MAJOR HISTORICAL PERSPECTIVES OF NURSING AND COMPUTERS

• Computers were introduced into the nursing profession over 40 years ago. Major milestones of nursing are
interwoven with the advancement of computer and information technologies, the increased need for nursing data,
development of nursing applications, and changes making the nursing profession an autonomous discipline.

Prior to 1960s

• Computers were first developed in the late 1930s to early 1940s. As computers have evolved, computing power
has increased. This was attributed to the increasing number of transistors or chips placed in an integrated circuit.

• In the mid-1960s Gordon Moore noted that the number doubled approximately every two years. This argument
has become known as Moore’s law (Techopedia, 2019).

• Use of computers in the healthcare industry did not occur until the 1950s and 1960s. During this time, there
were only a few experts nationally and nternationally who formed a cadre of pioneers that adapted computers to
healthcare and nursing which was undergoing major changes.

• Several professional advances provided the impetus for the profession to embrace computers—a new
technological tool. Computers were initially used in healthcare facilities for basic office, administrative, and
financial accounting functions.

• These early computers used punch cards to store data and card readers to read computer programs, sort, and
prepare data for processing

• Computers were linked together and operated by paper tape using teletypewriters to print their output. As
computer technology advanced, healthcare technologies also advanced.

• During the 1960s the uses of computer technology in healthcare settings began to be explored. Questions such as
“Why use computers?” and “What should be computerized?” were discussed.

• Nursing practice standards were reviewed, and nursing resources were analyzed. Studies were conducted to
determine how computer technology could be utilized effectively in the healthcare industry and what areas of
nursing should be automated

• The nurses’ station in the hospital was viewed as the hub of information exchange; therefore, numerous initial
computer applications were developed and implemented in this location.

• By the mid-1960s, clinical practice presented nurses with new opportunities for computer use. Increasingly
complex patient care requirements and the proliferation of intensive care units (ICUs) required that nurses become
super users of computer technology as nurses monitored patients’ status via cardiac monitors and instituted
treatment regimens through ventilators and other computerized devices such as infusion pumps.

• A significant increase in time spent by nurses documenting patient care, in some cases estimated at 40%, as well
as a noted rise in medication administration errors prompted the need to investigate emerging hospital computer-
based information systems (Sherman, 1965; Wolkodoff, 1963).

1970s
• During the late 1960s through the 1970s, hospitals began developing computer-based information systems which
initially focused on computerized physician order entry (CPOE) and results reporting; pharmacy, laboratory, and
radiology reports; information for financial and managerial purposes; and physiologic monitoring systems in the
intensive care units; and a few systems started to include care planning, decision support, and interdisciplinary
problem lists.

• Regardless of the focus, which remained primarily on medical practice, nurses often were involved in
implementing health information technology (HIT) systems.

• Interest in computers and nursing began to emerge in public health, home health, and education during the
1960s to 1970s. Automation in public health agencies began as a result of pressure to standardize data collection
procedures and provide state-wide reports on the activities and health of the public (Parker, Ausman, & Ovedovitz,
1965).

• In the 1970s, conferences sponsored by the Division of Nursing (DN), Public Health Service (PHS), and the
National League for Nursing (NLN) helped public health and home health nurses understand the importance of
nursing data and their relationship to new Medicare and Medicaid legislation requirements passed in 1966.

• Additional government-sponsored conferences focused on educational uses of computers for nurses (Public
Health Service, 1976).

• Simultaneously, hospitals and public health agencies embarked on investigating computers and nursing; the
opportunity to improve education using computer technology commenced.

• Bitzer (1966) reported on one of the first uses of a computerized teaching system called PLATO, which was
implemented to teach classes in off campus sites as an alternative to traditional classroom education.

• The early nursing networks, which were conceived at health informatics organizational meetings, helped to
expand nursing awareness of computers and the impact HIT could have on practice.

• The state of technology initially limited opportunities for nurses to contribute to the HIT design, but as
technology evolved toward the later part of the 1970s and as nurses provided workshops nationally, nurses gained
confidence that they could use computers to improve practice.

