Research in Nursing Informatics: Naming, Claiming,

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Research in Nursing InformaticsNaming,Claiming,
ChangingHealth Outcomes

• Patricia Flatley Brennan,RN, PhD, FAAN
• University of Wisconsin-Madison
• Supported by grants from the NIH and the
  UW-Madison Graduate School

School of Nursing University of Wisconsin-Madison
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Nursing Informatics
Diagnosis treatment of human responses Health
Policy Genomics
Representation, Transformation, Manipulation
Application of Information
Semantics
Syntax
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Knowledge building in health informatics
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Health Policy Clinical Practice
Health Care
System Definition
System Evaluation
System Construction
System Validation
Informatics
System Description
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25 Years of Progress In Nursing Informatics
Research
Clinical Practice
System Evaluation
System Definition
System Validation
System Construction
System Description
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2001
ReferenceModels
Ontologies
Formal Languages
Vocabularies
Controlled Terms
Terms
1976
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Health Care Vocabularies

• Standardized vocabularies are sufficiently robust
  to capture most terms needed to describe the
  problems nurses treat ( 70--80)
• Bakken (Henry), 1994

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Nursing-Specific Terminologies

• NANDA
• NIC
• NOC
• HHCC
• Omaha System
• ICNP
• NILT
• Patient Care Data Set
• AORN Data Set

• Nursing terminologiesprovide a rich set of terms
  to represent nursing concepts
• BUT
• lack the grammars and syntax rules, and
  granularity, needed to support full
  computerizationHardiker, 1999

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Genomic Data Mining
2001
Bayesian Belief Nets
Explanation
Clinical Practice
System Definition
System Evaluation
AI, Probability Models and certainty factors
System Construction
System Validation
1976
System Description
Decision Support for Diagnostics Therapeutics
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Clinical Decision Support Supports!

• Patients in a nursing home had fewer wetting
  events when nurses used UNIS to help plan care
• Petrucci, 1993

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Alerts Reminders
Clinical Information systems
Bringing knowledge to the point of care
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Clinical Information Systems Help

• Structured assessment and clinical guidelines,
  integrated in the clinical information system,
  facilitate compliance

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Computer screens effect performance

• Nurses using a graphical interface to manipulate
  order sets completed tasks faster, and with fewer
  errors, than when using text entry.
• Staggers Kolbus, 2001

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Home Telenursing Aids Recovery

• Access to HeartCare helped patients recovering
  from CABG surgery to get better, faster.

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Lessons Learned
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Where nursing goes, nursing informatics follows
and sometimes leads!
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Youve got to build it to use it
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Sometimes a rose by any other name isnt
recognizable
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Structured data entry helps
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Decision support works behind the scene
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Data security wins
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Patients are Users, too
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Genes are more than bits of people, andPeople
are more than bits of genes
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We like to work together
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How does Nursing Informatics Research differ
from other NURSING Researchendeavors?
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Different Knowledge Products

• Nursing Informatics Research
• Focus on the structure and manipulation of the
  data
• Provides manipulation tools specific to knowledge
• Emphasizes system acceptability effect

• Nursing Research
• Focus on the substance of the discipline
• Makes nursing phenomena explicit
• Develops and tests clinical therapeutics

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Vision for the Future
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Health Policy Clinical Practice
Health Care
System Definition
System Evaluation
System Construction
System Validation
Informatics
System Description
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Health Policy Clinical Practice
Nursing Science
CS
Health Care
System Definition
System Evaluation
System Construction
System Validation
Informatics
HSR
System Description
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Visions for the future

• Innovative care models with a balance of human
  and techological resources
• Development of a full range of nursing practice
  tools
• Linking genomic data to genetic information, and
  then to the patient record and placed in to the
  patients hand
• Technical solutions to the challenges of privacy
  and security
• Natural language and speech recognition
• The problem lies in creating representation of
  the context within which the speech is produced
  and should be interpreted
• Virtual Human -- genomic functions anatomy

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Guidance for the Future
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ask yourself if the step you contemplate is
going to be of any use to the poorest and
weakest man whom you have seenWill he gain
anything by it?Will it restore him to control
over his life and destiny?then you will find
your doubts and yourself melting away

• Gandhi,1947

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if we can call it nursing to set up the
emergency shelter after the dam has burst, isnt
is also nursing to lobby to be sure that the dam
never gets made in the first place?

• Florence Storlie, 1971

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Acknowledgements

• The work of colleagues over the past 50 years
• Conversations and debates with many including
• AMIA colleagues Mark Musen, Gil Kuperman, Carol
  Friedman, Bonnie Kaplan, Charley Safran
• UW-Madison colleagues Rima Apple, Richard
  Staley, Barbara Bowers, Josette Jones the
  Brennan research team
• The Moehlman Bascom Professorship
• NIH

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http//healthinfo.engr.wisc.edu

• pbrennan_at_engr.wisc.edu

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