C790 NURSING INFORMATICS
Goal of EBP
- is improvement of systems and microsystems within healthcare, with these improvements
based on science
STEEEP principles
- The Institute of Medicine (IOM) expert panel issued recommendations for urgent action to
redesign healthcare so that it is safe, timely, effective, efficient, equitable, and patient-
centered
(S) in STEEEP
- Safe-Avoid injuries to patients from the care that is intended to help them.
(T) in STEEEP
- Timely-Reduce waits and sometimes harmful delays for both those who receive and those
who give care.
(E) in STEEEP
- Effective-Provide services based on scientific knowledge to all who could benefit, and refrain
from providing services to those not likely to benefit.
(E) in STEEEP
- Efficient-Avoid waste, including waste of equipment, supplies, ideas, and energy.
(E) in STEEEP
- Equitable-Provide care that does not vary in quality because of personal characteristics such
as gender, ethnicity, geographic location, and socioeconomic status.
,(P) in STEEEP
- Patient-centered Provide care that is respectful of and responsive to individual patient
preferences, needs, and values, and ensure that patient values guide all clinical decisions.
ACE Star Model of Knowledge Transformation
Advancing Research and Clinical Practice through Close Collaboration (ARCC)
Model of Evidence-Based Practice in Nursing and Healthcare
Johns Hopkins Nursing Evidence-Based Practice Model and Guidelines
Iowa Model of Evidence-Based Practice
Stetler Model of Research Utilization
- FOCUS: EBP, research use, and knowledge transformation processes
DESCRIPTION: Direct a systematic approach to synthesizing knowledge and transforming
research findings to improve patient outcomes and the quality of care
Address both individual practitioners and healthcare organizations Focus on increasing the
meaningfulness and utility of research findings in clinical decision making
Promoting Action on Research Implementation in Health Services (PARiHS)
Vratny and Shriver Model for Evidence-Based Practice Pettigrew and Whipp Model of Strategic
Change
Outcomes-Focused Knowledge Translation
Determinants of Effective Implementation of Complex Innovations in Organizations
Ottawa Model of Research Use
- FOCUS: Strategic and organizational change theory to promote uptake and adoption of new
knowledge
DESCRIPTION: Trace mechanisms by which individual, small group, and organizational
contexts affect diffusion, uptake, and adoption of new knowledge and innovation
Premise is that interventions, outcomes evaluations, and feedback are important methods to
promote practice change
Collaborative Model for Knowledge Translation between Research and Practice Settings
Framework for Translating Evidence into Action
Knowledge Transfer and Exchange
Canadian Institutes of Health Research Knowledge Translation within the Research Cycle Model
or Knowledge Action Model
Interactive Systems Framework for Dissemination and Implementation
,- FOCUS: Knowledge exchange and synthesis for application and inquiry
DESCRIPTION: Structure ongoing interactions among practitioners, researchers, policy-
makers, and consumers to facilitate the generation of clinically relevant knowledge and the
application of knowledge in practice
All parties are engaged in bidirectional collaboration across the translation continuum
Knowledge Transformation
- (Ace Star Model)
is defined as the conversion of research findings from discovery of primary research results,
through a series of stages and forms, to increase the relevance, accessibility, and utility of
evidence at the point of care to improve healthcare and health outcomes by way of evidence-
based care.
Ace Star Model
- These five points are discovery research, evidence summary, translation to guidelines,
practice integration, and evaluation of process and outcome
Clinical practice guidelines (CPGs)
- The IOM defines clinical guidelines as "systematically developed statements to assist
practitioner and patient decisions about appropriate health care for specific clinical
circumstances.
Usability
- 1.Increased user productivity and efficiency
2.Decreased user errors and increased safety
3.Improved cognitive support
Human factors
- is "the scientific discipline concerned with the understanding of interactions among humans
and other elements of a system, and the profession that applies theory, principles, data and
methods to design in order to optimize human well-being and overall system performance."
, In healthcare, human factors might concern the design of a new operating room to better
support teamwork and patient flow.
Ergonomics
- used interchangeably with human factors by the HFES in Europe but in the U.S. and other
countries its focus is on human performance with physical characteristics of tools, systems,
and machines
i.e. power drill fitting in hand
Human-computer interaction (HCI)
- is the study of how people design, implement, and evaluate interactive computer systems in
the context of users' tasks and work
Usability
- is often used interchangeably with HCI when the product is a computer but usability also
concerns products beyond computers. Usability is also more focused on interactions within a
specific context or environment for a specific product.
Formally, the ISO defines usability as the extent to which a product can be used by specific
users in a specific context to achieve specific goals with effectiveness, efficiency, and
satisfaction.
