Chapter 1

Nursing Science and the Foundation

of Knowledge
 Objectives
• Define nursing science and its relationship to
various nursing roles and nursing informatics.
• Introduce the Foundation of Knowledge
Model © 2007 as the organizing conceptual
framework for the book.
• Explain the relationship between knowledge
acquisition, knowledge processing, knowledge
generation, knowledge dissemination and
wisdom.
 Key Terms Defined
• Borrowed theory - Theories borrowed or made
use of from other disciplines; as nursing began to
evolve, theories from other disciplines such as
psychology, sociology, etc., were adopted to try
to empirically describe , explain or predict
nursing phenomena. As nursing theories continue
to be developed, nurses are now questioning
whether or not these borrowed theories were
sufficient or satisfactory in their relation to the
nursing phenomena they were used to describe,
explain or predict.
 Key Terms Defined
• Building blocks - Basic element or part of
nursing informatics such as information
science, computer science, cognitive science
and nursing science.
• Clinical Databases - A collection of related
patient records stored in a computer system
using software that permits a person or
program to query the data in order to extract
needed patient information.
 Key Terms Defined
• Clinical practice guidelines - Informal or
formal rules or guiding principles that a
healthcare provider uses when determining
diagnostic tests and treatment strategies for
individual patients, in the EHR they are
included in a variety of ways such as prompts,
pop ups and text messages.
 Key Terms Defined
• Conceptual framework - Used in research to
chart feasible courses of action or to present a
desired approach to a study or analysis;
framework built from a set of concepts, these
concepts are related to a proposed or existing
system of methods, behaviors, functions,
relationships and objects; a relational model;
formal way of thinking or conceptualizing
about a phenomenon, process, or system
under study.
 Key Terms Defined
• Data - Raw fact; lacks meaning.
• Data mining - Software that sorts thorough
data in order to discover patterns and
ascertain or establish relationships; software
that discovers or uncovers previously
unidentified relationships among the data in a
database; program that conducts exploratory
analysis looking for hidden patterns in data.
 Key Terms Defined
• Evidence - Artifacts, productions, attestations or
other examples that demonstrate what an
individual’s knowledge, skills or valued attributes.
• Feedback - Input in the form of opinions about or
reactions to something such as shared
knowledge; in an ISs, feedback refers to
information from the system that is used to make
modifications in the input, processing actions or
outputs .
 Key Terms Defined
• Foundation of Knowledge Model© 2007 - This model
represents that humans are organic information
systems constantly acquiring, processing and
generating information or knowledge both in our
professional and personal lives. It is our high degree of
knowledge that characterizes us as extremely
intelligent organic machines. Individuals have the
ability to manage knowledge. This ability is learned
and honed from birth. We make our way through life
interacting with our environment and being inundated
with information and knowledge. We experience our
environment and learn by acquiring, processing,
generating and disseminating knowledge.
 Key Terms Defined
• Foundation of Knowledge Model© 2007 – (cont’d) As we
interact in our environment, we acquire knowledge that we
must process. This processing effort causes us to redefine
and restructure our knowledge base and generate new
knowledge. We then share (disseminate) this new
knowledge, and receive feedback from others. The
dissemination and feedback initiates this cycle of
knowledge all over again since we acquire, process,
generate and disseminate the knowledge gained from
sharing and re-exploring our own knowledge base. As
others respond to our knowledge dissemination and we
acquire new knowledge, we are engaged to re-think about
and reflect on our knowledge, processing, generating and
then disseminating anew.
 Key Terms Defined
• Information - Data that are interpreted,
organized, or structured; data that is
processed using knowledge or data made
functional through the application of
knowledge.
 Key Terms Defined
• Knowledge - The awareness and understanding of a set of
information and ways that information can be made useful
to support a specific task or arrive at a decision; abounds
with others’ thoughts and information; information that is
synthesized so that relationships are identified and
formalized; understanding that comes through a process of
interaction or experience with world around us ; info that
has judgment applied to it or meaning extracted from it;
processed information that helps to clarify or explain some
portion of our environment or world that we can use as a
basis for action or upon which we can act; internal process
of thinking or cognition; external process of testing, senses,
observation, interacting.
