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Section I
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Building Blocks of Nursing

Informatics
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Chapter 1 Nursing Science and the Foundation of
Knowledge
Chapter 2 Introduction to Information, Information
© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
Science, and Information Systems
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Chapter 3 Computer Science and the Foundation of
Knowledge Model
Chapter 4 Introduction to Cognitive Science and
nes & Bartlett Learning, LLC ­Cognitive Informatics
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Chapter 5 Ethical Applications SALE OR DISTRIBUTION
of Informatics

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2 Section I: Building Blocks of Nursing Informatics

© Jones & Bartlett

Nursing Learning,
professionals LLC
are information-dependent © Jones
knowledge workers. & Bartlett Learnin
As health
NOT care
FOR SALEtoOR
continues DISTRIBUTION
evolve NOT
in an increasingly competitive information FOR SALE OR DISTR
marketplace,
­ rofessionals—that is, the knowledge workers—must be well prepared to make
p
significant contributions by harnessing appropriate and timely information. Nurs-
ing informatics (NI), a product of the scientific synthesis of information in nursing,
encompasses concepts from computer science, cognitive science, information science,
© Jones & BartlettandLearning, LLC
nursing ­science. NI continues to evolve as more © Jones
and more&professionals
Bartlett Learning,
access, LLC
NOT FOR SALE OR DISTRIBUTION NOT FOR SALE
use, and develop the information, computer, and cognitive sciences necessary to OR DISTRIBUTION
advance ­nursing ­science for the betterment of patients and the profession. Regardless
of their future roles in the healthcare milieu, it is clear that nurses need to understand
the ­ethical application of computer, information, and cognitive sciences to advance
­nursing ­science.
nes & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
To implement NI, one must view it from the perspective of both the current health-
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care delivery system and specific, individual organizational needs, while anticipating
and creating future applications in both the healthcare system and the nursing profes-
sion. Nursing professionals should be expected to discover opportunities to use NI,
participate in the design of solutions, and be challenged to identify, develop, evaluate,
© Jones
modify, &and
Bartlett Learning,
enhance applications LLC patient care. This text is©
to improve Jones
designed & Bartlett Learnin
to pro-
vide the reader with
NOT FOR SALE OR DISTRIBUTION the information and knowledge needed to meet this expectation.
NOT FOR SALE OR DISTR
Section I presents an overview of the building blocks of NI: nursing, informa-
tion, computer, and cognitive sciences. Also included in this section is a chapter on
­ethical applications of healthcare informatics. This section lays the foundation for the
remainder of the book.
© Jones & Bartlett Learning, LLC and the Foundation of Knowledge
The Nursing Science © Jones & Bartlett
chapter Learning, LLC
describes nursing
NOT FOR SALE OR DISTRIBUTION
­science and introduces the Foundation of Knowledge NOT FOR
model SALE
as the ORframe-
conceptual DISTRIBUTION
work for the book. In this chapter, a clinical case scenario is used to illustrate the con-
cepts central to nursing science. A definition of nursing science is also derived from
the American Nurses Association’s definition of nursing. Nursing science is the ethical
application of knowledge acquired through education, research, and practice to pro-
nes & Bartlett Learning, LLC ©patients
vide services and interventions to Jones to & Bartlett
maintain, Learning,
enhance, LLC
or restore their health,
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and to acquire, process, generate, and FOR SALE
disseminate ORknowledge
nursing DISTRIBUTIONto advance the
nursing profession. Information is a central concept and health care’s most valuable
resource. Information science and systems, together with computers, are constantly
changing the way healthcare organizations conduct their business. This will continue
to evolve.
© Jones & Bartlett Learning, LLC © Jones & Bartlett Learnin
To prepare for these innovations, the reader must understand fundamental infor-
NOT mation
FOR and SALE OR concepts,
computer DISTRIBUTION NOT FOR
covered in the Introduction to Information, Informa-SALE OR DISTR
tion Science, and Information Systems and Computer Science and the Foundation of
Knowledge Model chapters, respectively. Information science deals with the interchange
(or flow) and scaffolding (or structure) of information and involves the application of
© Jones & Bartlettinformation
Learning, toolsLLC
for solutions to patient care and©business
Jonesproblems
& Bartlettin health care.
Learning, LLC
To be able to use and synthesize information effectively, an individual must be able to
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obtain, perceive, process, synthesize, comprehend, convey, and manage the informa-
tion. Computer science deals with understanding the development, design, structure,

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Section I: Building Blocks of Nursing Informatics 3

© Jones
and relationship & Bartlett
of computer Learning,
hardware and software.LLCThis science offers extremely© Jones & Bartlett Learnin
valuable NOT FOR
tools that, SALE
if used OR
skillfully, facilitate the acquisition and manipulation ofNOT FOR SALE OR DISTR
canDISTRIBUTION
data and information by nurses, who can then synthesize these resources into an ever-
evolving knowledge and wisdom base. This not only facilitates professional develop-
ment and the ability to apply evidence-based practice decisions within nursing care,
but, if the results are disseminated and shared, can also advance the profession’s knowl-
© Jones edge&base.
Bartlett Learning,
The development LLC tools, such as the automation
of knowledge © Jones & Bartlett Learning, LLC
of decision
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making and strides in artificial intelligence, has altered the understanding of knowledge SALE OR DISTRIBUTION
and its representation. The ability to structure knowledge electronically facilitates the
ability to share knowledge structures and enhance collective knowledge.
As discussed in the Introduction to Cognitive Science and Cognitive Informatics
chapter, cognitive science deals with how the human mind functions. This science
nes & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
encompasses how people think, understand, remember, synthesize, and access stored
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and knowledge. The nature of knowledge, including how it is developed,
used, modified, and shared, provides the basis for continued learning and intellectual
growth.
The Ethical Applications of Informatics chapter focuses on ethical issues associated
© Jones
with managing private&information
Bartlett Learning,
with technology LLC
and provides a framework for© Jones & Bartlett Learnin
analyzingNOT ethicalFOR
issues and supporting ethical
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The material within this book is placed within the context of the Foundation of
Knowledge model (shown in Figure I-1 and periodically throughout the book, but
more fully introduced and explained in the Nursing Science and the Foundation of
Knowledge chapter). The Foundation of Knowledge model is used throughout the
© Jones text&toBartlett Learning,
illustrate how knowledge LLC © Jones
is used to meet the needs of healthcare & sys-
delivery Bartlett Learning, LLC
NOT FOR tems,SALE OR DISTRIBUTION
organizations, patients, and nurses. It is through interactionNOT FOR
with these SALE OR DISTRIBUTION
building
blocks—the theories, architecture, and tools—that one acquires the bits and pieces of
data necessary, processes these into information, and generates and disseminates the
resulting knowledge. Through this dynamic exchange, which includes feedback, indi-
viduals continue the interaction and use of these sciences to input or acquire, process,
nes & Bartlett Learning,
and output orLLC disseminate generated knowledge. © Jones & Bartlett
Humans experience theirLearning,
environ- LLC
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and learn by acquiring, processing, generating, NOT FOR SALE OR
and disseminating DISTRIBUTION
knowledge.
When they then share (disseminate) this new knowledge and receive feedback on the
knowledge they have shared, the feedback initiates the cycle of knowledge all over
again. As individuals acquire, process, generate, and disseminate knowledge, they are
motivated to share, rethink, and explore their own knowledge base. This complex pro-
© Jones & Bartlett Learning, LLC
cess is captured in the Foundation of Knowledge model. Throughout the chapters
© Jones & Bartlett Learnin
NOTBlocks
in the Building FORofSALE Nursing OR Informatics section, readers are challenged to thinkNOT FOR SALE OR DISTR
DISTRIBUTION
about how the model can help them to understand the ways in which they acquire,
process, generate, disseminate, and then receive feedback on their new knowledge of
the building blocks of NI.
© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
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4 Section I: Building Blocks of Nursing Informatics

