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Chapter 1
Nursing Science and the Foundation
of Knowledge
Key Terms Defined
Borrowed theory - Theories borrowed or made
use of from other disciplines; as nursing began to
evolve, theories from other disciplines such as
psychology, sociology, etc., were adopted to try
to empirically describe , explain or predict nursing
phenomena. As nursing theories continue to be
developed, nurses are now questioning whether
or not these borrowed theories were sufficient or
satisfactory in their relation to the nursing
phenomena they were used to describe, explain
or predict.
Objectives
Define nursing science and its relationship to
various nursing roles and nursing informatics.
Introduce the Foundation of Knowledge
Model 2007 as the organizing conceptual
framework for the book.
Explain the relationship between knowledge
acquisition, knowledge processing, knowledge
generation, knowledge dissemination and
wisdom.
Key Terms Defined
Building blocks - Basic element or part of
nursing informatics such as information
science, computer science, cognitive science
and nursing science.
Clinical Databases - A collection of related
patient records stored in a computer system
using software that permits a person or
program to query the data in order to extract
needed patient information.
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Key Terms Defined
Clinical practice guidelines - Informal or
formal rules or guiding principles that a
healthcare provider uses when determining
diagnostic tests and treatment strategies for
individual patients, in the EHR they are
included in a variety of ways such as prompts,
pop ups and text messages.
Key Terms Defined
Data - Raw fact; lacks meaning.
Data mining - Software that sorts thorough
data in order to discover patterns and
ascertain or establish relationships; software
that discovers or uncovers previously
unidentified relationships among the data in a
database; program that conducts exploratory
analysis looking for hidden patterns in data.
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Key Terms Defined
Conceptual framework - Used in research to
chart feasible courses of action or to present a
desired approach to a study or analysis;
framework built from a set of concepts, these
concepts are related to a proposed or existing
system of methods, behaviors, functions,
relationships and objects; a relational model;
formal way of thinking or conceptualizing
about a phenomenon, process, or system
under study.
Key Terms Defined
Evidence - Artifacts, productions, attestations or
other examples that demonstrate what an
individuals knowledge, skills or valued attributes.
Feedback - Input in the form of opinions about or
reactions to something such as shared
knowledge; in an ISs, feedback refers to
information from the system that is used to make
modifications in the input, processing actions or
outputs .
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Key Terms Defined
Foundation of Knowledge Model 2007 - This model
represents that humans are organic information
systems constantly acquiring, processing and
generating information or knowledge both in our
professional and personal lives. It is our high degree of
knowledge that characterizes us as extremely
intelligent organic machines. Individuals have the
ability to manage knowledge. This ability is learned and
honed from birth. We make our way through life
interacting with our environment and being inundated
with information and knowledge. We experience our
environment and learn by acquiring, processing,
generating and disseminating knowledge.
Key Terms Defined
Information - Data that are interpreted,
organized, or structured; data that is
processed using knowledge or data made
functional through the application of
knowledge.
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Key Terms Defined
Foundation of Knowledge Model 2007 (contd) As we
interact in our environment, we acquire knowledge that we
must process. This processing effort causes us to redefine
and restructure our knowledge base and generate new
knowledge. We then share (disseminate) this new
knowledge, and receive feedback from others. The
dissemination and feedback initiates this cycle of
knowledge all over again since we acquire, process,
generate and disseminate the knowledge gained from
sharing and re-exploring our own knowledge base. As
others respond to our knowledge dissemination and we
acquire new knowledge, we are engaged to re-think about
and reflect on our knowledge, processing, generating and
then disseminating anew.
Key Terms Defined
Knowledge - The awareness and understanding of a set of
information and ways that information can be made useful
to support a specific task or arrive at a decision; abounds
with others thoughts and information; information that is
synthesized so that relationships are identified and
formalized; understanding that comes through a process of
interaction or experience with world around us ; info that
has judgment applied to it or meaning extracted from it;
processed information that helps to clarify or explain some
portion of our environment or world that we can use as a
basis for action or upon which we can act; internal process
of thinking or cognition; external process of testing, senses,
observation, interacting.
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Key Terms Defined
Knowledge acquisition - Act of acquiring or
getting knowledge.
Knowledge dissemination - Distribution and
sharing of knowledge.
Knowledge generation - Creating new
knowledge by changing and evolving
knowledge based on your experience,
education, and input from others.
Key Terms Defined
Nursing informatics - A specialty that integrates
nursing science, computer science, cognitive
science, and information science to manage and
communicate data, information, knowledge and
wisdom in nursing practice; Nursing informatics
facilitates the integration of data, information,
and knowledge to support patients, nurses, and
other providers in their decision-making in all
roles and settings.
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Key Terms Defined
Knowledge processing - The activity or
process of gathering or collecting, perceiving,
analyzing, synthesizing, saving or storing,
manipulating, conveying, and transmitting
knowledge.
Knowledge worker - Work with information
and generate information and knowledge as a
product.
Key Terms Defined
Nursing informatics - This support is accomplished
through the use of information structures, information
processes, and information technology; a specialty
that integrates nursing science, computer science, and
information science to manage and communicate data,
information, and knowledge (Staggers & Thompson,
2002, p. 260); synthesis of nursing science, information
science, computer science and cognitive science to
facilitate the management of healthcare data for the
improvement of patient care and advancement of the
nursing profession.
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Key Terms Defined
Nursing science - The ethical application of
knowledge acquired through education,
research and practice to provide services and
interventions to patients in order to maintain,
enhance or restore their health; to advocate
for health, and to acquire, process, generate
and disseminate nursing knowledge to
advance the nursing profession.
Key Terms Defined
Transparent - Done without conscious thought.
Wisdom - Knowledge applied in a practical way or
translated into actions; uses knowledge and
experience to heighten common sense and
insight to exercise sound judgment in practical
matters; sometimes thought of as the highest
form of common sense resulting from
accumulated knowledge or erudition (deep
thorough learning) or enlightenment (education
that results in understanding and the
dissemination of knowledge);
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Key Terms Defined
Nursing theory - Concepts, propositions and
definitions that represent a methodical viewpoint
and provide a framework for organizing and
standardizing nursing actions.
Relational database - A collection of related
records stored in a computer system using tables
that can be related to one another and the data
extracted in a variety of ways to gain needed
information without having to reorganize the
tables.
Key Terms Defined
Wisdom (contd) it is the ability to apply
valuable and viable knowledge, experience,
understanding and insight while being
prudent and sensible; is focused on our own
minds; the synthesis of our experience,
insight, understanding and knowledge; the
appropriate use of knowledge to solve human
problems. It is knowing when and how to
apply knowledge.
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Nursing Science
One of the most frequently quoted and widely
accepted definitions of nursing informatics is that
it is a combination of nursing science, information
science and computer science.
In this chapter, we will focus on nursing science
as one of the building blocks of nursing
informatics, although in this text we extend the
traditional definition of nursing informatics to
include cognitive science as one of the building
blocks.
Foundation of Knowledge Model
2007
This book uses the Foundation of Knowledge
Model 2007 reflecting that knowledge is a
powerful tool and for that reason, nurses focus
on information as a key building block of
knowledge.
We will also introduce the Foundation of
Knowledge Model 2007 as the organizing
conceptual framework of this text, and tie the
model to nursing science and the practice of
nursing informatics.
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Use of Knowledge
Individuals have an amazing ability to manage
knowledge. This ability is learned and honed
from birth.
We experience our environment and learn by
acquiring, processing, generating and
disseminating knowledge.
ANA Definition of Nursing
The American Nurses Association (2003) defines
nursing in this way: Nursing is the
protection, promotion, and optimization of
health and abilities, prevention of illness and
injury, alleviation of suffering through the
diagnosis and treatment of human response,
and advocacy in the care of individuals,
families, communities, and populations.
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Nursing
Thus the focus of nursing is on the human
responses to actual or potential health problems,
and advocacy for various clients.
Nurses must possess the technical skills to
manage equipment and perform procedures,
interpersonal skills to interact appropriately with
people, and cognitive skills to observe, recognize
and collect data, analyze and interpret data and
reach a reasonable conclusion that forms the
basis of a decision.
Nursing and Knowlege
Nurses are knowledge workers, working with
information and generating information and
knowledge as a product.
We are knowledge acquirers, providing
convenient and efficient means of capturing and
storing knowledge.
We are knowledge users, individuals or groups
who benefit from valuable, viable knowledge.
Nurses are knowledge engineers, designing,
developing, implementing and maintaining
knowledge.
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Nursing
Nursing is an information intensive profession.
The steps of utilizing information, applying
knowledge to a problem, and acting with
wisdom form the basis of nursing practice
science.
We acquire data and information in bits and
pieces and then transform the information
into knowledge.
Nursing and Knowledge
We are knowledge managers, capturing and
processing collective expertise and
distributing it where it can create the largest
benefit.
We are knowledge developers or generators,
changing and evolving knowledge based on
the tasks at hand and information available.
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Use of Knowledge
Knowledge must also be viable.
Knowledge viability refers to applications
(most technology based) that offer easily
accessible, accurate and timely information
obtained from a variety of resources and
methods and presented in a manner as to
provide us with the necessary elements to
generate new knowledge.
Use of Wisdom
Wisdom is the application of knowledge to an
appropriate situation.
In the practice of nursing science, we expect
action and/or actions directed by wisdom.
Wisdom uses knowledge and experience to
heighten common sense and insight to
exercise sound judgment in practical matters.
It is developed through knowledge,
experience, insight and reflection.
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Use of Knowledge
All nurses have the opportunity to be involved
in the formal dissemination of knowledge via
their participation in professional conferences
either as presenters or attendees.
All nurses regardless of the practice arena
must use informatics and technology to
inform and support that practice.
Beyond Nursing Practice
In order for nurse educators to be effective,
they must be in the habit of constantly
building and rebuilding their foundation of
knowledge about nursing science.
Nurse researchers must acquire and process
new knowledge as they design and conduct
their research studies.
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Nursing in the Future Nursing in the Future

