NURSING INFORMATICS MODULECHAPTER 1- INTRODUCTION

The American Nurses Association (ANA) defined nursing informatics as a specialty

that integrates  nursing science, computer science  and information science to

manage and communicate data, information and knowledge in nursing

practice. It represents the transition of data and data information and knowledge into

action. (V. Saba and K. McCormick,4th Ed., 2006).  Informatics (informatics comes from

the French word informatique which means computer science). Informatics is defined

as computer science + information science. Used in conjunction with the name of a

discipline, it denotes an application of computer science and information science to the

management and processing of data, information, and knowledge in the named

discipline. Thus we have, medical informatics, nursing informatics, pharmacy

informatics and so on.  Hebda (1998 p. 3), defines nursing informatics as "the use of

computers technology to support.

We can consider NI or nursing informatics as a multifaceted interdisciplinary field

of nursing science. Information integrity and ensuring the safety of data transmission is

an essential part, not only in nursing, but also, in the field of information and

communications technology (ICT). And with the progressive integration of ICT concepts

and protocols in the practice of nursing, whether in the clinical, academe or research,

nurses should be prepared to become globally competitive healthcare professionals.

In the Philippines, the Informatics Nurses Society of the Philippines has been

leading in the development and advancement of nursing informatics through local and

international linkages and collaboration.

Nurses and academicians currently utilizing several programs are aware that there

is a need to standardize the contents of the course being implemented by nursing

schools. Theoretical concepts and practical applications should be aligned so that it may

be applicable to the Philippine setting. In this regard, the concept of nursing informatics

needs to be concretized in the Nursing curriculum so that trained faculty members and

instructors in the Colleges of Nursing appropriately handle both the lecture and

laboratory component of the course. More so, nursing informatics need to be integrated

to the realms of nursing education, practice and research. Thus, Philippine Medical

Informatics Society-Nursing Informatics (PMIS-NI) is created to translate these ideas into

reality. It envisions itself to be the lead organization in promoting a culture of excellence

among its members through nursing informatics applied to nursing education, research

and practice dedicated towards paying forward to the society.

Definition- KEY TERMS

Building blocks - Basic element or part of nursing informatics such as information

science, computer science, cognitive science and nursing science.

Clinical Databases - A collection of related patient records stored in a computer system

using software that permits a person or program to query the data in order to extract

patient information

Data - Raw fact; lacks meaning.

Data mining - Software that sorts thorough data in order to discover patterns and

ascertain or establish relationships; software that discovers or uncovers previously

unidentified relationships among the data in a database; program that conducts

exploratory analysis looking for hidden patterns in data.

Evidence - Artifacts, productions, attestations or other examples that demonstrate what

an individual’s knowledge, skills or valued attributes.

Feedback - Input in the form of opinions about or reactions to something such as shared

knowledge; in an ISs, feedback refers to information from the system that is used to

make modifications in the input, processing actions or outputs .

Information - Data that are interpreted, organized, or structured; data that is processed

using knowledge or data made functional through the application of knowledge.

Knowledge - The awareness and understanding of a set of information and ways that

information can be made useful to support a specific task or arrive at a decision;

abounds with others’ thoughts and information; information that is synthesized so that

relationships are identified and formalized

Knowledge acquisition - Act of acquiring or getting knowledge.

Knowledge dissemination - Distribution and sharing of knowledge.

Knowledge generation - Creating new knowledge by changing and evolving

knowledge based on your experience, education, and input from others.

Nursing informatics - This support is accomplished through the use of information

structures, information processes, and information technology; “a specialty that

integrates nursing science, computer science, and information science to manage and

communicate data, information, and knowledge” (Staggers & Thompson, 2002, p. 260)

Nursing science - The ethical application of knowledge acquired through education,

research and practice to provide services and interventions to patients in order to

maintain, enhance or restore their health; to advocate for health,  and to acquire,

process, generate and disseminate nursing knowledge to advance the nursing

profession.

Chapter Quiz:

1. Have a film viewing about nursing during Florence Nightingale’s time. Describe the

health care delivery system.

2. Visit a hospital in your locality. Compare and contrast nursing practice in the past

and in the present.

Chapter 2-What is informatics?

The healthcare of our clients is largely dependant on information. Every action taken

depends on previous information and knowledge. The delivery of health care requires

information about:

Science of type of care (nursing) * Process and systems for delivery of

care

Provider * Outcomes

Patient or client

The “science of care” refers to the scientific foundations of the profession that provides

healthcare. Information on the client is required for his/her individual care. The use of

technology can assist in collecting this information. It can be found in the patient record,

the patient’s history, lab results. What is important to note is, information changes and

grows over time.

Information about the process and systems for delivery of care assists in deciding on

the type and the amount of care required. Information about each of these areas have

an impact on the type and the amount of care given. Information must be:

accurate

timely

accessible

understandable

What is Data: discrete entities objectively described, without interpretation or context.

Example: 110

What is Information: data processed into a structured form. Data that are interpreted,

organized,

structured and given meaning are referred to as information. Example: When

combining 110 with other data, it becomes information. Systolic blood pressure of

110 mmHg and diastolic blood pressure of 70 mm Hg. This information can be

captured in a form, on a graph on in a report.

What is Knowledge: synthesized information derived from the interpretation of data. It

provides a

logical basis for making decisions. Essential to decision-making and to new

discoveries. Example: When the blood pressure reading is combined with

information about anatomy and physiology, pharmacology, pathophysiology,

knowledge is used to decide about further care and treatment.

Decisions that guide practice result from effective data collection to accumulate a body

of knowledge which is the foundation of different disciplines.

The management and processing components may be considered the functional

components of informatics.

•

Information has five rights:

Right information

Right person

Right time

Right place

Right amount

With the knowledge of the importance of information in healthcare, healthcare

informatics has become a specialty. Healthcare informatics is a combination of

computer science, healthcare science, information science and cognitive

science.

• Computer science: development, configuration, architecture of computer

hardware and software.

• Healthcare science: body of knowledge on which healthcare profession bases

their practice. The sciences of anatomy, physiology and knowledge specific to each

profession.

• Information science: also includes information technology which involves the

process of sending and receiving information.

• Cognitive science: the process of human thinking, understanding and

remembering.

“Nursing Informatics (NI) is the application of computer science and information

science to nursing. NI promotes the generation, management and processing of relevant

data in order to use information and develop knowledge that supports nursing in all

practice domains” (Hebert, 2000).

Informatics enables nurses to use information and communications technologies in

the:

– collection of data,

– use of information

– generation of knowledge to support nursing practice

Challenges for informaticists include the following:

Integration of data—duplication often

Inability to access data for decision making

Unique distinctions between roles has not been defined--competencies

Application of Nursing Informatics:  

Nursing Informatics can be applied to all areas of nursing practice, which include; clinical

practice, administration, education, and research. Below are some examples of how

nursing informatics, information technology and computers, are used to support various

areas of nursing practice.

Nursing Clinical Practice (Point-of-Care Systems and Clinical Information Systems)

Work lists to remind staff of planned nursing interventions

Computer generated client documentation

Electronic Medical Record  (EMR) and Computer-Based Patient Record (CPR)

Monitoring devices  that record vital signs and other measurements directly into

the client record (electronic medical record)

Computer - generated nursing care plans and critical pathways

Automatic billing for supplies or procedures with nursing documentation

Reminders and prompts that appear during documentation to ensure

comprehensive charting

Nursing Administration (Health Care Information Systems)

Automated staff scheduling

E-mail for improved communication

Cost analysis and finding trends for budget purposes

Quality assurance and outcomes analysis

Nursing Education

Computerized record -keeping

Computerized-assisted instruction

Interactive video technology

Distance Learning -Web based courses and degree programs

Internet resources-CEU's and formal nursing courses and degree programs

Presentation software for preparing slides and handouts-PowerPoint and MS Word

Nursing Research

Computerized literature searching-CINAHL, Medline and Web sources

The adoption of standardized language related to nursing terms-NANDA, etc.

The ability to find trends in aggregate data, that is data derived from large

population groups-Statistical Software, SPSS

Benefits of Computer Automation in Health Care:

Many of these benefits have came about with the development of the electronic

medical record, which is the electronic version of the client data found in the traditional

paper record. 

EMR benefits include:

Improved access to the medical record. The EMR can be accessed from several different

locations simultaneously, as well as by different levels of providers.

Decreased redundancy of data entry. For example, allergies and vital signs need only be

entered once.

Decreased time spent in documentation. Automation allows direct entry from monitoring

equipment, as well as point-of-care data entry.

Increased time for client care. More time is available for client care because less time is

required for documentation and transcription of physician orders.

Facilitation of data collection for research. Electronically stored client records provide

quick access to clinical data for a large number of clients.

Improved communication and decreased potential for error. Improved legibility of

clinician documentation and orders is seen with computerized information systems.

Creation of a lifetime clinical record facilitated by information systems.

Other benefits of automation and computerization are related to the use of decision-

support software, computer software programs that organize information to aid in

decision making for client care or administrative issues; these include:

Decision-support tools as well as alerts and reminders notify the clinician of

possible concerns or omissions. An example of this, is the documentation of

patient allergies in the computer system. The health care providers would be

alerted to any discrepancies in the patient medication orders.

Effective data management and trend-finding include the ability to provide

historical or current data reports.

Extensive financial information can be collected and analyzed for trends. An

extremely important benefit in this era of managed care and cost cutting.