• The national nursing organization’s federal agencies (Public Health Service, Army Nurse Corps) and several
university schools of nursing provided educational conferences and workshops on the state-of the- art regarding
computer technology and its influence on nursing.

• During this time, the Clinical Center at the National Institutes of Health implemented the Technicon Data System
(TDS) system; one of the earliest clinical information systems (called Eclipsys & Allscripts) was the first system to
include nursing practice protocols.

• In addition to the use of computers, advancement was underway for other technologies and/or devices used by
nurses. For example, the first point-of-care blood glucose monitor became available for use in the clinical setting in
1970 (Clarke & Foster, 2012). The devices became smaller and more widespread in the 1980s.

1980s

• In the 1980s, the field of nursing informatics exploded and became visible in the healthcare industry and nursing.
• Technology challenged creative professionals in the use of computers in nursing. As computer systems were
implemented, the needs of nursing took on a cause-and-effect modality; that is, as new computer technologies
emerged and as computer architecture advanced, the need for nursing software evolved.

• It became apparent that the nursing profession needed to update its practice standards and determine specific
data standards, vocabularies, and classification schemes that could be used for the computer-based patient record
systems.

• In the 1980s, the microcomputer or personal computer (PC) emerged. This revolutionary technology made
computers more accessible, affordable, and usable by nurses and other healthcare providers.

• The PC brought computing power to the workplace and, more importantly, to the point of care. Also, the PCs
served as dumb terminals linked to the mainframe computers and as stand-alone systems (workstations).

• The PCs were user-friendly and allowed nurses to design and program their own applications. The influence of
computer technology extended to the introduction of devices to improve patient safety. For example, the
automated dispensing cabinets (ADCs) were introduced in the 1980s (Grissinger, 2012).

• The computer controlled ADCs replaced medication carts and drug floor stock. Tracking of medications occurred
at the point of care. The use of ADCs in the clinical setting has resulted in the reduction of medication errors.

• Starting in 1981, national and international conferences and workshops were conducted by an increasing number
of nursing pioneers to help nurses understand and get involved in this new emerging nursing specialty.

• Also during the 1980s, invitational conferences were conducted to develop nursing data sets and vocabularies as
well as numerous workshops were conducted at universities to introduce this new specialty into nursing
education.

• During this period, many mainframe healthcare information systems (HISs) emerged with nursing subsystems.
These systems documented several aspects of the patient record, namely, provider order entry and results
reporting, the Kardex reporting, vital signs, and other systems-documented narrative nursing notes using word-
processing software packages.

• Discharge planning systems were developed and used as referrals to community, public, and home healthcare
facilities for the continuum of care

• Nurses began presenting at multidisciplinary conferences and formed their own working groups within HIT
organizations, such as the first Nursing Special Interest Group on Computers which met for the first time during
SCAMC (Symposium on Computer Applications in Medical Care) in 1981.

• As medical informatics evolved, nursing began focusing on what was unique about nursing within the context of
informatics.

• Resolutions were passed by the American Nurses Association (ANA) regarding computer use in nursing and in
1985, the ANA approved the formation of the Council on Computer Applications in Nursing (CCAN).

• One of the first activities the CCAN executive board initiated was to solicit several early pioneers to develop
monographs on the status of computers in nursing practice, education, research, and management.
• The CCAN board developed a yearly Computer Nurse Directory on the known nurses involved in the field,
conducted computer applications demonstrations at the ANA annual conferences, and shared information with
their growing members in the first CCAN newsletter Input-Output.

• During this time NI newsletters, journals, and several books, such as the first edition of this book Essentials of
Computers for Nurses published in 1986, were used for educational courses introduced in the academic nursing
programs, and workshops conducted on computers and nursing.

• The CCAN became a very powerful force in integrating computer applications into the nursing profession.

