The idea for this text originated with the development of nursing informatics (NI) classes, the publication of articles related to technology-based education, and the creation of the Online Journal of Nursing Informatics (OJNI), which Dr. Dee McGonigle cofounded with Dr. Renee Eggers. Like most nurse informaticists, we fell into the specialty; our love affair with technology and gadgets and willingness to be the first to try new things helped to hook us into the specialty of informatics. The rapid evolution of technology and its transformation of the ways of nursing prompted us to try to capture the essence of NI in a text.
As we were developing the first edition, we realized that we could not possibly know all there is to know about informatics and the way in which it supports nursing practice, education, administration, and research. We also knew that our faculty roles constrained our opportunities for exposure to changes in this rapidly evolving field. Therefore, we developed a tentative outline and a working model of the theoretical framework for the text and invited participation from informatics experts and specialists around the world. We were pleased with the enthusiastic responses we received from some of those invited contributors and a few volunteers who heard about the text and asked to participate in their particular area of expertise.
In the second edition, we invited the original contributors to revise and update their chapters. Not everyone chose to participate in the second edition, so we revised several of the chapters using the original work as a springboard. The revisions to the text were guided by the contributors' growing informatics expertise and the reviews provided by textbook adopters. In the revisions, we sought to do the following:
New chapters that were added to the second edition included those focusing on technology and patient safety, system development life cycle, workflow analysis, gaming, simulation, and bioinformatics.
In the third edition, we reviewed and updated all the chapters, reordered some chapters for better content flow, eliminated duplicated content, split the education and research content into two sections, integrated social media content, and added two new chapters: Data Mining as a Research Tool and The Art of Caring in Technology-Laden Environments.
In the fourth edition, we reviewed and updated all the chapters based on technological advancements and changes to the healthcare arena, including reimbursement mechanisms for services.
In the fifth edition, we added specific information on informatics contributions to quality improvements, interprofessional collaboration, and pandemic response. We pared the fifth edition down to 26 chapters from the previous edition's 29; one chapter each was deleted from Sections II, V, and VII. Section I includes updates to the same five chapters on the building blocks of nursing informatics, with extensive changes to Chapter 3, Computer Science and the Foundation of Knowledge Model. To improve flow, we combined content. There was a section describing a virtual reality product with access information for the reader; this product can be accessed in 2D as well as 3D. Chapter 24, The Art of Caring in Technology-Laden Environments, was enhanced, and Chapter 25 was replaced with Our Expanding Realities.
In this sixth edition, we have once again reviewed and updated all the chapters based on technological advancements and changes to the healthcare arena, including reimbursement mechanisms for services. We have added specific information on informatics contributions to quality improvements and interprofessional collaboration. The section describing a virtual reality product remains, with access information for the reader; this product can be accessed in 2D as well as 3D. This edition has been decreased to 25 chapters. Chapter 24. Bioinformatics, Biomedical Informatics, and Computational Biology, was eliminated by integrating this content appropriately throughout the textbook.
The major revisions follow:
Chapter 1 was enhanced by exploring the impacts of AI, cognitive systems, machine learning and predictive analytics on knowledge management in organizations, the importance of knowledge co-creation, and the characteristics of knowledge work.
Chapter 2 emphasizes the need to ethically implement ISs to mitigate impacts on users and institutions, discusses the issues associated with asset classification (i.e., drug or device), and explores issues related to IoT (Intelligence of Things; Internet of Things) and AIoT (Artificial Intelligence of Things).
Chapter 3 was heavily revised and shortened. Tables were created for computer components, summarizing major types of software and input devices. The following were added: haptics for immersive technologies and VR (Virtual Reality), VPN (Virtual Private Network) with encryption, and the introduction of the concept of the metaverse.
Chapter 4 explores AI (Artificial Intelligence), machine learning, and natural language processing.
Chapter 5 discusses the ethics of using robots as substitutes for human carers, identifies challenges and opportunities related to social media use by patients and providers, and discusses motives for seeking information and emotional support online.