Data related to treatment such as inpatient length of stay and the lowest level of

care provider required can be used to decrease costs.

The Role of the Nursing Informatics Specialist (NIS):

Because of the increased importance of computers and information technology in the

practice of professional nursing; a new role has emerged, the nursing informatics

specialist (NIS). The NIS is a nurse who has formal education, certification and

practical experience in using computers in patient care settings. The American Nurses

Association (ANA, 1994), lists several functions of the NIS:

Theory development. The NIS contributes to the scientific knowledge base of nursing

informatics.

Analysis of information needs. The identification of information that nurses' need to in

order to accomplish their work; client care, education, administration, and research

Selection of computer systems. The NIS, guides the user in making informed decisions

related to the purchase of computer systems.

Design of computer systems and customizations. The NIS collaborates with users and

computer programmers to make decisions about how data will be displayed and

accessed.

Testing of computer systems. Systems must be checked for proper functioning before

they are made available for use in patient care.

Training users of computer systems. Users need to be trained in how the system works,

the importance of accurate data entry, and how the system will benefit them, and more

importantly how it will improve patient outcomes

Evaluation of the effectiveness of computer systems. The unique role of the NIS makes

them the ideal person to evaluate the effectiveness of computer systems.

Ongoing maintenance and enhancements. The NIS makes sure the computerized system

functions properly and explores possible enhancements to the system that will better

serve the users and the patients.

Identification of computer technologies that can benefit nursing. The NIS must keep

abreast of the changes in the fields of computers and information technology, including

new hardware and software that will benefit the nurse and patient.

(http://www.csulb.edu/~dkumrow/informatics/lec2.html, 2014)

Seatwork No. 2: Draw a model of your definition of informatics in your discipline. Give a

brief description of your diagram. Check out these Web sites for some examples:

A. An Overview of Nursing Informatics

B. A Mathematical Model of Communication (p. 2)

Chapter 3- Nursing Informatics: A historical perspective

History of Nursing Informatics in the World

The advent of computers made recording and data collection so much handier and

easier. Computers are used in various fields of industry. In nursing, computers are used

to manage information, track patient progress, monitor patient quality of patient care

and assess/evaluate patient outcome. Computers and the internet have paved the way

for easier communication between individuals who are physically apart. Sending and

receiving information can be done with the touch of a button. Thus, the world wide web

was established. The new breed of nurses need to be cognizant as well as competent in

the use of the computer to enhance planning, implementation of interventions,

programming, budgeting and even research for a better nursing practice.

Let’s look back to a time when great inventions are being made.

Early Man relied on counting on his fingers and toes (which by the way, is the basis

for our base 10 numbering system). He also used sticks and stones as

markers. Later notched sticks and knotted cords were used for

counting. Finally came symbols written on hides, parchment, and later

paper. Man invents the concept of number, then invents devices to help

keep up with the numbers of his possessions. 

Roman Empire

The ancient Romans developed an Abacus, the first "machine" for

calculating. While it predates the Chinese abacus we do not know if it was the ancestor

of that Abacus. Counters in the lower groove are 1 x 10n, those in the upper groove are 5

x 10n 

Industrial Age - 1600

John Napier, a Scottish nobleman and politician

devoted much of his leisure time to the study of

mathematics. He was especially interested in

devising ways to aid computations. His greatest

contribution was the invention of logarithms. He inscribed logarithmic

measurements on a set of 10 wooden rods and thus was able to do multiplication and

division by matching up numbers on the rods. These became known as Napier’s Bones.

1621 - The Sliderule 

Napier invented logarithms, Edmund Gunter invented the logarithmic

scales (lines etched on metal or wood), but it was William Oughtred, in

England who invented the sliderule. Using the concept of Napier’s bones,

he inscribed logarithms on strips of wood and invented the calculating

"machine" which was used up until the mid-1970s when the first hand-held calculators

and microcomputers appeared.

1642 - Blaise Pascal(1623-1662)

Blaise Pascal, a French mathematical

genius, at the age of 19 invented a machine,

which he called the Pascaline that could do

addition and subtraction to help his father,

who was also a mathematician. Pascal’s machine consisted of a series of gears with 10

teeth each, representing the numbers 0 to 9. As each gear made one turn it would trip

the next gear up to make 1/10 of a revolution. This principle remained the foundation of

all mechanical adding machines for centuries after his death. The Pascal programming

language was named in his honor. 

1673 - Gottfried Wilhelm von Leibniz (1646-1716)

Gottfried Wilhelm von Leibniz invented differential and integral

calculus independently of Sir Isaac Newton, who is

usually given sole credit. He invented a calculating

machine known as Leibniz’s Wheel or the Step

Reckoner. It could add and subtract, like Pascal’s

machine, but it could also multiply and divide. It did this by

repeated additions or subtractions, the way mechanical adding machines of the mid to

late 20th century did. Leibniz also invented something essential to modern computers

— binary arithmetic. 

1725 - The Bouchon Loom

Basile Bouchon, the son of an organ maker,

worked in the textile industry. At this time fabrics with

very intricate patterns woven into them were very much

in vogue. To weave a complex pattern, however,

involved somewhat complicated manipulations of the

threads in a loom which frequently became tangled,

broken, or out of place. Bouchon observed the paper

rolls with punched holes that his father made to program

his player organs and adapted the idea as a way of

"programming" a loom. The paper passed over a section

of the loom and where the holes appeared certain

threads were lifted. As a result, the pattern could be woven repeatedly. This was the first

punched paper, stored program. Unfortunately the paper tore and was hard to advance.

So, Bouchon’s loom never really caught on and eventually ended up in the back room

collecting dust. 

1728 - Falçon Loom

In 1728 Jean-Batist Falçon, substituted a deck of punched cardboard cards for the paper

roll of Bouchon’s loom. This was much more durable, but the deck of cards tended to get

shuffled and it was tedious to continuously switch cards. So, Falçon’s loom ended up

collecting dust next to Bouchon’s loom. 

1745 - Joseph Marie Jacquard (1752-1834)

It took inventor Joseph M. Jacquard to bring together Bouchon’s idea of a

continuous punched roll, and Falcon’s ides of

durable punched cards to produce a really

workable programmable loom. Weaving

operations were controlled by punched cards tied together

to form a long loop. And, you could add as many cards as

you wanted. Each time a thread was woven in, the roll was

clicked forward by one card. The results revolutionized the

weaving industry and made a lot of money for Jacquard. This

idea of punched data storage was later adapted for

computer data input. 

1822 – Charles Babbage (1791-1871) and Ada Augusta, The Countess of

Lovelace

Charles Babbage is known as the Father of the modern computer (even

though none of his computers worked or were even constructed in their

entirety). He first designed plans to build, what he called the Automatic

Difference Engine. It was designed to help in the construction of

mathematical tables for navigation. Unfortunately, engineering

limitations of his time made it impossible for the computer to be built. His next project

was much more ambitious. 

While a professor of mathematics at Cambridge

University (where Stephen Hawkin is now), a position he

never actually occupied, he proposed the construction

of a machine he called the Analytic Engine. It was to

have a punched card input, a memory unit (called

the store), an arithmetic unit (called the mill), automatic printout,

sequential program control, and 20-place decimal accuracy. He had

actually worked out a plan for a computer 100 years ahead of its time.

Unfortunately it was never completed. It had to wait for manufacturing technology to

catch up to his ideas. 

During a nine-month period in 1842-1843, Ada Lovelace translated Italian mathematician

Luigi Menabrea's memoir on Charles Babbage's Analytic Engine. With her translation she

appended a set of notes which specified in complete detail a method for calculating

Bernoulli numbers with the Engine. Historians now recognize this as the world's first

computer program and honor her as the first programmer. Too bad she has such an ill-

received programming language named after her. 

1880s – Herman Hollerith (1860-1929)

The computer trail next takes us to, of all places, the U.S. Bureau of Census. In 1880

taking the U.S. census proved to be a monumental task. By

the time it was completed it was almost time to start over

for the 1890 census. To try to overcome this problem the

Census Bureau hired Dr. Herman Hollerith. In 1887, using

Jacquard’s idea of the punched card data storage, Hollerith developed a

punched card tabulating system, which allowed the census takers to

record all the information needed on punched cards which were then placed in a special

tabulating machine with a series of counters. When a lever was pulled a number of pins

came down on the card. Where there was a hole the pin went through the card and made

contact with a tiny pool of mercury below and tripped one of the counters by one. With

Hollerith’s machine the 1890 census tabulation was completed in 1/8 the time. And they

checked the count twice. 

After the census Hollerith turned to using his tabulating machines for business and in

1896 organized the Tabulating Machine Company which later merged with other

companies to become IBM. His contribution to the computer then is the use of punched

card data storage.

BTW: The punched cards in computers were made the same size as those of Hollerith’s

machine. And, Hollerith chose the size he did because that was the same size as the one

dollar bill at that time and therefore he could find plenty of boxes just the right size to

hold the cards. 

1939-1942 Dr. John Vincent Atanasoff(1903-1995) and

Clifford Berry (1918-1963) 

Dr. John Vincent Atanasoff and his graduate assistant, Clifford Barry, built

the first truly electronic computer, called the Atanasoff-Berry Computer or

ABC. Atanasoff said the idea came to him as he was sitting in a small

roadside tavern in Illinois. This computer used a circuit with 45 vacuum

tubes to perform the calculations, and capacitors for storage. This was

also the first computer to use binary math. 