• In 1988, the CCAN commissioned three NI experts to prepare a set of criteria on the integration of nursing
practice for EHR vendors to follow (Zielstorff, McHugh, & Clinton, 1988).

• In 1989, the ANA renamed the CCAN to the Steering Committee on Databases to Support Clinical Nursing
Practice, which later became the Committee for Nursing Practice Information Infrastructure (CNPII).

• The purpose of the CNPII was to support development and recognition of national health data standards (Coenen
et al., 2001).

1990s

• By the 1990s, large integrated healthcare delivery systems evolved, further creating the need for information
across healthcare facilities within these large systems to standardize processes, control costs, and assure the
quality of care (Shortliffe, Perreault, Wiederhold, & Pagan, 2003).

• Advances in relational databases, client- server architectures, and new programming methods created the
opportunity for better application development at lower costs

• Legislative activity in the mid-1990s paved the way for EHRs through the Health Insurance Portability and
Accountability Act (HIPAA) of 1996 (public-law 104- 191), emphasizing standardized transactions, and privacy and
security of patient-identifiable information (Gallagher, 2010).

• In 1992, the ANA recognized nursing informatics as a new nursing specialty with a separate Scope of Nursing
Informatics Practice Standards, and also established a specific credentialing examination for it (ANA, 2008).

• Numerous local, national, and international organizations provided a forum for networking and continuing
education for nurses involved with informatics (Sackett & Erdley, 2002).

• The demand for NI expertise increased in the healthcare industry and other settings where nurses functioned,
and the technology revolution continued to impact the nursing profession

• The need for computer-based nursing practice standards, data standards, nursing minimum data sets, and
national databases emerged concurrently with the need for a unified nursing language, including nomenclatures,
vocabularies, taxonomies, and classification schemes (Westra, Delaney, Konicek, & Keenan, 2008

• Nurse administrators started to demand that the HITs include nursing care protocols and nurse educators
continued to require the use of innovative technologies for all levels and types of nursing and patient education.
Also, nurse researchers required knowledge representation, decision support, and expert systems based on
standards that allowed for aggregated data (Bakken, 2006).

• In 1997, the ANA developed the Nursing Information and Data Set Evaluation Center (NIDSEC) to evaluate and
recognize nursing information systems (ANA, 1997

• The purpose was to guide the development and selection of nursing systems that included standardized nursing
terminologies integrated throughout the system whenever it was appropriate.

• Technology rapidly changed in the 1990s, increasing its use within and across nursing units as well as across
healthcare facilities.

• Computer hardware—PCs—continued to get smaller and computer notebooks were becoming affordable,
increasing the types of computer technology available for nurses to use.

• By 1995, the Internet began providing access to information and knowledge databases to be integrated into
desktop computer systems. It revolutionized information technologies.

• The Internet moved into the mainstream social milieu with electronic mail (e-mail), file transfer protocol (FTP),
and World Wide Web (WWW) protocols greatly enhanced its usability and user-friendliness (Saba, 1996; Sparks,
1996)

• The WWW also became an integral part of the HIT systems and the means for nurses to browse the Internet and
search worldwide resources (Nicoll, 1998; Saba, 1995).

2000s

• A change occurred in the new millennium as more and more healthcare information became digitalized and
newer technologies emerged. In 2004 an executive order 13335 established the ONC and issued a
recommendation calling for all healthcare providers to adopt interoperable EHRs by at least 2014 or 2015
(http://healthhit.gocv/topic/about-onc).

• In the late 2000s, as hospitals became “paperless,” they began employing new nurses who had never charted on
paper.

• Technological developments that influenced healthcare and nursing included data capture and data sharing
technological tools. Wireless, point of care, regional database projects, and increased IT solutions proliferated in
healthcare environments, but predominately in hospitals and large healthcare systems

• The use of bar coding and radiofrequency identification (RFID) emerged as a useful technology to match the
“right patient with the right medication” to improve patient safety

• A barcode medication administration (BCMA) system was first implemented in 2000 in an acute care hospital to
electronically capture medication management (Wideman, Whittler, & Anderson, 2005).

