Nursing Informatics Prelims ♡
rkd | BSN 2G | Karl Gallardo
Nursing Informatics
Outline
I. Informatics
II. Nursing Informatics
III. Origin of Nursing Informatics
IV. Top 4 Problems of Nurses in the workplace
V. Framework for Nursing Informatics
VI. Application of Nursing Informatics
VII. Computers in Nursing Education
VIII. Computers in Nursing Practice
IX. Computers in Nursing Research
X. Automated System in the Philippines
Informatics
● French word “informatique” = computer science
● The study of computers, including both hardware
and software design.
● Defined as = computer science + information
science.
● Body of knowledge that provides theoretical basis
for information technology
● 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.
○ DIK - Data, Information, and Knowledge
Nursing Informatics
● “The use of computers technology to support
nursing, including clinical practice, administration,
education, and research.” - Hebda (1998)
● “The development and evaluation of applications,
tools, processes, and structures which assist nurses
with the management of data in taking care of
patients or supporting the practice of nursing.” -
American Nurses Association (ANA) (1994)
● 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,
J.R., & Corcoran, S., 1989)
Origin of Nursing Informatics
● Increase in knowledge has led to the development of
many specialties and sub-specialties
● The number of cases increased with increase in
population, discovery of more diseases, and
extension of life expectancy.
● Due to increase workload, lack of time to channel into
useful information or knowledge – lead to
development of healthcare informatics.
TOP 4 PROBLEMS OF NURSES IN THE
WORKPLACE:
● Documentation is Excessive
○ Writes narratives (patient’s history, progress notes,
care plans, and special reports)
○ Fills up forms, record VS in graphing paper and
writes in tables input/ output.
● Turnaround Time is too long
○ Turnaround time starts from the time a request is
made to the time it was fully accomplished (ex.
laboratory tests or ancillary orders)
○ Automation helps accelerate the processes of
request and facilitate the presentation of current
status of result of the request.
● Nursing Processes are Inaccurate
○ Rushing of nursing process may lead to
commission of errors.
○ Errors: Medication errors, wrong entries, dictation,
translation, and transcription of orders.
○ Automation of these processes mostly done beside
a patient leads to a great reduction of errors.
● Communication is Poor
○ Communication between healthcare providers and
between departments is POOR when served with
telephone systems because of its real-time nature
that requires the presence of both.
○ Phone lines may be tapped or bugged breaching
privacy and confidentiality.
○ Computers provide different modes of
communication like chat, telephony, or video
conferencing, or e-mail and simple text messaging
whatever is most convenient and appropriate.
Framework for Nursing Informatics
Relies on the central concepts of data, information, and
knowledge:
● A DATA is defined as discrete entities that are
described objectively without interpretation.
● An INFORMATION as data that is interpreted,
organized or structured.
● A KNOWLEDGE as information that has been
synthesized so that interrelationships are identified
and formalized
● Resulting in DECISIONS that guide practice.
<<
Teaching Nursing Informatics is a must in the Ph.
● January 2008 - CHED memorandum order (CMO)
NO. 5 Series of 2008 to all deans of the colleges of
nursing throughout the country.
CMO No. 5 Series of 2008
● It requires the replacement of basic computer with
3-unit Nursing Informatics in the new curriculum.
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 Application of Nursing Informatics ● May provide information or decisions to modify
budget, provide different staffing, move supplies to
● Nursing Informatics can be applied to areas of
different locations, or make other changes for more
nursing practice, which include:
efficient and higher-quality care.
○ Clinical practice
○ Administration Computers in Nursing Research
○ Education, and 1. PROBLEM IDENTIFICATION
○ Research ● Useful in locating current literature about the
Computers in Nursing Education problem and related concepts. Helps in searching
for existing documents, and e-mail to colleagues.
Computer-Assisted Education <

