1. Nursing Roadmap 2030 The Board of Nursing has mandated itself to pursue the challenge in the Nursing profession.

Amidst all controversies, the new set of board has maintained its course toward unifying the profession and paving its way to excellence and competitive Nursing in the year 2030. The Operating-Room Nurses of the Philippines Inc. (ORNAP) shared the same enthusiasm as our leaders in the profession set forth in accomplishing the task at hand. Together with the different Professional Nursing Organizations in the Philippines we are enjoined to commit ourselves in this endeavor. Last June 05, 2008, ORNAP attended the seminar workshop that was headed by the BON co-sponsored by the Association of Deans of Philippines College of Nursing (ADPCN) at the University of Sto. Tomas hall. The workshop focuses on gathering the groups thoughts and to contemplate on the vision, mission, and the core values of the Nursing Profession. Furthermore, the group deliberated the set targets and objectives corresponding to the given vision and mission. The ORNAP representative, youngest amongst the delegates present, never back down in the discussion. We were ready and eager to be a part of building the profession and bringing it to a higher level of success. As a result of the workshop, the group was able to construct the vision and mission and enumerated the core values and objectives of the profession. VISION: By 2030, the Philippines shall be the lead in promoting Professional Nursing in the Asia Pacific Region. MISSION: We, the Filipino Nurses are committed to provide society with professional Nursing service through innovations in education and training research and management that will improve the well-being and quality of life. CORE VALUES: Love of God, Caring, Love of People, Love of Country STRATEGIC OBJECTIVES: Develop dynamic leaders and provide opportunities for innovative management in education, training and research. Ensure adherence to professional ethical and legal standards for the health and safety of the public Practice good governance to sustain participative efforts among nurses and nursing organizations. Maintain linkages with domestic and international stakeholders. Sustain growth and productivity that will improve the quality of life of nurses, the Filipinos and the people of the world. Following the formulation of the VMO, the BON, ORNAP and other Professional Nursing Organizations will continue its quest in achieving their desired goals. In connection with this, the Occupational Health Nurses Association of the Philippines (OHNAP) hosted lecture forum on Balanced Scorecard at the PNA Conference Room last June 26, 2008. On the other hand last August 01, 2008, the Association of Nursing Service Administrators of the Philippines (ANSAP) also sponsored a one day workshop on Strategic Planning at the Philippines Heart Center. In spite of pouring rain delegates came to attend the workshop. We reviewed the objectives and the four perspectives namely Learning and Growth, Internal Processes, Customer and Financial Perspectives. The participants were grouped to work on the different perspectives and be able to strategically plan, create initiatives, and do brain storming to come up with an acceptable and measurable target for 2030. We were asked to present our output after the workshop and we were able to deliver. The Nursing Profession has been struggling to cope up with the changes in our field of practice, and a lot has been said little has been done. With the leadership of the Board of Nursing and the effort and dedication of the different Professional Nursing Organizations of the Philippines we hope to walk or even run to a rough free journey towards 2030. The ORNAP representative was enjoined by other Professional Nursing Organizations who battled for the same reason. They are the following: PNA, ANSAP, ADPCN, OHNAP, SCVNPP, CCNAPI, MCNAP, ADNEP, RENAP, NLGNP, CNGP, GNCP, PSECN, PHICNA, PONA, APDNPP and the UP Manila College of Nursing as WHO collaborating Center for leadership in Nursing Development.