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learnin

NOT FOR SALEKA
OR DISTRIBUTION
KP KG
NOT FOR SALE OR DISTR

KD

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
NOT FOR SALE OR DISTRIBUTION
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KA - Knowledge acquisition
nes & Bartlett Learning, LLC © Jones & Bartlett Learning,
KD - Knowledge LLC
dissemination
FOR SALE OR DISTRIBUTION NOT FOR SALEKG OR- Knowledge generation
DISTRIBUTION
KP - Knowledge processing

Information Bytes
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Information Information
Bits Data
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© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
Figure
NOT FOR I-1 Foundation
SALE OR of Knowledge Model
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Source: Designed by Alicia Mastrian.

nes & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
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© Jones & Bartlett Learning, LLC © Jones & Bartlett Learnin

NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTR

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
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© Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION.

nes & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
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1
c h a p t e r
© Jones & Bartlett Learning, LLC © Jones & Bartlett Learnin
NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTR

Nursing Science and the

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

Foundation of Knowledge
nes & Bartlett Learning, LLC and Dee McGonigle
Kathleen Mastrian © Jones & Bartlett Learning, LLC
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Objectives
© Jones & Bartlett Learning, LLC Key Terms
© Jones & Bartlett Learnin
1. NOT
Define FOR
nursing SALE
science and itsOR DISTRIBUTION
relationship to various nursing roles and Borrowed theory SALE OR DISTR
NOT FOR
­nursing informatics. Building blocks
2. Introduce the Foundation of Knowledge model as the organizing conceptualClinical databases
framework for the text. Clinical practice guidelines
Conceptual framework
3. Explain the relationships among knowledge acquisition, knowledge
© Jones & Bartlett Learning, LLC © Jones
& Bartlett
Data Learning, LLC
­processing, knowledge generation, knowledge dissemination, and wisdom.
NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION
Data mining
Evidence
Feedback
Foundation of Knowledge
model
Introduction Information
nes & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
Knowledge
Nursing informatics is defined as the combination of nursing science, infor-
FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Knowledge acquisition
mation science, and computer science. This chapter focuses on nursing science
Knowledge dissemination
as one of the building blocks of nursing informatics, although in this text the Knowledge generation
traditional definition of nursing informatics is extended to include cognitive Knowledge processing
science as one of the building blocks. The Foundation of Knowledge model is Knowledge worker
© Jones
also introduced as the&organizing
Bartlettconceptual
Learning, LLC of this text, and the Nursing
framework © Jones & Bartlett Learnin
informatics
model is NOT Nursing science
FOR SALE OR DISTRIBUTION
tied to nursing science and the practice of nursing informatics. To lay NOT FOR SALE OR DISTR
Nursing theory
the groundwork for this discussion, consider the following patient scenario:
Relational database
Transparent wisdom
Tom H. is a registered nurse who works in a very busy metropolitan hospi-
tal emergency room. He has just admitted a 79-year-old man whose wife
© Jones & Bartlett
brought him to Learning, LLChe is having trouble breathing.
the hospital because ©Tom
Jones & Bartlett Learning, LLC
NOT FORimmediately
SALE OR clips a pulse oximeter to the patient’s finger and performs a FOR SALE OR DISTRIBUTION
DISTRIBUTION NOT
5

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6 chapter 1: Nursing Science and the Foundation of Knowledge

