LES 2.2: The Practice Specialty of Nursing Informatics (Models & Theories)

Models

Are representations of some aspect of the real world; show particular perspectives of a selected aspect and may illustrate relationships

False

True or False: There is one right model for NI.

Clinical-Information-System (CIS)

This model shows how modeling can be used to organize different concepts into a logical whole. The purpose of this model is to depict system components, influencing factors, and relationships that need to be considered when attempting to capture the complexities of professional nursing practice.

Graves & Corcoran’s Model

Model that places data, information and knowledge in sequential boxes with one-way arrows pointing form data to information to knowledge. The management processing box is directly above with arrows pointing in one direction from management processing to each of the three boxes.

Graves & Corcoran Model

Identify the model.

Patricia Schwirian’s Model

Model of NI intended to stimulate and guide systematic research in this discipline.Provides a framework for identifying significant information needs.

Patricia Schwirian’s Model

Identify the model.

Raw Materials

Component of Patricia Schwirian’s Model

Nursing related information

Technology

Component of Patricia Schwirian’s Model

A computing system comprised of hardware and software

Users

Component of Patricia Schwirian’s Model

Surrounded by context which are the nurses and students

Goal

Component of Patricia Schwirian’s Model

Toward the preceding elements are directed

Turley (1996)

Model in which the core components of informatics (cognitive, information, and computer sciences are depicted as intersecting circles. NI is the intersection between the discipline-specific science (nursing) and the area of informatics

Turley’s Model (1996)

Identify the model.

McGonigle & Mastrian’s Foundation of the Knowledge Model

Base of this model shows data and info distributed randomly. From this base, transparent cones grow upward and intersect. The upward cones represent acquisition, generation, and dissemination of knowledge. knowledge processing is represented by the intersections of these three cones. Circling and connecting all the cones is feedback. The cones and feedback circle are dynamic in nature

McGonigle & Mastrian’s Foundation of the Knowledge Model

Identify the model.

Knowledge

• Acquisition

• Generation

• Dissemination

In McGonigle & Mastrian’s Foundation of the Knowledge Model what do the upward cones represent?

Knowledge Processing

In McGonigle & Mastrian’s Foundation of the Knowledge Model what do the intersection of the three cones represent?

Feedback

In McGonigle & Mastrian’s Foundation of the Knowledge Model what circles and connects the cones?

Theory

A scholarly, organized view of some aspect of the world (reality); can describe, explain, predict, or prescribe selected phenomena within this reality

1. Grand

2. Middle-Range

3. Situation-Specific or Practice Theories

Theory Classifications

Grand Theories

Theory Classification

Are broad in scope and the most complex of the 3

Situation-Specific/Practice Theories

Theory Classification

Are the most specific of the 3; Usually provide prescriptions or directions for practitioners

Middle-Range Theories

Theory Classification

Are somewhere in the middle of the 2; are more specific than grand but not as prescriptive as practice theories

Nursing Theories

Are about nursing practice-a nurse’s interactions or relationships with individuals, groups, or communities (aka patients or clients) focused on applying the nursing process

Grand Nursing Theories

Discuss nursing practice in broad terms, providing different worldviews of how, when, and why nurses relate to clients

Middle-Range Nursing Theories

Might describe a particular phenomenon of interest to nurses, explain how one phenomenon relates to one or more other phenomena or predict how a phenomenon impacts nurses and or clients

Practice Nursing Theories

A particular approach to breast feeding or a set of specific principles for the care of preterm infants that improves heir health outcomes are two examples of this.

Patricia Benner’s Novice to Expert

Model to explain how nursing students and professional nurses acquired nursing skills

1. Novice

2. Advance Beginner

3. Competent

4. Proficient

5. Expert

5 Stages of Novice to Expert

Novice

Stage of Novice to Expert

Follow rules provided for each situation and is not flexible in real life situations

Advanced Beginner

Stage of Novice to Expert

When one acquires real-life experiences and can appreciate environmental influences on rule sets

Competent

Stage of Novice to Expert

A learner is able to tell what is important and what is not important in assessing a given situation-a learner has gained perspective

Proficient

Stage of Novice to Expert

Able to see a situation in terms of the larger setting or environmental situation and begins to use intuition in decision-making

Expert

Stage of Novice to Expert

Intuitively understands a situation and immediately connects action to this understanding

Computer Science

Study of algorithms for solving computation problems; if an algorithm can be identified for solving a particular problem, an automated solution to the problem can be developed

False

True or False: A computer is the focus of comp sci, rather than a tool.

Information Science

Focuses on the gathering, manipulation, classification, storage and retrieval of recorded knowledge; can be socially oriented, focused on humans and machines and closely linked to communications and human behavior

1. Information Retrieval

2. Human-computer interactions from the perspective of knowledge manipulation

3. Information handling within a system (human or machine)

3 Important Branches of Information Science

Communication Theory

Uses the concept of communication channel and additional principles developed since then to analyze information transfer and effectiveness and efficiency of communication

below

If the sender’s entropy rate is ___ the channel capacity, there is a way to encode the information so that it can be received without errors

Bruce I. Blum

Within a communication model, who presented a taxonomy?

