As we have learned, nursing informatics is the integration of science and technology to manage information, data, knowledge, and wisdom in nursing (American Nurses Association, 2015). With that being said, nursing informatics is a co-requisite to making professional nursing judgments because the nurses need to manage and collect data in order to make informed decisions. The concept of professional nursing judgment involves the nurse making rational decisions based on his or her knowledge and experience, as well as intuition, reasoning, critical thinking skills, and practice (Seidi et al., 2015). Meanwhile, although it is a difficult concept to define, wisdom is essentially the application of knowledge. Therefore, the concept of wisdom in nursing informatics compares to the concept of professional nursing judgment in that both work together hand in hand, where having the wisdom in nursing informatics help nurses with their professional nursing judgments. In other words, having wisdom in nursing informatics help nurses make informed decisions when providing patient care. Having wisdom requires you not to only have knowledge and information, but to also be able to apply that knowledge into situations. In the healthcare setting, nurses who have wisdom in nursing informatics are able to then apply their knowledge by making quality, clinical decisions when caring for their patients.
DIKW stands for data, knowledge, information, and wisdom. As a nurse, I want to provide the best and most informed decisions when providing patient care, and I do so by following DIKW. DIKW involves the ability to transform data to information to knowledge, and finally, to wisdom (Topaz, 2013). When making clinical decisions, I first have to gather all possible data regarding the patient, such as medical history. Data is comprised of discrete facts. It is only transformed into information when data is interpreted and given meaning. This means that I am able to give meaning to data, such as seeing a blood pressure reading of 150/95 mm Hg and recognizing that the patient has hypertension. Then, by synthesizing all of the data I have collected, I am able to then transform information into knowledge. Knowledge involves being able to understand and see the relationships between different groups of information, such as acknowledging that the patient may be at high risk of diabetes if symptoms like hypertension, increased thirst, and frequent urination are present. Information transforms into wisdom when I am able to use knowledge to make informed clinical judgments when deciding what action to take during patient care, such as making sure that the patient keeps his or her blood pressure controlled.
Since nursing informatics is a relatively new discipline and a combination of a variety of scientific fields; information science, computer science and nursing science, informatics needs to have a theoretical framework to guide the discipline (McGonigle & Mastrian, 2015). DIKW, or data, information, knowledge and wisdom, is a framework with the potential to address challenges in the discipline (Topaz, 2013). Data are just non-meaningful facts which describe things about a patient, they have no context or meaning (Topaz, 2013). Information adds the context and brings data together to make it meaningful, essentially painting a picture. As more and more information is gathered, assumptions can be made, theories can be used and patterns or relationships between information can be distinguished thus obtaining knowledge (Topaz, 2013). Wisdom integrates the nurse’s ethics, experience and practice background with the contextual knowledge to lead them to make sound applicable judgements for resolving problems (Topaz, 2013). Professional nursing judgment is found by using wisdom, knowledge, information and data! Essentially, to make sound professional judgment you need to have the wisdom and knowledge to do so, they work together. Topaz (2013) additionally states the DIKW framework is not completely rigid but rather interrelated because of the change that naturally occurs between all of the different framework parts. As new data is found, new knowledge is formed which when coupled with wisdom may elicit new data (Topaz, 2013).
The use of DIKW can happen unconsciously every day. We take in new data all the time, we integrate these new data points into their respective context and formulate new knowledge thus increasing our wisdom for current or future clinical judgement. As an example, to illustrate the use of DIKW think of a nurse who receives a patient who suffered injury from a fall, this is data without context or meaning. When more data is added, such as this patient is elderly, has co-morbidities and has recent history of falls, it becomes information with context and knowledge is formed outlining a fall problem. The experience of the nurse and his/her background coupled with the new knowledge is the wisdom which is used to interpret the current situation and allows them to make the best judgment for practice with patient specific data. This allows the entire picture to be seen, and suggests this patient may need follow-up assistance, assistive devices, education on hazards, assistance at home for fall safety and, additionally, may potentially lead to assessment of new data points such as the need for an eye exam!