© Jones
very&quick
Bartlett Learning,
assessment LLC
of the patient’s other vital signs. He discovers a© Jones
rapid pulse & Bartlett Learnin
NOT FOR SALE
rate and a decreased oxygen saturation level in addition to the rapid NOT
OR DISTRIBUTION FOR SALE OR DISTR
and labored
breathing. Tom determines that the patient is not in immediate danger and that
he does not require intubation. Tom focuses his initial attention on easing the
patient’s labored breathing by elevating the head of the bed and initiating oxygen
treatment; he then hooks the patient up to a heart monitor. Tom continues to
© Jones & Bartlett Learning, LLC
assess the patient’s ©a Jones
breathing status as he performs head-to-toe&assessment
Bartlettof Learning,
the LLC
NOT FOR SALE ORpatient
DISTRIBUTION NOT FOR SALE OR
that leads to the nursing diagnoses and additional interventions necessaryDISTRIBUTION
to provide comprehensive care to this patient.
Consider Tom’s actions and how and why he intervened as he did. Tom relied on
the immediate data and information that he acquired during his initial rapid assess-
nes & Bartlett Learning, LLC
ment to deliver appropriate care © Jones & Bartlett
to his patient. Tom alsoLearning,
used technology LLC(a pulse
FOR SALE OR DISTRIBUTION oximeter and a heart monitor) NOT to assistFOR SALE
with and supportOR the DISTRIBUTION
delivery of care. What is
not immediately apparent, and some would argue is transparent (done without con-
scious thought), is the fact that during the rapid assessment, Tom reached into his
knowledge base of previous learning and experiences to direct his care, so that he could
act with transparent wisdom. He used both nursing theory and borrowed theory to
© Jones
inform&hisBartlett Learning,
practice. Tom LLC
certainly used nursing process theory, and he © may
Jones & Bartlett Learnin
have also
NOT used
FOR SALE OR DISTRIBUTION NOT FOR
one of several other nursing theories, such as Rogers’s science of unitary human SALE OR DISTR
beings, Orem’s theory of self-care deficit, or Roy’s adaptation theory. In addition, Tom
may have applied his knowledge from some of the basic sciences, such as anatomy,
physiology, psychology, and chemistry, as he determined the patient’s immediate
© Jones & Bartlettneeds. Information from Maslow’s hierarchy of needs, Lazarus’s transaction model
Learning, LLC © Jones & Bartlett Learning, LLC
of stress and coping, and the health belief model may have also helped Tom practice
NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION
professional nursing. He gathered data, and then analyzed and interpreted those data
to form a conclusion—the essence of science. Tom has illustrated the practical aspects
of nursing science.
The American Nurses Association (2003) defines nursing in this way: “Nursing
is the protection, promotion, and optimization of health and abilities, prevention
nes & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
of illness and injury, alleviation of suffering through the diagnosis and treatment of
FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION
human response, and advocacy in the care of individuals, families, communities, and
populations” (p. 6). Thus the focus of nursing is on human responses to actual or
potential health problems and advocacy for various clients. These human responses
are varied and may change over time in a single case. Nurses must possess the tech-
© Jones & Bartlett
nical skills to manageLearning,
equipment andLLC © Jones
perform procedures, the interpersonal skills&toBartlett Learnin
interact appropriately
NOT FOR SALE OR DISTRIBUTION with people, and the cognitive skills to observe,NOT FORandSALE OR DISTR
recognize,
collect data; analyze and interpret data; and reach a reasonable conclusion that forms
the basis of a decision. At the heart of all of these skills lies the management of data
and information. This definition of nursing science focuses on the ethical application
of knowledge acquired through education, research, and practice to provide services
© Jones & BartlettandLearning,
interventionsLLC © Jones
to patients to maintain, enhance, or restore& their
Bartlett
healthLearning,
and to LLC
NOT FOR SALE OR DISTRIBUTION
acquire, process, generate, and disseminate nursing NOT FORtoSALE
knowledge advance OR DISTRIBUTION
the nursing
profession.

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Introduction 7

© Jones
Nursing & Bartlett Learning,
is an information-intensive profession. LLC
The steps of using information,© Jones & Bartlett Learnin
applyingNOTknowledgeFOR to aSALE
problem, OR acting with wisdom form the basis of nursingNOT FOR SALE OR DISTR
andDISTRIBUTION
practice science. Information is composed of data that were processed using knowl-
edge. For information to be valuable, it must be accessible, accurate, timely, complete,
cost-effective, flexible, reliable, relevant, simple, verifiable, and secure. Knowledge is
the awareness and understanding of a set of information and ways that information can
© Jones & Bartlett
be made useful to Learning, LLC
support a specific ©the
task or arrive at a decision. In Jones & Bartlett Learning, LLC
case scenario,
NOT FOR SALE OR DISTRIBUTION NOT FOR
Tom used accessible, accurate, timely, relevant, and verifiable data and information. SALE
He OR DISTRIBUTION
compared that data and information to his knowledge base and previous experiences to
determine which data and information were relevant to the current case. By applying
his previous knowledge to data, he converted those data into information, and infor-
mation into new knowledge—that is, an understanding of which nursing interventions
nes & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
were appropriate in this case. Thus information is data made functional through the
FOR SALE ORapplication
DISTRIBUTION of knowledge.
NOT FOR SALE OR DISTRIBUTION
Humans acquire data and information in bits and pieces and then transform the
information into knowledge. The information-processing functions of the brain are
frequently compared to those of a computer, and vice versa (an idea discussed further
© Jones
in the Introduction & Bartlett
to Cognitive ScienceLearning, LLC
and Cognitive Informatics chapter). Humans can© Jones & Bartlett Learnin
be thoughtNOT FOR SALE OR DISTRIBUTION acquiring, processing,NOT FOR SALE OR DISTR
of as organic information systems that are constantly
and generating information or knowledge in their professional and personal lives.
They have an amazing ability to manage knowledge. This ability is learned and honed
from birth as individuals make their way through life interacting with the environment
and being inundated with data and information. Each person experiences the environ-
© Jones ment& and
Bartlett
learns byLearning, LLC generating, and disseminating
acquiring, processing, © Jones & Bartlett Learning, LLC
knowledge.
NOT FORTom, SALE OR DISTRIBUTION
for example, acquired knowledge in his basic nursing NOT FOR
education SALE OR DISTRIBUTION
program
and continues to build his foundation of knowledge by engaging in such activities
as reading nursing research and theory articles, attending continuing education pro-
grams, consulting with expert colleagues, and using clinical databases and clinical
practice guidelines. As he interacts in the environment, he acquires knowledge that
nes & Bartlett Learning,
must be processed.LLCThis processing effort causes © him
Jones & Bartlett
to redefine Learning,
and restructure his LLC
FOR SALE ORknowledge
DISTRIBUTION base and generate new knowledge. NOT Tom can FOR SALE
then share OR DISTRIBUTION
(disseminate) this
new knowledge with colleagues, and he may receive feedback on the knowledge that
he shares. This dissemination and feedback builds the knowledge foundation anew as
Tom acquires, processes, generates, and disseminates new knowledge as a result of his
interactions. As others respond to his knowledge dissemination and he acquires yet
© Jones & Bartlett Learning, LLC
more knowledge, he is engaged to rethink, reflect on, and reexplore his knowledge
© Jones & Bartlett Learnin
NOT
acquisition, FOR
leading SALE
to further OR DISTRIBUTION
processing, generating, and then disseminating knowl-NOT FOR SALE OR DISTR
edge. This ongoing process is captured in the Foundation of Knowledge model, which
is used as an organizing framework for this text.
At its base, the model contains bits, bytes (computer terms for chunks of infor-
mation),
© Jones & Bartlett data, and information LLC
Learning, in a random representation (Figure 1-1). Growing
© Jones & Bartlett Learning, LLC
out of the base are separate cones of light that expand as they reflect upward; these
NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION
cones r­epresent knowledge acquisition, knowledge generation, and knowledge

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nes & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
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8 chapter 1: Nursing Science and the Foundation of Knowledge