With the nursing professions vision of becoming the lead in promoting Philippine Nursing in the Asia Pacific Region by 2030, five strategic themes and four perspectives set the framework of the Balance Scorecard (BSC) that will determine the outcome measures that will have to be achieved. The five strategic themes are: Dynamic Leadership, Service Excellence, Operational Excellence, Strategic Partnerships and Social Responsibility. The performance of the nursing profession shall be measured across four balanced perspectives namely: Learning and Growth, Internal Processes, Customer and Financial Perspectives. These are the key areas of the nursing profession into which objectives naturally fit. The crafting of the Nursing Roadmap is a continuing work in progress participated in by three (3) clusters of organizations, namely: the Philippine Nurses Association (PNA) as the accredited professional organization, the nursing specialty organizations and nursing interest groups. In 2007, the Board of Nursing and representatives from nursing practice, education and nursing welfare formed the Coordinating Body for Good Governance of the Nursing Profession (CBGGN) and together with 16 nursing organizations committed to work together to uplift the status of Philippine nursing. With the Board of Nursing taking the lead, the nursing profession through the CBGGNP, enrolled in the Institute for Solidarity in Asia (ISA) Public Governance System (PGS) Program and earned the recognition of PGS Compliant for following the public governance system process in August 2007. The CBGGNP struggled in its efforts to create a comprehensive strategic plan. Concerns on organizational structure, administrative matters and logistics needed to be seriously addressed. As more questions were raised, the CBGGNP acknowledged the need for more guidance and decided to consult on the process of roadmapping. This would necessitate a formal engagement with ISA as the consultant on strategy development and execution. A Series of meetings, discussions and exploratory talks with ISA ensued. ISA would provide the technology to process the strategy which is based on the Balanced Scorecard (BSC) framework and customize the process to ensure that it captures all the feasible and workable strategies that the nursing profession wishes to undertake. The Roadmap and the BSC is for the entire nursing profession to integrate and cascade the information and strategies to all stakeholders through alignment and subsidiary scorecards. Because this work is of great magnitude affecting the present and the future of the nursing profession in the Philippines, it will necessitate the creation of an Office of Strategy Management. The main product of the roadmapping process is the Good Governance Pathway. As such, the Nursing Profession would need to progress in the public governance pathway from Compliant to Proficient status. To achieve this goal and assist the nursing profession in this journey would entail the formal engagement of ISA as consultant of the nursing sector for it to audit, assess and intervene in accordance with the Nursing Roadmap and the strategies that the profession decides to undertake. If all nurses, as stakeholders, take on the commitment now, there is a certainty that future nursing leadership will do the same. The Nursing Roadmap addresses this by strengthening a multisector coalition that shall share resources, responsibilities and accountabilities which is also a means of guaranteeing commitment. Furthermore, the Nursing Roadmap will propel the profession to work towards institutionalization with a fully functioning Office of Strategy Management which shall regularly monitor the strategic performance of the profession. 2. QUALITY IMPROVEMENT Quality Improvement is a formal approach to the analysis of performance and systematic efforts to improve it. There are numerous models used. Some commonly discussed include: FADE PDSA Six Sigma (DMAIC) CQI: Continuous Quality Improvement - TQM: Total Quality Management

These models are all means to get at the same thing: Improvement. They are forms of ongoing effort to make performance better. In medical practice, the focus is on reducing medical errors and needless morbidity and mortality.

Quality Improvement QI involves both prospective and retrospective reviews. It is aimed at improvement -- measuring where you are, and figuring out ways to make things better. It specifically attempts to avoid attributing blame, and to create systems to prevent errors from happening. QI activities can be very helpful in improving how things work. Trying to find where the defect in the system is, and figuring out new ways to do things can be challenging and fun. Its a great opportunity to think outside the box. An effective QI program can really help make your life better.

Example Who are the Stakeholders in Healthcare? In Healthcare, the definition of quality can be complex and controversial because of the different views of people with a stake in good Healthcare. Lets look at a few different stakeholders. What does each of these stakeholders want? Providers Payers

Employers

Patients

Can you see any conflicts between what these stakeholders want? The decisions around the conflicts often determine if a QI project will be a success. Potential Areas of Conflict 1.Patient and Employer 2. Providers and Payers Quality in Healthcare If you wanted to get a sense of the quality of healthcare delivery, how would you go about it? You could ask each of the providers if they were following the guidelines for a specific disease You could ask providers to keep track of their errors or near misses