 Key Terms Defined
• Knowledge acquisition - Act of acquiring or
getting knowledge.
• Knowledge dissemination - Distribution and
sharing of knowledge.
• Knowledge generation - Creating new
knowledge by changing and evolving
knowledge based on your experience,
education, and input from others.
 Key Terms Defined
• Knowledge processing - The activity or
process of gathering or collecting, perceiving,
analyzing, synthesizing, saving or storing,
manipulating, conveying, and transmitting
knowledge.
• Knowledge worker - Work with information
and generate information and knowledge as a
product.
 Key Terms Defined
• Nursing informatics - A specialty that integrates
nursing science, computer science, cognitive
science, and information science to manage and
communicate data, information, knowledge and
wisdom in nursing practice; Nursing informatics
facilitates the integration of data, information,
and knowledge to support patients, nurses, and
other providers in their decision-making in all
roles and settings.
 Key Terms Defined
• Nursing informatics - This support is accomplished
through the use of information structures, information
processes, and information technology; “a specialty
that integrates nursing science, computer science, and
information science to manage and communicate data,
information, and knowledge” (Staggers & Thompson,
2002, p. 260); synthesis of nursing science, information
science, computer science and cognitive science to
facilitate the management of healthcare data for the
improvement of patient care and advancement of the
nursing profession.
 Key Terms Defined
• Nursing science - The ethical application of
knowledge acquired through education,
research and practice to provide services and
interventions to patients in order to maintain,
enhance or restore their health; to advocate
for health,  and to acquire, process, generate
and disseminate nursing knowledge to
advance the nursing profession.
 Key Terms Defined
• Nursing theory - Concepts, propositions and
definitions that represent a methodical viewpoint
and provide a framework for organizing and
standardizing nursing actions.
• Relational database - A collection of related
records stored in a computer system using tables
that can be related to one another and the data
extracted in a variety of ways to gain needed
information without having to reorganize the
tables.
 Key Terms Defined
• Transparent - Done without conscious thought.
• Wisdom - Knowledge applied in a practical way
or translated into actions; uses knowledge and
experience to heighten common sense and
insight to exercise sound judgment in practical
matters; sometimes thought of as the highest
form of common sense resulting from
accumulated knowledge or erudition (deep
thorough learning) or enlightenment (education
that results in understanding and the
dissemination of knowledge);
 Key Terms Defined
• Wisdom – (cont’d) it is the ability to apply
valuable and viable knowledge, experience,
understanding and insight while being
prudent and sensible; is focused on our own
minds; the synthesis of our experience,
insight, understanding and knowledge; the
appropriate use of knowledge to solve human
problems.  It is knowing when and how to
apply knowledge.
 Nursing Science
• One of the most frequently quoted and widely
accepted definitions of nursing informatics is that
it is a combination of nursing science,
information science and computer science.
• In this chapter, we will focus on nursing science
as one of the building blocks of nursing
informatics, although in this text we extend the
traditional definition of nursing informatics to
include cognitive science as one of the building
blocks.
 Use of Knowledge
• Individuals have an amazing ability to manage
knowledge. This ability is learned and honed
from birth.
• We experience our environment and learn by
acquiring, processing, generating and
disseminating knowledge.
 Foundation of Knowledge Model ©
2007
• This book uses the Foundation of Knowledge
Model © 2007 reflecting that knowledge is a
powerful tool and for that reason, nurses focus
on information as a key building block of
knowledge.
• We will also introduce the Foundation of
Knowledge Model © 2007 as the organizing
conceptual framework of this text, and tie the
model to nursing science and the practice of
nursing informatics.