© Jones & Bartlett

­dissemination. At theLearning,
intersection ofLLC © Jones
the cones and forming a new cone & Bartlett Learnin
is knowledge
NOT processing.
FOR SALE OR DISTRIBUTION
Encircling NOT FOR
and cutting through the knowledge cones is feedback SALE OR DISTR
that acts
on and may transform any or all aspects of knowledge represented by the cones. One
should imagine the model as a dynamic figure in which the cones of light and the
feedback rotate and interact rather than remain static. Knowledge acquisition, knowl-
edge generation, knowledge dissemination, knowledge processing, and feedback are
© Jones & Bartlettconstantly
Learning, LLC
evolving © Jones
for nurse scientists. The transparent effect&
of Bartlett
the cones isLearning,
delib- LLC
NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR
erate and is intended to suggest that as knowledge grows and expands its use becomesDISTRIBUTION
more t­ ransparent—a person uses this knowledge during practice without even being
consciously aware of which aspect of knowledge is being used at any given moment.
Experienced nurses, thinking back to their novice years, may recall feeling like their
head was filled with bits of data and information that did not form any type of cohesive
nes & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
whole. As the model depicts, the processing of knowledge begins a bit later (imagine a
FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION
timeline applied vertically) with early experiences on the bottom and expertise growing
as the processing of knowledge ensues. Early on in nurses’ education, conscious atten-
tion is focused mainly on knowledge acquisition, and they depend on their instruc-
tors and others to process, generate, and disseminate knowledge. As nurses become
© Jones & Bartlett Learning, LLC © Jones & Bartlett Learnin
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KA KP KG

KD

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NOT FOR Feedback
SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION
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nes & Bartlett Learning, LLC © Jones & Bartlett Learning,
KD - Knowledge LLC
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- Knowledge processing

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© Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION.

nes & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
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Introduction 9

© Jones
more comfortable & the
with Bartlett Learning,
science of nursing, theyLLCbegin to take over some of the© Jones & Bartlett Learnin
NOT FOR
other Foundation SALE functions.
of Knowledge However, to keep up with the explosion ofNOT FOR SALE OR DISTR
OR DISTRIBUTION
information in nursing and health care, they must continue to rely on the knowledge
generation of nursing theorists and researchers and the dissemination of their work. In
this sense, nurses are committed to lifelong learning and the use of knowledge in the
practice of nursing science.
© Jones & TheBartlett
Foundation Learning,
of Knowledge LLC © Jones
model permeates this text, reflecting & Bartlett Learning, LLC
the under-
NOT FOR standing that knowledge is a powerful tool and that nurses focus on informationSALE
SALE OR DISTRIBUTION NOT FOR as a OR DISTRIBUTION
key building block of knowledge. The application of the model is described in each sec-
tion of the text to help the reader understand and appreciate the foundation of knowl-
edge in nursing science and see how it applies to nursing informatics. All of the various
nursing roles (practice, administration, education, research, and informatics) involve
nes & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
the science of nursing. Nurses are knowledge workers, working with information and
FOR SALE ORgenerating
DISTRIBUTION NOT FOR SALE OR DISTRIBUTION
information and knowledge as a product. They are knowledge acquirers,
providing convenient and efficient means of capturing and storing knowledge. They
are knowledge users, meaning individuals or groups who benefit from valuable, viable
knowledge. Nurses are knowledge engineers, designing, developing, implementing,
© Jones
and maintaining & Bartlett
knowledge. They areLearning, LLC capturing and processing© Jones & Bartlett Learnin
knowledge managers,
collectiveNOT
expertise and distributing it
FOR SALE OR DISTRIBUTION where it can create the largest benefit. Finally,NOT FOR SALE OR DISTR
they are knowledge developers and generators, changing and evolving knowledge based
on the tasks at hand and the information available.
In the case scenario, at first glance one might label Tom as a knowledge worker, a
knowledge acquirer, and a knowledge user. However, stopping here might sell Tom
© Jones & in
short Bartlett Learning,
his practice LLC Although he acquired and©used
of nursing science. Jones & Bartlett
knowledge to Learning, LLC
NOT FOR help SALE
him achieveORhisDISTRIBUTION NOT FOR
work, he also processed the data and information SALE OR DISTRIBUTION
he collected
to develop a nursing diagnosis and a plan of care. The knowledge stores Tom used to
develop and glean knowledge from valuable information are generative (having the
ability to originate and produce or generate) in nature. For example, Tom may have
learned something new about his patient’s culture from the patient or his wife that he
nes & Bartlett Learning,
will file away inLLC
the knowledge repository of his © mind
Jones to be&used
Bartlett Learning,
in another similar LLC
FOR SALE ORsituation.
DISTRIBUTION NOT FOR
As he compares this new cultural information SALE
to what OR DISTRIBUTION
he already knows,
he may gain insight into the effect of culture on a patient’s response to illness. In this
sense, Tom is a knowledge generator. If he shares this newly acquired knowledge with
another practitioner, and as he records his observations and his conclusions, he is then
disseminating knowledge. Tom also uses feedback from the various technologies he
© Jones & Bartlett Learning, LLC
has applied to monitor his patient’s status. In addition, he may rely on feedback from
© Jones & Bartlett Learnin
laboratory NOT FOR
reports SALE
or even OR DISTRIBUTION
other practitioners to help him rethink, revise, and apply theNOT FOR SALE OR DISTR
knowledge about this patient that he is generating.
To have ongoing value, knowledge must be viable. Knowledge viability refers to appli-
cations (most technology based) that offer easily accessible, accurate, and timely infor-
© Jones mation obtained from
& Bartlett a variety ofLLC
Learning, resources and methods and presented in a manner
© Jones so
& Bartlett Learning, LLC
as to provide the necessary elements to generate new knowledge. In the case scenario,
NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION
Tom may have felt the need to consult an electronic database or a clinical guidelines
repository that he has downloaded on his personal digital assistant (PDA) or that reside

© Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION.

nes & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
FOR SALE OR DISTRIBUTION
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ones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
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10 chapter 1: Nursing Science and the Foundation of Knowledge

