INFORMATICS THEORY

Theories, Models and Frameworks

1985, Kathryn Hannah

Informatics is the use of information technologies

in relation to any nursing functions and actions
of nurses.
1989, Graves and Corcoran

Nursing informatics is 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.
1992, ANA

Nursing informatics is the specialty that integrates nursing

science, computer science and information science in
identifying, collecting, processing and managing data and
information to support nursing practice, administration,
education, research and the expansion of nursing knowledge.
 *1992, ANA

Established nursing informatics as a distinct specialty

in nursing with a distinct body of knowledge which
provides official recognition that nursing informatics
is indeed a part of nursing and that it has a distinct
scope of practice.
MODELS FOR NURSING INFORMATICS

Patricia Schwirian, 1986

Graves & Corcoran,1989
Turley, 1996
 PATRICIA SCHWIRIAN, 1986
To provide a framework for identifying significant information needs
which in turn can foster to research

Four elements:
1.Raw material (nursing-related information)
2. The technology (a computing system)
3. The users (nurses, students and context)
4. The goal (objective toward which the preceding elements are
directed)
 GRAVES & CORCORAN,1989
NI as the linear progression—from data into information
knowledge.

Management processing is integrated within each elements,

depicting nursing informatics as the proper management of
knowledge.
 TURLEY, 1996
NI is the intersection between the discipline and the area of
informatics.

Three Core components:

a. Cognitive science
b. Information science
c. Computer Science
MODELS FOR NURSING INFORMATICS

Patricia Schwirian, 1986

Graves & Corcoran,1989
Turley, 1996
 DATA, INFORMATION, AND KNOWLEDGE

Data are “discrete entities that are described objectively without

interpretation”

Information reflects interpretation, organization or structuring of data – the

result of structuring of data.

Knowledge is the information that is synthesized so that relationships are

identifies and formalized.
COMPETENCIES

Benner’s
Staggers, Gassert & Curran
BENNER’S
Expert

Proficient
Competent
Advanced Beginner

Novice
STAGGERS, GASSERT & CURRAN

Informatics
Innovator
Informatics
Specialist
Experienced
Nurse
Beginning
Nurse
 TERMINOLOGIES

NURSING MINIMUM DATA SET (NMDS) – DR.HARRIET

WERLEY
- Considered the foundational work of nursing
languages & represents the first attempt to
standardize the collection of essential nursing data.
 NORTH AMERICAN NURSING DIAGNOSIS ASSOCIATION
(NANDA)

has evolved a conceptual system that guides the

classification of nursing diagnoses in a taxonomy and
includes definitions and defining characteristics.

includes 167 recognized diagnoses

 NURSING INTERVENTION CLASSIFICATION (NIC)

Contains 514 nursing interventions that describe

the treatments nurses perform, updated linkages
with NANDA diagnoses, and core interventions
identified for 44 specialty practice areas.
NURSING OUTCOMES CLASSIFICATION (NOC)

•NOC has 330 research-based outcomes to provide

standardization of expected patient, caregiver,
family and community outcomes for measuring
the effect of nursing interventions.
 AMERICAN MEDICAL INFORMATICS ASSOCIATION (AMIA)
The AMIA is an individual membership organization dedicated to the development
and application of medical informatics in the support of patient care, teaching,
research and healthcare administration.

AMIA serves as an authoritative body in the field of medical informatics and

frequently represents the United States in the informational arena of medical
informatics in international forums

 is the U.S. member of the International Medical Informatics Association (IMIA).

 HEALTHCARE INFORMATION AND MANAGEMENT
SYSTEMS SOCIETY (HIMSS)
 The HIMSS represents a membership of over 14,000 individuals and 200
corporations interested in healthcare informatics, clinical systems,
information systems, management engineering and telecommunications.