1943 – Colossus I

The first really successful electronic computer was built in Bletchley Park, England. It was

capable of performing only one function, that of code breaking during World War II. It

could not be re-programmed. 

1944 – Mark I - Howard Aiken (1900-1973) and Grace Hopper

(1906-1992)

In 1944 Dr. Howard Aiken of Harvard finished the construction of the

Automatic Sequence Controlled Calculator, popularly known as the

Mark I. It contained over 3000 mechanical relays and was the first

electro-mechanical computer capable of making logical decisions,

like if x==3 then do this not like If its raining outside I need to carry an umbrella. It

could perform an addition in 3/10 of a second. Compare that with something on the order

of a couple of nano-seconds (billionths of a second) today. 

The important contribution of this machine was that it was programmed

by means of a punched paper tape, and the instructions could be

altered. In many ways, the Mark I was the realization of Babbage’s

dream. 

One of the primary programmers for the Mark I was Grace Hopper. One

day the Mark I was malfunctioning and not reading its paper tape input

correctly. Ms Hopper checked out the reader and found a dead moth in

the mechanism with its wings blocking the reading of the holes in the paper tape. She

removed the moth, taped it into her log book, and recorded...Relay #70 Panel F (moth)

in relay. First actual case of bug being found. 

She had debugged the program, and while the word bug had been used to describe

defects since at least 1889, she is credited with coining the word debugging to describe

the work of eliminating program errors. 

It was Howard Aiken, in 1947, who made the rather short-sighted comment

to the effect that the computer is a wonderful machine, but I can see

that six such machines would be enough to satisfy all the

computing needs of the entire United States. 

1946 – ENIAC - J. Prosper Eckert (1919-1995) and John W. Mauchly (1907-1980) 

The first all electronic computer was the Electrical Numerical Integrator and

Calculator, known as ENIAC. It was designed by J. Prosper

Eckert and John W. Mauchly of the Moore School of

Engineering at the University of Pennsylvania. ENIAC was the

first multipurpose electronic computer, though very difficult to re-

program. It was primarily used to computer aircraft courses,

shell trajectories, and to break codes during World War II. 

ENIAC occupied a 20 x 40 foot room and used 18,000

vacuum tubes. ENIAC also could never be turned off. If it was

it blew too many tubes when turned back on. It had a very

limited storage capacity and it was programmed by jumper

wires plugged into a large board. 

1948 – The Transister

In 1948 an event occurred that was to forever change the

course of computers and electronics. Working at Bell Labs three

scientists, John Bordeen (1908-1991) (left), Waltar

Brattain (1902-1987) (right), and William Shockly (1910-

1989) (seated) invented the transistor.

The change over from vacuum tube circuits to transistor circuits occurred between 1956

and 1959. This brought in the second generation of computers, those based on

transisters. The first generation was mechanical and vacuum tube computers. 

1951 – UNIVAC

The first practical electronic computer was built by Eckert and

Mauchly (of ENIAC fame) and was known as UNIVAC (UNIVersal

Automatic Computer). The first UNIVAC was used by the Bureau

of Census. The unique feature of the UNIVAC was that it was

not a one-of-a-kindcomputer. It was mass produced.

1954 – IBM 650

In 1954 the first electronic computer for business was

installed at General Electric Appliance Park in Louisville,

Kentucky. This year also saw the beginning of operation of the

IBM 650 in Boston. This comparatively inexpensive

computer gave IBM the lead in the computer market. Over

1000 650s were sold. 

1957-59 – IBM 704

From 1957-1959 the IBM 704 computer appeared, for which the

Fortran language was developed. At this time the state of the art in computers allowed 1

component per chip, that is individual transistors. 

1958 - 1962 – Programming languagesFrom 1958-1962 many programming languages were developed.

          FORTRAN (FORmula TRANslator) ALGOL (ALGOrithmic Language)          COBOL (COmmon Business Oriented Language)    LISP (LISt Processor)                    BASIC (Beginners All-purpose Symbolic Instruction Code) 1964 – IBM System/360In 1964 the beginning of the third-generation

computers came with the introduction of the IBM System/360. Thanks to the new hybrid circuits (that gross looking orange thing in the circuit board on the right), the state of the art in computer technology allowed for 10 components per chip. 

1965 - PDP-8In 1965 the first integrated circuit computer, the PDP-8 from Digital Equipment Corporation appeared. (PDP stands for Programmable Data Processor) After this the real revolution in computer cost and size began. 

1970 - Integrated CircuitsBy the early 70s the state of the art in computer technology allowed for 1000 components per chip. To get an idea of just how much the size of electronic components had shrunk by this time look at the image on the right. The woman is peering through a microscope at a 16K RAM memory integrated circuit. The stand she has her microscopy sitting on is a 16K vacuum tube memory curcuit from about 20 years previous. 

1971The Intel corporation produced the first microprocessor chip which was a 4-bit chip. Today’s chips are 64-bit. At approximately 1/16 x

1/8 inches in size, this chip contained 250 transistors and had all the computing power of ENIAC. It matched IBM computers of the early 60s that had a CPU the size of an office desk. 

1975 – Altair 8800The January 1975 issue of Popular Electronics carried an article, the first, to describe the Altair 8800, the first low-cost microprocessor computer

which had just became commercially available. 

Late 1970s to early 1980s – The Microcomputer ExplosionDuring this period many companies appeared and disappeared, manufacturing a variety of microcomputers (they were called micro to distinguish them from the mainframes which some people referred to asreal computers). There was Radio Shack’s TRS-80, the Commodore 64, the Atari, but... 

1977 - The Apple II The most successful of the early microcomputers was the Apple II, designed and built by Steve Wozniak. With fellow computer whiz and business savvy friend, Steve Jobs, they started Apple Computer in 1977 in Woz’s garage. Less than three years later the company earned over $100 million. Not bad for a couple of college dropout computer geeks. 

1981In 1981, IBM produced their first microcomputer. Then the clones started to appear. This microcomputer explosion fulfilled its slogan computers by the millions for the

millions. Compared to ENIAC, microcomputers of the early 80s:         Were 20 times faster (Apple II ran at the speed of ¼

Megahertz).         Had a memory capacity as much as 16 times larger (Apple

had 64 K).         Were thousands of times more reliable.         Consumed the power of a light bulb instead of a locomotive.         Were 1/30,000 the size.          Cost 1/10,000 as much in comparable dollars              (An Apple II with full 64 K of RAM cost $1200 in 1979.              That’s the equivalent of about $8000 to $10000 in today's dollars)

1984-1989In 1984 the Macintosh was introduced. This was the first mass-produced,

commercially-available computer with a Graphical User Interface. In 1989 Windows 1.0 was introduced for the PC. It was sort of Mac-like but greatly inferior. Macintosh owners were know to refer to it sarcastically as AGAM-84 Almost as Good As Macintosh 84. 

1990sCompared to ENIAC, microcomputers of the 90s:       Were 36,000 times faster (450 Megahertz was the average speed)       Had a memory capacity 1000 to 5000 times larger (average was between 4 and 20 Megabytes)       Were 1/30,000 the size 

       Cost 1/30,000 as much in comparable dollars (A PC still cost around $1500 the equivalent of about $2500 in 2008 dollars)

Early 2000sCompared to ENIAC, microcomputers of the early 2000s:       Are 180,000 times faster (2.5+ Gigahertz is the average speed)       Have a memory capacity 25,000 times larger (average 1+ Gigabytes of RAM)       Are 1/30,000 the size        Cost 1/60,000 as much in comparable dollars (A PC can cost from $700 to $1500)

Chapter 5-Data StorageData storage has also grown in capacity and shrunk in size as dramatically as have computers. Today a single data DVD will hold around 4.8 gigabytes. It would take 90,000,000 punch cards to hold the same amount of data. And, there is talk of a new high density video disk (HVD) that will be able to hold fifty times that much data. That's more than 240 gigabytes. 

Just how much data is that 8 bits = 1 byte

1024 bytes = 1 kilobyte

1024 K = 1 Megabyte = 1,048,576 bytes

1024 Mb = 1 Gigabyte = 10,73,741,824 bytes

1024 Gb = 1 Terabyte = 1,099,511,627,776 bytes

1024 Tb = 1 Petabyte = 1,125,899,906,842,624 bytes

1024 Pb = 1 Exabyte = 1,152,921,504,606,846,976 bytes

1024 Eb = 1 Zettabyte = 1,180,591,620,717,411,303,424 bytes

1024 Zb = 1 Yottabyte = 1,208,925,819,614,629,174,706,176 bytes

By comparison 1K is approximately the memory needed to store one single spaced typed

page.

The microcomputer 1980s

1990s saw the integration of computers in nursing practice

Prior to the established protocol for document retrieval in the internet, there was

Unix OS. While Unix OS, its command language is obscure to average user. The set of

protocols widely used today is called Hypertext Transfer Protocol (HTTP). It allows text

linking commands to be incorporated to any text or document.

Person Contribution

Tim Berners-Lee Conceived the WWW as a system utility program that

requires all users to adhere to a standard set of text

retrieval protocols

Charles Babbage

Joseph Jacquard

Herman Hollerith

Rear Admiral Grace M.

