The Nursing Informatics Models and Theories

 Codes of Ethics

    According to the American Nurses Association (ANA), the nursing code of ethics is a guide for “carrying out nursing responsibilities in a manner consistent with quality in nursing care and the ethical obligations of the profession.” Ethics, in general, are the moral principles that dictate how a person will conduct themselves. Ethical values are essential for ALL healthcare workers, especially nurses. 

1. Autonomy is recognizing each individual patient’s right to self-determination and decision-making
2. Beneficence is acting for the good and welfare of others and including such attributes as kindness and charity. The American Nurses Association defines this as “actions guided by compassion.”
3. Justice is fairness in all medical and nursing decisions and care. Nurses must care for all patients with the same level of fairness despite the individual's financial abilities, race, religion, gender, and/or sexual orientation. 
4. Non-maleficence is to do no harm, it is selecting interventions and care that will cause the least amount of harm to achieve a beneficial outcome.

Nursing Social Policy Statement

    The Essence of the Profession is essential for all nurses to understand nursing as it is defined, nursing as a profession, nursing process, nursing regulation, and advanced nursing practice. The definition of nursing, as cited earlier in this chapter, is used in legal, practice, education, and scope of practice documents. The essence of the profession of nursing—formalized and defined in the 2010 document—provides the basis for nursing practice. The nursing process has long been the critical thinking model for the profession and the basis for assessment, diagnosis, outcomes identification, planning, implementation, and evaluation. The profession has consciously reaffirmed the importance of the nursing process in the care of healthcare consumers. The definition of nursing specialties, which forms the basis of recognition for those specialties, is also delineated herein. In fact, advanced nursing practice and advanced specialized nursing practice are defined and differentiated. This guide thus provides the basis for legal regulation and health policy for all nurses. Members of the nursing faculty will find the content of the social policy statement useful in all levels of nursing education. Students will benefit from reviewing that statement as they learn about the evolution of their profession through its key attributes, the definition of nursing, the profession’s description of the characteristics of a nursing specialty, and the delineation of its scope of practice and accompanying standards and competency statements. Such competency statements will provide them with assistance and understanding of the complexity of nursing practice. The social policy statement will also provide them with a clear delineation of the six social concerns in health care that undergird nursing’s social contract with society. In addition, the social policy statement reaffirms the importance of collaboration within nursing and interprofessional teams. The social policy statement may be used in professional development to reinforce the concepts of autonomy and competence and to address the importance of the scope of nursing practice, the nursing process, and the use of the standards of practice and professional performance in an everyday practice setting. Nurse leaders and administrators will find the social policy statement very beneficial as a resource for strategic planning, vision and mission statements, and presentations about nurses and nursing. It is also valuable to members of legal and regulatory bodies to better understand how professional, self, and legal regulations complement each other. Researchers may use the statement to provide a historical perspective of the definition of nursing. It also provides valuable insights related to the social context of nursing.

Nursing Scope and Standard of Practice

    The scope and standards of practice are authoritative statements on how the professional nurse should practice. They aren’t prescriptive; they don’t state exactly how to perform specific job tasks or functions. But they do serve as a guide on how to perform those tasks and functions competently.

    

    Providing a framework for the expectations of critical thinking and professional behavior, they are developed by nursing specialty organizations in concert with the American Nurses Association (ANA). This sets standards of practice and professional performance for registered nurses (RNs) in all specialties, roles, and practice environments. Nursing specialty organizations then develop documents to meet the practice and performance competencies of their specific specialty. This offers conceptual models that nurse administrators should study and understand so they can do their job effectively. The scope statement provides a conceptual description of the specialty—the who, what, when, why, and how. Although it doesn’t cover the clinical scope of practice, it defines the specialty nursing practice and differentiates it from other types of practice.

Standards of Nursing Informatics Practice

s        The standards of nursing informatics practice are composed of first: to identify the issue or the problem, after finding the problem/issue, identify alternatives to solve issues, third: choose and develop a solution once chosen, implement it to help the client or fellow nurse and final is to evaluate and adjust the solutions to the problem. 

    Healthcare Information Model 

        Health informatics is a term that describes the acquisition, storage, retrieval, and use of healthcare information to foster better collaboration among a patient's various healthcare providers. It applies informatics concepts theories, and practices to real-life situations to achieve better health outcomes. This includes collecting, storing, analyzing, and presenting data in a digital format. 

