NURSING

INFORMATICS
ARIEL M. ORTUOSTE, RN MAN
 PHILOSOPHY
• Emilio Aguinaldo College is a private,
non-sectarian, co-educational institution
of learning that fosters equal and fair
opportunities of education, the total
development of a person, and one’s
national identity while conscious of
his/her role in the global community.
 VISION
• Emilio Aguinaldo College envisions
itself as an internationally recognized
private non-sectarian academic
institution rooted in the Filipino
nationalist tradition that consistently
pursues the advancement and welfare
of humanity.
 MISSION
• Emilio Aguinaldo College provides a
learner-centered, inquiry-based, and
socially relevant academic
community.
 CORE VALUES

• VIRTUE
• EXCELLENCE
• SERVICE
 QUALITY POLICY
We, the employees of Emilio Aguinaldo College are committed
to:
Comply to all statutory and regulatory standards;
Provide consistent quality service to our students, parents, and
other stakeholders;
Develop a responsible person through relevant and quality
education, able to lead and enhance one’s life, and contribute to
the development of the country and humanity; and
Improve continuously our QMS by communicating the needs of
customer to the entire organization, standardizing the processes,
enhancing employees’ competence, periodic review of the
system, and addressing the needs for continual improvement.
 QUALITY OBJECTIVES
• The objectives of Emilio Aguinaldo College are to:
• offer opportunities for quality and relevant education
to all;
• cultivate the intellectual, spiritual, moral, social, and
physical aspects of a person;
• instill appreciation and pride for one’s national
identity; and
• produce graduates of global quality equipped with
competencies in their field of expertise
SCHOOL OF NURSING
 VISION
• The School of Nursing is a proactive school
which upholds academic global trends and
issues; committed to the formation of
professional Emilian nurses; able to meet the
ever changing and challenging demands of
health care for the individual, family,
community; and living a life of virtue,
excellence and service.
 MISSION
• Guided by our vision, we commit ourselves in the:
• 1. Creation of educational environment that promotes
integration of personal values and professional competence.
• 2. Formation of globally competitive nurses enriched by:
• Faith
• Compassion
• Humility
• Leadership
• Respect
• 3. Formation of holistic service for humanity with integrity
regardless of race, nationality and religion.
 A.
COMPUTER
AND
NURSING
 OBJECTIVES

1. Introduce NURSING INFORMATICS and

CLINICAL INFORMATION SYSTEMS
(CIS)
2. Highlight new technologies and their
applications in traditional and new
environments of nursing
 KEY WORDS
• Nursing Informatics (NI)
• Electronic Health Record (EHR)
• Nursing Standards
 INTRODUCTION
• Nursing Informatics (NI) represents the
transition of data and data information and
knowledge into action.
• NI represents the practice, administration,
community health, nursing education, and
nursing research applications.
 NURSING INFORMATICS
• A specialty that
integrates nursing
science, computer
science, and information
science to manage and
communicate data,
information and
knowledge 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.

(American Nurses
Associations (ANA, 2001)
• nursing
informatics is "the use
of computers
technology to support
nursing, including
clinical practice,
administration,
education, and
research."

• Hebda (1998 )
 Nursing Informatics
• A field that combines
nursing and computers
• Informatics is computer
science plus information
science
 HEALTHCARE INFORMATICS
• Is the integration of information science,
health science, computer science and cognitive
science.
• It is the derivative of the holistic objective of
the medical practitioners such as the nurse,
healthcare providers, physicians, healthcare
staffs, etc.
 Example