Can you imagine any reason these methods may not work? Earnest Interviewer: Have any of your patients gotten worse because of treatment you provided? Reluctant Provider: Er, um No, never, of course not. EI: Do you use the approved guidelines for this condition? RP: Of courseevery time! EI: What about the time . . . ? RP: (interrupting) Well, that was a special case. These methods would be fraught with problems of validity and reliability. Self-report of errors is shown to be low and, particularly if there is a potential punitive response, reporting would be infrequent and inaccurate. This leaves us with a deficit in how we can assess quality. QI in a Healthcare Setting One means of getting around the problems with self-report is to use more objective data. You start with a small problem. Perhaps you want to see how well your group is doing with patients with a chronic disease, such as diabetes, asthma, or hypertension. From that point you can narrow your focus even further. Decide what aspect of care you think might be a problem. o How about assessment of how well the condition is being controlled? o Within an office visit what measurements would be useful? Examples: Each of these measures is valid for a specific purpose. Understanding that value and its limitations determine if that is the correct measure to use for what you want to evaluate. These challenges are at the heart of healthcare QI. Next we talk about these measures and other ways of gathering data. Measures There are 3 types of measures used in quality work: Structure: Physical equipment and facilities Process: How the system works Outcome: The final product, results Structure and process are easier to measure; outcome is more important. Can you think of an example in Healthcare? If you were concerned about reducing prenatal mortality, you might look at: Structure Process Outcome Suppose you wanted to measure the quality of care for ankle injuries; consider what you could measure for each. You could consider: Structure Process Outcome Defining Process and Outcome Structure is a relatively easy concept to define, as it is typically the physical plant (e.g., buildings, equipment, raw material, parts). Defining process and outcome becomes key in understanding a QI project. What is the difference between Process and Outcome? Process:

How Healthcare is provided How the system works Outcome: Health status Does it make a difference?

Many Healthcare issues are very complex. Think about the prevention of heart disease. The goal is to reduce morbidity and mortality. The disease process is very slowit would take decades to show up. What can you measure in a timely fashion? This leads to the concept of proxy measures. Using a proxy measure means when you cant measure exactly what you want/need, you measure what you can. Sometimes you have to use a process measure instead of an outcome Or you use a measurable process in place of one that is tougher to get at For example, you may be interested in how effective the members of your practice are in counseling for smoking cessation. Since details of that are embedded in free text in medical records, to enable you to make use of computer records you may choose instead to look at: How many patients had tobacco abuse coded as a diagnosis How many received prescriptions for Zyban or nicotine replacement While these clearly do not represent exactly what you want to look at, the presence of either does suggest that smoking cessation counseling did occur. Proxy measures: Are used when you cant exactly measure what you want or need Measure something that is close enough to reflect similarly Can you think of proxy measures that might be used to assess care for prevention of coronary artery disease? These are all process measures. Since it is impossible to measure outcomes that dont occur, we use measures of care that have been shown in other research to be effective in achieving our goal. Convenience Samples In the future, electronic medical records will hopefully make it easy to mine for quality data on all patients. Currently available computer systems often make queries of this type very difficult and timeconsuming. This leads many people to the mistaken impression that measurement is not possible. One technique for dealing with problematic data sources is to use sampling -- measure a limited number and extrapolate to the whole population. The nice thing about QI is that, unlike research, you dont necessarily have to do this in a randomized, controlled fashion. You can use a convenience sample -whatever sample is relatively easy for you to get your hands on. For instance, a convenience sample can be: A shelf in the file room A days schedule A single payer group (e.g., Medicaid), especially if data is more readily available When using a convenience sample, you always have to keep in mind that it is NOT a random sample, and may or may not reflect the whole group. In the above list, for example, the characteristics of Medicaid patients may be different enough from patients with commercial insurance that your measures may be significantly different for some things. Example: Suppose you wanted to assess the timeliness of medication administration on a hospital ward, but the Medication Administration Record (MAR) system cant handle a query of what percentage of med's were administered within 30 minutes of scheduled time? There are too many patients and too many medications to manually review them all. What might you do? What might be the limitations of these samples?

Measurement is Possible ] When you run into barriers (its inevitable), dont give up! Use your ingenuity and creativity to find the answers in a useful form. Using proxy measures and samples can make it possible when you have to do all the work manually. As this isnt formal research, it is not necessary to randomize. But you can if you want to! We have covered the concepts of measurement and gathering data, now what can you do with the data you have gathered? The next section introduces QI models and methods of implementation. Methods of Quality Improvement ] The FADE Model (Organizational Dynamics Institute, Wakefield, MA) There are 4 broad steps to the FADE QI model: FOCUS: Define and verify the process to be improved ANALYZE: Collect and analyze data to establish baselines, identify root causes and point toward possible solutions DEVELOP: Based on the data, develop action plans for improvement, including implementation, communication, and measuring/monitoring EXECUTE: Implement the action plans, on a pilot basis as indicated, and EVALUATE: Install an ongoing measuring/monitoring (process control) system to ensure success. FADE Model in Action

This is the model in graphic form, including a little more detail of what can be included in each step. As you can see there are many parts within each of the basic four steps. Start in the middle of the circle and move out in each phase to see the sequential flow of the FADE process. The small details are less important than the 4-step cycle. PDSA Another commonly used QI model is the PDSA cycle: 1. PLAN: Plan a change or test of how something works.