© Jones
in the & Bartlett
emergency Learning,
room’s LLC system to assist him in ©
networked computer theJones & Bartlett Learnin
development
NOT of
FOR SALE ORcare
a comprehensive plan for his patient. In this way, Tom usesNOT
DISTRIBUTION FORand
technology SALE OR DISTR
evidence to support and inform his practice. It is also possible in this scenario that an
alert might appear in the patient’s electronic health record or the clinical information
system (CIS) reminding Tom to ask about influenza and pneumonia vaccines. Clinical
information technologies that support and inform nursing practice and nursing admin-
© Jones & Bartlettistration
Learning, LLC part of nursing informatics
are an important © Jones & Bartlett
and are covered in detailLearning,
in the LLC
NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR
Nursing Informatics Administrative Applications: Precare and Care Support and Nursing DISTRIBUTION
Informatics Practice Applications: Care Delivery sections of this text. Technologies that
support and inform nursing education and nursing research are covered in the Educa-
tion Applications and Research Applications of Nursing Informatics sections respectively.
nes & Bartlett Learning, LLCThis text provides a framework © that
Jones embraces knowledge so that readers can develop
& Bartlett Learning, LLC
the wisdom necessary to apply what they have learned. Wisdom is the application of
FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION
knowledge to an appropriate situation. In the practice of nursing science, one expects
actions to be directed by wisdom. Wisdom uses knowledge and experience to heighten
common sense and insight to exercise sound judgment in practical matters. It is devel-
oped through knowledge, experience, insight, and reflection. Wisdom is sometimes
© Jones
thought& ofBartlett Learning,
as the highest LLC sense, resulting from accumulated
form of common © Jones & Bartlett Learnin
knowl-
edge or erudition (deep,
NOT FOR SALE OR DISTRIBUTION thorough learning) or enlightenment (education that
NOT FOR results
SALE OR DISTR
in understanding and the dissemination of knowledge). It is the ability to apply valu-
able and viable knowledge, experience, understanding, and insight while being prudent
and sensible. Knowledge and wisdom are not synonymous: Knowledge abounds with
others’ thoughts and information, whereas wisdom is focused on one’s own mind and
© Jones & BartletttheLearning, LLC insight, understanding,©and
synthesis of experience, Jones & Bartlett
knowledge. Wisdom has Learning,
been LLC
NOT FOR SALE OR DISTRIBUTION
called the foundation of the art of nursing. NOT FOR SALE OR DISTRIBUTION
Some nursing roles might be viewed as more focused on some aspects rather
than other aspects of the foundation of knowledge. For example, some might
argue that nurse educators are primarily knowledge disseminators and that nurse
researchers are knowledge generators. Although the more frequent output of their
nes & Bartlett Learning, LLC
efforts can certainly be viewed © inJones & itBartlett
this way, Learning,
is important LLC
to realize that nurses
FOR SALE OR DISTRIBUTION NOT FOR
use all of the aspects of the Foundation of SALE
KnowledgeORmodel
DISTRIBUTION
regardless of their
area of practice. For nurse educators to be effective, they must be in the habit of
constantly building and rebuilding their foundation of knowledge about nursing
science. In addition, as they develop and implement curricular innovations, they
must evaluate the effectiveness of those changes. In some cases, they use formal
© Jones & Bartlett Learning, LLC © Jones & Bartlett Learnin
research techniques to achieve this goal and, therefore, generate knowledge about
NOT the
FOR bestSALE
and most OR DISTRIBUTION
effective NOT FOR
teaching strategies. Similarly, nurse researchers mustSALE OR DISTR
acquire and process new knowledge as they design and conduct their research
studies. All nurses have the opportunity to be involved in the formal dissemina-
tion of knowledge via their participation in professional conferences, either as pre-
© Jones & Bartlettsenters or as attendees.
Learning, LLC In addition, some nurses©disseminate
Jones &knowledge
BartlettbyLearning,
formal LLC
publication of their ideas. In the cases of conference presentation and publication,
NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION
nurses may receive feedback that stimulates rethinking about the knowledge they

© Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION.

nes & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
FOR SALE OR DISTRIBUTION
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ones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
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Introduction 11

© Jones
have ­generated & BartlettinLearning,
and disseminated, turn promptingLLC them to acquire and process© Jones & Bartlett Learnin
data andNOT FORanew.
information SALE OR DISTRIBUTION NOT FOR SALE OR DISTR
All nurses, regardless of their practice arena, must use informatics and technology
to inform and support that practice. The case scenario discussed Tom’s use of various
monitoring devices that provide feedback on the physiologic status of the patient.
It was also suggested that Tom might consult a clinical database or nursing practice
© Jones & Bartlett
guidelines residingLearning, LLC agency network as he develops
on a PDA or a clinical © Jones & Bartlett Learning, LLC
an appropriate
NOT FOR plan of action for his nursing interventions. Perhaps the CIS in the agency supportsSALE
SALE OR DISTRIBUTION NOT FOR the OR DISTRIBUTION
collection of data about patients in a relational database, providing an opportunity for
data mining by nursing administrators or nurse researchers. In this way, administra-
tors and researchers can glean information about best practices and determine which
improvements are necessary to deliver the best and most effective nursing care (Swan,
nes & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
Lang, & McGinley, 2004).
FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION
The future of nursing science and nursing informatics is closely associated with
nursing education and nursing research. Skiba (2007) suggests that techno-savvy
and well-informed faculty who can demonstrate the appropriate use of technolo-
gies to enhance the delivery of nursing care are needed. Along those lines, Greenfield
© Jones
(2007) conducted & Bartlett
research Learning,
among nursing students LLC
to determine the effectiveness of© Jones & Bartlett Learnin
PDA technology applied to medication
NOT FOR SALE OR DISTRIBUTION administration. Her study makes a good caseNOT FOR SALE OR DISTR
for incorporating such technology into nursing curricula. Girard (2007) discussed
­cutting-edge operating room technologies, such as nanosurgery using nanorobots,
smart fabrics that aid in patient assessment during surgery, biopharmacy techniques
for the safe and effective delivery of anesthesia, and virtual reality training. She makes
© Jones an & Bartlett
extremely Learning,
provocative point LLC © Jones
about nursing education: “Educators & Bartlett
will need to Learning, LLC
NOT FOR expandSALE OR DISTRIBUTION
their knowledge NOT
and teach for the future and not the past. They FOR
must take SALE
heed OR DISTRIBUTION
that the old tried-and-true nursing education methods and curriculum that has lasted
100 years will have to change, and that change will be mandated for all areas of nursing”
(p. 353). Bassendowski (2007) specifically addresses the potential for the generation of
knowledge in educational endeavors as faculty apply new technologies to teaching and
nes & Bartlett Learning,
the focus shiftsLLC
away from individual to group © Jonesthat
instruction & Bartlett Learning,
promotes sharing and LLC
FOR SALE ORprocessing
DISTRIBUTION
of knowledge. NOT FOR SALE OR DISTRIBUTION
Several key national groups are promoting the inclusion of informatics content
in nursing education programs. These initiatives include a proposal by the National
League for Nursing (NLN, 2008); recommendations in the Quality and Safety Educa-
tion for Nurses (Cronenwett et al., 2007) report; the Technology Informatics Guiding
© Jones & Bartlett Learning, LLC
Education Reform (TIGER) Initiative (2007); and a plan by the American Association
© Jones & Bartlett Learnin
NOT
of Colleges FOR(AACN,
of Nursing SALE2008). OR DISTRIBUTION NOT FOR SALE OR DISTR
The NLN’s (2008) position statement, Preparing the Next Generation of Nurses to
Practice in a Technology-Rich Environment: An Informatics Agenda, challenges nurse
educators to prepare informatics-competent nurses who can practice safely in a
© Jones ­technology-rich
& Bartletthealthcare
Learning, environment.
LLC © Jones & Bartlett Learning, LLC
In the Quality and Safety Education for Nurses (2007) report, Cronenwett and col-
NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION
leagues identified several core competencies for nursing education. One ­competency

© Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION.

nes & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
FOR SALE OR DISTRIBUTION
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12 chapter 1: Nursing Science and the Foundation of Knowledge

© Jones & Bartlett

specifically addressedLearning, LLC “Use information and©technology
nursing informatics: Jones &toBartlett Learnin
NOT ­cFOR SALEmanage
ommunicate, OR DISTRIBUTION NOT FOR SALE OR DISTR
knowledge, mitigate error, and support decision-making”
(p. 129). Another addressed the appropriate use of data and information in nursing
practice to promote quality improvement: “Use data to monitor the outcomes and
processes and use improvement methods to design and test changes to continuously
improve the quality and safety of health care systems” (p. 127).
© Jones & Bartlett Learning, LLC initiative identifies a key©purpose:
The TIGER (2007) Jones“to & create
Bartlett Learning,
a vision for LLC
NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR
the future of nursing that bridges the quality chasm with information technology,DISTRIBUTION
enabling nurses to use informatics in practice and education to provide safer,
higher-quality patient care” (p. 4). The pillars of the TIGER vision include the
­following:
nes & Bartlett Learning, LLC■■ Management and Leadership:
© Jones & Bartlett
Revolutionary leadershipLearning, LLC
that drives, empowers,
FOR SALE OR DISTRIBUTION NOT of
and executes the transformation FOR
healthSALE
care. OR DISTRIBUTION
Education: Collaborative learning communities that maximize the possibilities
■■

of technology toward knowledge development and dissemination, driving rapid

deployment and implementation of best practices.
■■ Communication and Collaboration: Standardized, person-centered, technology-
© Jones enabled
& Bartlett Learning, LLC © Jones & Bartlett Learnin
processes to facilitate teamwork and relationships across the
NOT FOR SALE OR
continuum of care. DISTRIBUTION NOT FOR SALE OR DISTR
■■ Informatics Design: Evidence-based, interoperable intelligence systems that

­support education and practice to foster quality care and safety.

■■ Information Technology: Smart, people-centered, affordable technologies that

are universal,
© Jones & Bartlett Learning, useable, useful, and standards ©
LLC based.
Jones & Bartlett Learning, LLC
■■ Policy: Consistent, incentives-based initiatives (organizational and
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­governmental) that support advocacy and coalition-building, achieving and
resourcing an ethical culture of safety.
■■ Culture: A respectful, open system that leverages technology and informatics

across multiple disciplines in an environment where all stakeholders trust each

nes & Bartlett Learning, LLC other to work together toward© Jonesthe goal&
of Bartlett
high qualityLearning,
and safety (p. 4).
LLC
FOR SALE OR DISTRIBUTION NOT
The Essentials of Baccalaureate FORforSALE
Education OR Nursing
Professional DISTRIBUTION
Practice (AACN,
2008, pp. 18–19) includes the following technology-related outcomes for baccalaureate
nursing graduates:

1. Demonstrate skills in using patient care technologies, information systems, and

© Jones communication
& Bartlett Learning, LLC safe nursing practice. © Jones & Bartlett Learnin
devices that support
NOT FOR SALE
2. Use OR DISTRIBUTION
telecommunication NOT FOR
technologies to assist in effective communication in a SALE OR DISTR
variety of healthcare settings.
3. Apply safeguards and decision-making support tools embedded in patient care
technologies and information systems to support a safe practice environment
for both patients and healthcare workers.
© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
4. Understand the use of CIS to document interventions related to achieving
NOT FOR SALE OR DISTRIBUTION
nurse-sensitive outcomes. NOT FOR SALE OR DISTRIBUTION

© Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION.

nes & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
FOR SALE OR DISTRIBUTION
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Introduction 13

5. Use ©standardized
Jones &terminology
Bartlett in Learning, LLC that reflects nursing’s © Jones & Bartlett Learnin
a care environment
NOTcontribution
unique FOR SALE ORoutcomes.
to patient DISTRIBUTION NOT FOR SALE OR DISTR
6. Evaluate data from all relevant sources, including technology, to inform the
delivery of care.
7. Recognize the role of information technology in improving patient care
­outcomes and creating a safe care environment.
© Jones & Bartlett
8. Uphold ethicalLearning, LLCto data security, regulatory©requirements,
standards related Jones & Bartlett Learning, LLC
NOT FOR SALE OR DISTRIBUTION
confidentiality, and clients’ right to privacy. NOT FOR SALE OR DISTRIBUTION
9. Apply patient care technologies as appropriate to address the needs of a diverse
patient population.
10. Advocate for the use of new patient care technologies for safe, quality care.
11. Recognize that redesign of workflow and care processes should precede
nes & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
­implementation of care technology to facilitate nursing practice.
FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION
12. Participate in the evaluation of information systems in practice settings
through policy and procedure development.
The report suggests the following sample content for achieving these student out-
comes (AACN, 2008, pp. 19–20):
© Jones & Bartlett Learning, LLC © Jones & Bartlett Learnin
Use of patient care technologies (e.g., monitors, pumps, computer-assisted
NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTR
■■

devices)
■■ Use of technology and information systems for clinical decision making

■■ Computer skills that may include basic software, spreadsheet, and healthcare

databases
© Jones & Information
■■ Bartlett Learning,
management for LLC
patient safety © Jones & Bartlett Learning, LLC
NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION
■■ Regulatory requirements through electronic data-monitoring systems

■■ Ethical and legal issues related to the use of information technology, including

copyright, privacy, and confidentiality issues

■■ Retrieval information systems, including access, evaluation of data, and

­application of relevant data to patient care

nes & Bartlett Learning, LLC searches
■■ Online literature © Jones & Bartlett Learning, LLC
FOR SALE OR DISTRIBUTION
■■ Technological resources for evidence-basedNOT FOR SALE OR DISTRIBUTION
practice
■■ Web-based learning and online literature searches for self and patient use

■■ Technology and information systems safeguards (e.g., patient monitoring, equip-

ment, patient identification systems, drug alerts and IV systems, and bar coding)
■■ Interstate practice regulations (e.g., licensure, telehealth)
© Jones & Bartlett Learning, LLC
■■ Technology for virtual care delivery and monitoring
© Jones & Bartlett Learnin
NOT related
■■ Principles FOR toSALEnursingOR DISTRIBUTION
workload measurement and resources and NOT FOR SALE OR DISTR
­information systems
■■ Information literacy