THE NURSING INFORMATICS MODELS AND THEORIES 

1. Graves and Corcoran (1989)

- Defines the nursing informatics as a linear progression, starting from data that when combined with other data can for information which then led to the knowledge which nurses use to provide comfort or management to the patients

2. Schwirian (1986)

- Similar to Maslow’s Hierarchy of needs wherein she defines nursing informatics involves identification of information needs, resolution of the needs, and attainment of nursing goals/objectives. It first needs raw materials that when combined will form technology and these are the machines we use in the hospital and these machines that we use will help us to meet the goal/objective we set for the betterment of our patients.

3. Turley, (1996)

- Nursing informatics is the intersection between discipline-specific science (nursing) and the area of informatics (computer science, information science, and cognitive science).

- The science is the vehicle the knowledge base for understanding the other 3 sciences.

o   Computer science gives us the hardware and the ability to program the hardware to process nursing information. It is the skills in using software and understanding how they can work for processing nursing knowledge.

o   Information science is the ability to access information, research, and knowledge. It includes the ability to evaluate the quality of the information as well as its applicability.

o   Cognitive science is consisting of critical thinking, decision making, and problem-solving which we need when we have the information. It is how we will act when we got information. 

 4. Dreyfus and Deyfus Model – “The Five Dreyfus Model Stages” 

During the seventies, the Dreyfus brothers conducted thorough research on the topic of how an individual obtains and masters a skill. They observed people with high-quality expertise in different spheres and came to the conclusion, that the individual doesn’t only acquire more knowledge in his field, his whole perception and approach to the world evolves. They created a five-stage model which aims to describe the journey of a person from obtaining a skill to mastering it.

a. Being a Novice

When the individual has little or no experience at all in executing a particular skill. The Dreyfus brothers describe it in a manner, which is untraditional. By “experience” they mean the fact that performing the particular skill would lead to no change of perspective or thought within the person.
The notice aims to succeed and focuses on results rather than knowledge. The latter explains why managing teams consisting of novices could be a struggle.

b. Advanced Beginners

The novice evolves by figuring out the mistakes in his work. The newly, “promoted” advanced beginner dwells into the world of troubleshooting. Unfortunately, the hasty mindset is not lost, and the individual still aims to acquire results fast, in this case, gaining knowledge and information. 

c. Competent

We are in the middle ground of the model. An individual falls into this category when he is fully capable of troubleshooting and solving problems on their own, as well as planning their future actions while avoiding previous mistakes. The practitioner will still experience trouble when it comes to pinpointing the exact details to focus on. The IT sphere works mainly in teams in order to smoothen out these processes.

d. Proficient
- The individual now looks at the bigger picture. Their focus falls onto understanding the essentials of the framework and often experiences frustration when documentation is oversimplified. Proficiency is defined by the self-improvement skills which each person in the stage has. Not only does the proficient practitioner learn from his own mistakes, he observes others as well, anything could be a vital source of information.

        e. Expert
        - when the individual becomes an expert in the field. The difference between the fourth and the fifth stage is that people in the fifth are a source of information and knowledge themselves. Their experience is so vast  that other people look up to them. A major part of the work done by the expert is based on his intuition.         They lead major teams, write books, conduct studies and etc.

5. Staggers, Gassert, and Curran, (2001) – “Four Level of Practice"

    a. Beginning Nurse 

• Has fundamental information management and computer technology skills. 
• Uses existing information systems and available information to manage practice.  

    b. Experienced Nurse 

• Has proficiency in a domain of interest (e.g., public health, education, administration).
• Highly skilled in using information management and computer technology skills to support their major area of practice. 
• Sees relationships among data elements and makes judgments based on trends and patterns within these data. 
• Uses current information systems but collaborates with the informatics nurse specialist to suggest improvement to systems. 

    c. Informatics Nurse Specialist 

•  An RN with advanced preparation possessing additional knowledge and skills specific to information management and computer technology. 
• Focuses on information needs for the practice of nursing, which includes education, administration, research, and clinical practice. 
• Practice is built on the integration and application of information science, computer science, and nursing science. 
• Uses the tools of critical thinking, process skills, data management skills (including identifying, acquiring, preserving, retrieving, aggregating, analyzing, and transmitting data), systems development life cycle, and computer skills. 

    d. Informatics Innovator 

• Educationally prepared to conduct informatics research and generate informatics theory. 
• Has a vision of what is possible and a keen sense of timing to make things happen.
• Leads the advancement of informatics practice and research. 
• Functions with an ongoing, healthy skepticism of existing data management practices and are creative in developing solutions. 
• Possesses a sophisticated level of understanding and skills in information management and computer technology. 

        

                                                                                            Cabatit, Nicole Dawn V. 

                                                                                                    BSN 2B