing theories- about nursing practice. NI can
utilize the theories in nursing since it involves the
individual, groups and communities and can be used
accordingly.
 Informatics Theory

Novice to expert- Dreyfus and Dreyfus (1989),

proposed a model of how people become experts.
There are five stages: novice (rule follower), advanced
beginner (plus real-life experience), competent
(important and not important), proficient (sees a larger
situation and can decide based on intuition), and
expert (understands a situation and immediately
connects actions). Example, intravenous insertion or
starting a line.
 Informatics Theory

Computer science- a study of algorithms for solving

computation problems. An automated solution to
problems if algorithm is identified, then a machine can
be built. Like when a computer was built as a tool.
 Informatics Theory

Information science- focuses on the gathering,

manipulation, classification, storage, and retrieval of
recorded knowledge. Three important branches are
information retrieval, human-computer interactions,
and information handling within a system.
 Informatics Theory

The Mathematical Theory of Communication (1949)

by Weaver and Shannon- concept of communication
channel which was sequential to the Classic
information theory that focuses on a central problem
that has been the engineering problem of the
transmission of information over a noisy channel.
Sender (source of information), a transmission
medium (with noise and distortion), and a receiver
(whose goal is to reconstruct the sender’s messages.
 Informatics Theory

Encoding and decoding- if the data exceeds or

sent below the channel capacity, errors are inevitable.
Information can be encoded so that it can be received
without errors then the receiver will have to decode
the message.
 Informatics Theory

Communication- Bruce I. Blum (1985) presented the

central concepts of data (raw), information
(interpreted, organized, or structured), and knowledge
(synthesis of inter-relationships of data and
information) which are adopted by NI.
 Informatics Theory

Systems- the theory that relates to the properties of

systems as a whole. The focus are organization and
interdependence of relationships within a system. It is
constantly changing.
Closed system- does not interact with the
surrounding environment. Example, human circulatory
system because the blood never leaves the system of
blood vessels.
Open system- can be influenced by events outside
of the actual or conceptual boundaries. Example,
people.
 Informatics Theory

Six key concepts in understanding system change:

dynamic homeostasis (preserves the character of a
system through its growth), entropy (disorder or
breaking down into the smallest parts, eg loss of
information), negentropy (in order, organized),
specialization, reverberation (one part of the system
changes, the rest of the system are affected), and
equifinality (same end, different routes).
 Informatics Theory

Behavioral and social sciences- the process driving

actions. Although interchangeably used, behavior can
include emotions, cognition, and motivation while
social processes and acts can be status, levels of
social context, and biosocial interactions (Office of
Behavioral and Social Sciences, 2010.)
 Informatics Theory

Change- in healthcare and nursing informatics,

change often has to be dealt with among groups of
people and healthcare organizations. Affects not only
structures and ways of doing tasks, but also the
performance, expectations, and perceptions of all
involved parties.
 Informatics Theory

The Informatics Nurse Specialist (INS)- primary

change agent in facilitating the implementation of
clinical information system (CIS).
Planned-change theory- collection of ideas
about modifications to an organization or social
system that are explicitly designed and put into place.
Change do not happen by chance.
 Informatics Theory

Lewin’s basic planned-change model: unfreezing

(overcoming inertia and dismantling the existing
mindset), changing (behavioral change occurs, a
period of confusion), refreezing (a new mindset has
formed, returning comfort level).
 Informatics Theory

Diffusion of innovations theory- Everett Rogers, 1962,

“Diffusion of Innovations”.

Five specific groups of innovation adopters:

innovators, early adopters, early majority, late majority,
and laggards.

Five-stage model for the diffusion of innovation:

knowledge, persuasion, the adopter makes a decision,
implementation, and confirmation.
 Informatics Theory

Characteristics that mostly affect the rate of adoption:

relative advantage (degree to which an innovation is
perceived as better than the idea it replaces),
compatibility (degree to which an innovation is
perceived as being consistent with existing values,
past experiences, and needs of potential adopters),
 Informatics Theory

complexity (a negative characteristics, degree to

which an innovation is perceived as difficult to
understand and use), trialability (degree to which an
innovation may be tried out or experimented with), and
observability (degree to which the results of an
innovation are visible to others).
 Informatics Theory

Learning- two basic elements: pairing and

reinforcement. Pairing is a combination of a stimulus
and response. Reinforcement, the stimulus-response
element that has two pathways- positive and
negative.
 Informatics Theory

Cognitive learning theory- internal mental processes,

including insight, information processing, memory, and
perception. Four steps in learning: information input
(the information is received by the learner), input
processing (the information is either remembered
only for a short time or is moved to long-term memory
where it can be drawn upon as needed), output
behaviors (that demonstrate if learning has taken
place), and the use of feedback to embed the same
information more firmly or to correct errors.
 Informatics Theory

Organizational behavior- focused on organizations

which are examined, using the methods drawn from
economics, sociology, political science, anthropology,
and psychology.

Management- management science uses

mathematics and other analytical methods to help
make better decisions. Uses techniques to inform and
improve decisions of all kinds.
 Informatics Theory

Group dynamics- focuses on the nature of groups.

Formal and informal groups. Tuckman’s model (1965):
forming (pretending to get on or get along with
others), storming (letting down the politeness barrier
and trying to get down to the issues even if tempers
flare up), norming (getting used to each other and
developing trust and productivity), and performing
(working in a group to a common goal on a highly
efficient and cooperative basis).
Post-test
 Assignment

INDIVIDUAL: Index card with your complete name

(last name, first name and middle initial) and student
ID number

Next meeting:
Questions?
 Closing

✓ Kindness

✓ Always be curious

✓ Try and train

✓ Humor and humility

✓ You're ENOUGH
Prayer
END