Hopper

Vinton Cerf and Bob Kahn

Paul Barran

Stephen Jobs

Augusta Ada Byron

De Dombal

Ted Nelson

Paul Terryl

Seymour Cray

Bill Gates CEO of Microsoft corporation

Brewster Kahle

Terms/acronyms Meaning

Project Gutenberg

debugging Trouble shooting

ISOC

COBOL First English-like language

HIPAA

EHR Electronic charts

UNIVAC-1

Loop concept Automatic repetitious arithmetic steps

Internist I

Collosus Mark I

MYCIN

URL

IBM

GUI

HTML

UMLS

Bit

Terabyte Largest existing storage capacity

Megahertz One million cycles per second

Digital divide The distance between internet user and non-user

Google, Yahoo Search engine

Intel 8008

Apple

Binary System

To err is human: building a safer health system

On March 15, 2001 the first survey to determine how large the internet was conducted.

Chapter 4-History of Nursing Informatics in the Philippines

Information Technology (IT) in the Philippines followed biomedical informatics.

Early 1990s saw milestones in development of computers and its application to industry.

The desire to be at par with global competence, nursing leaders and academicians

sought to train leading personalities in health care.

The Philippine Nurses Association (PNA) participated in the development of

Standards for Health Information in the Philippines (SHIP) in 1999. It aims to awaken the

minds and enable the hands of Filipino nurses to be technologically skilful. Leading

schools of nursing like the University of the Philippines decided to open courses that will

improve computer literacy of Filipino nurses, thus, the formation of the Master of Science

in Health Informatics (MSHI) began in 2005. It is followed by the establishment of the

Philippine Nursing Informatics Association (PNIA) in 2010 as a sub-specialty organization

of PNA for nursing informatics.

The words "nursing informatics" were unfamiliar among the nursing community

until the year 2008. There were only a handful of people with knowledge and experience

in nursing informatics but the discipline have not yet found its recognition as a sub-

specialty of nursing arts and science in the country. The origin of this budding discipline

indirectly came from the pioneers of health informatics in The Philippine Medical

Informatics Society (PMIS) and its founders had strong influence in the development of

health informatics in the Philippines. The PMIA was officially registered under the

Securities and Exchange Commission in 1996 by its board composed of eleven

physicians. The organization was headed by Dr. Alvin Marcelo.

Since 1998, several faculty members of the University of the Philippines began

formal education and training. Dr. Herman Tolentino took a post-doctoral fellowship in

medical informatics at the University of Washington. Dr. Alvin Marcelo followed a year

later for his training at the National Library of Medicine. Dr. Cito Maramba went to

Coventry for his Masters in Information Sciences at the University of Warwick. They were

later followed by other physicians such as Dr. Micheal Muin and Dr. Ryan Bañez.

By the year 2003, a Master of Science in Health Informatics was proposed to be

offered by UP-Manila College of Medicine (major in medical informatics) and the College

of Arts and Science (major in bioinformatics) and was later approved to be offered

starting academic year 2005-2006. In 1999, a study group was formed headed by the

National Institute of Health of the University of the Philippines Manila.

This group identified international standards for health information and their

adaptability in the Philippines. The document is referred to as the "Standards of Health

Information in the Philippines, 1999 version" or"SHIP99".Representatives from various

sectors collaborated on this project including the Philippine Nurses Association (PNA) in

the person of Ms. Evelyn Protacio.

In compliance to CHED Memorandum 14 series of 2009, otherwise known as

Policies and Standards for Bachelor of Science in Nursing [BSN] Program, Nursing schools

across the country has been implementing the course Informatics. In 2008, Nursing

Informatics course in the undergraduate curriculum was defined by the Commission on

Higher Education (CHED) Memorandum Order 5 Series of 2008. This was later revised

and included as Health Informatics course in CHED Memorandum Order 14 Series of

2009. This was first implemented in the summer of 2010.

Early in 2009, Mr. Kristian R. Sumabat and Ms.Mia Alcantara-Santiago, both nurses

and graduate students of Master of Science in Health Informatics at the University of the

Philippines, Manila began drafting plans to create a nursing informatics organization. In

February 2010, they began recruiting other nursing informatics specialists and

practitioners to organize a group which later became as the Philippine Nursing

Informatics Association.

They were joined by founding members Ms.Sheryl Ochea, a graduate of Master of

Science in Nursing major in nursing informatics at Xavier University (Ohio, USA), Ms.

Alexandra Bernal, a graduate student and telehealth nurse of the National Telehealth

Center, Ms.Pia Pelayo, a former telehealth nurse and a project coordinator of the

National Epidemiology Center, Department of Health and Mr. Sid Cardenas, also a

telehealth nurse. Other founding members include Mr. Noel Bañez, Ms. Rona Abcede,

and Mr. Harby Ongbay Abellanosa.

Like many other disciplines, nursing informatics face many challenges while in its

infancy stage. The inclusion of informatics as an integral part of the undergraduate

curriculum has been one of the most influential factors for the increased awareness and

interest in this field of nursing. However, the contents of the curriculum was adapted

from international materials which does not match the local needs.

A community-centered approach to the use of information, communication and

technology in nursing practice must be adapted to ensure the impact of the program in

the local healthcare system. Lack of certification and credentialing programs in post-

graduate levels are also absent with the scarcity of local nursing informatics experts.

This new field has yet to gain acceptance and recognition in the nursing community as a

sub-specialty.

Development of training, certification and credentialing programs are in the

pipeline for the Philippine Nursing Informatics Association. Future partnerships with local

and international nursing and health informatics organizations have started as well.

Other programs are expected to be slowly delivered with PNIAs CORE X strategic

platform which stands for Competency, Organization, Recognition, Experience and

Expertise. It is also a major thrust to support the use of health information standards in

the Philippines and to have nursing informatics specialists in every hospital in the

country

Organizations seeking to improve informatics and nursing capabilities gave rise to

establilshment of groups such as Informatics Nurses Society of the

Philippines or iNurse SP which is Nursing Informatics Organization that serves as the

portal to get involved with real life practices on information and communications

technology applied in nursing education, research, service and administration. The group

is currently led by Dr. Annabelle Borromeo of SLMC-GC, Mark Donald Renosa of RITM,

John Faustorilla of World Bank and UP Manila, Calixto Trillanes III of The Big Leap and Joel

Job Belen of SLMC-QC. http://www.slideshare.net/shakiamarie/history-of-nursing-

informatics-in-the-philippines-19508238

If you want to become a member of the Informatics Nurses Society of the

Philippines, fill-up the form by visiting their website at http://www.inursesp.org/. The

iNurse SP Facebook is http://bit.ly/inursespfb.

NAME: _____________________________________Activity No: _________Date: _______

Chapter Quiz:

1.In 1850 to 1900, nursing was concerned with:

a. Maintaining a hygienic environment c. Using different inventions &

innovations

b. Providing a comfortable environment d. Giving the correct medication

2. When did the proliferation of hospitals begin?

a. 1860 b. 1870 c. 1880 d. 1890

3. Which of the following was not an innovation between the 1850 & 1900?

a. Bedpan b. IV  c. Syringe d. Foot Cradle

4. What was the emphasis of nursing care in the 1940s?

a. Maintaining a hygienic environment c. Nursing the equipment 

b. Using different inventions & innovations d. Documenting the procedure 

5. Which of the following was not an innovation between the 1950s & 1960s?

a. BT b. Antibiotics c. Hospice d. IV 

6. Which of the following were developed from 1965 to 1980?

a. BT b. Antibiotics c. Hospice d. IV

7. Which of the following were developed from 1980 to the present?

a. Patient Monitoring Device c. Fetal Monitor

b. Dialysis Machine d. Automatic Recording Device

8. Which of the following is a useful function of robots that can enhance delivery of care?

a. Laundry services c. All of the above

b. Interdepartmental services d. None of the above

9. An example of a work management system is:

a. Automated census board b. PDA c. Robotic Surgery d. Telesurgery

10. Which of the following is more convenient to use?

a. Voice activation b. Touch screen c. Mouse  d. Keyboard 

11.

12.

13.

14.

15.

Essay. 1.

2.

Chapter 5-History of COMPUTERS

Before the invention of the modern computer, in 1800s Augusta Ada Byron, Countess of

Lovelace who was a well-known mathematician together with coresearcher, Charles

Babbage, first conceptualized a stored computer program (Toole, 1992). Being an

inventor, Charles Babbage tried conceptualized a device he later dubbed “analytical

machine” which was later built by his son in 1910. However, such device did not yield

expected result. Since it was the countess who first conceptualized a device that will

work using automatic repetitive arithmetic steps, she was named the “first

programmer”.

Years passed before the first commercial impact of computers was felt

necessary.August 2, 1790. The American election was held

Chapter 5-Types of Computers

Hardware, Software, and the Roles of Support Personnel: 

 Hardware is the physical part of the computer and its associated equipment. Computer

hardware can comprise many different parts, these include: 

 

Input Devices: used to enter data; keyboard, mouse, trackball, touch screen, light

pen, microphone, bar code reader, fax modem card, joystick, and scanner.

Output Devices: used to view and hear processed data; video monitor screens,

printers, speakers, and fax.

Central Processing Unit (CPU) "brain" of the computer, three components:

Arithmetic Logic Unit (ALU): number "crunching"

Memory: is the storage area in which program instruction (code) reside during execution.

Read-only memory (ROM) is permanent; it remains when the power is off. Start-up

instructions for the computer is an example of ROM.