 HIMSS members are responsible for developing many of today’s key

innovations in healthcare delivery and administration, including tele-
health, CPRs or EHRs, community health information networks, and
portable/wireless healthcare computing.
 NATIONAL LEAGUE FOR NURSING (NLN)

MISSION: to advance quality nursing education that

prepares the nursing workforce to meet the needs of
diverse populations in an ever-changing healthcare
environment.
 SOCIETY FOR HEALTH SYSTEMS (SHS)

Society of industrial engineers

An individual membership organization that exists to

enhance the career development & continuing
education of professionals who use industrial
management & engineering
 ASSOCIATION FOR COMPUTING & MACHINERY (ACM)

Founded in 1947
A major force in advancing the skills of information
technology professionals and students worldwide
 AMERICAN SOCIETY FOR INFORMATION SCIENCE &
TECHNOLOGY (ASIS & T)
Established in 1937
The society for information professionals leading
the search for new and better theories, techniques
an technologies to improve success to information
 NATIONAL LEAGUE FOR NURSING (NLN)

MISSION: to advance quality nursing education that

prepares the nursing workforce to meet the needs of
diverse populations in an ever-changing healthcare
environment.
ADVANCED TERMINOLOGY SYSTEMS
 THE VOCABULARY PROBLEM
1. The development of multiple specialized terminologies has
resulted in areas of overlapping content, areas for which no
content exits, and large numbers of codes and terms.

2. Existing terminologies are most often developed to provide sets of

terms and definitions of concepts for human interpretation with
computer interpretation as only as secondary goal.
 CONCEPT ORIENTATION

1. Understand the definition of & relationships among things

in the world (objects)
2. Our thoughts about things in the world (concepts)
3. The labels we use to represent and communicate &
communicate our thoughts about things in the world
(terms)
 SEMIOTIC TRIANGLE

Symbolizes Refers to

Stands for
CONCEPT (THOUGHT / REFERENCE) – unit of knowledge
created by a unique combination of characteristics

OBJECT (REFERENT) – anything perceivable / conceivable

TERM (SYMBOL) – verbal designation of a general concept

in a specific subject field
 TERMINOLOGY MODEL

a concept-based representation of a collection of

domain-specific terms that is optimized for the
management of terminological definitions.

encompasses both schemata and type definitions.

 ADVANTAGES OF ADVANCED TERMINOLOGY
SYSTEMS
1. Nonambiguous representation of concepts
2. Facilitation of data abstraction /de-abstraction without loss
of original data
3. Nonambiguous mapping among terminologies
4. Data reuse in different contexts
5. Automated classification of new concepts and an ability to
support multiple inheritance of defining characteristics
ADVANCED TERMINOLOGICAL APPROACHES IN
NURSING

1. ISO 18104:2003
2. the GALEN Project
3. SNOMED
 ISO 18104:2003

1. Facilitate the representation of nursing diagnosis and

nursing action concepts and their relationships in a
manner suitable for computer processing
2. Provide a framework for the generation of
compositional expressions from atomic concepts within
a reference terminology
 ISO 18104:2003

3. Facilitate the mapping among nursing diagnosis and

nursing action concepts from various terminologies
4. Enable the systematic evaluation of terminologies and
associated terminology models for purposes of
harmonization
 ISO 18104:2003

5. Provide a language to describe the structure of

nursing diagnosis and nursing action concepts in
order to enable appropriate integration with
information models
 THE GALEN PROJECT
(GENERALIZED ARCHITECTURE FOR LANGUAGES, ENCYCLOPEDIA &
NOMENCLATURES IN MEDICINE)
GRAIL ( GALEN Representation And Integration Language)
- A terminological language that provides a means of
capturing the knowledge that underpins clinical
terminology in a formal compositional model from which
all and only sensible clinical concepts can be generated
 SNOMED / SNOMED CT
(SYSTEMATIZED NOMENCLATURE OF MEDICINE – CLINICAL TERMS)

A systematically organized computer processable

collection of medical terms providing codes, terms,
synonyms and definitions used in clinical
documentation & reporting