2. LITERATURE REVIEW
● PDA (personal digital assistants)
● Software facilitate searches, contains thesauruses
● LCD Projectors
so that the most appropriate terms can be selected.
● Wireless Routers
● Desktops 3. RESEARCH DESIGN
● Laptops ● Search literature for instruments that have already
● Smartphone been established or to design and test instruments
● Videos/animations that need to be developed for past study.
● Distance learning 4. DATA COLLECTION AND ANALYSIS
● Testing (NCLEX) ● Helps create form for the collection of data such as
● Student and course record management informed consent, demographic data, and recording
forms. Commonly used software for quantitative
Computers in Nursing Practice
data analysis: SPSS (statistical package for social
Functions sciences), SAS (statistical analysis system), Sys
1. Records client information STAT, MYSTAT
2. Provides access to other departments 5. RESEARCH DISSEMINATION
3. Used to manage client scheduling ● Computer word processing programs are used to
4. Documentation of clients' status & medical records author the final reports of research and send
keeping research to various readerships.
● Provides access to standardized forms, policies, ● Help speeds completion or research projects.
and procedures
● Access data about clients that may be somewhere Automated System in the Philippines
in the medical record or elsewhere in health care ● 1970s
agency. ○ Computers are mainly used to automate billing.
5. Bedside Data Entry ○ Hospital networks expanded to include information
● Records client’s assessments, medication process in admission, discharge, and transfer
administration, progress notes, care plan updating, (ADT) (mid 70s)
client acuity, and accrued charges ○ Networks now include pharmacy section, now
6. Computer-Based Client Records (EMRs/CPRs) connecting 3 big departments: accounting, ADT,
● Provide easy retrieval of specific data such as and pharmacy. (Late 70s)
trends in vital signs, immunization records, and ● 1980s
current problems. ○ Laboratory and imaging departments are already
● It can be designed to work providers about using their special computers (early 80s)
conflicting medications or client parameters that ○ Integrated system expanded to the clinical area.
indicate dangerous conditions. (mid 80s)
7. Electronic Access to Clients ○ 90’s hospital bought conversion software and
● Used extensively in health care to assess and hardware in order to deliver the laboratory and
monitor clients’ conditions imaging machines to link their main system creating
● Data accumulated from various electronic devices interfaced systems.
are stored for research purposes
● 2000s
● Can monitor client
○ Laboratory Information System (LIS) & Radiology
● Computerized diagnosis
Information System (RIS) started to encroach into
● Telemedicine
the main hospital information systems.
8. Practice Management
● Used to order supplies, tests, meals, and services, ● Late 2000s
from other departments. ○ The Philippine Heart Center will soon implement the
● Allows nursing service to determine the most costly internet-based hospital information system (HIS) to
items used by a particular nursing unit. allow healthcare team to access it anywhere.

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 Computer Parts and Systems STORAGE DEVICES
● Hold data and programs permanently
● Different from RAM
Outline
I. Parts of the Computer System ★ Hard Drive
II. Types of Computers ○ very fast means of storing and retrieving data as
Looking Inside the Computer System
well as having a large storage capacity
★ Magnetic Storage
Parts of the Computer System ○ Floppy/DISKETTE and hard drive
● Computer systems have four parts: ○ Uses a magnet to access data
1. Hardware ★ Optical Storage
2. Software ○ CD and DVD drives
3. Data ○ Uses a laser to access data
4. User
SOFTWARE
HARDWARE
● Tell the computer what to do; describe the function or
● Mechanical devices in the computer; physical the contribution of the sets of commands, procedures
components of the machine in the computer system
● Anything that can be touched ● Also called a program
○ Electronic circuits, microchips, processors & ● Thousands of programs exist
motherboard – main circuit board that all other ○ Operating system
internal components connect to (placed inside ○ Word processor
computer housing) ○ Database
○ PERIPHERAL DEVICES (input & output devices) ● Benefits the nursing from doing a manual preparation
of reports and documents, due to readily available
Essential Computer Hardware
information, the nurse will have more time
● Computer use the same basic hardware synthesizing and analyzing information.
● Hardware categorized into four types:
Software Runs the Machine
PROCESSING DEVICES
● Brains of the computer ● Two types:
● Carries out instructions from the program ○ System Software
● Manipulate the data ○ Application Software
● Most computers have multiple processors SYSTEM SOFTWARE
● Central processing unit (CPU) ● “Boots up” (starts up and initializes) the computer
● Secondary processors system; controls, input, and storage; and controls the
● Processors made of silicon and copper operation of the application software.
MEMORY DEVICES ● Most important software
● Stores data or programs ● Operating system
● Random Access Memory (RAM) ○ Windows XP
○ Volatile ● Network Operating System (OS)
○ Stores current data and programs (temporarily) ○ Window Server 2003
○ More RAM results in a faster system ● Utility
○ Changeable and used for primary storage ○ Symantec Antivirus