2. DO: Carry out the plan. 3. STUDY: Look at the results. What did you find out? 4. ACT: Decide what actions should be taken to improve. Repeat as needed until the desired goal is achieved As you can see, its very similar to the FADE cycle. PDSA Example Issue: Ineffective team meetings that were causing more problems than they would resolve. Cycle 1 PLAN Took suggestions from group and used the suggestions to plan implementation of changes to improve the meetings effectiveness. Fewer meetings Follow an agenda Assigning tasks prior to meeting DO Documented the process and passed out to group members for commentary and commitment to changes. STUDY Group members were worried about their assignments and agenda items to submit, todays topic may not be the hot issue when the meeting was held. ACT Decided to proceed with the changes in spite of the concerns due to perception that the concerns were unfounded and based on fear of change. Cycle 2 PLAN New process initiated but only one topic submitted for agenda. DO He created an agenda with one topic and one regarding the lack of agenda items, assigned roles and held the meeting. STUDY Meeting was short for the wrong reason. People did not know what format to use when submitting agenda items. Also, concerned about how items would be used. ACT A form was created for submitting agenda items. Everyone was assigned to submit one item using the form for the next meeting. Any further process issues would be addressed in the same manner. Six Sigma Six Sigma is another model for improvement. The term comes from the use in statistics of the Greek Letter (sigma) to denote Standard Deviation from the mean. 6 sigma is equivalent to 3.4 defects or errors per million. Six Sigma is a measurement-based strategy for process improvement and problem reduction completed through the application of improvement projects. This is accomplished through the use of two Six Sigma models: DMAIC and DMADV. DMAIC (define, measure, analyze, improve, control) is an improvement system for existing processes falling below specification and looking for incremental improvement. DMADV (define, measure, analyze, design, verify) is an improvement system used to develop new processor products at Six Sigma quality levels. Emergency Department example of Six Sigma use: http://Healthcare.isixsigma.com/library/content/c040428a.asp The ED is often the first entry point for a community to the hospital, thus it is the place where positive or negative perceptions of the hospital initially may be formed. North Shore University Hospital in Forest Hills, N.Y., addressed this issue by initiating a Six Sigma project aimed at improving the patient experience in its Emergency Department. The project team took on the problem of excessive wait times in the ED while struggling at the same time with rising Healthcare costs and increasing volumes of patients. The results have been impressive Cardiac Cath Lab use of Six Sigma: http://Healthcare.isixsigma.com/library/content/c040721a.asp Cardiac catherization labs represent a significant capital investment for many hospitals. Realizing a return on this investment is increasingly challenging, given the introduction of advanced technologies and limitations in reimbursement. To meet the challenges and maintain fiscal health, hospitals are

pursuing strategies such as Six Sigma, lean and change management techniques to improve throughput, maximize equipment utilization and increase efficiency. Reducing Coding Errors with Six Sigma: http://Healthcare.isixsigma.com/library/content/c030501a.asp Like a detective, Pam Thomson probed the mysteries of CPT coding errors in the pulmonary medicine department at University of Virginia (UVA) Medical Center, looking for hard evidence of what went wrong and why. Were coding errors correlated with the time of day, day of the week, or workload? Was something amiss in the physician/coder interaction that produced the code? Were errors related to some fundamental misunderstanding of a specific type of code that caused consistent overcoding or undercoding? A Comparison of the Models FADE Focus Analyze Develop Execute Evaluate PDSA DMAIC Define Measure, Analyze DMADV Define Measure, Analyze Design