• Data= 9:00 am -100, 4:00 am 180

• Information= time glucose
9:00 AM 100
4:00 PM 180

• Knowledge= My clients glucose level rises in

the late afternoon. His insulin dose needs to
be adjusted
 NI SPECIALISTS
• 1985 = 15 Nurses
• 1990 = 5,000 Nurses
• 2000 = ↑ 500%
• 2010 = Majority of
Nurses entering the
profession will be
computer literate
 CLINICAL INFORMATION
SYSTEM (CIS)
• CIS is designed to support clinical nursing
practice. It requires not only an understanding
of professional nursing practice but also
technology that is the application for the
science to function electronically.
Advantages and disadvantages of
computer system and the
traditional healthcare system
 MANUAL HEALTH CARE
SYSTEM
• DISADVANTAGES
– Needs lots of paper
– Problem with maintenance
– Volume of data becomes a problem
– Problem with interpretation/transcription
– Data is not converted easily to information
– Readiness of information
– Coordination of data and information is a problem
– Integration with the other system such as laboratory,
accounting etc. is a problem
– Data handling is a problem
 MANUAL HEALTH CARE
SYSTEM
• ADVANTAGES
– Easy to implement
– Low cost
– No extra training required
– Requires minimum effort
– Can be stored anywhere
– Cannot be easily corrupted
– Easy to prepare
– Data profiling can be processed easily
 COMPUTER INFORMATION
SYSTEM
• ADVANTAGES
– No paper is required
– Data maintenance
– Low maintenance cost
– Volume of data is not an issue
– No problem with interpretation/transcription
– Data can be stored easily to information
– Readiness of the information and data
 COMPUTER INFORMATION
SYSTEM
• ADVANTAGES (con’t)
– Data cannot be corrupted easily (with proper
backup)
– Can be integrated with the other system such as
laboratory, pharmacy, accounting etc.
– Data handling is easy
– Data communication is possible
– Data integrity is preserved
– Can be expanded
– Easy data profiling
 COMPUTER INFORMATION
SYSTEM
• DISADVANTAGES
– Implementation requires severe justification
– High starting cost
– Requires training for nursing and health care giver
– Requires additional effort to implement
– Additional manpower is necessary
– Data communication system will have an
additional cost
 COMPUTER INFORMATION
SYSTEM
• DISADVANTAGES (con’t)
– Data can be easily corrupted (if no back-up is
provided)
– Readiness of data and information is possible
when software is provided in the health care
information system
– Requires extensive planning, designing and
commercial implementation
– Information management is essential
B. Historical perspective
of nursing and the
computer
 ASSIGNMENT
to be passed on wednesday (April 5, 2017)

1. Highlight a major historical perspective of

nursing and computers
2. List and discuss the major landmark events
and milestones of nursing and computers.
Major Historical perspective of nursing
and the computer
1. Six time periods
2. Four major nursing areas
3. Standards initiatives
4. Significant landmark events
5. Major landmark milestone chart
 OBJECTIVES

1. Highlight a brief major historical perspective

of nursing and computers
2. List the major landmark events and
milestones of nursing and computers.
 KEY WORDS