Chapter 6 explores the evolution of NI definitions and shares the current NI definition. It also updates AACN education guidelines and shares 2021 informatics competencies identified in Essentials: Core Competencies for Professional Nursing Education.
Chapter 7 shares updates from the third edition of the ANA's Nursing Informatics: Scope and Standards of Practice (2022), presents ways in which INSs (Informatics Nurse Specialist) provide value, and explores trends influencing the future of NI (Nursing Informatics).
Chapter 8 was updated to reflect the concerns related to the use of personal devices in the workplace and BYOD policies, notes that CMPs (Civil Monetary Penalties) associated with PHI (Protected Health Information) breaches may increase with inflation, alerts that Privacy Rule changes are expected in mid-2023, and provides access to the global health legislation tracker.
Chapter 9 updates the description of object-oriented modeling, CASE (Computer-aided Software Engineering), and differentiates between free software and open source software.
Chapter 10 expands the discussion of interoperability and the use of metadata tagging in the interoperability context, discusses documentation integrity, introduces and defines unified communication for health care, updates ADT (Admission, Discharge, and Transfer System) description and use, and introduces CDI (Clinical Documentation Improvement).
Chapter 11 explores data visualization as a tool to model complex healthcare data and clarifies NFC (Near-field Communication) transactions. Also added is a detailed description of VR headset use and a discussion of the importance of managing HTI (Human-Technology Interaction) with new technologies.
Chapter 12 provides updated tips for creating strong passwords, expands the discussion of electronic data vulnerability, and reviews recent data breaches.
Chapter 13 emphasizes the value of process improvement theories, introduces the Patient Room ‘Next' (PRN) strategy for providing high-quality healthcare regardless of patient location, and reviews the seven key steps for a quality improvement project.
Chapter 14 updates EHR (Electronic Health Record) adoption statistics and explores how interoperable EHRs facilitate data sharing.
Chapter 15 shares 10 common medical errors leading to patient deaths and access to global strategies for safety. It also explores the contributions of wearable technologies to safety and early detection of issues.
Chapter 16 shares changes in the fitness app market, explores the use of an AI-powered web-based symptom checker and medical misinformation during the pandemic, discusses the digital divide via an interactive map tool, identifies wearable technology as consumer-centric technology, and introduces virtual and augmented reality tools for engagement.
Chapter 17 describes the EPA (Environmental Protection Agency) risk assessment, introduces AI as a prediction tool for disease outbreaks, and explores quality public health messaging.
Chapter 18 provides updated healthcare spending costs. It offers a definition and explains its use to help reduce disparities. It also explores medical and nurse licensure compacts as well as telehealth support and regulations changes post-pandemic.
Chapter 19 acknowledges the pandemic's impact on telecommunications, virtual technology use, and the paradigm shift with the shutdowns. It reviews clinical replacement and augmentation with simulation, explains how adaptive learning is integrated into LMS (Learning Management System), and provides updates on Gen Z, AI, and the learning disruption caused by ChatGPT. It also provides an actual, unedited interaction with ChatGPT about AI and explores some faculty's reactions to ChatGPT or other AI products students are using.
Chapter 20 acknowledges the role of the pandemic in the escalated integration of virtual simulation and explores a new initiative at a children's hospital with VR on every unit.
Chapter 21 identifies the information literacy competency standards specific to nursing and acknowledges the role of the pandemic in accelerating the commitment to collecting healthcare data in a standardized way to facilitate data sharing and treatment outcomes.
Chapter 22 expands the former data mining chapter to include artificial intelligence, bioinformatics, and computational biology contributions to data analytics. It acknowledges the contributions of the former BD2K (Big Data to Knowledge) program, advocates for the use of EHR data for comparative effectiveness research, and identifies three main types of data analytics. Finally, this chapter incorporates information from the former Chapter 24 from the fifth edition on bioinformatics and computational biology and their contributions to data analysis.
