Chapter 6

Overview of Nursing Informatics

 Objectives
• Define nursing informatics (NI) and key
terminology

• Explore NI metastructures, concepts and tools

• Reflect on the sciences underpinning NI

• Describe phenomena of nursing

 Key Terms Defined
• Decision support system (DSS) - Computer
applications designed to facilitate human
decision making processes. Usually DSS are rule-
based, using a specified knowledge base and a
set of rules to analyze data and information and
provide recommendations typically through the
use of a knowledge base and rules to make
recommendations to users; “Any computer-
based support of medical, managerial,
administrative, and financial decisions in
healthcare using knowledge bases and/or
reference material (HIMSS, 2006b, p. 24).”
 Key Terms Defined
• Ergonomics - In the United States, this term is
used to describe the physical characteristics of
equipment, for example, the optimal fit of a
scissors to a human hand. In Europe, the term
is synonymous with Human Factors. It is the
interaction of humans with physical attributes
of equipment or the interaction of humans
and the arrangement of equipment in the
work environment.
 Key Terms Defined
• Expert System - A type of decision support
system that implements the knowledge of one or
more human experts.
• Human-Computer Interaction (HCI) - The
processes, dialogues and actions that a user
employs to interact with a computer; also the
study of interaction between people (users) and
computers (Wikipedia, 8/1/07); deals with
people, software applications, computer
technology and the ways they influence each
other.
 Key Terms Defined
• Informatics Nurse Specialist (INS) - An RN
with formal, graduate education in the field of
informatics or a related field and is considered
a specialist in the field of nursing informatics.
• Informatics Nurse (IN) - An RN with an
interest or experience working in an
informatics field. A generalist in the field of
informatics in nursing.
 Key Terms Defined
• Informatics Solution - A generic term used to
describe the product an IN specialist
recommends after identifying and analyzing
an issue. Informatics solutions may
encompass technology and non-technology
products such as information systems, new
applications, nursing vocabulary, or
informatics curricula.
 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.
• Information Literacy - Recognizing when
information is needed and having the ability to
locate, evaluate, and effectively use the needed
information; an intellectual framework for
finding, understanding, evaluating, and using
information.
 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
• Nanotechnology - Microscopic technology on the
order of one-billionth of a meter.
• Nursing informatics (NI) - 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. (cont’d)
 Key Terms Defined
• Nursing informatics (NI) – (cont’d) 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
• Usability - The ease with which people can
use an interface to achieve a particular goal;
issues of human performance during
computer interactions for specific tasks within
a particular context.
 Key Terms Defined
• 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); 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 Informatics
• Nursing Informatics (NI) centers on the
concepts of data, information, knowledge and
wisdom.
• Nursing informatics (NI) is a specialty that
integrates nursing science, computer science,
and information science to manage and
communicate data, information, knowledge
and wisdom in nursing practice.
 Introduction to NI
• NI supports consumers, patients, nurses, and
other providers in their decision-making in all
roles and settings.
• The goal of NI is to improve the health of
populations, communities, families, and
individuals by optimizing information
management and communication.
 Introduction to NI
• NI is one example of a discipline-specific
informatics practice within the broader
category of health informatics.
• NI has become well established within nursing
since its recognition as a specialty for
registered nurses by the American Nurses
Association (ANA) in 1992.
 Metastructures
• Metastructures are overarching concepts used
in theory and science.
• Data, which are processed to information and
then knowledge, may be obtained from
individuals, families, communities, and
populations.
• Data, information, and knowledge are of
concern to nurses in all areas of practice.
 Metastructures
• While knowledge focuses on what is known;
wisdom focuses on the appropriate
application of that knowledge.
• If the study of NI was limited to what the
computer can process, the study of
informatics could not fully appreciate the
interrelationships that exist between nursing
science/practice and information
science/technology.
 Metastructures
• The appropriate use of knowledge involves
the integration of empirical, ethical, personal
and aesthetic knowledge in the process of
implementing actions.
• An example of applied wisdom demonstrating
this integration in NI is the appropriate use of
information management and technological
tools to support effective nursing practice.
 Metastructures
• NI is now concerned with the use of
information technology to improve the access
and quality of health care that is delivered to
individuals, families and communities.
 Sciences Underpinning Nursing
Informatics