■■ Electronic health record and physician order entry

■■ Decision support tools

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
■■ Role of the nurse informaticist in the context of health informatics and
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­information systems
NOT FOR SALE OR DISTRIBUTION

© Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION.

nes & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
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ones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
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14 chapter 1: Nursing Science and the Foundation of Knowledge

© Jones
The&Informatics
Bartlettand Learning, LLC
Healthcare Technologies © Jones
Essentials of Master’s Education&inBartlett Learnin
NOT Nursing
FOR SALEincludes OR DISTRIBUTION
the following elements: NOT FOR SALE OR DISTR
Essential V: Informatics and Healthcare Technologies
Rationale
© Jones & BartlettInformatics
Learning, LLC technologies encompass
and healthcare ©five
Jones & Bartlett Learning, LLC
broad areas:
NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION
Use of patient care and other technologies to deliver and enhance care
■■

Communication technologies to integrate and coordinate care

■■

■■ Data management to analyze and improve outcomes of care

■■ Health information management for evidence-based care and health education

nes & Bartlett Learning, LLC■■ Facilitation and use of electronic

© Jones health&records
Bartlett Learning,
to improve LLC
patient care (AACN,
FOR SALE OR DISTRIBUTION 2011, pp. 17–18). NOT FOR SALE OR DISTRIBUTION

Quality and Safety Education for Nurses

As nursing science evolves, it is critical that patient care improves. Sometimes, unfor-
© Jones & patient
tunately, Bartlett
care Learning, LLCand is unsafe. Therefore, quality
is less than adequate © Jones & Bartlett Learnin
and safety
NOT have
FOR SALE
become OR DISTRIBUTION
paramount. NOT
The Quality and Safety Education for Nurses FOR
(QSEN) SALE OR DISTR
Insti-
tute project seeks to prepare future nurses who will have the knowledge, skills, and atti-
tudes (KSAs) necessary to continuously improve the quality and safety of the healthcare
systems within which they work.
Prelicensure informatics KSAs include the following (QSEN Institute, n.d.b):
© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
NOT FOR SALE OR DISTRIBUTION INFORMATICS NOT FOR SALE OR DISTRIBUTION
Knowledge Skills Attitudes
Explain why information Seek education about Appreciate the neces-
and technology skills are how information is sity for all health
­essential for safe patient managed in care settings professionals to seek
nes & Bartlett Learning, LLCcare
© before
Jones & Bartlett Learning,
providing care
LLC
lifelong, continuous
FOR SALE OR DISTRIBUTION NOT
ApplyFOR SALE
technology and OR DISTRIBUTION
learning of informa-
information management tion technology skills
tools to support safe
processes of care

© Jones & Bartlett

Identify Learning,
essential informa- LLCthe electronic
Navigate © Jones & Bartlett Learnin
Value technologies
tion that must be available
NOT FOR SALE OR DISTRIBUTION health record that support
NOTclinical
FOR SALE OR DISTR
in a common database to Document and plan pa- decision making, error
support patient care tient care in an electronic prevention, and care
Contrast benefits and health record coordination
limitations of different Employ communication Protect the confiden-
© Jones & Bartlett Learning,
communication LLC technolo- © Jones tiality
technologies to coordi- & Bartlett Learning, LLC
of protected
gies and
NOT FOR SALE OR DISTRIBUTIONtheir impact on nate care for patients health
NOT FOR SALE information
OR DISTRIBUTION
safety and quality in electronic health
records

© Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION.

nes & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
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Quality and Safety Education for Nurses 15

© Jones & BartlettINFORMATICS

Learning, LLC © Jones & Bartlett Learnin
NOT
Knowledge
FOR SALE OR
Skills
DISTRIBUTION Attitudes NOT FOR SALE OR DISTR
Describe examples of how Respond appropriately to Value nurses’
technology and information clinical decision-making ­involvement in design,
management are related supports and alerts selection, implemen-
© Jones to&the
Bartlett
quality andLearning,
LLC safety of
Use information manage- © and
tation, Jones & Bartlett Learning, LLC
evaluation
patient care of information tech-
NOT FOR SALE OR DISTRIBUTION
ment tools to monitor NOT FOR SALE OR DISTRIBUTION
Recognize the time, effort, the outcomes of care nologies to support
and skill required for com- processes patient care
puters, databases, and other Use high-quality elec-
technologies to become tronic sources of health-
nes & Bartlett Learning, LLC tools
reliable and effective © Jones
care information & Bartlett Learning, LLC
for patient care
FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION
Definition: Use information and technology to communicate, manage knowledge,
mitigate error, and support decision making.
Reprinted from Nursing Outlook, 55(3), Cronenwett, L., Sherwood, G., Barnsteiner J., Disch,
J., ­Johnson, J., Mitchell, P., Sullivan, D., Warren, J., Quality and safety education for nurses, pages
122–131. ©copyright
Jones 2007,&withBartlett Learning,
permission from Elsevier. LLC © Jones & Bartlett Learnin
NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTR

Graduate-level informatics KSAs include the following (QSEN Institute, n.d.a):

© Jones & Bartlett Learning, LLC INFORMATICS © Jones & Bartlett Learning, LLC
NOT FORKnowledge
SALE OR DISTRIBUTION
Skills AttitudesNOT FOR SALE OR DISTRIBUTION
Contrast benefits and Participate in the selec- Value the use of informa-
limitations of common tion, design, implementa- tion and communication
information technol- tion, and evaluation of technologies in patient care
ogy strategies used in information systems
nes & Bartlett Learning, LLC
the delivery of patient © Jones & Bartlett Learning, LLC
Communicate the inte-
FOR SALE OR DISTRIBUTION
care NOT FOR SALE OR DISTRIBUTION
gral role of information
Evaluate the strengths technology in nurses’
and weaknesses of work
information systems Model behaviors that
used in patient caresupport the implemen-
© Jones & Bartlett Learning, LLC
tation and appropriate
© Jones & Bartlett Learnin
NOT FOR SALEuse ofOR DISTRIBUTION
electronic health NOT FOR SALE OR DISTR
records
Assist team members
to adopt ­information
­technology by piloting
© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
and evaluating proposed
NOT FOR SALE OR DISTRIBUTION
technologies NOT FOR SALE OR DISTRIBUTION

(continues)
© Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION.
nes & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
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16 chapter 1: Nursing Science and the Foundation of Knowledge

