This dissertation examined the historical development of nursing clinical information systems (CIS) in healthcare during the late twentieth century. CIS were recast as a contextually bound technological system of skills, tools, and knowledge needed to provide patient care. This recasting provided for consideration of the historical and contemporary meanings of these systems and challenged pervasive assumptions about their structure. Three tools, the Classification of Nursing Diagnosis, the American Nurses' Association Social Policy Statement, and the Nursing Minimum Data Set, were analyzed to gain an understanding of how nurses prioritized certain types of information, skills, and knowledge, while excluding others. Primary source material from individual nurses and nursing organizations that were involved with the creation of CIS were used. The process of identifying information to be included in CIS was contentious. Individual nurses who argued on behalf of a particular piece of data or form of data, did so because of a strong belief in how nursing practice (through information collection) should be structured. Throughout the historical cases, participants paid little attention to existing practice conditions that would ultimately determine whether or not the CIS would be used. Time and time again, the composition of the group determined for whom the information practice would be most useful and where the information practice would likely be applied. The development of CIS illustrated the political nature of practice, the importance of including the perspectives of those who do the work of CIS, and how, when existing conditions are ignored, CIS can fail.
|Advisor:||Fairman, Julie A.|
|School:||University of Pennsylvania|
|School Location:||United States -- Pennsylvania|
|Source:||DAI-B 69/09, Dissertation Abstracts International|
|Subjects:||Nursing, Health care management|
|Keywords:||Clinical information systems, Data sets|
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