Question

Week 3 Assignment -- Nursing informatics and foundations of knowledge

Description Data-to-Wisdom Continuum Analysis Paper

The purpose of this assignment is to be able to incorporate the data-to-wisdom continuum into the practice of professional nurse. You are required to think of a concept/issue/idea in your practice area then relate it to the four steps of the data, information, knowledge, wisdom continuum.

• Develop the concept/idea/issue you selected from your practice area into a relevant question. For example, if you are thinking of patient falls, you may think of a question such as: what factors that leads to patient falls in a nursing home?

• Describe the question you developed and then relate how you would work through the four steps of the data, information, knowledge, wisdom continuum. Be specific. o Identify the databases and search words you would use to search for data and information about your topic. o Relate how you would take the information gleaned and turn it into useable knowledge. o Can informatics be used to gain wisdom? o Describe how you would progress from simply having useful knowledge to the wisdom to make decisions about the information you have found during your database search.

• Must use at least 5 scholarly reference of which, at least 2 journal articles.

• Limit the paper to three-five pages excluding the cover page, reference and appendices pages, using APA format. Writing style is at a graduate level.

Answer 1

Nursing informatics and foundations of knowledge

to incorporate the data-to-wisdom continuum into the practice of professional nurse

Information technology is transforming the health care field with a plethora of new tools, software, and devices. This transformation has especially affected nurses, which is why health care information technology is often referred to as “nursing informatics.”

Nursing informatics is used in practice settings to help organize and apply data, information, knowledge, and wisdom. The continuum of data, information, knowledge, and wisdom shows how nurses use facts to make decisions and provide care. This continuum provides insight for how nursing informatics contribute to different levels of understanding, decision-making, and evidence-based practice.

The lowest level on the continuum is data. The term “data” refers to discrete sets of details related to a specific situation, patient, or population. You can think of data as isolated islands of facts that any observer would be able to view and objectively identify.

The next level on the continuum, directly above data, is information. Information is the result of processing and organizing data into more manageable structures, and interpreting the meanings of individual data points. Information systems, such as electronic health records (EHRs), compile data and support nurses at the information level of the continuum.

After information, the next level up is knowledge. Knowledge arises when information is synthesized into formal relationships and interconnections. Knowledge involves recognizing patterns and abnormalities based on separate sets of information.

Nursing informatics that operate at the knowledge level are called decision-support systems. Finally, the highest level of the continuum is wisdom. Wisdom is the application of knowledge to addressing clinical problems and complex patient health issues with compassion and regard for ethics and quality of life.

Let’s explore a clinical example of how data, information, knowledge, and wisdom build on each other. Consider a 48-year-old male patient of average height who is slightly overweight. The patient’s recent blood test indicates that he has impaired glucose tolerance and slightly high cholesterol. All of these initial facts about the patient represent data.

The nurse discusses the results of the blood test with the patient, and invites him to return for a follow-up visit. The second blood test indicates higher glucose levels and the same high cholesterol. These serialized blood test results represent information. The nurse then takes this information, refers to the patient’s electronic health record, and discovers that the patient has a family history of diabetes. This data, added to the information from the blood tests, allows the nurse to determine that the patient has type 2 diabetes. This diagnosis is knowledge. Finally, the nurse uses wisdom to determine the most appropriate strategy for addressing this patient’s diabetes. Because the patient does not have a personal history with diabetes and is relatively young, the nurse discusses lifestyle interventions to manage his glucose levels.

If after six months, the patient’s glucose is not within the normal range, the nurse and the physician will consider medications and other treatment options. This example illustrates the flow from data to information, information to knowledge, and knowledge to wisdom. It also demonstrates how nurses apply this continuum in their everyday practices and how  and how informatics can play an important role.

Knowledge is fundamental in the nursing practice. Nurses use a wide variety of theoretical and practical knowledge in their roles. In the contemporary age, nurses need a substantial amount of new knowledge to deliver appropriate health care to the patients.

Generating knowledge in nursing has been on the forefront so as to enable the nurse practitioners to commission their roles effectively. The search for knowledge has a structure. It commences from setting the data requirements. The extraction of information is from identified sources. The next step involves synthesizing of information to establish relationships. Proper application of the knowledge leads to wisdom

Summary

This article details how a family nurse practitioner can synthesize data, information and knowledge to attain wisdom. It demonstrates these through developing a clinical research question. The essay uses databases where a family nurse practitioner can retrieve data to answer the question. The document explains how to extract relevant information from articles in the databases. It also explains how the information can be structured to useful knowledge and applied to gain wisdom.

Nursing informatics aids to manage and communicate data, information, knowledge and wisdom. To understand how this continuum works, I have selected a clinical nursing research question to relate how I would work with it through progression from data to information, knowledge and wisdom

I will employ the use of a case study of a patient to form my clinical question. The patient's name is Edward Johnson. Johnson is a patient admitted with high blood pressure and diabetes mellitus in Cook County Hospital, Chicago. Later, the patient acquired nosocomial pneumonia and urinary tract infection after spending some time in the hospital ward. Though Mr. Johnson is cooperative in taking his medications, he is complacent when it comes to keeping high hygiene levels such as washing hands. Thus, for this patient it is vital if he learns that his new infections are as a result of not keeping high level of hygiene like washing hands regularly . This case study formed my research question since I was uncertain of the relationship between hygiene and washing hands regularly. To begin my research, I identified the key problem of Mr. Johnson, the treatment I was considering, the alternative treatment available and the outcome I wanted to avoid.

