The InternetApalin, Ruth Rendell BSN 3A1-3Batang, Jonalyn Muliloda, FatimaNacua, HannahNicolas, MichellePino, Alysa

InternetWorldwide network of interconnected computer networks that operates using a standard set of communications

Any communications network that can carry two-way digital data can also carry Internet traffic; thus, Internet traffic flows through networks that use conventional copper wire, coaxial cable, optical fiber and radio waves.

The internet is named after the Internet Protocol, the standard communications protocol used by every computer on the Internet.

Brief History of the Internet

Vannevar Bush Wrote the first

visionary description of the potential uses for information technology with his description of the “memex” automated library system.

Norbert Weiner Invented the

Field of Cybernetics, inspiring future researchers to focus on the use of technology to extend human capabilities.

1956 Dartmouth Artificial Intelligence Conference Crystallized the concept that

technology was improving at an exponential rate, and provided the first serious consideration of the consequences.

Marshall McLuhan Made the idea

of a global village interconnected by an electronic nervous system part of our popular culture.

I nternet vs. i nternet An internet (small “i”) refers

to any network of computers The Internet (large “I”) is a

specific name Given to the communication network comprised of hundreds of thousands of inter-connected networks

On October 4 ,1957 the Soviet Union launched the first satellite called Sputnik

This prompted then United States PresidentDwight Eisenhower to create the Advanced Research Project Agency (ARPA). ARPA was tasked with the job to regain the technological lead in the arms race.

ARPA formed the Information Processing Techniques Office (IPTO) to do research on a Semi Automatic Ground Environment (SAGE) program to help protect the US against a space-based nuclear attack.

IPTO pushed the benefits of a country-wide communications network .

The Department of Defense got together with the Massachusetts Institute of Technology (MIT) and created… ARPAnet (Advanced

Research Projects Agency) to develop an alternative communication system that could enable the military to function in the event of a nuclear strike.

1970’s brought about Stanford University’s testing and development of early internet protocols

Vinton Cerf -- Father of the Internet

1980’s & National Science Foundation

NSF obtained control of network for government and educational use

Technologies Behind the Internet

Standard protocols enable the Internet to function. It can be treated as the standard language for the Internet.

Protocols determine the following:Data transmission between 2

devicesThe type of error checking that will

be performed.Data compressionSignals and notifications

The main protocols on which the functioning of the Internet is dependent are listed below:

Transmission Control Protocol (TCP) – allows computers to connect to a network and exchange data; carries the task of breaking messages into small packets (datagrams)

Internet Protocol (IP) – considered a lower level protocol which is responsible for making decision on the packets and routing them.

Other protocols used on the Internet are the following:

Hypertext Transmission Protocol (HTTP) – which supports the World Wide Web (WWW)

File Transmission Protocol (FTP) – permit users to send all types of electronic files over the Internet

Anatomy of a Web Address

Web addresses are also referred to as URLs. It can identify a specific machine, directory and file of that machine

Example: https://www.facebook.com/

HTTP – short for Hypertext Transfer Protocol described as the transmission protocol, introduces a web document or directory

WWW – Short for World Wide Web Directory – The directory or folder(s) in

the web server that contains a group of related web pages within a website

Domain Name – identifies the computer name, web server name, web name or host name. The Internet Domain Name System (DNS) permit users to give globally unique names to networks. Top level domains:

.edu – educational site (for a university or college)

.com – commercial business site/computer

.gov – government/non military site .mil – military sites or agencies .net – networks, internet service

providers, organizations .org – non profit organizations and

others

Web Navigation and Search Engines

There are 4 domains and 5 basic techniques in web navigations

Directions: Back – go back to the previous page

(alt+left arrow key) Forward – go forward to a new page after

going back (alt+right arrow key) Link – click a link and jump to a new

page Jump – select a new page from external

source such as bookmarked sites

Techniques: Surfing – Jumping ahead of the browser if

the link is already loaded but the rest of the page is lagging behind

Chains – After clicking several websites, a chain of internet pages are created and explored backward or forward.

Reload – refreshing the page to ensure that the latest copy is loaded

Stopping – Stopping the loading process of a site anytime the user wants.

