Building Blocks of Nursing Informatics
Nursing Informatics
Nursing Science
Computer Science
Cognitive Science
Information Science
these data, one may review the ultrasound of a pregnant patient, examine a patient’s echocardiogram, watch an animated video for professional development, or learn how to operate a new technology tool, such as a pump or monitoring system. The data we gather, such as heart and lung sounds or Xrays, help us produce information. For ex ample, if a patient’s Xrays show a fracture, it is interpreted into information such as spiral, compound, or hairline. This information is then processed into knowledge and a treatment plan is formulated based on the healthcare professional’s wisdom.
The integrity and quality of the data, rather than the form, are what matter. Integrity refers to whole, complete, correct, and consistent data (Figure 2-2). Data integrity can be compromised through human error; viruses, worms, or other computer bugs; hard ware failures or crashes; transmission errors; or hackers entering the system. Figure 2-3 illustrates some ways that data can be compromised. Information technologies help to decrease these errors by putting into place safeguards, such as backing up files on a routine basis, error detection for transmissions, and user interfaces that help people enter the data correctly. Highquality data are relevant and accurately represent their cor responding concepts. Data are dirty when a database contains errors, such as duplicate, incomplete, or outdated records. One author (D.M.) found 50 cases of tongue cancer in a database she examined for data quality. When the records were tracked down and analyzed, and the dirty data were removed, only one case of tongue cancer remained. In this situation, the data for the same person had been entered erroneously 49 times. The major problem was with the patient’s identification number and name: The num ber was changed or his name was misspelled repeatedly. If researchers had just taken the number of cases in that defined population as 50, they would have concluded that tongue cancer was an epidemic, resulting in flawed information that is not meaningful. As this example demonstrates, it is imperative that data be clean if the goal is quality information. The data that are processed into information must be of high quality and integrity to create meaning to inform assessments and decision making.
To be valuable and meaningful, information must be of good quality. Its value relates directly to how the information informs decision making. Characteristics of valuable, quality information include accessibility, security, timeliness, accuracy, rel evancy, completeness, flexibility, reliability, objectivity, utility, transparency, verifiabil ity, and reproducibility.
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Figure 2-2 Data Integrity
Data integrity
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Wh ole Quality data
Accessibility is a must; the right user must be able to obtain the right information at the right time and in the right format to meet his or her needs. Getting meaningful information to the right user at the right time is as vital as generating the information in the first place. The right user refers to an authorized user who has the right to obtain the data and information he or she is seeking. Security is a major challenge because unauthorized users must be blocked while the authorized user is provided with open, easy access (see the Electronic Security chapter).
Timely information means that the information is available when it is needed for the right purpose and at the right time. Knowing who won the lottery last week does not help one to know if the person won it today. Accurate information means that there are no errors in the data and information. Relevant information is a subjective descriptor, in that the user must have information that is relevant or applicable to his or her needs. If a healthcare provider is trying to decide whether a patient needs insulin and only the patient’s CT scan information is available, this information is not relevant for that cur rent need. However, if one needed information about the CT scan, the information is relevant.