• Computer Literacy
• Computer systems
• Information systems
• Internet
• Data standards
Major Historical perspective of nursing
and the computer
1. Six time periods
2. Four major nursing areas
3. Standards initiatives
4. Significant landmark events
5. Major landmark milestone chart
 1. SIX TIME PERIODS
1. Prior to the 1960’s
2. 1960’s
3. 1970’s
4. 1980’s
5. 1990’s
6. Post-2000
 Prior to the 1960’s
• During this time, there were only a few experts
who formed a cadre of pioneers that attempted
to adapt computers to health care and nursing.
• The image of nursing was improving, nursing
practices and services were expanding its
scope and complexity, and the number of
nurses was increasing.
• Computers were initially used in health care
facilities for basic business office functions.
• The early computers used punch-cards to store
data and card readers to read computer
programs, sort, and prepare data for
processing.
• They were linked together and operated by
paper tape and used teletypewriters to print
their output.
 1960’s
• During this period, computer technology
advanced, while the number of health care
facilities increased.
• The introduction of cathode ray tube (CRT)
terminals, online data communications, and
real-time processing added important
dimensions to the computer systems, providing
more accessible and “user-friendly”
machines.
• Hospital Information Systems (HIS) were
developed primarily to process financial
transactions and serve as billing and
accounting system.
• Vendors of computer systems were beginning
to enter the health care field and market
software applications for various hospital
functions.
• However, because of technology limitations,
lack of standardizations, and diversity of
paper-based patient care records, progress was
slow.
 1970’s
• During this decade, giant steps were taken in
both dimensions: nursing and computer
technology.
• Nurse’s recognized the computers potential for
improving the documentation of nursing
practice, the quality of patient care, and the
repetitive aspects of managing patient care.
• During this period, several states and large
community health agencies developed and/or
contracted for their own computer-based
management information systems (MIS).
 1980’s
• During the 1980’s the field of informatics
emerged in the health care industry and
nursing.
• NI became an accepted specialty and many
nursing experts entered the field.
• As computer systems implemented, the needs
of nursing took on a cause-and-effect
modality; the need for nursing software
evolved.
• It became apparent that the nursing profession
needed not only to update its practice
standards but also determine its data standards,
vocabularies, and classification schemes that
could be coded for the computer-based patient
record systems (CPRS).
• During this period, many mainframe HIS
emerged with nursing subsystems.
• These systems documented several aspects of
the patient record; namely, order entry
emulating the Kardex, results reporting, vital
signs, and other systems that documented
narrative nursing notes via word-processing
packages.
• In the 1980s, the microcomputer or personal
computer (PC) emerged.
• PCs brought computing power to the
workplace and more importantly, to the point-
of-care.
 1990s
• Beginning with the early 1990s, computer
technology became an integral part of health
care settings, nursing practice, and the nursing
professions.
• The 1990s brought smaller and faster
computers - laptops and notebooks – to the
bedside and all of the point-of-care settings.
• Workstations and local area networks (LAN)
were developed for hospital nursing units,
wide area networks (WAN) were developed
for linking care across health care facilities,
and the internet started to be used for linking
across the different systems.
• In the 1990s, the Internet brought new
cyberspace tools forming building blocks for
increasingly sophisticated information
technologies.
• By the 1995, the internet had moved into the
mainstream social milieu with electronic mail
(e-mail), file transfer protocol (FTP), Gopher,
Telnet, and WWW (World Wide Web)
protocols.
• The internet began to be used for high
performance computing and communication
(HPCC) or the “information superhighway”
• The “web” became the means for
communicating online services and resources
to the nursing community.
• The WWW used to browse the Internet and
search worldwide resources.
 POST-2000
• Clinical information systems became
individualized in the electronic patient record
(EPR) and patient specific systems considered
for the lifelong longitudinal record or the
electronic health record (EHR).
• Information technologies continued to
advanced with mobile technologies such as
with wireless tablet computers, personal
digital assistants (PDA) and smart cellular
telephones.
2. FOUR MAJOR NURSING
AREAS
 1. NURSING PRACTICE
• Nursing practice has evolved and changed
radically.
• It has become an integral part of the EHR.
• Computer systems with nursing and patient
care data, nursing care plans are no longer
separate subsystems of the computerized HISs,
but rather integrated into one interdisciplinary
patient health record in the EHR.
• Further nursing practice data emerged with the
introduction of several nursing terminologies
that were recognized by the ANA as coded
terminologies usable for the EHR.
• They are used to assessed problems, document
care, track the care process, and measure