Data

Communication Model

Discrete entities that are described objectively without interpretation; facts without context; sometimes referred to as being “raw”

Information

Communication Model

Data that are interpreted, organized, or structured; brings in the idea of processing data so that it can be displayed or presented for human use

Knowledge

Communication Model

Information that has been synthesized so that interrelationships of data and information are identified and formalized

Wisdom

Many informatics theorists have added this to Blum’s theory; the appropriate use of knowledge in managing and solving problems

Cognitive Science

Study of the mind of how we think

Computers, phones, web browsers

What are examples of cognitive technologies that are emerging from cognitive science that help in learning, memory, problem solving, and living faily life in modern society?

1. Biological-Base Intelligence

2. Artificial Intelligence

What are two significant branches of cognitive technologies?

Systems Theory

Theory that relates to the properties of ____ as a whole; focuses on the organization and interdependence of relationships within a ____

System

Any set (group) of interdependent or temporarily interacting parts

Parts

Are systems themselves and are composed of other parts

1. Closed

2. Open

Boundary of a system may be:

Closed System

Systems theory

Has an impermeable boundary and does not interact with the surrounding environment

Example: Human circulatory system since the blood never leaves the system of blood vessels

Open System

System theory

Can be influence by events outside of the actual or conceptual boundaries; have semipermeable boundaries that restrict the exchange of selective components but allow free exchange of all other components

Example: Information systems and people, although there can be the opposite systems within these systems

Behavior

Can include emotions, cognitions, motivation

Social Processes & Acts

Can be status (demographic, economic, or cultural), levels of social context, and biosocial interaction

Behavioral and Social Sciences

Study of behavior; examining how people act alone and with others

Change

Entail not only structures and ways of doing tasks but also the performance, expectations, and perceptions of all involved parties

Informatics Nurse Specialist (INS)

Who is often the primary change agent in facilitating the implementation of clinical information systems (CIS) in healthcare settings?

Planned Change

A collection of ideas about modifications to an organization or social system that are explicitly designed and put into place

1. Lewin’s Theory on Planned-Change Model

2. Rogers’ Diffusion of Innovations Model

What are the 2 most familiar change perspectives?

1. Unfreezing

2. Changing

3. Refreezing

3 Stages of Lewin’s Theory on Planned Change Model

Unfreezing

Stage of Lewin’s Theory on Planned Change Model

Involves overcoming inertia and dismantling the existing mindset. Defense mechanisms or resistance patterns have to be bypassed.

A change agent must uncover reasons or rewards that will be influential in __ or changing a behavior.

Moving

Stage of Lewin’s Theory on Planned Change Model

Behavioral change occurs; typically is a period of confusion

People are aware that the old ways are being challenged but do not have a clear picture yet of how to replace the old ways

Refreezing

Stage of Lewin’s Theory on Planned Change Model

A new mindset has formed and the comfort level is returned to previous levels

Everett Rogers

Who formalized the diffusion of innovation theory?

Diffusion of Innovations (1962)

In what book did Everett Rogers formalize the diffusion of innovation theory?

1. Innovators

2. Early Adopters

3. Early Majority

4. Late Majority

5. Laggards

5 Specific Groups of Innovation Adopters

1. Knowledge

2. Persuasion

3. The Adopter Makes a Decision

4. Implementation

5. Confirmation

5 Stages of Diffusion of Innovations Model

1: Knowledge

Stage of Diffusion of Innovations Model

Learning about the existence and function of the innovation

2: Persuasion

Stage of Diffusion of Innovations Model

Becoming convinced of the value of the innovation

3: The Adopter Makes a Decision.

Stage of Diffusion of Innovations Model

Committing to the adoption of the innovation

4: Implementation

Stage of Diffusion of Innovations Model

Putting it to use

5: Confirmation

Stage of Diffusion of Innovations Model

The ultimate acceptance (or rejection) of the innovation.

Learning

Process of acquiring KSA, or values through study, experiences or teaching

Organizational Behavior

In this field, organizations are examined, using methods drawn from economics, sociology, political science, anthropology, and psychology

Management Science

Uses mathematics and other analytical methods to help make better decisions

Group Dynamics

Is a social science field that focuses on the nature of groups; urges to belong or to identify may make for distinctly different attitudes

Bruce Tuckman (1965)

Who proposed a 4 stage model for ideal group decision making process?

1. Forming

2. Storming

3. Norming

4. Performing

4 Stages for ideal group decision making process

1: Forming

Stage for ideal group decision making process

Pretending to get on or get along with others

2: Storming

Stage for ideal group decision making process

Letting down the politeness barrier and trying to get down to the issues even if tempers flare up

3: Norming

Stage for ideal group decision making process

Getting used to each other and developing trust and productivity

4: Performing

Stage for ideal group decision making process

Working in a group to a common goal on a highly efficient and cooperative basis