WHAT IS NURSING INFORMATICS?

It is the use of computer technology to support nursing

including clinical practice, education, administration and

research( Hebda, 1998)

It is also the development and evaluation of applications, tools and processes and structures which assist

nurses with the management of data in taking care of patients or supporting practice of nursing. (American Nurses

Association, 1994)

FRAMEWORKS FOR NURSING INFORMATICS

DecisionKnowledgeInformationData

COMPUTERS AND NURSING

HISTORICAL PERSPECTIVES OF COMPUTERS AND NURSING

Prior to 1960’s is the use of

punchcards and teletypewritter

s.

In 1960's, use of computers in healthcare is

questioned, but studies on

computers in nursing is

started. The introduction of

cathode ray tubes and

development of hospital

information system for financial

transactions started.

In 1970's, nurses assisted in the design of HIS. Computers

are used in financial and management functions, and

several communities

developed management

information system.

In 1980's, nur

sing Informatics is formally accepted as

new nursing

specialty.

• In 1990's, computer technology became an integral part of the healthcare setting.

• And in the year 2000, Clinical Information System became individualized in the electronic patient record, mobile computing device were introduced, new technologies were utilized, internet provided new means of development and Health Insurance Portability and Accountability Act of 1996 was enacted.

Computers can perform a wide range of activities that save time and help nurses provide quality nursing care. It involves:

Nursing practiceNursing educationNursing managementNursing research

ELECTRONIC HEALTH RECORD

It is an electronic record composed of health information regarding an individual

patient that exists as part of a complete system designed to provide access to, and

management of, such information

The Healthcare Information and Management Systems Society (HIMSS) is the healthcare

industry's membership organization exclusively focused on providing global

leadership for the optimal use of healthcare information technology (IT) and management

systems for the betterment of healthcare

COMPUTER SYSTEM

A system of interconnected computers that share a central storage system and various peripheral devices such as

a printers, scanners, or routers.

Input and output devices

storage devices

Central processing unit

COMPUTER HARDWARE

Hardware is the general term for physical artifacts of technology.

First Generation Computers- Used vacuum tubes as a design. Those

computer ran hot and thus required a great cooling. Vacuum tubes got hot easily, and when they get hot, they

failed regularly. First generation computers were physically huge , but

their power was much less than that of the average desktop computer of the

1900’s.

Second Generation Computers - They use transistors instead of vacuum tubes.

This meant less heat, improved reliability, and much greater

speeds. Second generation CPU access speeds were measured in millionths rather than thousandths of a second (microseconds). They still quite large, but transistors were smaller and more durable than vacuum tubes. They also allowed for the development of much

more powerful computers.

The Third generation computers were introduced- In this

generation, they used microminiature, solid state

components. Third generation CPU access speeds were measured in

billionths of a seconds (nanoseconds)

CLASSESS OF COMPUTER

Analog computer- operates on continuous physical or

electrical magnitudes, measuring, ongoing continuous analog

quantities such as voltage , current, temperature and

pressure.

Digital computer- operates on discrete discontinuous

numerical digits using the binary numbering system.

It represents data using discrete values for all

data.

Hybrid Computers- As its name implies, contains

features of both the analog and the digital computer. It is used for specific applications,

such as complex signal processing and other engineering-oriented

applications.

Supercomputers- This is a

computational-oriented

computer specially

designed for scientific

applications requiring gigantic

amount of calculations.

Mainframes- This is the

fastest, largest, and most

expensive type of computer

used for processing, storing and

retrieving data the computing

needs.

Handheld Computers-

have smaller size than

standard desktop microcomputers,

some have claimed to have almost the same

function and processing

capabilities as the standard

desktop microcomputer.

TYPES OF COMPUTER

Computer Hardware Fundamentals

Central processing unit- brain of the computer

Motherboard- main printed circuit board (PCB) found in computers and other expandable systems. It holds many of the crucial electronic

components of the system, such as the central processing unit (CPU) and memory, and provides connectors for other peripherals.

Storage devices

Primary Memory

read only memory- is permanent; it remains when power is off. Example: start

up instructions for computer is an example

Random access memory-is a temporary storage area for program instructions and data that is being processed. It is only active when computer is on

Secondary memory

Floppy disk

Hard disk

CD- Rom

USB flash drives

Memory cards

Input devices- used to enter data. Example: trackball, joystick, mouse, keyboard, modems, stylus, touchscreen, light pen, microphone, scanner and bar code

reader.

Output devices- used to visualize and hear processed data. Example: video monitor screens, speakers, fax and printers

NETWORK

Types of Networks• Local Area Networks (LAN) - networks

within a area, location or business. The University connects all its computers on a

LAN. • Wide Area Networks (WAN) - several

LAN connected together

This allows the sharing of computer and software resources, through the use of the network. For example, several computers

may share one computer, or a word processing program could also be accessed by many different users.