Random access memory (RAM) is a temporary storage area for program instructions and

data that is being processed, it is only active while the computer is turned on. (located

on the motherboard not part of CPU) 

 

Control Unit: manages instructions to other parts of the computer, including input and

output devices "traffic cop"

 

Secondary Storage: provides space to retain data in an area separate from the

computer's memory after the computer is turned off, these include; hard disk

drives, floppy disks, tape, zip drives, optical drives and CD-ROM drives.

Computer Categories: 

 

Super computers, are the largest and most expensive, can perform

billions of instructions every second

Mainframes, large computers capable of processing several millions

instructions per second. They support organizational functions,

therefore have been the traditional equipment in hospitals. Customized

software results in high cost.

Minicomputer, is a scaled-down version of the mainframe, since they

are now becoming more powerful they can now be found in hospitals

and HMO's

Microcomputers (PCs), inexpensive processing power for an individual

user.

Laptop or Notebook, Handheld, and Personal Digital Assistants (PDAs)

Chapter 6- The Internet

Networks: 

 

A network is "a combination of hardware and software that allows communication

and electronic transfer of information between computers" (as cited in Hebda,

1998, p. 19).

Hardware may be connected permanently by wire (Ethernet), or temporarily by

wireless communication, and modems/telephone lines. 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.

Networks, no matter how small or large, operate with the client/server technology. 

 

A Server stores files and programs that are accessed by the client on the

network. When you access the Internet from home, you the client (your

computer), requests files from a Server (another computer), you see the

results displayed on your screen through a browser. You may also access a

network in your clinical practice; you the client, accesses a patient record on

the floor from a server, which stores the patient record.

Types of Networks: They range from small (home network) to very large

(Internet) 

 

Home Networks - within a home

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

Internet - many WAN connected together around the globe to give us

the Internet that we use today 

 

Intranets - private company networks that are protected from

outside access Kaiser HMO and its clinics and hospitals is an

example.

Extranets - several Intranets connected together, Kaiser

maintains Extranet a network connection with its suppliers

Selection Criteria for Computer Equipment: 

 When selecting a computer system or related hardware, you must take into

consideration the following:

The types of applications required Some people need word processing, while

others may need database or spread sheet software.

The program execution time and computer capacity needed to process

jobs Complex jobs require more processor speed and memory.

Storage Capacity Needs are determined by the amount of information that

must be kept and the length of time that it must be retained.

Backup Options When information is critical to conduct daily business,

another backup system may be need if the primary one fails. 

 

Chapter 7-Operating Systems

Operating Systems: A collection of programs that manage all of the computer's

activities, including the control of hardware, execution of software, and management of

information. 

  Operating Systems provides a user interface by which the individual interacts with

the computer. Types include; text based commands, graphical user interfaces(GUI),

and object-oriented interfaces (OOI) a graphic interface in which visual metaphors are

employed. 

 

Roles of Support Personnel: 

 

Support for computer systems and networks is extremely important in order to maintain

system functionality, support includes: 1) planning system upgrades, 2) installation of

upgrades for operating systems and various applications, 3) troubleshooting, and 4) user

education and training. 

 

Superuser: This person has additional experience over the average employee

and serves as a local resource person. In the hospital setting this is user who

know the clinical area and the computer system.

Microcomputer Specialist: Provides PC information and training; has special

training and degree in computer science or a related area.

Analyst: They are frequently clinicians, who become involved in system

selection and training. Many have learned their role on the job and furthered

their education by taking computer or information science classes.

Programmer: Writes code, computer instructions; they often lack the clinical

experience. For this reason the analysts are responsible for communicating

user needs to programmers

Network Administrator: They are responsible for the planning, management

and expansion of networks.

Director, Information Services: These individuals should have a board view of

the needs of the institution and the design, implementation, and evaluation

of information systems. Responsibilities include planning, policy

development, budgeting, information security, and overall management of

the information systems.

(http://www.csulb.edu/~dkumrow/informatics/lec2.html, 2014)

Generations of computers

Computer Hardware

Computer Software

Computer Programming

Past

Present

Computer Systems

NAME: _____________________________________Activity No: _________Date: _______

Chapter Quiz:

1. Which of the following is NOT one of the four major data processing functions of a

computer?

a. gathering data c. analyzing the data or information

b. processing data into information d. storing the data or information 

2. ____________ is the science that attempts to produce machines that display the same

type of intelligence that humans do.

a. Nanoscience b. Nanotechnology c. Simulation d. AI 

3. The name for the way that computers manipulate data into information is called:

a. programming. b. processing c. storing. d. organizing.

4. Computers gather data, which means that they allow users to ____________ data.

a. Present b. Input c. Output d. Store

5. After a picture has been taken with a digital camera and processed appropriately, the

actual print of the picture is considered:

a. data. b. output. c. input. d. the process 

6. Computers use the ____________ language to process data.

a. Processing b. Kilobyte c. Binary d. Representational

7. Computers process data into information by working exclusively with:

a. multimedia. b. words. c. characters. d. numbers. 

8. In the binary language each letter of the alphabet, each number and each special

character is made up of a unique combination of:

a. eight bytes. b. eight kilobytes.c. eight characters. d. eight bits 

9. A string of eight 0s and 1s is called a:

a. megabyte. b. byte. c. kilobyte. d. gigabyte.

10. The term bit is short for:

a. megabyte. b. binary language. c. binary digit. d. binary number.

11. A ____________ is approximately one billion bytes.

a. Kilobyte b. Bit c. Gigabyte d. Megabyte

12. A ____________ is approximately a million bytes.

a. Gigabyte b. Kilobyte c. Megabyte d. Terabyte

13. ____________ is any part of the computer that you can physically touch.

a. Hardware b. A device c. A peripheral d. An application

14. The components that process data are located in the:

a. input devices. b. output devices. c. system unit. d. storage component. 

15. All of the following are examples of input devices EXCEPT a:

a. scanner. b. mouse. c. keyboard. d. printer. 

16. Which of the following is an example of an input device?

a. Scanner b. Speaker c. CD d. Printer

16. All of the following are examples of storage devices EXCEPT:

a. hard disk drives. b. printers. c. floppy disk drives. d. CD drives.

17. The ____________, also called the “brains” of the computer, is responsible for

processing data.

a. Motherboard b. Memory c. RAM d. CPU 

18. The CPU and memory are located on the:

a. expansion board. b. motherboard. c. storage device.d. output device.

19. Word processing, spreadsheet, and photo-editing are examples of:

a. application software. b. system software. c. operating system software.d. platform

software.

18. ____________ is a set of computer programs used on a computer to help perform

tasks.

a. An instruction b. Software c. Memory d. A processor

19. ____________ bits equal one byte.

a. Eight b. Two c. One thousand d. One million

20. The operating system is the most common type of ____________ software.

a. Communication b. Application c. System d. word-processing software

21. Which of the following is the correct order of the four major functions of a computer?

a. Process - Output - Input - Storage c. Process - Storage - Input - Output

b. Input - Output - Process – Storage d. Input - Process - Output – Storage 

22. ____________ are specially designed computers that perform complex calculations

extremely rapidly.

a. Servers b. Supercomputers c. Laptops d. Mainframes 

23. The difference between people with access to computers and the Internet and those

without this access is known as the:

a. digital divide. b. Internet divide.c. Web divide. d. broadband divide.

24. DSL is an example of a ____________ connection.

a. Network b. Wireless c. Slow d. broadband 

25. Smaller and less expensive PC-based servers are replacing ____________ in many

businesses.

a. supercomputers b. clients c. laptops d. mainframes 

26. Servers are computers that provide resources to other computers connected to a:

a. network. b. mainframe. c. supercomputer. d. client.

27. The PC and the Apple Macintosh are examples of two different:

a. platforms. b. applications. c. programs. d. storage devices.

28. System software is the set of programs that enables your computer’s hardware

devices and ____________ software to work together.

a. management b. processing c. utility d. application 

29. The binary language consists of ____________ digit(s).

a. 8 b. 2 c. 1,000 d. 1

30. A byte can hold one ____________ of data.

a. bit b. binary digit c. character d. kilobyte 

NAME: _____________________________________Activity No: _________Date: _______

Chapter Quiz:

1. ____________ controls the way in which the computer system functions and provides a

means by which users can interact with the computer. 

a. The platform b. The operating system c. Application software d. The

motherboard 

2. ____________ are specially designed computer chips that reside inside other devices,

such as your car or your electronic thermostat.

a. Servers b. Embedded computers c. Robotic computers d. Mainframes

3. The steps and tasks needed to process data, such as responses to questions or

clicking an icon, are called:

a. instructions. b. the operating system. c. application software. d. the system

unit. 

History of the INTERNET

Theoretical Foundations of Informatics

Theory

A theory is just a model of the universe, or a restricted part of it, and a set of rules that

relate quantities in the model to observations that we make.— Hawking, S. (1988) A Brief

History of Time, p. 9.

Major Theories

• Systems and Chaos theory • Information theories • Learning theories • Change

theories

Systems Theory

• A set of interrelated interacting parts within a boundary

• As a result of the interrelationships, a system is more than the sum of its parts.

An Open System Interacting With the Environment

Environment

matter and energy)___________> Process _________>Output (information,

Feedback

Chaos Theory & Complex Systems

• A tiny difference in initial parameters result in a completely different behavior

• The Uncertainty Principle prohibits accuracy

• There is order in chaos

Information Theories

• There is more than one definition of information and more than one theory of

information.

– Shannon and Weavers Information-Communication Theory

The amount of information in the message is measured by the reduction in uncertainty.