• The RFID also emerged to help nurses find equipment or scan patients to assure that all surgical equipment is
removed from inside patients before surgical sites are closed (Westra, 2009)
• Smaller mobile devices with wireless or Internet access such as notebooks, tablet PCs, personal digital assistants
(PDAs), and smart cellular telephones increased access to information for nurses within hospitals and in the
community.

• The development and subsequent refinement of voice over Internet protocol (VoIP) provided voice cost-effective
communication for healthcare organizations.

• The Internet which appeared in 1995 provided a means for the development of clinical applications. Also,
databases for EHRs could be hosted remotely on the Internet, decreasing costs of implementing EHRs.

• Remote monitoring of multiple critical care units from a single site increased access for safe and effective cardiac
care (Rajecki, 2008)

• Telehealth applications, a recognized specialty for nursing since the late 1990s, provided a means for nurses to
monitor patients at home and support specialty consultation in rural and underserved areas.

• The NI research agenda promoted the integration of nursing care data in HIT systems that would also generate
data for analysis, reuse, and aggregation.

• One of the first ONC initiatives was the Healthcare Information Technology Standards Panel (HITSP) which was
designed to determine what coding systems were used to process patient care data from admission to discharge.

• It was found that the nursing care data was missing in the existing EHRs. Initially, in 2005–2007, the Clinical Care
Classification (CCC) System met the established standards as interoperable and was accepted and approved as the
free, coded, nursing taxonomies that could be used for assessing and documenting nursing care to generate quality
outcomes (Saba & Whittenburg, 2015). This project ended in 2009 when the HITECH Act of 2009 emerged.

HISTORY OF NURSING INFORMATICS IN THE PHILIPPINES

Nursing Informatics in the Philippines

• The word “Nursing Informatics” was made familiar to the Philippine by the year 2008.

• 1996 - Philippine Medical Informatics Society (PMIS) was established which made a very 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 physician. The organization was headed by Dr. Alvin Marcelo

• 1998- faculty members of the University of the Philippines began formal education and training in medical
informatics and information science.

• 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,
England.
• 1999- Standards of Health Information of the Philippines 1999 (SHIP99) was established. It was headed by
National Institute of Health of the UP Manila with the collaboration of Philippine Nurses Association in the person
of Ms. Evelyn Protacio

• 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.

• 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.

• 2010: formation of Philippine Nursing Informatics Association (PNIA) as a sub- specialty organization of PNA for
nursing informatics

• PNIA is an association of Registered Nurses with a common vision to promote the use of Information and
Communications Technology (ICT) to improve Nursing Practice, Education, Administration and Research in the
Philippines.

• Founding members of PNIA are:

 Ms. Sheryl Ochea, a graduate of Master of Science in Nursing major in nursing informatics at Xavier
University (Ohio, USA)
 Ms. Alexrandra 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
 Mr. Sid Cardenas, also a telehealth nurse. Other founding members include Mr. Noel Bañez, Ms. Rona
Abcede, and Mr. Harby Ongbay Abellanosa

• 2008 - Commission on Higher Education Memorandum 5 Series of 2008 defined Nursing Informatics course in the
undergraduate curriculum.

• 2009 - This was later revised and included as Health Informatics coursein CHED Memorandum Order 14 Series of
2009 First Implementation of the integration of Nursing Informatics in the undergraduate curriculum was on the
summer of 2010.

• 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.

• 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.
• As information technology and computing slowly advance HEALTH CARE practices nowadays, there is seemingly a
need to improve the preparation of our nursing students academically and clinically as they engage themselves
with a new concept of Nursing Informatics.

• Nursing schools across the country has been implementing the course Informatics. However, 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.

Future Direction

• 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 PNIA's 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.

Overview of Nursing Informatics

Informatics

• Informatics is a French word which refers to the field of applied computer science concerned with the processing
of information such as nursing information (Nelson, 2013).

• Informatics is a science that combines a, computer science, information science, and cognitive science.

