d. informatics theory
TRANSCRIPT
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.
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.
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).
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.
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):
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.
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.
SNOMED CT:core clinical
terminology containing over 357,000 healthcare concepts with unique meanings and formal
logic-based definitions organized into multiple
hierarchies.
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.
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.
Components of Advanced Terminology Systems
Terminology Model
Representation Language
Computer-Based Tools
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
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
GALEN ProgramCan 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.
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
- 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)
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 projectTransition 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)
Project TeamLed 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
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
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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
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 flowchartGrid chartDecision tableOrganizational chartModel
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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
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