– The Data to Wisdom Continuum

Data

• Uninterrupted observations and measurements made about the world

• Patient assessment forms are, for the most part, data collection forms.

Data Attributes: • Descriptive • Measurable

Information

• Processed data that contains meaning

• A completed patient assessment contains a great deal of information.

Information Attributes:

• Quantifiable • Accessible • Free from bias • Comprehensive • Clear

• Appropriate • Timely • Precise • Accurate

Knowledge-Knowledge results when data and information are identified and the

relationships between the data and information are formalized. A knowledge base is

more than the sum of the data and information pieces in that knowledge base.

Knowledge Attributes: • Accurate • Relevant • Quality

Type: A. Empirical B. Ethical C. Personal D. Aesthetics

Wisdom-Knowing when and how to use knowledge in the process of caring for people

Learning Theories

• Behavioral theory or reductionism

– Conditioning, reinforcement

• Information processing or cognitive

– Short Term Memory or Long Term Memory

– Critical thinking

• Developmental – Adult learning– Learning styles

Learning Principles

• Meaningfulness assists learning.

• Only so much input can be handled at one time.

• Timing of learning is critical.

• Participation and practice support retention.

• Conceptual learning is enhanced with concrete examples.

Learning Principles

• Taking in new material through more than one modality can facilitate learning.

• Learning is enhanced when the teaching method includes the cognitive, affective, and

psychomotor

domains in concert.

• Learning takes place intentionally and unintentionally.

• Learning is contagious.

Change Theories

• The study of change in organizations and individuals

– Planned change – Kurt Lewin

– Diffusion of innovation – Everett Rogers

Planned Change

• Unfreezing • Moving • Refreezing

Chapter 8-Net Etiquette

THE CORE RULES OF NETIQUETTE by Virginia Shea

The Core Rules of Netiquette are excerpted from the book Netiquette by Virginia Shea.

Rule 1: Remember the Human.

Rule 2: Adhere to the same standards of behavior online that you follow in real life.

Rule 3: Know where you are in cyberspace.

Rule 4: Respect other people's time and bandwidth.

Rule 5: Make yourself look good online.

Rule 6: Share expert knowledge.

Rule 7: Help keep flame wars under control.

Rule 8: Respect other people's privacy.

Rule 9: Don't abuse your power.

Rule 10: Be forgiving of other people's mistakes.

What is Netiquette? In a nutshell, it's network etiquette the proper use of

cyberspace. And "etiquette" means "the forms required by good breeding or prescribed

by authority to be required in social or official life." In other words, Netiquette is a set of

rules for behaving properly online.

Cyberspace has its own culture -- you're liable to commit a few social blunders. A

user especially a “newbie” might offend people without meaning to might misunderstand

what others say and take offense when it's not intended. To make matters worse,

something about cyberspace makes it easy to forget that the user is interacting with

other real people -- not just ASCII characters on a screen, but live human characters.

So, partly as a result of forgetting that people online are still real, and partly

because they don't know the conventions, well-meaning cybernauts, especially new

ones, make all kinds of mistakes.

The list of core rules below, and the explanations that follow, are excerpted from

the book. They are offered here as a set of general guidelines for cyberspace behavior.

They should give you some basic principles to use in solving your own Netiquette

dilemmas.

Rule 1: Remember the human

The golden rule: Do unto others as you'd have others do unto you applies in the

use of internet. Imagine how you'd feel if you were in the other person's shoes. Stand up

for yourself, but try not to hurt people's feelings. In cyberspace, we state this in an even

more basic manner: Remember the human.

When you communicate electronically, all you see is a computer screen. You don't

have the opportunity to use facial expressions, gestures, and tone of voice to

communicate your meaning; words -- lonely written words -- are all you've got. And that

goes for your correspondent as well. When you're having a conversation online --

whether it's an email exchange or a response to a discussion group posting -- it's easy to

misinterpret your correspondent's meaning. And it's frighteningly easy to forget that

your correspondent is a person with feelings more or less like your own.

It's ironic, really. Computer networks bring people together who'd otherwise never

meet. But the impersonality of the medium changes that meeting to something less --

well, less personal. Most of them would never act in such inhumane fashion at work or at

home. But the interposition of the machine seems to make it acceptable.

The message of Netiquette is that it's not acceptable. Yes, use your network

connections to express yourself freely, explore strange new worlds, and boldly go where

you've never gone before. But remember the Prime Directive of Netiquette: Those are

real people out there.

Before posting something, ask yourself: Would you say it to the person's face?

Writer and  evangelist Guy Kawasaki tells a story about getting email from some fellow

he's never met. Online, this fellow tells Guy that he's a bad writer with nothing

interesting to say.

Unbelievably rude? Yes, but unfortunately, it happens all the time in cyberspace.

Maybe it's the awesome power of being able to send mail directly to a well-known writer

like Guy. Maybe it's the fact that you can't see his face crumple in misery as he reads

your cruel words. Whatever the reason, it's incredibly common. Guy proposes a

useful test for anything you're about to post or mail: Ask yourself, "Would I say this to

the person's face?" If the answer is no, rewrite and reread. Repeat the process till you

feel sure that you'd feel as comfortable saying these words to the live person as you do

sending them through cyberspace.

Another reason not to be offensive online

When you communicate through cyberspace -- via email or on discussion groups --

your words are written. And chances are they're stored somewhere where you have no

control over them. In other words, there's a good chance they can come back to haunt

you.

Never forget the story of famous email user Oliver North. Ollie, you'll remember,

was a great devotee of the White House email system, PROFS. He diligently deleted all

incriminating notes he sent or received. What he didn't realize was that, somewhere else

in the White House, computer room staff were equally diligently backing up the

mainframe where his messages were stored. When he went on trial, all those handy

backup tapes were readily available as evidence against him.

You don't have to be engaged in criminal activity to want to be careful. Any message you

send could be saved or forwarded by its recipient. You have nocontrol over where it

goes.

Rule 2: Adhere to the same standards of behavior online that you follow in real

life

In real life, most people are fairly law-abiding, either by disposition or because we're

afraid of getting caught. In cyberspace, the chances of getting caught sometimes seem

slim. And, perhaps because people sometimes forget that there's a human being on the

other side of the computer, some people think that a lower standard of ethics or personal

behavior is acceptable in cyberspace.

The confusion may be understandable, but these people are mistaken. Standards of

behavior may be different in some areas of cyberspace, but they are not lower than in

real life.

Remember breaking the law is bad Netiquette and always strive to be ethical.

Rule 3: Know where you are in cyberspace.

Netiquette varies from domain to domain. Netiquette is different in different places, it's

important to know where you are. Thus the next corollary:

Lurk before you leap. When you enter a domain of cyberspace that's new to you, take a

look around. Spend a while listening to the chat or reading the archives. Get a sense of

how the people who are already there act. Then go ahead and participate.

Rule 4: Respect other people's time and bandwidth.

When you send email or post to a discussion group, you're taking up other people's time

(or hoping to). It's your responsibility to ensure that the time they spend reading your

posting isn't wasted.

The word "bandwidth" is sometimes used synonymously with time, but it's really a

different thing. Bandwidth is the information-carrying capacity of the wires and channels

that connect everyone in cyberspace. There's a limit to the amount of data that any

piece of wiring can carry at any given moment. Do not post the same message over and

over again.

You are not the center of cyberspace. It's easy to forget that other people have concerns

other than yours. So don't expect instant responses to all your questions, and don't

assume that all readers will agree with -- or care about -- your passionate arguments.

Rules for discussion groups. Rule 4 has a number of implications for discussion group

users. Most discussion group readers are already spending too much time sitting at the

computer; their significant others, families, and roommates are drumming their fingers.

Post only salient information.

To whom should messages be directed? Today, it's as easy to copy practically anyone on

your mail as it is not to. And we sometimes find ourselves copying people almost out of

habit. In general, this is rude. Before you copy people on your messages, ask yourself

whether they really need to know. If the answer is no, don't waste their time. If the

answer is maybe, think twice before you hit the send key.

Rule 5: Make yourself look good online

Take advantage of your anonymity. Networks -- particularly discussion groups -- let you

reach out to people you'd otherwise never meet. And none of them can see you. You

won't be judged by the color of your skin, eyes, or hair, your weight, your age, or your

clothing. You will, however, be judged by the quality of your writing. For most people

who choose to communicate online, this is an advantage; if they didn't enjoy using the

written word, they wouldn't be there. So spelling and grammar do count.

Know what you're talking about and make sense. Pay attention to the content of your

writing. Be sure you know what you're talking about. Ask yourself whether you really

want to post this note before checking your facts. Bad information propagates like

wildfire on the net. Whatever you originally said may be unrecognizable.

In addition, make sure your notes are clear and logical. It's perfectly possible to write a

paragraph that contains no errors in grammar or spelling, but still makes no sense

whatsoever. It's better to keep it simple.

Don't post flame-bait. Finally, be pleasant and polite. Don't use offensive language, and

don't be confrontational for the sake of confrontation.

Exercise Question: Is swearing acceptable on the net?

Answer: Only in those areas where sewage is considered an art form, e.g., the USENET

newsgroup alt.tasteless. Usually, if you feel that cursing in some form is required, it's

preferable to use amusing euphemisms like "effing" and "sugar." You may also use the

classic asterisk filler -- for example, s***. The archness is somehow appropriate to the

net, and you avoid offending anyone needlessly. And everyone will know exactly what

you mean.