Healthcare informatics

• Healthcare informatics may be defined as the integration of healthcare sciences, computer science, information
science, and cognitive science to assist in the management of healthcare information.

Medical Informatics and Health Informatics

• Medical informatics, historically, was used in Europe and the United States as the preferred term for healthcare
informatics. Now, medical informatics is more clearly realized as a subset of healthcare informatics

• Health informatics may mean informatics used in educating healthcare clients and/or the general public.

Nursing

• Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury,
alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of
individuals, families, communities, and populations (ANA)

Components of ANA Definition of Nursing

• The focus of nursing is on the human responses to actual or potential health problems, and advocacy for various
clients
• Nurses must possess the following skills:
• Technical Skills
• Interpersonal skills
• Cognitive skills
• Information Intensive Skills

Overview of Nursing Informatics

• Nurses are expected to provide safe, competent, and compassionate care in an increasingly technical and digital
environment

• A major theme in this new healthcare environment is the use of information systems and technologies to
improve the quality and safety of patient care

• A new specialty, called Nursing Informatics, has emerged over the past 20 years to help nurses fully use
information technology to improve the delivery of care.

Nursing Informatics

• Nursing informatics (NI) is a subset of healthcare informatics. It shares common areas of science with other
health professions and, therefore, easily supports inter-professional education, practice, and research focused on
healthcare informatics.

• Nursing informatics also has unique areas that address the special information needs for the nursing profession.

• Kathryn Hannah proposed a definition that nursing informatics is the use of information technologies in relation
to any nursing functions and actions of nurses (Hannah, 1985).

• Nursing informatics is a combination of computer science, information science, and nursing science designed to
assist in the management and processing of nursing data, information, and knowledge to support the practice of
nursing and the delivery of nursing care (Graves & Corcoran, 1989).

• Nursing informatics as the 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, research, and the expansion of nursing knowledge (American Nurses 28/02/2023 Association, 1994).

• Nursing informatics is a specialty that integrates nursing science, computer science, and information science to
manage and communicate data, information, knowledge, and wisdom in nursing practice. ... American Nurses
Association (2008).

NI development of definition.

• Development of different definitions and a healthy debate on those definitions promotes validation of key
elements and concepts.

• A willingness to continue exploring possible definitions can prevent premature conceptual closure, which may
lead to errors in synthesis and knowledge development

• Nursing Informatics supports consumers, patients, nurses, and other providers in their decision-making in all
roles and settings.
• The goal of NI is to improve the health of populations, communities, families, and individuals by optimizing
information management and communication.

• NI has become well established within nursing since its recognition as a specialty for registered nurses by the
American Nurses Association (ANA) in 1992.

• Nurses collect data when assessing and monitoring the health of patients and record their observations in the
patient’s chart

• Nurses exchange service requests to, and receive results from, the clinical laboratory, radiology and other
departments

• Nurses receive and review admission data and discharge summaries

• Nurses review information on the results of clinical research and clinical trials

• Nurses communicate patients’ information between service providers

• Nurses summarize, calculate, and interpret workload indices for their nursing units for monitoring and
management purposes

• Nurse consult evidence-based clinical guidelines and protocols to guide their practice

• As knowledge workers, nurses use concepts such as these to influence decision making

Nursing Informatics (NI) centers on the concepts of DIKW

Framework: (Metastructures in Nursing Informatics)

Data

• Data: Raw facts which lacks meaning and described objectively without interpretation such as:
• Age: 17, 27, 34
• Number of patients: 4, 10, 20
• Weight: 44 kg, 78 kg, 81 kg
• Diseases: Hypertension, Pneumonia, Covid-19, TB
• HR: 78, 98, 100

Information

• Information: Data that are interpreted, organized, or structured. Data that is processed using knowledge. Data
made functional through the application of knowledge, such as:
• Prevalence of Covid 19 infection among ER nurses .
• Prevalence of pressure ulcer in patient admitted in ICU
• Percentage (%) of staff absenteeism on emergency department among staff nurses per month

Knowledge
• Knowledge: Processed information that helps to clarify or explain some aspects of our environment or world that
we can use as a basis for action or upon which we can act.

