Nursing Informatics

provide to the following two questions:
• Substantial and doctoral critical thinking responses that add to the question asked
• No incomplete sentences, use of vague terms
• APA 6th ed/ grammar / spelling and punctuation to be 100% correct
• Sources no more than 5 years old / from Evidence –Based articles
• Citations / Scholarly evidence based sources in text and more than 3 sources for each question
• Citations to be no abbreviations e.g Journal names, include page # and volumes
• Avoid inadequate citations; using one citation at the end of a paragraph and not citing every evidence based sentences in the paragraphs
• Writer to be Doctoral nurse practitioner credential , expert in Nursing informatics,
• No Title page required

Q1. Nursing Informatics and Advanced Nursing Practice
Derived from acute care or homehealth healthcare experience, describe the relationships among computer science, information science, and nursing

science from an advanced nursing practice perspective.
Q2. Nursing Information Systems and Advanced Nursing Practice
Derived from acute care or homehealth healthcare experience, describe the impact of a selected nursing information system on a selected healthcare

stakeholder (patient, family, or nurse) from an advanced nursing practice perspective.

Objectives:
• Define nursing informatics from an advanced nursing practice perspective.
• Describe the potential of nursing information systems in advanced nursing practice.
• Analyze the Foundation of Knowledge model from an advanced nursing practice perspective.
Explain nursing informatics from a DNP-prepared nurse perspective.
• Appraise attributes of knowledge from an advanced nursing practice perspective.
• Examine potential relationships among nursing science, information science, and computer science in advanced nursing practice

Overview
( i) Explore nursing informatics and nursing information systems. (ii) Consider basic concepts of nursing informatics and then apply them to the

perspective of advanced nursing practice (nurse practitioner. (iii) Examine how the development of nursing science has influenced the development of

nursing informatics. (iv) Explore nursing information systems, in relation to the Foundation of Knowledge model, and its potential contribution to

Doctoral Nursing practice-prepared practice (DNP) . As the DNP-prepared nurse is suited well to translate knowledge into practice, explain about how

nursing informatics can lead to improved advanced nursing practice!
Following Readings Taken directly from literature ( Do not copy and paste any of this information into writers response)
Overview of Informatics and Information Systems in Nursing

Introduction
Writer stop and reflect on the reading by Choi and Zucker (2013). This is an important reading in which doctoral graduates will want to consider

the degree to which manifest nursing informatics competencies. Remember that self-report may be considered a limitation in research but no more of

a limitation than the influence of the Hawthorne effect when one is observed. Stop for a moment, and consider what is perceive to be informatics

skills, knowledge, and integrative abilities for nurse practitioner/ doctoral graduates. You will want to revisit this article again for a question

I will pos in the coming weeks to you. This will determine the degree to which nurse practitioner perceived competencies have improved!

The Internet has become a major influence on U.S. healthcare. As Internet use has become commonplace, healthcare consumers turn to it for

interactive health assessments; personalized diet and fitness programs; accessing healthcare information; and shopping for pharmaceuticals,

insurance plans, and medical supplies and equipment. In addition to public-use computer applications in health services, information systems include

administrative and clinical information systems and decision-support systems. Administrators, boards of directors, and medical and nursing staff

members depend on information systems for the timely management of data in all areas of the healthcare organization (Shi & Singh, 2008). From the

perspective of advanced nursing practice, nothing has been as dramatic in patient care as the recent influence of nursing informatics.
Nursing Science Versus Nursing Informatics
Through the years, nursing science has come to be thought of as a blended science, combining evidence-based practice, nursing research, and nursing

theory. To the same extent, nursing informatics has emerged as a blended science, combining computer, information, and nursing sciences. In their

early classic work, Graves and Corcoran (1989) defined nursing informatics as a “combination of computer science, information science, and nursing

science, designed to assist in the management and processing of nursing data, information, and knowledge” (p. 227). In the early 1980s, nursing

informatics emerged as a specialty that was initially centered around the application of computer science to nursing. With the rapid growth of

information science, nursing informatics has greatly benefited from emerging hardware and software applications for practice. Data can now be

isolated and communicated to construct information, which, in turn, can be further integrated into new knowledge and wisdom (Turley, 1996).
Nursing Informatics
Data:Information:Knowledge: Wisdom:
Wisdom:
Wisdom is defined as “understanding, applying, and applying with compassion”
(Englebardt & Nelson, 2002, p. 13).
The process of data ⇒ information ⇒ knowledge ⇒ wisdom is known as the Foundation of Knowledge model (Englebardt & Nelson, 2002). According to