Share expert knowledge. Finally, after all that negativity, some positive advice. The

strength of cyberspace is in its numbers. The reason asking questions online works is

that a lot of knowledgeable people are reading the questions. And if even a few of them

offer intelligent answers, the sum total of world knowledge increases. The Internet itself

was founded and grew because scientists wanted to share information. Gradually, the

rest of us got in on the act. So do your part. Don't be afraid to share what you know. It's

especially polite to share the results of your questions with others. Sharing your

knowledge is fun. It's a long-time net tradition. And it makes the world a better place.

Rule 7: Help keep flame wars under control. "Flaming" is what people do when they

express a strongly held opinion without holding back any emotion. It's the kind of

message that makes people respond, "Oh come on, tell us how you really feel." Tact is

not its objective.

Does Netiquette forbid flaming? Not at all. Flaming is a long-standing network tradition

(and Netiquette never messes with tradition). Flames can be lots of fun, both to write

and to read. And the recipients of flames sometimes deserve the heat. But Netiquette

does forbid the perpetuation of flame wars -- series of angry letters, most of them from

two or three people directed toward each other, that can dominate the tone and destroy

the camaraderie of a discussion group. It's unfair to the other members of the group.

And while flame wars can initially be amusing, they get boring very quickly to people

who aren't involved in them. They're an unfair monopolization of bandwidth.

Rule 8: Respect other people's privacy. Of course, you'd never dream of going

through your colleagues' desk drawers. So naturally you wouldn't read their email either.

Unfortunately, a lot of people would. This topic actually rates a separate section. For

now, here's a cautionary tale. Here’s a tale called

The case of the snoopy foreign correspondent

In 1993, a highly regarded foreign correspondent in the Moscow bureau of the Los

Angeles Times was caught reading his coworkers' email. His colleagues became

suspicious when system records showed that someone had logged in to check their

email at times when they knew they hadn't been near the computer. So they set up a

sting operation. They planted false information in messages from another one of the

paper's foreign bureaus. The reporter read the notes and later asked colleagues about

the false information. Bingo! As a disciplinary measure, he was immediately reassigned

to another position at the paper's Los Angeles bureau.

The moral: Failing to respect other people's privacy is not just bad Netiquette. It could

also cost you your job.

Rule 9: Don't abuse your power. Some people in cyberspace have more power than

others. There are wizards in MUDs (multi-user dungeons), experts in every office, and

system administrators in every system. Knowing more than others, or having more

power than they do, does not give you the right to take advantage of them. For example,

sysadmins should never read private email.

Rule 10: Be forgiving of other people's mistakes.

Everyone was a network newbie once. So when someone makes a mistake -- whether it's

a spelling error or a spelling flame, a stupid question or an unnecessarily long answer --

be kind about it. If it's a minor error, you may not need to say anything. Even if you feel

strongly about it, think twice before reacting. Having good manners yourself doesn't give

you license to correct everyone else.

If you do decide to inform someone of a mistake, point it out politely, and preferably by

private email rather than in public. Give people the benefit of the doubt; assume they

just don't know any better. And never be arrogant or self-righteous about it. Just as it's a

law of nature that spelling flames always contain spelling errors, notes pointing out

Netiquette violations are often examples of poor Netiquette.For more information: Visit

http://www.albion.com/netiquette/corerules.html

G

roup Work: What is cyber libel law? How does it limit or expand user

responsibility?

Chapter 9-Electronic Health Record

Chapter 10-CDSS

Visit the Virtual Hospital at http://www.vh.org/.

Under "What's New on the Virtual Hospital", could a database be developed that might

make it easier to find new information for the users visiting this site? How might you

structure a database of this information?

Name: ______________________________Activity No:________Date: _________

1. Which of the following is the best advantage of delivering multimedia content to the

bedside?

a. Patient monitoring c. Health education of the client

b. Medication administration d. Electronic Documentation

2. Which of the following is not a technological advancement of nursing education?

a. SP c. Healthstream software

b. Integrative Systems d. None of the above 

3. Which of the following is not a tool that nurses need for patient centered care?

a. Web based training program c. Wireless connectivity

b. Healthstream software d. Software integration

4. Having a web based training program provides for:

a. Better collaboration c. Self-directed learning

b. Integration of software applications d. Data accessibility

5. An advantage of software integration is:

a. Charting devices c. Biometric fingerprinting

b. Individual system updates d. Wireless connectivity

6. Which of the following is not a disadvantage of technology in nursing?

a. Response to nursing shortage c. Breach of confidentiality

b. Dehumanizes care d. Generational gaps

7. The best advantage of technology in nursing is:

a. Time saving for nurses c. Evidence based nursing

b. Cost saving for healthcare facility d. Patient safety 

8. HIPPA refers to:

a. Health Informatics Personnel & Protection Act c. Health Information Portability &

Protection Act

b. Health Insurance Portability & Protection Act d. Health Informatics Portability &

Protection Act

Matching Type

9. AACN a. Informatics competency

10. Institute of Medicine b. Technology into nursing education

11. Australian Nursing Federation c. ITIMS

12. Which author stated that the nurse must uphold the overall well-being of the patient

and advocate for the patient not the technology?

a. Fischer & Price b. Drought & Liaschenko c. Barnes & Noble d.

Saba & McCormick

13. In 1980 the definition of NI was “Nurses interacting with ____________ to produce

greater knowledge, or on the role of nurses who specialized in developing applications of

technology to nursing practice. “

a. Computers b. Patients c. Technology d. The

Internet

14. In 1992, the definition of NI was “A specialty that integrates nursing science,

computer science, and information science in identifying collecting, processing and

managing data and information to support nursing practice, administration, education,

and research; and to expand nursing ______________.”

a. Knowledge b. Attitude c. Skill d. Wisdom

15. The purpose of nursing informatics is to analyze_____________ requirements; design,

implement and evaluate information systems and data structures that support nursing,

and identify and apply computer technologies to nursing. 

a. Data b. Information c. Computer d. Network

DEFINE the following:

16. ANA

17. PMIS

18.

19.

20.

21.

22.

23.

24.

25.

TABLE OF CONTENTS

CHAPTER 1: Introduction to Informatics 1

CHAPTER 2: Major Theories and Healthcare Informatics Literacy

CHAPTER 3: Computers

CHAPTER 4: Databases

CHAPTER 5:

CHAPTER 6: Supporting Administrative and Clinical Decision Making

CHAPTER 7: Structure and Application of HIS

CHAPTER 8: Strategic Planning and Life Cycle of HIS

CHAPTER 9: Communication, Technology, and Education

CHAPTER 10: eHealth Trends and Research

CHAPTER 11: Impact of Informatics

CHAPTER 12: Technical and Professional Informatics Standards

CHAPTER 13: Accreditation and PHI

CHAPTER 14: Future and Directions of Informatics

CLASSROOM POLICIES

Guidelines for Student Conduct:

You are expected to comply with student conduct policy and procedures. Information on

student responsibilities and rights is available at the guidance office or secure a copy of

the student handbook.

Cell Phone Etiquette: To avoid disruption of class, please either turn off your cell

phone or put it on silence/vibrate.

Academic Honesty: (plagiarism, exam conduct, etc.) Academic honesty is highly

valued. You must always submit work that represents your original words or ideas. If any

words or ideas are used that do not represent your original words or ideas, please cite all

relevant sources both in the text and in the references listing at the end of the paper.

Absence: If you anticipate being absent from class when you need to turn in an

assignment, project, or take exams, you are STRONGLY encouraged to notify me in

advance. Repeated absence may interfere with your work and result in a lower grade.

Make-up examinations will not be given and you will need to discuss alternatives with me.

STUDENT SUPPORT SERVICES

Students are encouraged to seek campus support services when necessary to support

their learning and academic progress. Refer to student handbook, or brochures/flyers for

information.

Academic Misconduct: All acts of cheating, plagiarism, forgery, and falsification.

The term cheating includes, but is not limited to:

• Using any unauthorized assistance in taking quizzes or tests

• Using sources beyond those authorized by the instructor in writing papers, preparing

reports,

solving problems, or carrying out other assignments

• Acquiring tests or other academic material before such material is revealed or

distributed by the

instructor

• Misrepresenting papers, reports, assignments or other materials as the product of a

student’s sole

independent effort

• Failing to abide by the instructions of the proctor concerning test-taking procedures

• Influencing, or attempting to influence, any University employee in order to affect a

student’s grade

or evaluation

• Any forgery, alteration, unauthorized possession, or misuse of University documents

The term plagiarism includes, but is not limited to, the use, by paraphrase or direct

quotation, of the

published or unpublished work of another person without full or clear acknowledgement.

It also includes the unacknowledged use of materials prepared by another person or

agency engaged in the selling of term papers or other academic materials.

Academic misconduct also includes furnishing false information to a school official,

faculty member, or office; or the forgery, alteration, or misuse of any University

document, record, or instrument of

Identification (adapted

http://www.memphis.edu/nursing/pdfs/msn_handbook_03192014.pdf).

Testing Policy

Examinations

All examinations are mandatory. Students are expected to be present for tests at the

designated time and place provided by the course instructor. A test absence may be

excused only in extreme circumstances that are unplanned.

1. Students will participate in computerized testing at a time and place designated at the

beginning of

the semester.

2. All students must bring official identification to a test.

3. All student items, except a specified calculator, will be deposited on the floor in the

front of the

room. No coats, sweaters, or caps are allowed on the person during testing.

