Nursing Informatics Theories

• Nursing Informatics (NI) combines nursing science and information technology.
• It aims to enhance patient care, improve health outcomes, and streamline healthcare processes.

Informatics Theory

• Theoretical frameworks in Nursing Informatics explain how information systems can be integrated into nursing practice.

Information Theory

• Focuses on quantifying, storing, and communicating information.
• Helps understand how patient data is collected and shared in nursing informatics.
• Data, like patient vital signs in an Electronic Health Record (EHR), is transmitted to healthcare providers.

Change Theories

• Theories emphasize change stages, such as unfreezing, changing, and refreezing within organizations
• Applied when implementing new technologies or practices.
• Understanding these stages helps manage staff resistance and ensure smooth transitions when a hospital adopts a new EHR system.

Cognitive Theory

• Examines how individuals process information and make decisions.
• Informs the design of user interfaces for clinical decision support systems (CDSS) in nursing informatics.
• A CDSS presents patient data in a clear, concise format, enhancing nurses' decision-making capabilities.

Sociotechnical Theory

• Considers both social and technical aspects of healthcare systems.
• Successful informatics implementations require attention to human factors, such as user training, and technical components, like software functionality.
• Addresses the need to ensure nurses are trained when introducing telehealth services.

Models

• Visual representations or frameworks for understanding complex processes in Nursing Informatics.

Graves and Corcoran's Model

• Illustrates the progression from raw data to information and knowledge.
• Includes data of a patient's heart rate reading, like 85 beats per minute.
• Includes information such as knowing the heart rate is within the normal limits
• Includes the fact that understanding how to maintain a normal heart rate is crucial for patient stability.

Schwirian's Model

• Integrates multiple perspectives on nursing informatics.
• Highlights technological factors, policies, and user needs interact in healthcare settings.
• Implementing a new clinical software system requires user training needs (social), system capabilities (technical), and regulatory compliance (policy).

Framework

• Provide a structured approach to integrating informatics into nursing practice

The TIGER Initiative Framework

• The Technology Informatics Guiding Education Reform (TIGER) promotes the integration of informatics competencies into nursing education.
• Emphasizes organizing patient data in EHRs for easy access, known as information structures.
• Emphasizes effective procedures for documenting patient care, known as information processes.
• Emphasizes tools like mobile applications that enhance communication among healthcare providers, known as information technology.

Computer System

• Computer Hardware refers to the physical components for running informatics applications effectively

Computer Hardware

• Servers are centralized systems that store EHRs and other databases.
• Workstations: Computers are used by nurses at the bedside for real-time data entry.
• Mobile Devices: Tablets or smartphones allow nurses to access patient information on-the-go.
• A hospital uses a server to host its EHR system while nurses use tablets to enter patient data directly from their rooms.

Computer Software System

• Software encompasses the programs on computer hardware

Software

• Electronic Health Records (EHRs) are comprehensive digital records of patient health information.
• Clinical Decision Support Systems (CDSS) are tools that analyze data to provide evidence-based recommendations.
• An EHR system like Epic or Cerner allows nurses to document care and access historical patient data.

Open Source and Free Software

• Open-source software allows users to modify the source code freely.
• OpenMRS is an open-source medical record system enabling customization for different healthcare settings without licensing fees.
• Free software provides similar access without cost barriers and is beneficial in resource-limited settings where budget constraints are significant.

Data Assessment

• Assessing involves evaluating the quality of data collected through informatics systems

Quality Metrics

• Includes accuracy, completeness, consistency, and timeliness. -Hospitals conduct audits on EHR entries to ensure vital signs are recorded accurately and promptly to maintain high-quality patient care.

Personal, Professional, and Educational Informatics

• Informatics extends into personal health management and professional development.

Informatics

• Personal: Applications like MyFitnessPal or Apple Health allow individuals to track personal health metrics, like diet and exercise.
• Professional: Systems like UpToDate provide evidence-based resources for clinicians at the point of care.
• Educational: Online platforms like Coursera or Khan Academy offer courses on health informatics for students or professionals continuing education.

Electronic Health Records (EHRs)

• Theory Applied: Information Theory and Sociotechnical Theory
• Implementation transformed how patient information is recorded and accessed and improves patient safety by reducing medical errors.
• Hospitals using EHR systems like Epic or Cerner allow nurses to access comprehensive patient histories.
• Hospitals with robust EHR systems experienced a significant reduction in medication errors, improving overall patient safety and care quality.

Clinical Decision Support Systems (CDSS)

• Theory Used: Cognitive Theory and Change Theories
• Provide real-time alerts/recommendations based on patient data; for instance, a CDSS might analyze a patient's lab results and vital signs to alert nurses about potential complications (sepsis or medication).
• The use of CDSS has improved adherence to clinical guidelines and reduced rates of adverse events.
• A hospital that implemented a CDSS for medication management reported a 30% decrease in medication errors within the first year.

Telehealth and Remote Patient Monitoring

• Theory Applied: Sociotechnical Theory
• Telehealth services let nurses remotely monitor patients, especially with chronic conditions like diabetes or heart disease.
• Wearable technology, such as glucose monitors or heart rate trackers, allows healthcare providers to receive continuous data streams and enable timely interventions.
• Patients in remote monitoring programs had fewer hospital admissions and emergency visits due to well-managed chronic conditions, optimizing healthcare resource use.

Predictive Analytics and Early Warning Systems

• Theory Applied: Change Theories and Information Theory
• Hospitals use analytics to spot early patient deterioration risks such as an automated Early Warning System (EWS) analyzing EHR data.
• Implementing these systems has led to earlier recognition of clinical deterioration, reducing ICU transfers and improving patient survival rates

Algorithms for Identifying Abuse

• Theory Applied: Cognitive Theory and Sociotechnical Theory
• At John Peter Smith Hospital in Texas, nurses developed an algorithm in their EHR system to identify potential victims of intimate partner violence and human trafficking; the algorithm provides step-by-step guidance for nurses during assessments.
• The implementation of this algorithm has enhanced the hospital's ability to protect at-risk patients by facilitating timely interventions and referrals to appropriate services

Explore Nursing Informatics theories: Information, Change, and Cognitive. Understand data handling, change implementation, and decision-making in healthcare. Explore how these theories shape modern nursing practice.