Courtney, Alexander, and Demiris (2008), information technology is implemented in nursing practice in the same novice-to-expert pattern that nursing

intervention uses to support patient and provider decision making.
Theory Development and Nursing Information Systems
According to Elkind (2009), information systems are of significant assistance to advanced nursing practice. Information systems theory—which begins

with input, throughput, and output and ends with the closure of the feedback loop—connects with traditional communication theory, which begins with

the sender and then processes the message through to the receiver.
Early behavioral theories further influenced the development of nursing informatics. For example (i) the emphasis on all levels of nursing theory

abstraction (i.e., Nursing Philosophies, Grand Theories, Conceptual and Theoretical Models, Theories, and Middle-Range Theories). (ii) Then change

theories. One example is of Lewin’s (1951) change theory, whereby change is facilitated by unfreezing, introducing change, and refreezing, but other

change theories addressed included Lippitt, Watson, and Westley’s (1958) seven phases of planned change; Havelock’s (1973) six phases of planned

change; Rogers’ (1995) diffusion of innovation model; Prochaska, Redding, and Evers’ (2002) transtheoretical model; Kotter’s (1995) process for

leading change; or Berwick’s (2003) from description to prescription.
Popular systems theory has also had an impact on the development of nursing informatics. Simpson (2000) states that “systems theory is about

connectedness, interdependency, integration, the value of the individual, and the power of the collective . . . . So, too, is healthcare information

technology, which brings together systems to gather and generate data and knowledge for assessment and decision making” (p. 80). The abstracting of

nursing theory and informatics theory into new formalizations for advancing the nursing profession may be the answer to bringing theory, practice,

and research together to form a unified whole for the future.
Another theoretical contribution comes from the field of cognitive science. According to Sease (2008), cognitive science offers nursing information

systems the explanation of how human behavior interacts with computers. One outcome is the recognition that more workflow-driven systems are needed,

rather than data-driven systems (Murphy, 2010).
Human-Factor Issues in Nursing Informatics
The relationship between humans and their computers is called human-computer interaction. It sounds more like the relationship between humans and

their pets, but if you have ever encountered a computer on the fritz, you know that this relationship is tenuous at best! Human factors with regard

to human-computer interaction include (a) physical aspects, such as ergonomics and environment; (b) software aspects, such as visual display design,

user interfaces, and data representation; and (c) user satisfaction.
Much of people’s resistance to constant computing change falls under the category of usability factors. In the area of physical aspects, people need

an adequate workspace for data entry and retrieval, and they need ergonomically fit and adjustable computing stations. Moreover, the aspects of the

computing system that people interface with needs to promote satisfaction as opposed to frustration. The simple approach to understanding computer

technology is to think of hardware, software, processing, and communications. At the minimum, hardware includes input devices, output devices,

processors, and storage. Computer literacy suggests that one might readily comprehend input devices, such as point-of-service terminals that nurses

use to input data on the unit and the personal digital assistants (PDA) people carry to input information. Output devices include such things as

monitors and printers. Processors encompass the central processing unit (CPU), whereas storage is frequently described in terms of memory, such as

RAM for temporary storage and ROM for the memory that remains stored after the power source is shut down.
Reflection
The rapid changes that have taken place in computer technology over the last couple of decades certainly steal the show! Consider the following

reflection on doctoral education and informatics.
Reflection
I recall taking my first Computers in Nursing course as a part of my master’s degree in 1984. When I went on for my doctoral degree in nursing at

Texas Woman’s University, I was inspired by the computer technology provided to the students. At the time, the institution had a mainframe computer

(called Pandora) that seemed to occupy the equivalent space of a small house!
As doctoral nursing students, we were required to enroll in a variety of language courses to support our doctoral research, and computer languages

were accepted as one of our two language requirements. I soon discovered that computer languages had developed generations, just like antibiotics!

