NSG 107 Module 1 PDF

NSG 107: MODULE 1 Prepared by: Saliha Janine D. Gubaten, RN  NURSING INFORMATICS Informatics comes from the French word “informatique” which means “computer science”. Informatics is defined as computer science+information science. Hebda (1998), defines nursing info...

NSG 107: MODULE 1 Prepared by: Saliha Janine D. Gubaten, RN  NURSING INFORMATICS Informatics comes from the French word “informatique” which means “computer science”. Informatics is defined as computer science+information science. Hebda (1998), defines nursing informatics as “the use of computers technology to support nursing, including clinical practice, administration, education and research.”  ANA (American Nurses Association) 1994, has defined nursing informatics as the development and evaluation of applications, tools, processes and structures which assist nurses with the management of data in taking care of patients or supporting the practice of nursing. Application of Nursing Informatics/General Purpose Nursing Clinical Practice (Point-of-Care Systems and Clinical Information Systems) Work lists to remind staff of planned nursing interventions Computer generated client documentation Electronic Medical Record (EMR) and Computer-Based Patient Record (CPR) Monitoring devices that record vital signs and other measurements directly into the client record (electronic medical record). Computer - generated nursing care plans and critical pathways Automatic billing for supplies or procedures with nursing documentation Reminders and prompts that appear during documentation to ensure comprehensive charting Nursing Administration (Health Care Information System) Automated staff scheduling E-mail for improved communication Cost analysis and finding trends for budget purposes Quality assurance and outcomes analysis Nursing Education Computerized record keeping. Computerized assisted instruction. Interactive video technology. Distance learning-web based courses and degree programmes. Internet resources-formal nursing courses and degree programmes. Presentation software for preparing slides and handouts – power points and MS words. Nursing Research Computerized literature searching – CINHAL, Medline and web sources. The adoption of standardized language related to nursing terms – NANDA etc. The ability to find trends in aggregate data, that is data derived from large population groups – SPSS. Scope of Nursing Informatics P - Practice E - Education R - Research A – Administration Concepts, Principles and Theories in Nursing Informatics 1. General Systems Theory Developed by biologist Ludwig von Bertalanffy in 1936 Includes purpose, content and process, breaking down the “whole” and analyzing the parts The relationships between the parts of the whole are examined to learn how they work together 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. Assumptions of General System Theory 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 systems are open and dynamic 2. Change Theory Developed by Kurt Lewin who is considered the father of Social Psychology Lewin’s definition of behavior in this model is “a dynamic balance of forces working in opposite directions” 3 Major Concepts 1. Driving Forces – are those that push in a direction that causes change to occur. They cause a shift in the equilibrium towards change 2. Restraining Forces – are those forces that counter the driving forces 3. Equilibrium – is a state of being where driving forces equal restraining forces and no change occurs.  3 Stages 1. Unfreezing – process which involves finding a method of making it possible for people to let go of an old pattern that was somehow counterproductive 2. Change Stage – “moving to a new level” or “movement”. Involves a process of change in thoughts, feeling, behavior, or all three, that is In some way more liberating or more productive. 3. Refreezing Stage – establishing the change as the new habit. Major Assumptions A. People grow and change throughout their lives B. Change happens daily C. Reactions to change are grounded in the basic human needs for self-esteem, safety and security D. Change involves modification or alteration.  6 Components 1. Recognition of the area where change is needed 2. Analysis of a situation 3. Identification of methods by which change can occur 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 3. Cybernetics Theory Cybernetics is a transdisciplinary approach for exploring regulatory systems, their structures, constraints and possibilities “the scientific study of control and communication in the animal, machine and society” as defined by Norbert Wiener. 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, causal chains that move from action to sensing comparison with the desired goal, and again to action. Its focus is how anything (digital, mechanical or biological) processes information, reacts to information and changes or can be changed to better accomplish the first two tasks. Scope and Application of Cybernetics 1. Basis of modern communication systems 2. Application in cognitive science for modeling and learning 3. Application in management science Conclusion Cybernetics is applicable in any discipline relying on feedback processes including health sciences, sociology and psychology, which are based on communication process 4. Cognitive Learning Theory Explains why the brain is the most incredible network of information processing and interpretation in the body as we learn things 2 specific Theories A. Social Cognitive Theory B. Cognitive Behavioral Theory C. Social Cognitive Theory We consider 3 variables 1. Behavioral factors 2. Environmental factors (extrinsic) 3. Personal Factors (intrinsic) Basic Concepts 1. Observational Learning 2. Reproduction 3. Self Efficacy 4. Emotional Coping 5. Self regulatory Capability B. Cognitive Behavioral Theory Describes the role of cognition (knowing) to determining and predicting the behavioral pattern of an individual. Developed by Aaron Beck 5. 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). This Theory Can Be Applied to A. The development of nursing informatics skills, competencies, knowledge and expertise in NI B. The development of technological system competencies in practicing nurses working in an institution C. The education of nursing students, from first year to graduation and D. Transition of graduate nurse to expert nurse 5.1 Novice A novice doesn’t know anything about the subject he/she approaching and has to memorize its context-free features. The novice is then given rules for determining an action on the basis of this features. To improve the novice needs monitoring either by self observation or instructional feedback. 5.2 Advance Beginner Still dependent on rules, but as he/she gains more experience with the real-life situations, he/she begins to notice additional aspects that can be applied to related conditions 5.3 Competent The competent person grasps all relevant rules and facts of the field and is, for the first time, able to bring his/her own judgement to each case. This is the stage of learning that is often characterized by term problem-solving. A competent level nurse would be able to use a hospital information system with ease and know-how to solve technical difficulties. 