Nursing knowledge

• Nursing knowledge: Is defined as information that has been synthesized so that interrelationships are identified
and formalized resulting in decisions that guide nursing practice such as:
• Covid 19 transmission prevention in ER
• Effectiveness of pressure ulcer monitoring and prevention in ICU
• Relationship between emergency department nurse absenteeism and work load and work stress

Important Points to Remember about Metastructures

• Data, which are processed into information and then into knowledge, may be obtained from individuals, families,
communities, and populations.
• Knowledge focuses on what is known but Wisdom focuses on the appropriate application of that knowledge.

Wisdom

• Wisdom is defined as the appropriate use of knowledge to manage and solve human problems. It is knowing
when and how to apply knowledge to deal with complex problems or specific human need.
• A comprehensive literature search revealed characteristics of wisdom being described as cognitive, ethical,
intuitive, and emotional processes
• If the study of NI was limited to what the computer can process, then it could not fully appreciate the
interrelationships that exist between nursing science, practice and information, science, technology.
• The appropriate use of knowledge involves the integration of empirical, ethical, personal and philosophical
knowledge in the process of implementing actions.

Nursing Informatics Practice

• The collection of data about a client or about a management, education, or research situation is guided by a
nurse’s knowledge base built on formal and informal educational preparation, evidence and research, and previous
experiences.

• In healthcare, as in most areas of our lives, data, information, and knowledge are growing at astronomical rates
and demand increasing reliance on computer and information systems for collection, storage, organization and
management, analysis, and dissemination.

• Nursing informatics is the nursing specialty that endeavors to make the collection, management, and
dissemination of data, information, and knowledge—to support decision-making—easier for the practitioner.

Nursing Informatics as a Specialty

• In 1992, the ANA recognized nursing informatics as a specialty in nursing with a distinct body of knowledge.
• The core phenomena of nursing are the nurse, person, health, and environment.
• Nursing informatics focuses on the information of nursing needed to address these core phenomena.
 • Within this focus are the metastructures or overarching concepts of nursing informatics: data, information,
knowledge, and wisdom.

Informatics Nurse (IN)

• An informatics nurse (IN) is a registered nurse who has experience in nursing informatics.
• Informatics nurse specialists (INS) are prepared at the graduate level (master’s degree).

Computerization processing affect all aspects of healthcare delivery including:

Provision and Education of Scientific research Reimbursement legal and Safety and
documentation of healthcare for advancing for patient care ethical quality
patient care providers healthcare delivery. implications issues

Common uses for computers in healthcare

Medication Communication
and treatment Patient Telemedicine Surgical and sharing Medical imaging
diagnosis procedures information

TIGER

• Information technology is the use of computers to systematically solve problems

• In nursing, the Technology Informatics Guiding Education Reform (TIGER) Initiative began in 2006 to identify
information/knowledge management best practices and effective technology capabilities for nurses

• TIGER is focused on designing plans to

1. enhance the nurse’s ability to use electronic health records to improve health care delivery
2. Have more nurses engaged in influencing the national health care information systems infrastructure
3. speed the adoption of technology that can enhance health care safety and effectiveness (Hebda &
Calderone, 2012).

• Nurses increasingly use smart phones/tablets as calendar/date books, address books, drug and disease database
storage devices, and data entry and retrieval devices.

Sample Criteria for Evaluating Internet Health Information

• Author/sponsor: Who created and updates the site? Are their credentials listed and appropriate?

• Recency: When was the information in the site last updated?

• Accuracy/sourcing: Where does the site get its information? Are factual statements cited?
• Purpose: Is it clear whether the site is informational or commercial? Who is the intended audience? Sometimes,
the website URL provides some of this information; for example, .gov for government sites, .org for professional
organizations, .edu for educational institutions, and .com for companies

Common Computer-Related Acronyms