With recent technological advances, informatics become an integral part of the nursing practice. Modern day health care systems have assimilated technology to manage data, information, knowledge as well as wisdom in order to identify and solve potential problems through effective decision making. This integration of information and nursing science to manage data and information is referred to as nursing informatics. It is based on three major competencies: computer skills, informatics knowledge and informatics skills (Darvish, Bahramnezhad, Keyhanian & Navidhamidi, 2014). As a growing field in the nursing practice, nursing informatics has come a long way in helping nurses to integrate evidence-based practice in accessing patient information, providing care and making clinical decisions (Lee, 2014). Based on the concepts of nursing informatics, this paper develops a clinical (PICO) question relevant in my practice area (Psychiatric nursing). The main aim is to demonstrate how research and find answers to the question using the continuum of data, information, knowledge and wisdom. The paper begins with a summary of the clinical question, highlighting what is known and what is not known about the topic in question.
PICO Question
Consider a case scenario whereby a 65-year old male patient with depressive behaviors seeks medical assistance from a psychiatric nurse to advise him on how he can benefit from exercising as a natural way of alleviating his depression. The term “PICO” stands for Population/patient (P), Intervention (I), Comparison (C) and Outcome (O) (Mayer, 2004). Based on this scenario, therefore, the relevant PICO question would be as follows: For an elderly patient with depression (P), how does performing regular physical exercises (I), compare to taking antidepressants (C), in reducing depression in elderly adults (O).
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Search Strategies
As a psychiatric nurse handling such a patient, my initial search strategy would be interacting with the patient with an aim of identifying their health care needs and barriers to accessing health. This initial search would help determine appropriate intervention measures that are specific to the geriatric population. The strategy would also help to build trust between the patient and I. From the Walden University website, I would use to following research databases to locate the most relevant research articles: ProQuest, EBSCOhost, Cumulative Index of Nursing and Allied Health Literature (CINAHL) and the Psychological Information research database (PsychINFO). These research databases would are key in identifying credible and reliable sources related to the topic (Mayer, 2004). To locate specific articles relevant to the topic in question, I would use the following key words: depression, antidepressants, depressive behaviors, physical exercises, elderly patients. I would specify my search by finding articles that compare the effectiveness and efficacy of medication and exercise in treating elderly patients with depression. After locating the sources, I would extract the relevant information for this topic by evaluating the research questions, hypotheses and findings provided in each article.
Using Data, Information, Knowledge and Wisdom Continuum
As earlier mentioned, nursing informatics enables nurses to organize data, information, knowledge and wisdom and apply it to make ethical clinical decisions relating to patient care (Lewis et al., 2018). The data, information, knowledge and wisdom continuum indicates how nurses use evidence-based information to make clinical decisions and provide patient care appropriately. It, therefore, provides an insight on the importance of nursing informatics in evidence-based practice and decision making.
As the lowest level in the continuum, data refers to the details or facts that relate to a specific patient, population or situation under investigation. In the clinical setting, data may include observation and laboratory test results that could inform the nurse about the existing or current health condition of the patient (Eardley et al., 2018). For example, a lab test result showing high levels of blood glucose is data that could be used to derive information about the patient’s health. The initial facts to take into account from the PICO question and case scenario presented above would be the patient’s age, ethnicity and existing health condition. To obtain health-related data, I would first determine the patient’s pressure and temperature. Next, I would ask the client whether he has a history of hypertension or has any underlying health condition. I would also ask the patient about his depression to determine its onset. This set of data would lead me to information about the patient’s health condition.
Information is the next level of the continuum, which is the outcome of processing and interpreting the data obtained through systems such as Electronic Health Records (EHRs). EHR is an information systems that enables health care professionals to compile and interpret data to generate knowledge that is useful in providing diagnosis or treatment (McBride et al., 2018). To obtain information that would lead to effective diagnosis, I would compile and organize the data obtained above in an EHR system to keep record on the patient’s health. The EHR would enable me determine whether the patient has a family history of depressive disorder. The system would also reveal the various medications prescribed to the patient to relive depressive symptoms or any other symptoms related to another health condition.
Synthesizing of information obtained through data interpretation generates knowledge that would help the nurse to make decisions regarding treatment. The knowledge obtained should be based on information synthesized from relevant sources such as recent empirical or clinical studies. To generate usable knowledge that addresses the PICO question under investigation, I would specifically focus on the patient’s medication history. I would gather relevant reading materials (articles) that examine the effectiveness of medication in treating depression. For more knowledge, I would narrow down by identifying articles that specifically examine the effectiveness of the antidepressants currently used by the patient. On the same breadth, I would gather relevant sources that focus on comparing the use of exercise and medication, in treating depression. Next, I would synthesize all the evidence from research articles and eliminate any information that seems irrelevant to the topic in question. By doing so, I will have turned information into usable knowledge that would help me develop an effective treatment plan for the patient.
As the highest level on the continuum, wisdom involves applying knowledge generated or obtained from synthesizing evidence presented in clinical studies to solve complex health issues presented by patients. I would progress from having knowledge to wisdom by evaluating the evidence obtained from the articles used. I would develop a treatment plan based on the evidence presented in the articles. For instance, if evidence shows that both antidepressants and exercise are effective in treating depression, then, I would recommend a treatment plan that combines an excise program and medication. I would, however, prescribe other medications that are different from what the client has been taking and recommend him to come for a follow-up check after a few weeks. Similarly, if evidence indicates that moderate physical exercise are more effective that medications, I would create a treatment plan entirely based on an exercise program, taking into account the severity of the patient’s depression.
References
Darvish, A., Bahramnezhad, F., Keyhanian, S., & Navidhamidi, M. (2014). The role of nursing informatics on promoting quality of health care and the need for appropriate education. Global journal of health science, 6 (6), 11-8.
Eardley, D. L., Krumwiede, K. A., Secginli, S., Garner, L., Deblieck, C., Cosansu, G., & Nahcivan, N. O. (2018). The Omaha System as a Structured Instrument for Bridging Nursing Informatics With Public Health Nursing Education: A Feasibility Study. Cin: Computers, Informatics, Nursing, 36 (6), 275-283.
Lee, A. (2014). The role of informatics in nursing. Nursing made Incredibly Easy, 12 (4), 55.
Lewis, A., Block, L., Peltonen, L., Pruinelli, L., Topaz, M., & Lozada, E. P. (2018). Emerging Professional's View of the Landscape: Nursing Informatics Curriculum, Competencies, and Career Opportunities. Studies in health technology and informatics , 250, 60-61.
McBride, S., Tietze, M., Robichaux, C., Stokes, L., & Weber, E. (2018). Identifying and Addressing Ethical Issues with Use of Electronic Health Records. Online Journal of Issues in Nursing, 23 (1).
Mayer, D. (2004). Essential Evidence-Based Medicine, Volume 1 . Cambridge University Press.