Restarting – Stopping the connection and clicking the same link again

Few examples of Search Engines:

Yahoo! Google Ask.com

Two types of Search Engines: Directories

good at identifying general information Ex.: Yahoo Directory

Indexes Identify text on the given criteria by

searching contents of websites through the use of software and programs called robots and spiders that analyze millions of webpages

Ex.: Google & Yahoo Search

Electronic Mail (E-mail)

Program was developed by Ray Tomlinson in 1972

He introduced the @ symbol

In 1973, 75% of the traffic was E-mail

One of the most popular uses for the Internet remains the ability to send & receive electronic mail

Ex.: Yahoo Mail, Gmail & Hotmail

Anatomy of an Email Address

Internet works by connecting computers using the same protocol. Therefore, all email addresses are using the same format.

Example: hyper_yke@yahoo.com Name (Username) – the name of the

owner of the address. Users can devise their own name based on their availability.

Email Provider/Organizational Code – denotes the email providers or Organizational Code in conjunction with the organizational website

Domain – corresponds to the high level domain names

Evaluating Quality Health Information on the Internet

The health summit working group has identified the major criteria to evaluate an internet site.

The criteria identified include the following: Credibility – source of information &

timeliness of the content Content – to help judge accuracy,

examine the hierarchy of events and presence of original sources

Disclosure – the purpose & moderator of the site

Links – the quality of links provided by the site

Design – site accessibility & convenience of use

Interactivities – presence of feedback & communication

Caveats – achievement of site goals

Mobile Computing in Nursing

Mobile Computing in Nursing provides valuable insights into how nurses are using computing solutions at the bedside & how these solutions can best be used to solve existing workflow inefficiencies.

Mobile computing makes it easy to stay connected no matter where you are; or gamers enjoy peer-to-peer interaction; photographers can send immediate downloads; and employees can telecommute from different time zones

Tablet PCs are wireless devices that provide the most promising trend in mobile computing. The slightest of them is the size and weight of a spiral bound notebook.

Wireless Devices

Wireless devices and devices with wires almost perform the same functions but wireless devices have many advantages over the other devices with wires. It facilitates people to work in

different places where they cannot take the devices with wires attached to them.

In wireless devices, the data is transferred in the form of electromagnetic waves (which are the main part of electromagnetic spectrum present in the atmosphere)

Communication through wireless devices is known as Wireless Communication.

Other electronic devices:

Laptop – a wireless computer that anyone can take it with him or her with all the data stored in it.

USB – with the help of USB, one can transfer the date from one place to another by taking that stick in his or her pocket

Cell phones – Cell phones have become the most used wireless device by people in which the communication is done by using radio frequencies through different service provider stations

PDAs Radio, etc.

Nurses and the Internet

Contemporary nursing practice has changed tremendously over the last decade.

Professional competencies for new nurses now include informatics, case management, health care policy, cultural sensitivity and disaster preparedness.

The study of nursing involves life sciences, psychology, social services, patient education, and ethics, in addition to the traditional medical knowledge base.

The ability to use the internet is an essential skill for both nursing students and nurses, both to support their studies, especially as nursing students spend a lot of their time in placement away from the university campus and to support their development of skills in using what is becoming an increasingly essential tools for professionals.

US Government Medical & Health Informatics Resources

• The US federal government provides some of the most important sources of online information for medical professionals as well as health consumers.

NLM Gateway A handy entry point for searching the

resources at the National Library of Medicine.

Provides a global search function for PubMed, PubMed Central, and MedlinePlus.

Search results include consumer health information.

An excellent place to begin a search of health related government information.

Access: http://gateway.nlm.nih.gov/gw/Cmd

Resource for Medical Professional and Researchers

Agency for Healthcare Research and Quality (AHRQ)

• This federal agency both conducts and sponsors research on healthcare quality, safety and cost effectiveness.

• It’s “Consumers & Patients” links provide information on specific conditions, health insurance plans, prescriptions, health and wellness.

Access: http://www.ahrq.gov/

National Institute of Nursing Research

• One of the National Institutes of Health, this organization’s mission is to support research in nursing in clinical and community settings through grants and other funding programs.

• It provides information on its own funding initiatives, including diversity programs and resources, links to nursing organizations for various specialties, and publications from national conferences and meetings.

Access: http://ninr.nih.gov/nindr/index.html

PubMed Central

• A free digital archive of life sciences journal literature.

• The site offers access to the full text of more than 160 high-quality, open access life sciences journals from various publishers

Access: http://www.pubmedcentral.nih.gov/

Center for Disease Control and Prevention

• It’s mission is to monitor public health, put forth prevention initiatives, investigate health problems & promote healthy behaviors.