Although the first generation was a binary machine language, I found myself enrolled in third-generation languages, such as BASIC in my Computers in

Education course; FORTRAN in my Computer Science I course (where I learned to program GoFish); Pascal in my Computer Science II course; and I

ultimately moved onto fourth-generation applications, such as SPSS.
In just under two decades, advanced nursing practice has moved from supercomputers to mainframes; personal computers; laptops; PDAs; and natural

languages, such as the artificial intelligence now evolving in the new millennium. With thousands of health-related Internet sites and healthcare

providers scrambling to keep up with information-savvy patients who self-diagnose before scheduling their office visit, the influence of technology

on advanced nursing practice is unsurpassed! Yet, lest you think that the playing field is level, consider the phenomena known as the digital

divide, referring to the diverse populations that do not have access to the Internet, whether it is due to a lack of equipment, knowledge, personal

awareness, or outright stubbornness.
Nothing is changing more rapidly than healthcare, other than computer technology, in the new millennium. Nurses in all practice areas will,

therefore, have an ongoing need to upgrade their computing skills, knowledge, and integrative abilities to keep abreast of the changes in computing

technology, telecommunications, and networking. According to Szalma (2009), just as diversity exists among the patient population, variation among

computer users will continue to drive the need for technological adjustments among nurses in advanced nursing environments. Although setting the

stage for such ongoing technological change has become the constant, DNP-prepared nurses will need to develop themselves as leaders of technological

change in the interface between patient care and nursing informatics (Lorenzi & Riley, 2010).
References

Berwick, D. M. (2003). Disseminating innovations in healthcare. JAMA, 289(15), 1969–75.
Choi, J., & Zucker, D. M. (2013). Self-assessment of nursing informatics competencies for Doctor of Nursing Practice students. Journal of

Professional Nursing, 29(6), 381–387.
Courtney, K., Alexander, G., & Demiris, G. (2008). Information technology from novice to expert: Implementation implications. Journal of Nursing

Management, 16(6), 692–-699.
Elkind, E. (2009). Why information systems are helpful to nursing. Pennsylvania Nurse, 64(1), 24–25.
Englebardt, S., & Nelson, R. (2002). Healthcare informatics: An interdisciplinary approach. St. Louis, MO: Mosby-Year Book, Inc.
Graves, J. R., & Corcoran, S. (1989). The study of nursing informatics. Journal of Nursing Scholarship, 21(4), 227–231.
Havelock, R. G. (1973). The change agent’s guide to innovation in education. Englewood Cliffs, NJ: Educational Technology Publications, Inc.
Kotter, J. P. (1995). Leading change: Why transformation efforts fail. Harvard Business Review OnPoint (March-April), 1–10.
Lewin, K. (1951). Field theory in social science: Selected theoretical papers. D. Cartwright (Ed.). New York: Harper & Row.
Lippitt, R., Watson, J., & Westley, B. (1958). The dynamics of planned change – A Comparative Study of Principles and Techniques. W. B. Spalding

(Ed.). New York: Harcourt, Brace, & Company.
Lorenzi, N. M., & Riley, R. T. (2010). Managing technological change: Organizational aspects of health informatics. New York, NY: Springer

Publishing Company.
Murphy, J. (2010). Time flies—or does it? Why we need to move from data-driven systems to workflow-driven systems. Journal of Healthcare Information

Management, 22(3), 9–10.
Prochaska, J. O., Redding, C. & Evers, K. (2002). The transtheoretical model and stages of change. In K. Glanz, F. M. Lewis, and B. K. Rimer (Eds.),

Health behavior and health education: Theory, research and practice (3rd Edition). Hoboken, NJ: Jossey-Bass Publications, Inc.
Rogers, E. M. (1995). Diffusion of innovations. (4th ed.). New York, NY: The Free Press.
Sease, R. (2008). Metaphor’s role in the information behavior of humans interacting with computers. Information Technology & Libraries, 27(4), 9–16.
Shi, L., & Singh, D. (2008). Delivering healthcare in America: A systems approach (4th ed.). Sudbury, MA: Jones & Bartlett.
Simpson, R. L. (2000). Nursing informatics: A systems view of information technology. Nursing Administration Quarterly, 4(4), 80–82.
Szalma, J. (2009). Individual differences in human-technology interaction: Incorporating variation in human characteristics into human factors and

ergonomics research and design. Theoretical Issues in Ergonomics Science, 10(5), 381–397.
Turley, J. P. (1996). Toward a model for nursing informatics. Image: Journal of Nursing Scholarship, 28(4), 309–313.

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