Chapter 23 explores the potential contributions of bioinformatics and computational biology to evidence for practice, introduces the NCATS (National Center for Advancing Translational Sciences) translational science spectrum, and incorporates information from the former Chapter 24 from the fifth edition on bioinformatics and computational biology and their effects on clinical translation
Chapter 24 advocates for adding technology as a fifth dimension of the nursing paradigm, considerations for conveying caring while wearing PPE (Personal Protective Equipment), and caring encounters as communion-in-caring. It also emphasizes reflection to improve caring encounters.
Chapter 25 examines the emerging technologies evolving our sense of reality that will affect the future of health care, nursing practice, nursing informatics, and patient care. To help the reader consider the disruptive forces affecting our realities, we have provided a glimpse of patient experiences in future health care, care bots, cyborgs, and artificial intelligence. Through our use of nursing informatics in the integration of evolving technologies, we affect our reality, the reality of the healthcare industry, the reality of our patients, and the reality of the concept of the metaverse, and all of these concepts are explored in this chapter. In addition, the chapter explores haptic technology and its future in nursing, encourages the reader to think about the impact AI will have on our reality, and includes a new section on the metaverse in which the following topics are discussed:
In addition, the ancillary materials have been updated and enhanced to include competency-based self-assessments, mapping the content to the current NI standards, activities for both undergraduate and graduate nursing students, and 10 interactive case studies.
We believe that this text provides a comprehensive elucidation of this exciting field. Its theoretical underpinning is the Foundation of Knowledge model. This model is introduced in its entirety in the first chapter, which discusses nursing science and its relationship to NI. We believe that humans are organic information systems that are constantly acquiring, processing, and generating information or knowledge in both their professional and their personal lives. It is their high degree of knowledge that characterizes humans as extremely intelligent, organic machines. Individuals have the ability to manage knowledge-an ability that is learned and honed from birth. We make our way through life interacting with our environment and being inundated with information and knowledge. We experience our environment and learn by acquiring, processing, generating, and disseminating knowledge. As we interact in our environment, we acquire knowledge that we must process. This processing effort causes us to redefine and restructure our knowledge base and generate new knowledge. We then share (disseminate) this new knowledge and receive feedback from others. The dissemination and feedback initiate this cycle of knowledge over again, as we acquire, process, generate, and disseminate the knowledge gained from sharing and reexploring our own knowledge base. As others respond to our knowledge dissemination and we acquire new knowledge, we engage in rethinking and reflecting on our knowledge, processing, generating, and then disseminating anew.
The purpose of this text is to provide a set of practical and powerful tools to ensure that the reader gains an understanding of NI and moves from information through knowledge to wisdom. Defining the demands of nurses and providing tools to help them survive and succeed in the Knowledge Age remains a major challenge. Exposing nursing students and nurses to the principles and tools used in NI helps to prepare them to meet the challenge of practicing nursing in the Knowledge Age while striving to improve patient care at all levels.
The text provides a comprehensive framework that embraces knowledge so that readers can develop their knowledge repositories and the wisdom necessary to act on and apply that knowledge. The text is divided into seven sections.
The introduction to each section explains the relationship between the content of that section and the Foundation of Knowledge model. This text places the material within the context of knowledge acquisition, processing, generation, and dissemination. It serves both nursing students (BS to DNP/PhD) and professionals who need to understand, use, and evaluate NI knowledge. As nursing professors, our major responsibility is to prepare the practitioners and leaders in the field. Because NI permeates the entire scope of nursing (i.e., practice, administration, education, and research), nursing education curricula must include NI. Our primary objective is to develop the most comprehensive and user-friendly NI text on the market to prepare nurses for current and future practice challenges. In particular, this text provides a solid groundwork from which to integrate NI into practice, education, administration, and research.
The goals of this text are as follows:
Meeting these goals will help nurses and nursing students understand and use fundamental NI principles so that they efficiently and effectively function as current and future nursing professionals to enhance the nursing profession and improve the quality of health care. The authors would also like to challenge nursing informatics experts to continually expand their horizons and passion for appropriate integration of technology in all facets of nursing care. The overall vision, framework, and pedagogy of this text offer benefits to readers by highlighting established principles while drawing out new ones that continue to emerge as nursing and technology evolve.