● Read Only Memory (ROM) APPLICATION SOFTWARE

○ Permanent storage of programs; does not change; ● Includes the various programs that users require to
can’t be erased or altered perform day-to-day tasks. They are the programs that
○ Hold the computer boot directions support the actual work of the user. Accomplishes a
specific task.
INPUT AND OUTPUT DEVICES
● Most common type of software
● Allows the user to interact
○ MS Word
● Input devices accept data
● Covers most common uses of computers.
○ Keyboard, mouse
● Output devices deliver data to external world (text, THIRD TYPE OF SOFTWARE (third-party)
data files, sound, graphics, or signals) ● Utility programs
○ Monitor, printer, speaker ● Used to help maintain the system
● Some devices are input and output ● Clean unwanted programs
○ Touch screens
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● Protect the system against viruses and it can process a large number of functions at one
● Access the World Wide Web time.

DATA MICROCOMPUTERS (Personal Computer)

● Pieces of information ● Being used for an increasing number of independent
● Computer organize and present data applications as well as serving as a desktop link to
the programs of the mainframe.
Computer data
● Desktops can serve as stand-alone workstations and
● Fact with no meaning on its own can be linked to a network system to increase their
● Stored using the binary number system capabilities.
● Data can be organized into files
HANDHELD COMPUTERS
USERS
● These are small, special function computers; smaller
● People operating the computer size than the standard desktop microcomputers,
● Most important part some have claimed to have almost the same
● Tell the computer what to do functionality and processing capabilities as the
Computer users standard desktop microcomputer.
● Roles depends on ability ● More popular are the palm-sized computers such as
○ Setup the system personal digital assistant (PDA) = provides
○ Install software calendar, contacts, and note-taking functions and
○ Manage files may provide word processing and spreadsheet.
○ Maintain the system
● “Userless” computers Open Source and Free Software
○ Run with no user input
○ Automated systems Outline
I. Open Source Software
Information Processing Cycle II. Free Software
● Steps followed to process data: III. Four Essential Freedoms
IV. Compare/Contrast
○ Input V. VistA
○ Processing VI. Open Source Software Examples
○ Output VII. Free Software Examples
○ Storage VIII. Data Processing
○ Feedback FS/OSS
Types of Computers OPEN SOURCE SOFTWARE
SUPERCOMPUTERS ● The open source concept is said to promote
● Largest type of computer; a world-class “number software reliability and quality by supporting
cruncher” independent peer review and rapid evolution of
● It is a computational-oriented computer specially source code, as well as making in freely available.
designed for scientific applications requiring gigantic ● In addition to providing free access to the
amounts of calculations. programmer’s instructions to the computer in the
● Designed primarily for analysis of scientific and programming language in which they were written,
engineering problems and for tasks requiring millions many versions of open source license allow
or billions of computational operations and anyone to modify and redistribute the software.
calculations. ● The open source initiative (OSI) has created a
● It is found primarily in areas such as defense and certification mark, “OSI certified”
weaponry, weather forecasting, and scientific ○ Open Source comes with price, subscription, or
research. fees to pay
● In order to be OSI certified, the software must be
MAINFRAMES distributed under a license that guarantees the right
● It is the fastest, largest, and most expensive type of to read, redistribute, modify and use the software
computer used in corporate America for processing, freely.
storing, and retrieving data. ● The actual category of software that is considered
● It is a large multiuser central computer that meets the free is almost exactly the same as the actual
computing needs of a large organization such as category of software that is considered open source.
repetitive calculations of bills and payrolls.
● A mainframe has an extremely large memory FREE SOFTWARE
capacity and fast operating and processing time and ● Software that respects users' freedom and
community.
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● Freedom to run, copy, distribute, study, change and
improve the software.
● Thus, “free software” is a matter of liberty, not price.
“FOUR ESSENTIAL FREEDOMS”