Plan Do Improve Study Control Verify Act Each model reflects a common thread of analysis, implementation, and review. As in the graphic for the FADE model, each also has deeper meaning (further levels of analysis) for the headings. Using a methodology ensures that you are not missing any of the critical steps. No one method is best for everyone or all situations. Pick a method that makes sense to you and follow it. Things Quality Improvement is NOT Performance Improvement The terms quality improvement and performance improvement are sometimes used interchangeably. Performance Improvement means a change in the system performance. In Healthcare, this is often used to refer to administrative systems, as contrasted to QI as impacting the actual quality of healthcare. Example: The state child health report indicates no well child care is being done in your primary care clinic. You know very well that this isn't true, so you dig deeper to find out where the problem is. You identify a coding error, which led to none of your well child care being registered by the state. And by the way, none of it was paid for either! You promptly work with the administration to correct the related administrative/billing and systems responsible. The next state health report shows a dramatic improvement in scores. There is nothing affecting actual quality of care that was changed or improved. In this case it was a reporting error that was corrected. Research The distinction between QI and research is an important one. There is a spectrum, and it can be blurry sometimes, but there are some key points (with legal implications!). QI: 1. Intent is to improve current practice. For internal use only. 2. By definition, the data is confidential. 3. Action is within existing standards of care. 4. Institutional Review Board (IRB) approval is not necessary. Research:

1. Intended to create generalized knowledge. 2. Desire to publish or present. 3. Testing new methods. Is IRB approval needed for these projects? Example 1 Following up on the previous example on well child care-An audit shows the immunization rate for well children in your practice to be 45%. The state periodically reviews primary care practices for their performance on childhood immunizations. Your group is very disappointed by your score, which suggests that fewer than half of the eligible children in your practice are receiving their recommended immunizations. What do you do? Using the FADE model, consider: Step 1 - FOCUS Step 2 - ANALYZE 1. Children overdue for immunizations often are seen in the office for other problems and no one notices the need for vaccinations. 2. Children who receive their vaccines elsewhere dont always have these recorded in your records. **BEFORE YOU CREATE A NEW SYSTEM TO FIX SOMETHING, BE SURE THE STEP YOU ARE FIXING IS TRULY THE SOURCE OF THE PROBLEM!** Step 3 - DEVELOP Step 4 EXECUTE Step 5 - EVALUATE Summary Key points to remember. Improving Healthcare quality is our responsibility. Measurement and improvement are possible. Identify the root cause before making changes. Be creative in developing solutions. 3. ACCREDITNG BODIES TO NURSING SCHOOLS Philippine Accrediting Association of Schools, Colleges and Universities (PAASCU) is a private, voluntary, non-profit and non-stock corporation which was registered with the Securities and Exchange Commission of the Philippines on December 2, 1957. It is a service organization which accredits academic programs which meet commonly accepted standards of quality education. Commission on Collegiate Nursing Education (CCNE) is an autonomous accrediting agency, contributing to the improvement of the public's health. CCNE ensures the quality and integrity of baccalaureate, graduate, and residency programs in nursing. CCNE serves the public interest by assessing and identifying programs that engage in effective educational practices. As a voluntary, self-regulatory process, CCNE accreditation supports and encourages continuing self-assessment by nursing programs and supports continuing growth and improvement of collegiate professional education and post-baccalaureate nurse residency programs. is an autonomous accrediting agency, contributing to the improvement of the public's health. CCNE accreditation is a nongovernmental peer review process that operates in accordance with nationally recognized standards established for the practice of accreditation in the United States. Accreditation by CCNE is intended to accomplish at least five general purposes:

1. To hold nursing programs accountable to the community of interest the nursing profession, consumers, employers, higher education, students and their families, nurse residents and to one another by ensuring that these programs have mission statements, goals, and outcomes that are appropriate to prepare individuals to fulfill their expected roles. 2. To evaluate the success of a nursing program in achieving its mission, goals, and expected outcomes. 3. To assess the extent to which a nursing program meets accreditation standards. 4. To inform the public of the purposes and values of accreditation and to identify nursing programs that meet accreditation standards. 5. To foster continuing improvement in nursing programs and, thereby, in professional practice. National League for Nursing Accrediting Commission (NLNAC) The NLNAC is the only national agency to offer accreditation to all kinds of post-secondary and advanced nursing programs, including undergraduate degrees, graduate degrees, diplomas and certificates. The organization has been in operation for over 50 years, longer than any other nursing school accrediting agency. With recognition from the U.S. Department of Education and the Council for Higher Education Accreditation, it is no wonder why employers and federal financial assistance programs hold the NLNAC in such high regard. Commission on Collegiate Nursing Education (CCNE) The CCNE is a national, non-governmental organization that has been recognized by the U.S. Secretary of Education [PDF]. Offering accreditation to both undergraduate and graduate-level nursing programs, the CCNE aims to serve the public by lending credibility to the most effective nursing schools. The organization was created by the American Association of Colleges of Nursing (AACN) in 1996 and has quickly been established as one of the two leading national accrediting organizations for nursing schools. The CCNE's standards for accreditation are updated regularly to stay current with education trends. The organization prides itself on its voluntary, self-regulatory structure, which maintains an unbiased review process. American College of Nurse-Midwives (ACNM) Division of Accreditation The ACNM has over 40 years of experience with setting standards for nurse-midwifery educational programs. Since the early 1980's, the U.S. Department of Education has recognized the ACNM's Division of Accreditation (DOA). Though a school with a nurse-midwifery program may be accredited through the NLNAC and/or the CCNE, accreditation from the ACNM indicates that the school is particularly advanced in its midwifery education. Nurse-midwifery programs are reviewed by the ACNM based on "core competencies, standards of practice and the regularly conducted ACC/AMCB task analysis of midwifery practice". For more information on the review process, please refer to the organization's most recent Statement on Midwifery Education [DOC]. Council of Accreditation of Nurse Anesthesia Educational Programs (COA) The COA is another accrediting organization that is specific to an advanced practice of nursing. Founded in 1952 by the American Association of Nurse Anesthetists (AANA), the COA is an autonomous group of 12 council members that are associated with the nursing community. This includes nurse anesthesia professionals, educators, health care administrators and college representatives. The COA reviews post-graduate degree and certificate programs in order to offer recognition to quality nurse anesthesia programs. Colleges and universities are reviewed for accreditation, on-site, by at least two council members. Upon approval, the school will be subject to subsequent visits and progress reports in regular intervals of up to 10 years. Distance education courses are evaluated using slightly different

methods, which are outlined in the organization's Guidelines for Distance Education Courses and Programs [PDF]. Roadmap to Quality Higher Education Phase I : (AY 2009-2010) : All Existing 5-year programs with PRC licensure examinations, including Education and Nursing shall follow the 10+2+3 Programs for Phase I Nursing (1 Program) Pharmacy (1 Program) Physical Therapy (1 Program) Occupational Therapy (1 Program Institutional Quality Assurance Monitoring and Education (IQuAME) Components : KRA I Governance and Management KRA II Teaching and Research Setting and Achieving Program Standards Program approval Program monitoring and review PS 2.2 Academic Support KRA II Teaching and Research PS 2.2 Academic Support 2.2.1 Academic Counseling 2.2.2 Feedback Mechanism 2.2.3 Adequate Learning Resources to support each program a. Students are able to access the learning resources easily KRA II Teaching and Research Actions to Strengthen Programs Research capability KRA III Support for Students KRA IV Relations with the Community KRA V Management of Resources Faculty Profile Use of ICT and Learning Resources Resource Generation CHED RQUAT Policies and Standards per Program (CMO) Technical Panels (TP) Technical Committees (TC) Quality Assurance Team (RQUAT) Article I Statement of Policies Article II Authority to operate Article III Program Specification Article IV Competency Standards Article V Curriculum Article VI Program Administration Program Administration Library (Common) References (General and Special)

Professional Books 5 titles per subject in the curriculum published within the last 5 years Filipiniana (10-15% of the collection) Internet Access Electronic Resources E-books, E-journals Multi-media Resources Linkages and Networking Reading Area (10-20% of enrollment) Open Shelf System Organized and Cataloged Materials Deselect ion VII Transitory, Repealing and Effectivity Provision 4. NURSING INFORMATICS Nursing informatics is a combination of computer science, information science, and nursing science, designed to assist in the management and processing of nursing data, information, and knowledge to support nursing practice, education, research, and administration (Graves & Corcoran, 1989). "Information is an essential phenomenon of study for an information-based discipline such as nursing," (p. 2). Nursing informatics can be applied to model the human processing of data, information, and knowledge within a computer system in order to automate the processing of nursing data to information and the transformation of nursing information to nursing knowledge. "In the current Information Age, the doubling of knowledge every five years and the increased specialization of knowledge make it imperative that nurses have access to the latest scientific information to assist in the delivery of high quality care," (Hudgings, 1992, p.7). Toffler (1990) described the 1990's as a new era for informatics, the process of gaining power through the data-information-knowledge triad. This era continues as we enter the new millennium. The need for nurses to feel comfortable working with computerized data and information is escalating.