Access: http://www.cdc.gov/

Healthfinder

• This consumer health information site is maintained by the National Health Information Center of the US Department of Health and Human Services

• It is a hand selected directory of the health related web sites of more than 1,500 organizations (government , nonprofit, & educational)

Access: http://htalthfinder.gov

Medline Plus

• A consumer health resource that brings together information from various government agencies including the National Library of Medicine, the National Institutes for Health, and others.

Its medical encyclopedia, drug and herbal supplement information, current health news, and superior interactive tutorials are excellent resources for nursing students.

Access: www.rtlm.nih.gov/medlineplus/tutorial.html

National Institutes of Health• Another

directory of consumer health information, this site has a simple design and is organized by conditions, body systems, type of patient, etc.

• It also provides links to MedlinePlus and to specific institutes within NIH

Access: http://www.health.nih.gov/

Non – Governmental Portals

BioMed Central

• This resource publishes more than 140 open access journals covering all areas of biology and medicine• Included are journals on nutrition, public & international health & BMC nursing, specifically for nurses.

Access: http://www.biomedcentral.com/home

Mayo Clinic: Tools for Healthier Lives• Though aimed at

the layperson, nurses and students will welcome the plethora of information and tools provided by the Mayo Clinic

• Users can choose “Diseases & Conditions”, “Drugs & Supplements”, “Treatment Decisions”, “Healthy Living”, “Ask a Specialist” and “Health Tools.

Access: http://www.mayoclinic.com

Online Journal of Issues in Nursing

OJIN is a free, peer reviewed, international journal addressing topics affecting nursing practice, research, education and the wider health care sector.

OJIN presents timely information required by nurses and other health care professionals to provide current and informed patient care, to be socially responsive healthcare professionals and to meet professional development needs.

Access: http://www.nursingworld.org/ojin

Public Library of Science

• PLoS is an initiative by scientists & doctors to publish quality, peer reviewed literature and make it freely available to the public and other researchers.• It publishes journals in biology, medicine, clinical trials & genetics.Access: http://www.plos.org/

World Health Organization

• An excellent source of global health information, including statistics and country by country health overviews..

• This site is well indexed & easy to navigate.

Access: http://www.who.int/en/

Nursing Specialties & Disease Specific Sites

Alzheimer's Association

• The Alzheimer’s Association provides information and support to family members, caregivers and health professionals on Alzheimer’s disease.

• It is updated daily and includes news, resources & information.

Access: http://www.alz.org/

HIV InSite: Gateway to AIDS Knowledge

• San Francisco School of Medicine gives comprehensive, up-to-date information on HIV/AIDS treatment, prevention, and policy at this site.

Access: http://hivinsite.ucsf.edu/

Oncolink

• University of Pennsylvania cancer specialists launched this site in 1994 to “help cancer patients, families, health care professionals and the general public get accurate cancer-related information at no charge”

Access: http://www.oncolink.com

Public Health Nursing Section of the American Public Health Association

• This site provides current health related news, links to information about public health advocacy, articles of concern to public health nurses, ask an expert sites, and a discussion forum on public health nursing.

• A good all-purpose resource for nurses with an emphasis on public health.Access:

http://www.csuchico.edu/~horst/index.html

Study Aids for Nursing Students

AMA Medical Ethics Web pages

The American Medical Association (AMA) offers resources and information about medical ethics.

One especially helpful resource for nursing students is their “Virtual Mentor”, an interactive, Web based forum for analysis and discussion of ethical & professional issues.

Access: http://www.amaassn.org/ama/pub/category/2416.html

Geriatric Assessment-Case Studies

The Virtual Health Care Team Web Site is sponsored by the School of Health Professions and the School of Medicine at University of Missouri.

The approach, as explained authors, is an integrated team approach in which “team members actively coordinate care and services across disciplines in a process resembling problem-based learning.”

Access: http://www.vhct.oirg/index.shtml

Gray’s Anatomy of the Human Body

It features 1,247 pictures from the classic 1918 publication, as well as a subject index with 13,000 entries.

Access: http://www.bartleby.com/107/

Human Anatomy Online

Easy to navigate, the user begins by choosing among ten systems: skeletal, digestive, muscular, lymphatic, endocrine, nervous, cardiovascular, male or female reproductive and urinary.