© Jones & Bartlett Learning, LLC

INFORMATICS (continued)
© Jones & Bartlett Learnin
NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTR
Knowledge Skills Attitudes
Formulate essential Promote access to patient Appreciate the need for
information that care information for all consensus and collabora-
must be available in a professionals who provide tion in developing systems
© Jones & Bartlett Learning,
common database LLCto care to patients © Jones & Bartlett
to manage informationLearning,
for LLC
support patient
NOT FOR SALE OR DISTRIBUTION care in Serve as a resource patient care
NOT FOR SALE OR DISTRIBUTION
the practice specialty for how to document
Evaluate benefits and ­nursing care at basic and Value the confidentiality
limitations of differ- advanced levels and security of all patient
ent communication Develop safeguards for records
nes & Bartlett Learning, LLC
technologies and their © Jones
protected health & Bartlett Learning, LLC
infor-
FOR SALE OR DISTRIBUTION impact on safety and NOT FOR SALE OR DISTRIBUTION
mation
quality
Champion communica-
tion technologies that
support clinical decision
making, error preven-
© Jones & Bartlett Learning, LLC
tion, care coordination,
© Jones & Bartlett Learnin
NOT FOR SALE OR DISTRIBUTION
and protection of patient NOT FOR SALE OR DISTR
privacy
Describe and critique Access and evaluate Value the importance of
taxonomic and termi- high-quality electronic standardized terminologies
nology systems used
© Jones & Bartlett Learning, LLC sources of healthcare © in conducting
Jones searchesLearning,
& Bartlett LLC for
in national efforts to information patient information
NOT FOR SALE OR­enhance
DISTRIBUTION
interoper-
NOT FOR SALE OR DISTRIBUTION
Participate in the design Appreciate the contribu-
ability of information of clinical decision-making tion of technological alert
systems and knowl- supports and alerts systems
edge management
Search, retrieve, and Appreciate the time, effort,
systems
nes & Bartlett Learning, LLC © Jones
manage & BartlettandLearning,
data to make LLC
skill required for com-
­decisions using infor- puters, databases, and other
FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION
mation and knowledge technologies to become
management systems reliable and effective tools
Anticipate unintended for patient care
consequences of new
© Jones & Bartlett Learning, LLC
technology © Jones & Bartlett Learnin
NOT FOR SALE
Definition: OR DISTRIBUTION
Use information NOT FOR SALE OR DISTR
and technology to communicate, manage knowledge,
mitigate error, and support decision making.
Reprinted from Nursing Outlook, 57(6), Cronenwett, L., Sherwood, G., Pohl, J., Barnsteiner, J., Moore, S.,
Sullivan, D., Ward, D., Warren, J., Quality and safety education for advanced nursing practice, pages
338–348, copyright 2009, with permission from Elsevier.
© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

© Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION.

nes & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
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Summary 17

© Jones
This text is designed&toBartlett
include theLearning, LLC
necessary content to prepare nurses for practice© Jones & Bartlett Learnin
NOT FOR
in the ever-changing andSALE OR DISTRIBUTION
technology-laden healthcare environments. NOT FOR SALE OR DISTR
Goossen (2000) believes that the focus of nursing informatics research should
be on the structuring and processing of patient information and the ways that these
endeavors inform nursing decision making in clinical practice. The increased use of
technology to enhance nursing practice, nursing education, and nursing research will
© Jones open&newBartlett
avenues Learning, LLC generating, and disseminating
for acquiring, processing, © Jones & Bartlett Learning, LLC
knowledge.
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the future, nursing research will make significant contributions to the devel-SALE OR DISTRIBUTION
opment of nursing science. Technologies and translational research will abound, and
clinical practices will be evidence based, thereby improving patient outcomes and
decreasing safety concerns. Schools of nursing will embrace nursing science as they
strive to meet the needs of changing student populations and the increasing complexity
nes & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
of healthcare environments.
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Summary
Nursing science influences all areas of nursing practice. This chapter provided an over-
view of nursing science and considered how nursing science relates to typical nursing
© Jones
practice roles, nursing & Bartlett
education, andLearning, LLC
nursing research. The Foundation of Knowledge© Jones & Bartlett Learnin
model was introduced as the organizing conceptual framework for this text. Finally,NOT FOR SALE OR DISTR
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the relationship of nursing science to nursing informatics was discussed. In subsequent
chapters the reader will learn more about how nursing informatics supports nurses in
their many and varied roles. In an ideal world, nurses would embrace nursing science
as knowledge users, knowledge managers, knowledge developers, knowledge engineers,
© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
and knowledge workers.
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Thought-Provoking
Questions
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1. Imagine you are in a social situation and NOT
someone asksFOR SALE
you, “What does aOR
nurseDISTRIBUTION
do?”
Think about how you will capture and convey the richness that is nursing science in
your answer.
2. Choose a clinical scenario from your recent experience and analyze it using the Foun-
dation of Knowledge model. How did you acquire knowledge? How did you process
© Jones
knowledge? How did &you
Bartlett Learning,
generate knowledge? How LLC
did you disseminate knowledge? © Jones & Bartlett Learnin
How did you use feedback, and what was the effect of the feedback on the foundation
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of your knowledge?

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
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ones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
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18 chapter 1: Nursing Science and the Foundation of Knowledge

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References © Jones & Bartlett Learnin
NOT American
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Association of Colleges of Nursing (AACN). (2008, October 20). The essentials of
­ accalaureate education for professional nursing practice. http://www.aacn.nche.edu/­
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NOT FOR SALE OR American Nurses Association. (2003). Nursing’s social policy
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Bassendowski, S. (2007). NursingQuest: Supporting an analysis of nursing issues. Journal of
Nursing Education, 46(2), 92–95. Retrieved from Education Module database [document ID:
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nes & Bartlett Learning, LLC(2007). Quality and safety education
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AORN Journal, 86(3), 351–353. Retrieved from Health Module database [document ID:
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National League for Nursing (NLN). (2008). Preparing the next generation of nurses to prac-
tice in a technology rich environment: An informatics agenda [Position statement]. http://
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Skiba, D. (2007). Faculty 2.0: Flipping the novice to expert continuum. Nursing Education Per-
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[document ID: 1401240241].
Swan, B., Lang, N., & McGinley, A. (2004). Access to quality health care: Links between evidence,
nursing language, and informatics. Nursing Economics, 22(6), 325–332. Retrieved from Health
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nes & Bartlett Learning, LLCforming nursing: 3-year action© Jones & Bartlett Learning, LLC
steps toward a 10-year vision. http://www.tigersummit.com/
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uploads/TIGERInitiative_Report2007_Color.pdf

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