COMPUTER SOFTWARE AND SYSTEM

Computer software or simply software is any set of machine-readable instructions that directs a computer's processor to perform specific operations. Software is stored in computer

memory and is intangible.

Types of software

Application software- which

uses the computer system to perform special functions or provide entertainm

ent functions beyond

the basic operation of the computer

itself.

System software-which is designed to directly operate

the computer hardware, to provide basic functionality

needed by users and other software.

Malicious software or malware, which are computer programs developed to harm and disrupt computers. Malware is closely associated

with computer-related crimes, though some

malicious programs may have been

designed as practical jokes.

FREE SOFTWARE

- Is a matter of the users’ freedom to run copy, distribute, study, change, and

improve the software in any way they wish. A program is only free software if

users have all of these freedoms. Example are Amazon, Yahoo and Google .

OPEN SOURCE AND FREE SOFTWARE

O

PE

N

SO

UR

E

SO

FT

WA

RE

OSS is any software that satisfies the open

software initiative’s definition. The open

source concept is said to promote

software reliability and quality by

supporting independent peer review and

rapid evolution of source code, as well as

making the source code of software freely

available.

2. Free Redistribution The license shall not restrict any party from selling or giving

away the software as a component of an aggregate software

distribution containing programs from several different sources. The license shall not require a royalty

or other fee for such sale.

1. Source Code The program must include source

code, and must allow distribution in source code as well as compiled form. Where

some form of a product is not distributed with source code, there must be a well-

publicized means of obtaining the source code for no more than a reasonable

reproduction cost preferably, downloading via the Internet without charge.

The Open Source

3. Derived Works The license must allow modifications and derived works, and must allow them to be distributed under the same terms as the license of the original software.

4. Integrity of Author’s source code The license may restrict source-code from being distributed in modified form only if the license allows the distribution of "patch files" with the source code for the purpose of modifying the program at build time. The license must explicitly permit distribution of software built from modified source code.

6. No Discrimination Against Fields of Endeavor

- The license must not restrict anyone from making use of

the program in a specific field of endeavor. For example, it may not

restrict the program from being used in a business, or from being used for

genetic research.

5. No Discrimination Against Persons or Groups - The license must not discriminate against any person or group of persons.

7. Distribution of License - The rights attached to the program must apply to all to whom the program is redistributed without the need for execution of an additional license by those

8. License Must Not Be Specific to a Product - The rights attached to the program must not depend on the program's being part of a particular software distribution. If the program is extracted from that distribution and used or distributed within the terms of the program's license, all parties to whom the program is redistributed should have the same rights as those that are granted in conjunction with the original software distribution.

OpenEHR FreeMED

OpenEMR CARE2xs

Example of OSS/FS in health care

DATA PROCESSING

Manipulation of data by a computer. It includes the conversion of raw data to machine-readable form, flow of data through the CPU and memory to output devices, and formatting or transformation of output. Any use of computers to perform defined operations on data can be included under data processing. In the commercial world, data processing refers to the processing of data required to run organizations and businesses.

When data are interpreted, information is produced. While data are meaningless, information by definition is meaningful. For data to be interpreted and information produced, the data must be processed.

The raw, uninterrupted fact that are without meaning.

The quantities, characters, or symbols on which operations are performed by a computer.

Data

classifying

sorting

summarizing

Some common approaches in

organizing data:

calculating

DATABASE

PHONEBOOK PATIENT’S MEDICAL RECORD

It is an organized collection of related data.

Example

Example

Information system

-are used to process data and produce information.

-it is often used to refer to computer systems, but this is only one type of

information system. There are manual information systems as well

as human information system.

Example: Human Brain

It is the most effective and complex

information system.

TYPES OF DATA

Computer-based data types

- This classification is used to build the physical database within the computer system. It identifies the number of spaces needed to capture each data element and

specific function that can perform on these data

Computer-based data types

Alphanumeric data – include letters and numbers in any combination.

Social security number – is an example of alphanumeric data made up of numbers.

Memo  - is a specific type of alphanumeric data with increased spaces and decreased indexing option.

Numeric data – are used to perform numeric functions including adding, subtracting, multiplying and dividing. It can be long integer, currency or scientific

Date and time-are special types of numeric data with which certain numeric functions are appropriate.

Logic Data-  Are data limited to two options. Ex: yes or no; true or false

Conceptual data types

- reflect how users view the data. These can be based on

the source of the data. Example: the lab produces

lab data, and the x-ray department produces image

data.