 ANA Definition of Nursing
The American Nurses’ Association (2003) defines
nursing in this way: “Nursing is the
protection, promotion, and optimization of
health and abilities, prevention of illness and
injury, alleviation of suffering through the
diagnosis and treatment of human response,
and advocacy in the care of individuals,
families, communities, and populations.”
 Nursing
• Thus the focus of nursing is on the human
responses to actual or potential health problems,
and advocacy for various clients.
• Nurses must possess the technical skills to
manage equipment and perform procedures,
interpersonal skills to interact appropriately with
people, and cognitive skills to observe, recognize
and collect data, analyze and interpret data and
reach a reasonable conclusion that forms the
basis of a decision.
 Nursing
• Nursing is an information intensive profession.
• The steps of utilizing information, applying
knowledge to a problem, and acting with
wisdom form the basis of nursing practice
science.
• We acquire data and information in bits and
pieces and then transform the information
into knowledge.
 Nursing and Knowlege
• Nurses are knowledge workers, working with
information and generating information and
knowledge as a product.
• We are knowledge acquirers, providing
convenient and efficient means of capturing and
storing knowledge.
• We are knowledge users, individuals or groups
who benefit from valuable, viable knowledge.
• Nurses are knowledge engineers, designing,
developing, implementing and maintaining
knowledge.
 Nursing and Knowledge
• We are knowledge managers, capturing and
processing collective expertise and
distributing it where it can create the largest
benefit.
• We are knowledge developers or generators,
changing and evolving knowledge based on
the tasks at hand and information available.
 Use of Knowledge
• Knowledge must also be viable.
• Knowledge viability refers to applications
(most technology based) that offer easily
accessible, accurate and timely information
obtained from a variety of resources and
methods and presented in a manner as to
provide us with the necessary elements to
generate new knowledge.
 Use of Knowledge
• All nurses have the opportunity to be involved
in the formal dissemination of knowledge via
their participation in professional conferences
either as presenters or attendees.
• All nurses regardless of the practice arena
must use informatics and technology to
inform and support that practice.
 Use of Wisdom
• Wisdom is the application of knowledge to an
appropriate situation.
• In the practice of nursing science, we expect
action and/or actions directed by wisdom.
• Wisdom uses knowledge and experience to
heighten common sense and insight to
exercise sound judgment in practical matters.
It is developed through knowledge,
experience, insight and reflection.
 Beyond Nursing Practice
• In order for nurse educators to be effective,
they must be in the habit of constantly
building and rebuilding their foundation of
knowledge about nursing science.
• Nurse researchers must acquire and process
new knowledge as they design and conduct
their research studies.
 Nursing in the Future
• The future of nursing science and nursing
informatics is intimately associated with the
nursing education and nursing research
arenas.
• Skiba (2007) suggests that we need techno-
saavy and well-informed faculty who can
demonstrate the appropriate use of
technologies to enhance the delivery of
nursing care.
 Nursing in the Future
• Informatics and the use of technology in the
practice of nursing are equally important in
the nursing research arena.
• Participants in the development of The
National Nursing Research Agenda (NNRA)
identified these two technology related
priorities (among other research priorities) for
nursing research:
– Nursing Informatics: Enhancing Patient Care
– Technology Dependency across the Life-span
 Nursing in the Future
• Goosen (2002) believes that the focus on nursing
informatics research should be on the structuring
and processing of patient information and how
these inform nursing decision making in clinical
practice.
• It is clear that the increasing use of technology to
enhance nursing practice, nursing education, and
nursing research will open new avenues for
acquiring, processing, generating, and
disseminating knowledge.
 Thought Provoking Question
• Imagine you are in a social situation and
someone asks you, “ What does a nurse do?”
Think about how you will capture and convey
the richness that is nursing science in your
answer.
 Thought Provoking Question
Choose a clinical scenario from your recent
experience and analyze it using the Foundation
of Knowledge Model.
• How did you acquire knowledge?
• How did you process knowledge?
• How you generate knowledge?
• How did you disseminate knowledge?
• How did you use feedback and what was the effect of
feedback on the foundation of your knowledge?