• NI is a combination of nursing science,
information science, and computer science to
manage and process nursing data,
information, and knowledge to facilitate the
delivery of health care.
• The combination of sciences creates a unique
blend that is greater than the sum of its parts,
a unique combination that creates the
definitive specialty of NI.
 Sciences Underpinning Nursing
Informatics
• Computer and information science applied in
isolation will have less impact than when they
are applied within a disciplinary framework.
 Structured Language as a Tool for
Nursing Informatics
• Nursing knowledge is gained by the ability to
extract data that specifically defines nursing
phenomena.
• Many different languages and ways of organizing
data, information and knowledge exist based on
different concepts.
• The ANA has formalized the recognition of these
languages/vocabularies through a review process
of the Committee on Nursing Practice
Information Infrastructure (CNPII).
 Structured Language as a Tool for
Nursing Informatics
• At a higher level of structure, several resources
have developed to facilitate interoperability
between different types of systems of concepts
and nomenclature.
• The importance of languages and vocabularies
cannot be understated.
• The INS must attempt to envision the differing
functions that may be used with the data,
information and knowledge that have been
created.
Concepts and Tools from Information
Science and Computer Science
• Informatics tools and methods from computer
and information sciences are considered
fundamental elements of NI.
• Information technology includes computer
hardware, software, communication, and
network technologies, derived primarily from
computer science.
 Concepts and Tools from Information
Science and Computer Science
• Information structures organize data,
information, and knowledge for processing by
computers.
• Information management is an elemental process
within informatics in which one is able to file,
store, and manipulate data for various uses.
• The use of information technology distinguishes
informatics from more traditional methods of
information management.
 Human Computer Interaction and
Related Concepts
• Human–computer interaction (HCI), usability
and ergonomics concepts are of fundamental
interest to the INS.
• Elements of HCI are rooted in psychology,
social psychology and/or cognitive science.
• Usability issues address the efficiency and
effectiveness of an application.
 Human Computer Interaction and
Related Concepts
• HCI, usability, and ergonomics are related
concepts typically subsumed under the rubric
of human factors or how humans and
technology relate to each other.
• Optimal task completion includes the
concepts of efficiency and effectiveness,
including considerations about the safety of
the user.
 Human Computer Interaction and
Related Concepts
• HCI and usability assessments and methods
were being incorporated into health care at a
glacial speed.
• In the past 5 years the number of HCI and
usability publications in healthcare has
increased substantially.
• Vendors have installed usability laboratories
and incorporated usability testing of their
products into their systems lifecycles.
 Phenomena of Nursing
• The metaparadigm of nursing comprises four
key concepts: nurse, person, health, and
environment.
• Nursing actions are based upon the inter-
relationships between the concepts and are
related to the values nurses hold relative to
them.
 Phenomena of Nursing
• The decisions that nurses make can be
characterized by both the quality of decisions
and the impact of the actions resulting from
those decisions.
• The process of decision-making in nursing is
guided by the concept of critical thinking.
• Critical thinking is the intellectually disciplined
process of actively and skillfully using
knowledge.
 Phenomena of Nursing
• Wisdom in informatics is the ability of the NIS to
evaluate the documentation drawn from a Health
Information System (HIS) and the ability to adapt
or change the system settings or parameters to
improve the workflow of the clinical nurse.
• Nurses’ decision-making is described as an array
of decisions that include specific behaviors, as
well as cognitive processes surrounding a cluster
of issues.
 Phenomena of Nursing
• Nurses make decisions about potential
problems presented by an individual and
about appropriate recommendations for
addressing those problems.
• Decisions also may occur within specific
environments such as executive offices,
classrooms, and research laboratories.
 Phenomena of Nursing
• Decision support systems are typically rule-
based, using a specified knowledge base and a
set of rules to analyze data and information
and provide recommendations.
• An expert system is a type of decision support
system that implements the knowledge of one
or more human experts.
 Phenomena of Nursing
• The future of Nursing Informatics promises
increased saturation of informatics concepts
and solutions into mainstream nursing and
health care practices.
• As informatics solutions become as common a
tool as the stethoscope, each nurse may be
considered, in part, an informatics nurse.
• New materials and concepts will evolve in the
future.
 Thought Provoking Questions
• How is the concept of wisdom in nursing
informatics like or unlike professional nursing
judgment?

• Think of a futuristic technology and explain its

impact on nursing.