1. To run the program as you wish, for any purpose
(freedom 0).
2. To study how the program works, and change it so
it does your computing as you wish (freedom 1).
Access to the source code is a precondition for this.
3. To redistribute copies so you can help your
neighbor (freedom 2).
4. To distribute copies of your modified versions to
others (freedom 3).
● “Free software” does not mean “noncommercial”.
● But regardless of how you got your copies, you
always have the freedom to copy and change the
software, even to sell copies.
● Most free software licenses are based on copyright,
and there are limits on what kinds of requirements
can be imposed through copyright.
● However, some free software licenses are based on
contracts, and contracts can impose a much larger
range of possible restrictions. That means there are
many possible ways such a license could be
unacceptably restrictive and non-free.
COMPARE/CONTRAST
● free software and open source ideologies are distinct
● basically, refer to the same software licenses, with a
few minor exceptions
The term “open source” software is used by some
people to mean more or less the same category as free
software.
● accept some licenses that we consider too restrictive,
and there are free software licenses they have not
accepted.
● nearly all free software is open source, and nearly
all open source software is free.
● OSS/FS has been described as the electronic
equivalent of generic drugs.
● In the same way as the formulas for generic drugs
are made public, so OSS/FS source code is
accessible to the user. Any person can see how the
software works and can make changes to the
functionality.
● As the OSS/FS can be obtained royalty free, it is less
expensive to acquire than proprietary alternatives.
This means OSS/FS can transform healthcare in
developing countries just as the availability of the
generic drugs have.
VistA (Veterans Health Information System and
Technology Architecture)
● VistA is the “mother of all health care
applications”. It is not strictly OSS/FS but has been
promoted by it.
○ Patient records, prescriptions, laboratory results,
and other medical information. It contains among
other components, integrated hospital
management, patient records management, and
medical imaging systems.
Open Source Software
● Databases:
○ LDAP
○ MySQL (database)
○ PostgreSQL (relational database with the ability to
do stored procedures)
● Knowledge Management:
○ Plone (open source content management system)
○ Knowledge Tree
● Telephony:
○ Asterisk (A Phone system [PBX] that also supports
Voice Over IP technology)
○ Elastix
○ FreePBX
○ Trixbox CE
Free Software
● Operating systems and Desktop environments
● Linux - Operating system kernel
● Ubuntu - Linux distribution with full compliment of
software for everyday use. See also Kubuntu that
runs the KDE desktop which some people find this
easier if they previously used MS Windows. Ubuntu
is an easy-to-use operating system based on and
made possible by the Debian project.
● Google Chrome OS - Lightweight operating system
based around the web browser
● Android smart-phone operating system - by
Google / Open Handset Alliance
● Symbian smart-phone operating system - by
Nokia
DATA PROCESSING
● the collection and manipulation of items of data to
produce meaningful information.
● It is the process of putting information into a
computer so that the computer can organize it,
● change its form, and etc.
● It is also the conversion of raw data to
machine-readable form and its subsequent
processing (as storing, updating, rearranging, or
printing out) by a computer.
● Nurses continually collect data about their clients.
The data are organized and processed, producing
information about client needs and potential
interventions.
● Using an intensive nursing knowledge database, the
information is interpreted.
● The goal of this plan is to provide caring
cost-effective quality care.
● In modern healthcare, the process of moving from
data collection to implementing and evaluating, and
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 individualized plan of care is highly dependent on
automated database systems.

DATA PROCESSING FUNCTIONS

● Validation – Ensuring that supplied data is "clean,
correct and useful"
● Sorting – "arranging items in some sequence and/or
● in different sets."
● Summarization – reducing detail data to its main
points.
● Aggregation – combining multiple pieces of data.
● Analysis – the "collection, organization, analysis,
interpretation and presentation of data.".
● Reporting – list detail or summary data or computed
information.
● Classification – separates data into various
categories.