Informatics and the use of technology in the
The future of nursing science and nursing
practice of nursing are equally important in
informatics is intimately associated with the
the nursing research arena.
nursing education and nursing research
arenas. Participants in the development of The
National Nursing Research Agenda (NNRA)
Skiba (2007) suggests that we need techno-
identified these two technology related
saavy and well-informed faculty who can
priorities (among other research priorities) for
demonstrate the appropriate use of
nursing research:
technologies to enhance the delivery of
nursing care. Nursing Informatics: Enhancing Patient Care
Technology Dependency across the Life-span

Nursing in the Future Thought Provoking Question

Goosen (2002) believes that the focus on nursing Imagine you are in a social situation and
informatics research should be on the structuring someone asks you, What does a nurse do?
and processing of patient information and how
these inform nursing decision making in clinical Think about how you will capture and convey
practice. the richness that is nursing science in your
It is clear that the increasing use of technology to answer.
enhance nursing practice, nursing education, and
nursing research will open new avenues for
acquiring, processing, generating, and
disseminating knowledge.

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Thought Provoking Question

Choose a clinical scenario from your recent
experience and analyze it using the
Foundation of Knowledge Model.
How did you acquire knowledge?
How did you process knowledge?
How you generate knowledge?
How did you disseminate knowledge?
How did you use feedback and what was the effect of
feedback on the foundation of your knowledge?

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