4. A random seating arrangement for students in a test will be faculty generated.

5. During nursing tests, no questions should be asked out loud by students. If a question

must be

asked, raise your hand and the faculty proctor will come to you. Students may not walk

around

during tests.

6. If the instructor suspects any sharing during an exam, all students involved will

receive a 0 on that exam, and will face all consequences of academic dishonesty

according to the StudentHandbook.

7. Unless there is a faculty error in a test, there are no points given or items for which

two answers are given credit.

8. There are no make-up exams given in the LSON. When a test has been missed and

excused, the final examination for the course will weighted to account for the missed

test. Any other missed test will result in a grade of zero unless a student has been

granted an excused absence due to extreme

circumstances.

Example:

A nursing course has two unit tests that each comprises 25% of the course grade. The

final examination constitutes 30% of the course grade. If a student misses one of these

two unit tests, the

student’s final examination will constitute 55% of the course grade. Note: This policy

works to the

benefit of students because students don't fall further behind in class.

9. Final examinations are only missed in the case of an extreme emergency. With

notification of

faculty prior to the examination, a different final examination will be constructed. This

examination may be of a different format and/or a different length. It will never be the

same examination that has been used in the course.

(Adaptedhttp://www.memphis.edu/nursing/pdfs/msn_handbook_03192014.pdf).

Attendance

Class attendance may be mandatory as determined by the faculty of each course.

According to policy, students who do not attend classes in the first weeks of class will be

administratively dropped from the class. Or those that have incurred more than 20% of

total class hours.

Class Specific Policies and Procedures

Each individual course syllabus has specific policies and procedures that must be

followed.

Recording of Class or Lecture

Students should request permission from the instructor to audio or video-tape classroom

lectures.

Disruptive Classroom Behaviors

In accordance with GSDMSFI Student Handbook, the following behaviors have been

defined as disruptive to an optimal classroom learning environment and will not be

tolerated in the classroom. Consequences of for classroom misconduct are found in the

Code of

Student Rights and Responsibilities. See handbook.

Usage of Electronic Devices

Using cellular phones, text messaging iPods, MP3 players, etc. while class is in session.

Note:

Students may use laptop computers in class when given permission by the instructor.

Unexcused exits

Leaving to retrieve a soda or other snack items

Leaving to engage in a conversation (i.e. person-to-person or by phone)

Leaving before class is finished for any reason without prior permission from the

instructor

Non-Permitted Communication during Classroom Instruction

Talking while the instructor is talking

Talking before being recognized by the instructor (i.e. blurting out information)

Talking without permission during classroom instruction (i.e. side conversations with an

individual

or in a group)

Mimicking and/or consistently repeating an instructor’s words

Personal Attacks

Engaging in abusive or mean-spirited criticism of another student or an instructor

Questioning an instructor’s authority in front of the class

Continuing to insist on speaking with an instructor during classroom instruction

Telling an instructor to ―shut-up

Threatening Behaviors

Verbally abusing an instructor or student (i.e. cursing or extremely loud talking directed

at a

particular person)

Threatening to physically harm an instructor or student through verbal or body gestures

Intimidating through body gestures and/or posture or persistent staring at an instructor

or student

Overt Inattentiveness

Sleeping in class

Preventing others from concentrating on classroom instruction

Reading a newspaper, doing homework from another class, etc.

Other Distracting Behaviors

Arriving late to class, especially on test dates

Persistent Tardiness

Creating excessive noise from packing up before class has ended

Dressing inappropriately as to cause other students or instructor to be distracted (i.e.

wearing

pajamas, indecent exposure, or offensive words on clothing)

Grade Appeal Process

This appeal procedure provides any student at GSDMSFI with a clearly defined

avenue for appealing the assignment of a course grade that the student believes was

based on prejudice, discrimination, arbitrary or capricious action, or some other reason

not related to academic performance.

In all cases the complaining student shall have the burden of proof with respect to the

allegations in

the complaint and in the request for a hearing. The student must institute the appeal

process within five (5) class days following the releasing of grades.

Classroom Diversity Statement: Respect and foster optimal learning climate and an

environment of mutual respect. We recognize individual differences. Therefore, we are

responsible for the content and tone of our statements and are empathetic speakers and

listeners.

GRADING SYSTEM:

Assignment - 15%

Quiz - 30%

Recitation - 15%

Examination - _40%_

100%

Identification of Students with Behavioral Problems:

The School is responsible for identifying individuals with deteriorating academic

performance,

behavioral changes and excessive absenteeism, but is not responsible for diagnosing the

nature of the problem. Chemical dependency should not be determined on faculty

judgment alone. The student

should be evaluated by an appropriately prepared professional with an educational

background in chemical dependency, mental health issues, and treatment methodology.

It is the responsibility of every faculty member, clinical instructor or preceptor, and

nursing student to immediately report unsafe working conditions or hazardous activities

related to chemical impairment that may jeopardize the safety of the individual, the

patient, or colleagues. Faculty are also responsible for recognizing the signs and

symptoms of chemical impairment on academic and clinical performance. Faculty will

follow procedure for suspicion/identification (Appendix B).

Attendance Behavior

Excessive sick calls

Repeated absences with a pattern

Tardiness

Frequent accidents on the job

Frequent physical complaints

Peculiar/improbable excuses for absences

Frequent absence from clinical area

Frequent trips to rest room/locker room

Long coffee or lunch breaks

Early arrival or late departure

Presence in clinical during scheduled time off

Confusion about work schedule

Request for assignments at less supervised setting

Unkempt/inappropriate clothing

Poor hygiene

Mood swings

Frequent irritability with others

Excessive talkativeness

Poor recall

Physical abuse

Rigidity/inability to change plans

Incoherent or irrelevant statements

Drowsiness at work

Uncooperativeness with staff

Tendency towards isolation

Deteriorating relationships

Wears long sleeves all the time

Performance Physical Signs

Excessive time required for record keeping

Assignments require more effort /time

Difficulty recalling/understanding instructions

Difficulty in assigning priorities

Display of disinterest in work

Absentminded/forgetful

Alternate periods of high and low activity

Hand tremors

Excessive sweating

Marked nervousness

Coming to clinical area intoxicated

Blackouts

Frequent hangovers

Odor of alcohol

Increasing inability to meet schedules

Missed deadlines

Frequent requests for assistance

Carelessness/Tendency to blame others

Overreaction to criticism

Illogical or sloppy charting

Deteriorating handwriting

Poor judgment

Inattentive

Disorganized/Complaints regarding poor care

GI upset

Slurred Speech

Increased anxiety

Unsteady gait

Excessive use of breath mints/mouthwash

Sniffling, sneezing

Clumsiness

Flushed face

Watery eyes

Anorexia

Objectives:

Upon successful completion of this course, you will be able to:

1. Define Health Information Systems and explain what the two main categories.

2. Explain Clinical Information Systems and Administrative Information Systems.

3. Identify the different reporting systems.

4. Define and identify differences in databases.

5. Define security profiles and administrative functions.

6. Explain the differences between Integrated Systems and Modular Systems

7. Define Interfaces and explain the function of an interface.

8. Identify the differences between Home Health and Hospice Software, Maternal Infants,

and Electronic Medical Records Practice Management for Physician Offices and Clinics.

9. List different functions of Imagining and Service Desk software.

ACTIVITIES

Week 4: Securing Health Care Data - Increasingly, organizations are adopting ways

to implement the Health Information Portability and Accountability Act of 1996 (HIPAA),

especially in the areas of privacy and security. Review "Emergency Care" at and develop

a list of important elements that might need to be considered as health care information

goes online. Week 5: e-veloping Data Integrity Policies - Imagine you have been

asked to develop policies related to data integrity. What kinds of resources would you

use to create a framework of policies? Describe how and where you might explore the

Internet for resources related to data integrity.

Week 6: Online Learning Experiences - Imagine that you are thinking of enrolling in

a completely online course in which you will not physically meet the other students or

the teacher. Identify the benefits and barriers of this kind of learning experience. How

would you determine whether this type of course is right for you? List one or two

resources (online or print) that you might use.

Week 7: Barriers, Challenges, and Concerns for eHealth - The chapter concludes

with a list of barriers, challenges, and concerns for eHealth. After assessing the

definitions of eHealth and reviewing Web sites with a focus on eHealth, determine

whether the list is complete. What would you add? Is there anything you would delete?

What criteria did you use for your assessment?

Week 8: Organizational Differences of Health Care Organizations - Perform a

Web search for examples of an integrated health network and a traditional health care

organization. Can you tell the differences between these organizational structures from

their Web sites? What are the discriminating features?

Week 9: Professional Code of Conduct - Review information related to the

professional code of conduct posted at Web sites for several health care providers. Some

examples of organizations with such Web sites include the American Medical Association

(AMA), American Pharmaceutical Association (APA), and the American Nurses Association

(ANA). What do these codes of conduct have in common, and how do they apply to

health care informatics?

Week 10: Availability of Health Care Information - Complete a MEDLINE search on

HIPAA. Complete a Web search on HIPAA. Focus your attention on the data integrity

elements and privacy. Summarize the results of your searches in terms of focal area,

breadth of information provided, and availability. Describe how the two resources

provide different yet complementary sources of data.

Week 11: Educational Opportunities in Health Care Informatics - The following

table identifies the various types and levels of education possible in health care

informatics. After reviewing the table, search the Internet and find one or more programs

for each cell in the table.