Graphics are interactive and users can view animations of the system, tutorials and descriptions.

Access: http://www.innerbody.com/htm/body.html

McGill University Virtual Stethoscope

It is a multimedia tutorial featuring a virtual stethoscope to assess both respiratory and cardiovascular conditions.

Also included is a review of selected cardiac and pulmonary physiology and pathophysiology topics

Some examples are Biomedical Ethics & Law in Clinical Practice, Clinical Nutrition, Histology, EKG Tutorial, Gastroenterology, Endoscopic Pathology, Immunology, and Virtual CPR.

Access: http://www.sprojects.mmi.mcgill.ca/mvs/mvsteth.htm

Merck Manual of Diagnosis and Therapy

The Merck Manual’s 17th, Centennial Edition is available free, searchable by keyword or the table of contents.

It also offers two other complete manuals through this site: The Merck Manual of Geriatrics The Merck Manual of Health & Aging

Access: http://www.merck.com/mrkshared/mmanual/sections.jsp

Physical Exam Study Guides Created by the University of

Florida Medical Program, these guides are thorough and clear.

The exams offered are: Vital Signs Back & Extremity Chest & Lung Cardiology Head and Neck Eye Abdominal Breast Pelvic Neurologic & Mental Status

Access: http://www.medinfo.ufl.edu/year1/bcs/clist/index.html

RN Central

Created by nurses for nurses and students, this site offers good resource links, but the highlight is its “Care plan Corner,” with predefined nursing care plans under 3 categories: Altered/Alterations Impaired/Impairment General

Users can copy, save or print and modify any of the plans, and there is also a blank plain template to print out and fill in

Access: http://www.rncentral.com

RxList

Information provided for each drug includes the description, clinical pharmacology, indications and dosage, side effects and drug interactions, warnings and precautions, drug over dosage contraindications and patient information.

Words in the articles and descriptions that may need to be defined for the layperson or student are hyperlinked to Taber’s online medical dictionary

Access: http://www.rxlist.com

Philippine Based Nursing Resources

Philippine Nurses AssociationFounded on September 2, 1922 as Filipino Nurses Association (FNA) in a meeting of 150 nurses presided by then Anastacia Giron Tupas (Mrs. Tupas), the FNA was incorporated in 1924. The International Council of Nurses accepted the FNA as one of the member organizations during the Congress held in Montreal, Canada on July 8-13, 1929. The FNA became the PNA (Philippine Nurses Association) in 1966, which was the same year that the office at 1663 F.T. Benitez Street, Malate, Manila was inaugurated.Today there is a total of 368,589 licensed nurses (February 2005) in the Philippines and produces an average of 13,000 new nurses every year.The PNA was awarded the Most Outstanding Accredited Professional Organization by the Professional Regulation Commission in 2003 besting 40 other professional associations and was five-time nominee for the same award.

Nurse Directory Contains information

regarding nursing industry including Nurse Companies, Nursing Review Centers, Nursing Schools, Care Givers, and Nursing Articles

Decision Support System DSS are automated tools designed to

support decision making activities and improve the decision making process and decision

Such systems are intended to use on enormous amounts of data that exist in information systems to facilitate decision process

Clinical Decision Support Systems

As explained by Wyatt and Spiegelhater, they regard CDSS as active knowledge systems that use two or more items of patient data to generate case specific advice

Designed to integrate a medical knowledge base, patient data and an inference engine to generate case specific advice

A CDSS is designed to support healthcare providers in making decisions about the delivery and management of patient care

A CDSS program’s goals include:

Patient safety and improved outcomes for specific populations

Compliance with clinical guidelines, standards of practice, and regulatory requirements.

Components of CDSS

1. Integrated Real Time Patient Database Combines patient data from

multiple sources Ex.: Lab, Radiology, Pharmacy

Data, etc. This is needed to provide

context for results interpretation

2. Data-driven Mechanism

Allows event triggers to go into effect and activate alerts and reminders automatically

3. Knowledge Engineer

Translate the knowledge representation scheme used in the system so clinical knowledge in the system can be extracted and translated into machine executable logic

4. Time driven mechanism Permit automatic execution of programs

at a specific time to alert healthcare provider to carry out a specific function or ensure that action has been completed

Ex: Medication administration, Time Alerts

5. Long Term Clinical Data Repository Data collected over time

from a variety of sources allowing a longitudinal patient records.