Adapted from Nelson & Roos (1992), Computer Applications in Nursing Education and Practice, p.10. Health and nursing information science is the study of how health care data is acquired, communicated, stored, and managed, and how it is processed into information and knowledge. This knowledge is useful to nurses in decision-making at the operational, tactical, and strategic planning levels of health care.

Information systems used in health care include the people, structures, processes, and manual as well as automated tools that collect, store, interpret, transform, and report practice and management information. T he realization that health care data and information can be effectively managed and communicated using computer systems, networks, modems and telecommunications has catalyzed the emergence of the science of nursing informatics. As Virginia Saba (1992) predicted, "By the turn of the century, most health care delivery systems will function with computers and will be managed by computer literate nurses. I believe, that by the turn of the century, "high tech and high touch" will be an integral part of the health care delivery system," (p. xv). At present, nursing informatics is an emerging field of study. National nursing organizations support the need for nurses to become computer literate and versed in the dynamics of nursing informatics. We are at a transition period. Becoming educated in nursing informatics is, for the most party, a self-directed and independent endeavor. Programs that offer basic and further education in nursing informatics are beginning to spring up around the globe, but many more are needed to provide easy access for motivated nurses. Hospital Information System (HIS) are comprehensive, integrated information systems designed to manage the medical, administrative, financial and legal aspects of a hospital and its service processing. Traditional approaches encompass paper-based information processing as well as resident work position and mobile data acquisition and presentation. Benefits of HIS Easy Access to Patient Data to generate varied records, including classification based on demographic, gender, age, and so on. It is especially beneficial at ambulatory (out-patient) point, hence enhancing continuity of care. As well as, Internet-based access improves the ability to remotely access such data. [5] It helps as a decision support system for the hospital authorities for developing comprehensive health care policies.[6] Efficient and accurate administration of finance, diet of patient, engineering, and distribution of medical aid. Improved monitoring of drug usage, and study of effectiveness. This leads to the reduction of adverse drug interactions while promoting more appropriate pharmaceutical utilization. Enhances information integrity, reduces transcription errors, and reduces duplication of information entries.[7] Information systems are the software and hardware systems that support data-intensive applications. The journal Information Systems publishes articles concerning the design and implementation of languages, data models, process models, algorithms, software and hardware for information systems. Subject areas include data management issues as presented in the principal international database conferences (e.g. ACM SIGMOD, ACM PODS, VLDB, ICDE and ICDT/EDBT) as well as datarelated issues from the fields of data mining, information retrieval, internet and cloud data management, web semantics, visual and audio information systems, scientific computing, and organisational behaviour. Implementation papers having to do with massively parallel data management, fault tolerance in practice, and special purpose hardware for data-intensive systems are also welcome. All papers should motivate the problems they address with compelling examples from real or potential applications. Systems papers must be serious about experimentation either on real systems or simulations based on traces from real systems. Papers from industrial organisations are welcome. General-Purpose Applications Software General purpose application software packages are generally tools that provide specific capabilities, but not in support of a specific purpose. For example, a spreadsheet program is a

general purpose application. It does spreadsheets, but those could be spreadsheets that you use to balance your checkbook, or manage your fantasy football league. also known as an application or an "app", is computer software designed to help the user to perform specific tasks. Examples include enterprise software, accounting software, office suites, graphics software and media players. Many application programs deal principally with documents. references: http://journals.elsevier.com/03064379/information-systems/ Regulatory Board for Librarians. Director of Libraries, Lyceum of the ... en.wikipedia.org/.../List_of_recognized_higher_education_accr... www.slideshare.net/.../nursing-education - Estados Unidos - Naka-cache www.paascu.org.ph/paascuprimer.pdf www.businessdictionary.com/definition/information-system.html - Naka-cache

SAINT LOUIS UNIVERSITY SCHOOL OF NURSING BAGUIO CITY

SUBMITTED BY: ALYSSA AMOR B. ALMA-IN BSNIV-J2

SUBMITTED TO: MRS. GAY MARIE CABRERA INSTRUCTOR