-  It can also be based on the event that the data are attempting to capture. Examples of data  that reflect event capturing:

Assessment data  Intervention and outcomes data

DATABASE MANAGEMENT SYSTEMS (DBMSs)

- are computer programs used to input,

store, modify, process and access data in a

database. Before the DBMS can be used, the

DBM software must first be configured to

manage the data specific to the project. This

process of configuring the database software is

called DATABASE SYSTEM DESIGN.

A functioning DBMS consists of three (3) interacting parts:

SOME EXAMPLES OF DBMS:

1.  The data2.  The DBMS configured software program3.  The query language used to access the data.  

•Computerized library systems•Automated teller machines•Flight reservation systems

Types of Files

1.PROCESSING FILES

BATCH FILE Command file

2. Data files

master index file

FOUR (4) PRIMARY APPROACHES TO THE DEVELOPMENTR OF A PHYSICAL DATA MODEL:

HIERARCHICAL

NETWORK

MODEL

RELATIONAL DATABASE MODELS

OBJECT-

ORIENTED

MODEL

1. INITIATION

2. PLANNING AND ANALYSIS

3.DETAILED SYSTEM DESIGN

4.IMPLEMENTATION

5.EVALUATION AND

MAINTENANCE

3 BASIC TYPES OF DATA PROCESSING OPERATIONS:

1. Data Input Operations

2. Data Processin

g Processes

3. Data Output

Operations

DATA WAREHOUSE is a large collection of data imported from several different systems within one data base. Functions includes: extracting data from

the various computer systems, function as a database able to store and process all of the data and deliver the data in the warehouse back to the

users in the form of information.

DATA MINING

1. PREDICTING

2. DISCOVERY

3. DEVIATIONS

3 types of data mining processes:

1.Understanding

the business

2.Understanding the data

3.Data preparat

ion

4.Modeling

5.Evaluation

6.deployment

-is an international cross industry model it is now being applied to data mining within healthcare.

CRISP-DM MODEL

6 PHASES OF DATA MINING PROCESSES DESCRIBED BY CRISP-DM MODEL:

THE INTERNET: A NURSING RESOURCE

INTERNET

- describes as a network of computer network

- provides the ability for computes attached in some way to one of wires or cables on the system to send and information from computer networks regardless of the location.

TYPES OF PROTOCOLSInternet Protocol (IP)

Hypertext transmission protocol (HTTP)

File Transfer Protocol (FTP)

THE WORLD WIDE WEB

An information system on the Internet that allows documents

to be connected to other documents by hypertext links, enabling the user to search for

information by moving from one document to another. Invented

by Tim Berners lee

- Has special software that

allows receiving,

interpreting, and sending to

the client computer the request file.

- Web’s use of HTTP enables

the transmitting

and interpretation of all types of

files.

- hypertext is a system which

permits objects to be

linked to another.

FUNCTIONS OF WWW

CRITERIA FOR ASSESSING THE QUALITY OF HEALTH INFORMATION ON THE INTERNET

Informations should be credible

It must contain accurate content

It must illustrate

willingness for disclosure

It must have reliable linkages

PDA and WIRELESS DEVICES

PDA (Personal Digital Assistant)-weighing in at 8 oz. or less, it is a small enough to fit in a shirt

pocket. It comes with a miniature keyboard and a stylus for data entry. It has many

characteristics in common with the Smartphone

Palm OS Windows Mobile

PDA Operating Systems

A wireless device can refer to any kind of communications

equipment that does not require a physical wire for relaying

information to another device.

Example: wireless fidelity (Wi-Fi )governs how local

area networks (LANs) connect wirelessly

Example of PDA’s that helps nurses in their practice

1.) Address book 2.) Calculator 3.) Date book 4.) Memo pad

5.) Notepad 6.) to do list

Some of PDA applications

Epocrateas Rx

MobileMicromedex

Lexi-Complete

Medical calculator

The JohnsHopkins Antibiotic Guide

Infectious Disease Notes

INCORPORATING EVIDENCE: USE of COMPUTER-BASED CLINICAL DECISION SUPPORT SYSTEMS FOR HEALTH

PROFESSIONALS

Decision support systems (DSS) are automated tools

designed to support healthcare providers in making decisions about the delivery of patients

care.The primary goal of CDSS is the

optimization of both the efficiency and effectiveness with which clinical decisions

are made and care is delivered.

Nursing decision support systems(NDSS) are tools that help

nurses improve their effectiveness, determine areas in

need of policy or protocol development.

THREE MAIN PURPOSES OF A DSS ARE TO:

Assist in problemsolving

with semistructured problems

Support, not replace,

the judgement of a manager or

clinician

Improve the effectiveness of

the decision-making process

TYPES OF CDSS

ADMINISTRATIV

E AND ORGANIZATIONAL SYSTEMS

INTEGRATED SYSTEMS

CHARACTERISTIC

SFunctionalLogical

Structural