outcomes. Thus the electronic version of
nursing practice-the computer-has
revolutionized and transformed nursing
practice.
 2. NURSING ADMINISTRATION
• Nursing administrations in the hospitals has
also changed with the introduction of the
computer that links nursing departments
together.
• Most policy and procedure manuals are
accessed and retrieved by computer. Further,
workload measures acuity systems and other
nursing department system are online and
integrated with the hospital or patient’s EHR
system.
 3. NURSING EDUCATION
• The computer has radically changed nursing
education.
• Most universities and schools of nursing offer
computer enhanced courses, online courses,
and/or distance education.
• Campus-wide computer systems are available
for students to communicate via e-mail,
transfer data files, access the digital libraries
and retrieve online resources of millions of
internet sites.
• Today, most faculty members use the Internet
to teach courses via the Web and communicate
with their students via e-mail.
• The students on the other hand have to be
more active and assume more responsibility
for their education.
 4. NURSING RESEARCH
• Nursing research provides the impetus to use
the computer for analyzing nursing data.
• Software programs are available for processing
both quantitative and qualitative research data.
3. STANDARDS
INITIATIVES
• The third significant historical perspective
concerns standards initiatives focusing on
nursing practice standards, nursing data
standards, and health care data standards as
well as federal legislation that impact on the
use of the computer into nursing.
• These standards have influenced the nursing
profession and its need for computer systems,
information technology and terminologies to
gain acceptance among health care policy
maker.
• The legislative acts during the early stages
influenced significantly the use of the
computer for collection of federally required
data, reimbursement, measure quality and
evaluate outcomes.
A. NURSING PRACTICE
STANDARDS
• Nursing practice standards have developed and
recommended by the ANA.
• They recommend that the nursing process
serve as the conceptual framework for the
documentation of nursing practice.
B. NURSING DATA
STANDARDS
• The ANA is responsible for the recognition of
the terminologies and for determining if they
have met the criteria to be included in the
National Information Classification (NIC).
4. Significant landmark
events
• The major developments in the use of
information technologies and nursing, and in
the introduction of NI, were chronologically
described by program effort, or by
organizational initiative.
• The Landmark events were described by the
following categories:
– Early conferences
– Early academic initiatives
– Initial ANA initiatives
– Initial National League for Nursing initiatives
– Early international initiatives
– Initial educational resources
– Significant collaborative events.
5. MAJOR LANDMARK
MILESTONES
C. Electronic health record from a
historical perspective
 OBJECTIVES
– Describe the Nicholas E. Davies program
– Name the four key criteria sections of the Davies
application
– Name and describe one feature of an electronic
health record (EHR) implementation that has not
changed over time
– Describe an external factor that has impacted EHR
implementation
– Describe several of the commonalities found in all
Davies winners
 INTRODUCTION TO DAVIES
• A Computer-based Patient Record Institute
(CPRI) workgroup on CPR systems Evaluation
developed the CPR project evaluation criteria
in 1993.
• These criteria, drawn together with input from
national experts and volunteer members,
formed the basis of a self-assessment that
could be used by organizations and outside
reviewers to measure and evaluate the
accomplishments of CPR projects.
The FOUR MAJOR AREAS OF
THE INITIAL CRITERIA
– Management
– Functionality
– Technology
– Impact
Provided a framework to view an implementation of
computerized records.
• The criteria also provided the foundation for
the Nicholas E. Davies Award of Excellence
Program.
• The Davies program, named for Dr. Nicholas
E. Davies, and Atlanta-based physician,
president-elect of the American College of
Physicians, and a member of the Institute of
Medicine (IOM) committee on improving the
patient record, was killed in a plane crash just
as the IOM report on CPR was being released.
• The program is founded on the belief that
healthcare organizations benefit the collective
experiences and lessons learned are shared.
• During its 10 year existence, the Davies
program has had four criteria revisions and
seen its terminology updated from
computerized patient record (CPR) to
electronic medical record (EMR) and today’s
EHR.
 SUMMARY
 The Nicholas E. Davies program, founded by
CPRI in 1993 awards excellence in EHR
implementation.
 Organized into 3 different categories , the
award program has recognized 20 healthcare
organizations, 7 primary care practices, and 3
public health initiatives.
 SUMMARY
 Applicants for the awards answers questions
outlined by the project evaluation criteria.
These questions are focused on the four broad
areas of management, functionality,
technology, and value.
 A review of award receiving applications
reveals that some characteristics of winning
organizations remain unchanged over the past
decade while other characteristics are
remarkably different.
THANK YOU….