5.4 Proficient Is called “fluency” and is 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. The proficient hospital information system learner would know how to interpret data from all departmental information and provide guidance to other disciplinary members as needed. 5.5 Expert An expert’s repertoire of experienced situation immediately dictates an intuitively appropriate action. After a great deal of experience actually using a system in everyday situations, the expert nurse discovers that without his consciously using any rules, situations simply elicit from him/her appropriate responses. 6. The DIKW Theory When raw data is collected, it gets mixed up and the view seems jumbled Model by Fricke (2018) and Russell Ackoff (1989) “D” = Data “I” = Information “ K” = Knowledge “W” = Wisdom The DIKW model of transforming data into wisdom can be viewed from two different concepts 1. Contextual Concept – one moves from a phase of gathering data parts (data), the connection of raw data parts (information), formation of whole meaningful contents (knowledge), and conceptualizing and joining those whole meaningful contents(wisdom) 2. Understanding Concept – the DIKW Pyramid can be viewed as a processing starting with researching & absorbing, doing, interacting, and reflecting A. The “Data” of DIKW Collection of Raw data is the main requirement Any measurements, logging, tracking, records and many others are all considered as data. Example: 300 Users visits a website daily to take online lessons B. The “Information” of DIKW Data that has been given meaning by defining relational connections Example: 150 Users Visit Nursing Pharmacology section, 145 for Nursing Research , Out of them, 60% is in the age group of 18-22 years old , 70% of our visitors between 9am – 11pm C. The “Knowledge” of DIKW is the third level of DIKW Model. Knowledge means the appropriate collection of information that can make it be useful. The knowledge step tries to find the answer to the "How" question. Specific measures are pointed out, and the information derived in the previous step is used to answer this question. With respect to our scenario, we must find the answer that “ How do student nurses between the age group of 18-22 years old use our modular approach. D. The “Wisdom” of DIKW The Wisdom is the fourth and the last step of the 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 processes them through special types of human programming (such as the moral, ethical codes, etc.). Therefore, Wisdom can be thought as the process by which you can take a decision between the right and wrong, good and bad, or any improvement decisions. Wisdom is the topmost level in the DIKW pyramid and answers the questions related to "Why". In case of our example scenario, one example of wisdom gained might be that due to 70 % of the working professionals visit our tutorials to get help with their certifications and technology needs.  ROLE OF NURSE IN NURSING INFORMATICS Nurse Informaticists are often perceived as the “techy” nurse, “super-user”, or the “go-to” person when new technology is implemented. They are often referred to as “bi-lingual” nurses who can speak the nursing process and information technology language. Being an expert in both fields and a liaison between the two worlds, nurses have assumed different roles and positions in the arena of informatics. Nurses comprise the biggest workforce in healthcare. This being said, nurses are the largest work-group of end-users of electronic medical record and clinical information systems; therefore, it is imperative that nurses are well- represented in the selection, design, implementation, and evaluation of clinical information systems. Nursing Informatics Specialist Is responsible for providing clinical information and data analysis for effective patient care and monitoring. Works with computer systems, data and information and information analysis systems such as a statistical information system to ensure optimal healthcare is provided. Specific Role of Nurse Information Specialist Employs informatics theories, concepts, methods, and tools to analyze information and information system requirements. Design, select, implement, and evaluate information systems, data structures, and decision support mechanisms that support patients, nurses, and their human-computer interactions within health care contexts. Facilitates the creation of new nursing knowledge. Nursing Informatics Competencies It means knowledge and skills in electronic and structured documentation. Competence : the ability to obtain, store, retrieve, and communicate data, information, knowledge, and wisdom, which is essential to nursing practice. Skills levels of competencies in nursing informatics Beginning Nurses (Level 1) Beginning nurses have fundamental information management and computer technology skills and use existing information systems and available information to manage their practice.” Experienced Nurses (Level 2) Experienced nurses have proficiency in their domain of interest (e.g., public health). These nurses are highly skilled in using information management and computer technology skills to support their major area of practice. They see relationships among data elements, and make judgments based on trends and patterns within these data. Experienced nurses use current information systems, but collaborate with the informatics nurse specialist to suggest  Informatics Specialists (Level 3) Informatics [nurse] specialists (INSs) are registered nurses prepared at least at the baccalaureate level who possess additional knowledge and skills specific to information management and computer technology. They focus on information needs for the practice of nursing, which includes education, administration, research, and clinical practice. INS’s practices are built on the integration and application of information science, computer science, and nursing science. Informatics innovators (Level 4) Informatics innovators are educationally prepared to conduct informatics research and to generate informatics theory. These nurses lead the advancement of informatics practice and research. They function with an ongoing healthy skepticism of existing data management practices and are creative in developing solutions. Innovators possess a sophisticated level of understanding and skills, and understand the interdependence of systems, disciplines, and outcomes. CAREER OPPORTUNITIES IN NURSING INFORMATICS Nursing informatics can be a highly paid field compared to other healthcare careers. Nurse informatics Nursing informatics specialist Nursing informatics clinician Clinical informatics coordinator Clinical analyst Clinical nurse informatics specialist IT clinical nurse Preoperative informatics nurse