Allows users to achieve goals
Joint cognitive systems
- imply that information is shared or distributed among humans and technology. This
framework is useful for examining teamwork in healthcare where team members work
together on patient care
Health Human-Computer Interaction (HHCI) Framework
- Humans or products can initiate interactions. The information is processed through either
the product or the humans according to characteristics. The recipient then reacts to the
information; for example, a healthcare provider could read and respond to email from a
Goal of EBP
- is improvement of systems and microsystems within healthcare, with these improvements
based on science
STEEEP principles
- The Institute of Medicine (IOM) expert panel issued recommendations for urgent action to
redesign healthcare so that it is safe, timely, effective, efficient, equitable, and patient-
centered
(S) in STEEEP
- Safe-Avoid injuries to patients from the care that is intended to help them.
(T) in STEEEP
- Timely-Reduce waits and sometimes harmful delays for both those who receive and those
who give care.
(E) in STEEEP
- Effective-Provide services based on scientific knowledge to all who could benefit, and refrain
from providing services to those not likely to benefit.
(E) in STEEEP
- Efficient-Avoid waste, including waste of equipment, supplies, ideas, and energy.
(E) in STEEEP
- Equitable-Provide care that does not vary in quality because of personal characteristics such
as gender, ethnicity, geographic location, and socioeconomic status.
,(P) in STEEEP
- Patient-centered Provide care that is respectful of and responsive to individual patient
preferences, needs, and values, and ensure that patient values guide all clinical decisions.
ACE Star Model of Knowledge Transformation
Advancing Research and Clinical Practice through Close Collaboration (ARCC)
Model of Evidence-Based Practice in Nursing and Healthcare
Johns Hopkins Nursing Evidence-Based Practice Model and Guidelines
Iowa Model of Evidence-Based Practice
Stetler Model of Research Utilization
- FOCUS: EBP, research use, and knowledge transformation processes
DESCRIPTION: Direct a systematic approach to synthesizing knowledge and transforming
research findings to improve patient outcomes and the quality of care
Address both individual practitioners and healthcare organizations Focus on increasing the
meaningfulness and utility of research findings in clinical decision making
Promoting Action on Research Implementation in Health Services (PARiHS)
Vratny and Shriver Model for Evidence-Based Practice Pettigrew and Whipp Model of Strategic
Change
Outcomes-Focused Knowledge Translation
Determinants of Effective Implementation of Complex Innovations in Organizations
Ottawa Model of Research Use
- FOCUS: Strategic and organizational change theory to promote uptake and adoption of new
knowledge
DESCRIPTION: Trace mechanisms by which individual, small group, and organizational
contexts affect diffusion, uptake, and adoption of new knowledge and innovation
Premise is that interventions, outcomes evaluations, and feedback are important methods to
promote practice change
Collaborative Model for Knowledge Translation between Research and Practice Settings
Framework for Translating Evidence into Action
Knowledge Transfer and Exchange
Canadian Institutes of Health Research Knowledge Translation within the Research Cycle Model
or Knowledge Action Model
Interactive Systems Framework for Dissemination and Implementation
,- FOCUS: Knowledge exchange and synthesis for application and inquiry
DESCRIPTION: Structure ongoing interactions among practitioners, researchers, policy-
makers, and consumers to facilitate the generation of clinically relevant knowledge and the
application of knowledge in practice
All parties are engaged in bidirectional collaboration across the translation continuum
Knowledge Transformation
- (Ace Star Model)
is defined as the conversion of research findings from discovery of primary research results,
through a series of stages and forms, to increase the relevance, accessibility, and utility of
evidence at the point of care to improve healthcare and health outcomes by way of evidence-
based care.
Ace Star Model
- These five points are discovery research, evidence summary, translation to guidelines,
practice integration, and evaluation of process and outcome
Clinical practice guidelines (CPGs)
- The IOM defines clinical guidelines as "systematically developed statements to assist
practitioner and patient decisions about appropriate health care for specific clinical
circumstances.
Usability
- 1.Increased user productivity and efficiency
2.Decreased user errors and increased safety
3.Improved cognitive support
Human factors
- is "the scientific discipline concerned with the understanding of interactions among humans
and other elements of a system, and the profession that applies theory, principles, data and
methods to design in order to optimize human well-being and overall system performance."
, In healthcare, human factors might concern the design of a new operating room to better
support teamwork and patient flow.
Ergonomics
- used interchangeably with human factors by the HFES in Europe but in the U.S. and other
countries its focus is on human performance with physical characteristics of tools, systems,
and machines
i.e. power drill fitting in hand
Human-computer interaction (HCI)
- is the study of how people design, implement, and evaluate interactive computer systems in
the context of users' tasks and work
Usability
- is often used interchangeably with HCI when the product is a computer but usability also
concerns products beyond computers. Usability is also more focused on interactions within a
specific context or environment for a specific product.
Formally, the ISO defines usability as the extent to which a product can be used by specific
users in a specific context to achieve specific goals with effectiveness, efficiency, and
satisfaction.
Allows users to achieve goals
Joint cognitive systems
- imply that information is shared or distributed among humans and technology. This
framework is useful for examining teamwork in healthcare where team members work
together on patient care
Health Human-Computer Interaction (HHCI) Framework
- Humans or products can initiate interactions. The information is processed through either
the product or the humans according to characteristics. The recipient then reacts to the
information; for example, a healthcare provider could read and respond to email from a
