Building Blocks of Nursing Informatics

Nursing professionals are information-dependent knowledge workers. As health care continues to evolve as a data-driven and information-dependent enterprise, professionals-that is, the knowledge workers-must be well prepared to make significant contributions by harnessing informatics concepts and tools. Nursing informatics (NI), a product of the scientific synthesis of information in nursing, encompasses concepts from computer science, cognitive science, information science, and nursing science. NI continues to evolve as more and more professionals access, use, and develop the information, computer, and cognitive sciences necessary to 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 information, computer, and cognitive sciences to advance nursing science and build the nursing knowledge base.

To implement NI, one must view it from the perspective of both the current healthcare delivery system and the specific, individual organizational needs while anticipating and creating future applications in both the healthcare system and the nursing profession. Nursing professionals should be expected to discover opportunities to use NI; participate in the design of solutions; and be challenged to identify, develop, evaluate, modify, and enhance applications to improve patient care. This text is designed to provide the reader with the information and knowledge needed to meet this expectation.

Section I presents an overview of the building blocks of NI: the nursing, information, computer, and cognitive sciences. Also included in this section is a chapter on ethical applications of NI. This section is central to understanding the content in subsequent chapters.

Chapter 1, Nursing Science and Concepts of Knowledge, describes nursing science, explores concepts of knowledge and knowledge development, and introduces the Foundation of Knowledge model as the conceptual framework for the book. In this chapter, a clinical case scenario is used to illustrate the knowledge concepts central to nursing science and practice. A definition of nursing science is derived here from the American Nurses Association's definition of nursing. Nursing science is the ethical application of knowledge acquired through education, research, and practice to provide services and interventions to patients to maintain, enhance, or restore their health and to acquire, process, generate, and disseminate nursing knowledge to advance the nursing profession. Knowledge derived from information is a concept central to nursing, and knowledge is health care's most valuable resource. Informatics technologies support individual and organizational knowledge management. Information science and systems, together with computers and other technologies, are constantly changing the way that professionals practice and healthcare organizations conduct their business, which will continue to evolve.

To prepare for these innovations, the reader must understand fundamental information and computer concepts, covered in Chapters 2 and 3, Introduction to Information, Information Science, and Information Systems and Computer Science and the Foundation of Knowledge Model, respectively. Information science deals with the interchange (or flow) and scaffolding (or structure) of information and involves the application of information tools for solutions to patient care and business problems in health care. To be able to use and synthesize information effectively, an individual must be able to obtain, perceive, process, synthesize, comprehend, convey, and manage the information. Computer science deals with understanding the development, design, structure, and relationship of computer hardware and software. This science offers extremely valuable tools that, if used skillfully, can facilitate the acquisition and manipulation of data and information by nurses who can then synthesize these resources into an ever-evolving knowledge and wisdom base. This synthesis not only facilitates professional development and the ability to apply evidence-based practice decisions within nursing care, but if these resources are disseminated and shared, it can also advance the nursing science knowledge base. The development of knowledge tools, such as the automation of decision-making and the strides being made in artificial intelligence, has altered the understanding of knowledge and its representation. The ability to structure knowledge electronically facilitates the ability to share knowledge structures and enhance collective knowledge.

As discussed in Chapter 4, Introduction to Cognitive Science and Cognitive Informatics, cognitive science deals with how the human mind functions. This science encompasses how people think, understand, remember, synthesize, and access stored information and knowledge. The nature of knowledge, including how it is developed, used, modified, and shared, provides the basis for continued learning and intellectual growth. Cognitive science principles underpin computer and software development as well as more advanced informatics topics such as artificial intelligence (AI) and robotics. Chapter 5, Ethical Applications of Informatics, focuses on ethical issues associated with managing private information with technology and provides a framework for analyzing ethical issues and supporting ethical decision-making. This chapter provides working wisdom by allowing the reader to experience an expert's practical application of knowledge and experience as they address specific situations; it walks the reader through an expert's application of the ETHICAL model.

The material in this book is placed within the context of the Foundation of Knowledge model (shown in Figure I-1, which is more fully introduced and explained in Chapter 1, Nursing Science and Concepts of Knowledge). The Foundation of Knowledge model is used throughout the text to illustrate how knowledge is used to meet the needs of healthcare delivery systems, organizations, patients, and nurses. Through interaction with the building blocks of knowledge-the theories, architecture, and tools-one acquires the bits and pieces of data necessary to synthesize them into information and then generate and disseminate the resulting knowledge. Through this dynamic exchange, which includes feedback, individuals continue the interaction with and use of these sciences to input, or acquire; process; and output, or disseminate, generated knowledge. Humans experience their environment and learn by acquiring, processing, generating, and disseminating 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, reflect on, and explore their own knowledge base. This complex process is captured in the Foundation of Knowledge model. Throughout the chapters in Section I, Building Blocks of Nursing Informatics, readers are challenged to think about how the model can help them to understand the ways in which they acquire, process, generate, disseminate, and then receive and process feedback on their new knowledge of the building blocks of NI.

Figure I-1 Foundation of Knowledge Model

An illustration depicts the structure of the Foundation of Knowledge model.

The model features a three-dimensional illustration of three entwined, inverted cones labeled K A, K G, and K D. The three labeled cones converge to create a new cone labeled K P. Encircling these cones is a feedback loop. The entire composition is situated on a platform featuring repeated words such as information, data, bytes, and bits. K A indicates knowledge acquisition; K D indicates knowledge dissemination; K G indicates knowledge generation; and K P denotes knowledge processing.

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