Patient / Problem	Mr. E. Johnson: nosocomial pneumonia, urinary tract infections
Intervention	High levels of hygiene, the use of antibiotics
Outcome	Primary: Reduce the spread of nosocomial infections. Secondary: Reduce Mortality

The table above is a summary of Mr. Johnson's issue.

In the case of Mr. Edward Johnson, the clinical question developed, whether was there a relationship between the level of hygiene, such as hand washing, and the spread of nosocomial infections (Examples of some common nosocomial infections are staphylococcus, pseudomonas and enterococci)

From my experience as a family nurse practitioner, I learnt that washing hands is one of the ways of maintaining hygiene. Patients who keep high level of hygiene are able to avoid infections such as nosocomial infections. Hand washing typifies the initial steps people can take to avoid getting diseases and spreading germs. In hospitals where I have worked, many disorders become prevalent by not washing hands with soap andwater. Alcohol-based hand sanitizers can also be used to clean hands.

In all the serious complications which take place during hospitalization, nosocomial infections account for above 50 %. The research alleges that 80 % of diseases can be stopped through washing hands. It also has been found out that hand washing can prevent the common cold and influenza. Infections and germs found on the hands are a common means that people extend infections. Numerous investigations also back the findings that hand washing reduces both nosocomial infections and transfers of pathogens from the hands. Nosocomial infections are spread through contact from a patient to a patient through the hands of health professionals .

I would need additional information to answer the question. For instance, I would need information on the prevalence of nosocomial infections among patients in various hospitals. I would also need the level of hygiene and culture of hand washing among patients. A comprehensive profile of nosocomial infections and how they manifest in various circumstances could also be pivotal in answering the question. Comparison between the hospitals with high hand washing rates and low hand washing rates will be crucial in establishing the role hand washing plays in prevention of nosocomial relationships.

In a nutshell, the background information necessary to answer the research question includes statistical analysis of nosocomial infection rates, hand hygiene adherence rates and qualitative studies on the hand hygiene adherence.

I would use the continuum of data, information, knowledge and wisdom to determine how to undertake the research. First, I would identify the relevant data I need to answer the question from various nursing databases to help extract literature to form the research. I will use various databases to acquire the information. For instance, CINAHL Plus with full text, which contains a collection of nursing journals with background information on nosocomial infections.

The Journal of Hygiene and Preventive Medicine (JHPM) can also provide information on hygiene and its importance as a preventive measure to infections. The National Nursing Database by the American Nurses Association provides information on the family nursing indicators and prevalence of various infections in America. Hospital Wide Indicators: National University Hospital can also aid in providing information on the culture of hand washing in various hospitals. American Journal of Infection Control can be equally beneficial in background information on nosocomial infections. PubMed database is noteworthy because one can run the query of the relationship between hand washing and spread of nosocomial infections to get literature about it. High Beam Research and Journal of Hospital Infection databases reveal the prevalence of hospital acquired infections and how they manifest in patients.

I would find the most relevant articles and information through searching the databases on topical issues of the relationship between hand washing and nosocomial infections. I would use the searching of the words such as “nosocomial infections”, “hand washing and infections” and “relationship between hand washing and nosocomial infections”.

I would also trace books and journals that illustrate the link between nosocomial infections and hand washing. The relevant articles could be the ones that touch on the variables of the clinical research questions, which are hand washing and nosocomial infections .

I would extract the relevant information from the articles by extrapolating discrete entities described in the articles relating to the hand washing and nosocomial infections. First, I would preview the articles to know the chapters with information relevant in answering the clinical question. For instance, I would neeed a profile of nosocomial infections and how they manifest themselves in various circumstances. Therefore, I would look for chapters profiling nosocomial infections history and areas where they occur in most cases.

I would take the information and organize it into a conceptual framework to establish the relationship between hand washing and spread of nosocomial infections. I would also organize the information to charts and graphs to reveal the relationships between the research variables.

I would take the information gleaned and turn it into useable knowledge through synthesizing it and establishing the affiliation between hand washing and nosocomial infections. I would validate this relationship to form a rationale for creating it, and this would transform the information to logical knowledge.

I would take steps to gain wisdom by applying knowledge to manage and explain the predicament brought by nosocomial infections in the family nursing practice. I would initiate a “Clean hands” campaign to sensitize the family nurses and patients in various hospitals to help prevent the spread of nosocomial infections. I would also sensitize the family nursing practitioners to wash hands and wear protective gloves in situations such as examining incontinent patients, blood sampling and removal of drains and bandages.

As a family nurse practitioner, I would sensitize other family nurse practitioners to counsel and educate patients about importance of hygiene in preventing the spread of nosocomial infections. Family nurses should assume the counseling and education role in guiding patients to practice hand washing as a preventive measure in avoiding the spread of nosocomial infections.