A Theoretical Basis for Nursing Informatics

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A Theoretical Basis for Nursing Informatics

• by
• Ramona Nelson, PhD, RN-BC, ANEF, FAAN

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Theory

• A theory is just a model of the universe, or a
  restricted part of it, and a set of rules that
  relate quantities in the model to observations
  that we make.
• Hawking, S. (1988) A Brief History of Time,
  p. 9.

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Major Theories

• Systems and Chaos theory
• Information theories
• Learning theories
• Change theories

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Systems Theory

• A set of interrelated interacting parts within a
  boundary
• As a result of the interrelationships, a system
  is more than the sum of its parts.

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An Open System Interacting With the Environment
Environment
Input (information, matter and energy)
Process
Output (information, matter and energy)
Feedback
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Characteristics

• Purpose
• Structure
• Functions

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Change in a System

• Dynamic homeostasis
• Entropy
• Negentropy specialization
• Reverberation
• Equifinality

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Chaos Theory Complex Systems

• A tiny difference in initial parameters result in
  a completely different behavior
• The Uncertainty Principle prohibits accuracy
• There is order in chaos

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Information Theories

• There is more than one definition of information
  and more than one theory of information.
• Shannon and Weavers Information-Communication
  Theory
• The Data to Wisdom Continuum

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Shannon and Weavers Information/Communication
Model

• A sender transmits a message over a channel to a
  receiver.

Message
Channel
Sender
Receiver
Noise
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Shannon and Weavers Information/Communication
Model

• The amount of information in the message is
  measured by the reduction in uncertainty.

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The Nelson Data to Wisdom Continuum
Wisdom
Understanding, applying, applying
with compassion
Knowledge
Interpreting, integrating, understanding
Increasing Complexity
Information
Organizing, interpreting
Data
Naming, collecting, organizing
Increasing Interactions and Inter-relationships
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Data

• Uninterrupted observations and measurements made
  about the world
• Patient assessment forms are, for the most part,
  data collection forms.

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Data Attributes

• Descriptive
• Measurable

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Information

• Processed data that contains meaning
• A completed patient assessment contains a great
  deal of information.

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Information Attributes

• Quantifiable
• Verifiable
• Accessible
• Free from bias
• Comprehensive

• Clear
• Appropriate
• Timely
• Precise
• Accurate

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Knowledge

• Knowledge results when data and information are
  identified and the relationships between the data
  and information are formalized. A knowledge base
  is more than the sum of the data and information
  pieces in that knowledge base.

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Knowledge Attributes

• Accurate
• Relevant
• Quality
• Type
• Empirical
• Ethical
• Personal
• Aesthetic

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Wisdom

• Knowing when and how to use knowledge in the
  process of caring for people

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Learning Theories

• Behavioral theory or reductionism
• Conditioning, reinforcement
• Information processing or cognitive
• STM or LTM
• Critical thinking
• Developmental
• Adult learning
• Learning styles

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Learning Principles

• Meaningfulness assists learning.
• Only so much input can be handled at one time.
• Timing of learning is critical.
• Participation and practice support retention.
• Conceptual learning is enhanced with concrete
  examples.

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Learning Principles

• Taking in new material through more than one
  modality can facilitate learning.
• Learning is enhanced when the teaching method
  includes the cognitive, affective, and
  psychomotor domains in concert.
• Learning takes place intentionally and
  unintentionally.
• Learning is contagious.

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Change Theories

• The study of change in organizations and
  individuals
• Planned change Kurt Lewin
• Diffusion of innovation Everett Rogers

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Planned Change

• Unfreezing
• Moving
• Refreezing

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Diffusion of Innovation

• How do individuals, groups, and communities
  respond to new ideas, practices, and objects?

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Responding to Change

• Innovators
• Early adapters
• Early majority
• Late majority
• Laggards

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A Single Theory

• The final goal of science is to develop one
  theory that describes the whole universe. What we
  now have is several partial theories that
  describe parts of the universe.
• And a world where different people know different
  aspects of these parcial theories