ENDTERM Reviewer - 2nd Semester (NCM110NIF)

Alijah Abigail R.
Jayme BSN2 – Henderson B – 2nd Semester ENDTERM Reviewer
ENDTERM 2nd Semester – COMPREHENSIVE EXAMS
NCM110NIF – NURSING INFORMATICS
I. CONCEPTS, PRINCIPLES, & THEORIES

What is Nursing Informatics?
➢ a title that evolved from French word, “Informatique”
➢ a specialty that integrates Nursing Science, Computer
Science, and Information Science
o Nursing Science – development of theories and
practical concepts for improving how clinicians
and patients administer care
o Computer Science – study of computers and
computational systems
o Information Science – practice dealing with
collective data, and retrieval of information
➢ referred to the field of applied computer science
➢ concerned with the processing of information such as nursing information
Related Terms:
• Nursing • Computer Literacy – ability to
• Informatics use the computer efficiently
• Electronic Health Record – • Information System – integrated
electronic version of patient's set of components where we
medical history/data/chart collect, store, and process data to
• Telehealth – the use of digital provide information
information and communication • Internet – provides a variety of
technologies information, etc.
A. THEORIES
1. SYSTEMS THEORY
• is largely accredited to the Austrian biologist,
Karl Ludwig von Bertalanffy
• The theory looks at interacting parts within
boundaries, and can be seen with the use of
technology and the body systems of patients. *
• The underlying principles of Systems Theory
should seem largely intuitive to healthcare
professionals. **
2. COGNITIVE THEORY
• One of the basic building blocks to help understand informatics.
• Can be related to input, output, and processing.
• It helps understand the information processed by our brains.
• It includes:
o Problem solving
o Decision Making
o User centered interface
o Development and use of terminologies
Alijah Abigail R. Jayme BSN2 – Henderson B – 2nd Semester ENDTERM Reviewer
3. CHANGE THEORY
• Kurt Lewin, (1890 1947) a Gestalt social psychologist, has
been acknowledged as the “father of change theories”
• is applied in looking at the dynamic processes that are
incorporated with nursing informatics.
• It involves an action of planning and fact gathering before
proceeding on to the next phase of action.
• Lewin’s change theory is a ‘planned change’ guide that
consists of three distinct and vital stages:
o Unfreeze – a desire to change
o Moving to A New Level/Change Stage – involves
process of change in thought, behavior, etc.; new is
better; application of desired change
o Refreezing – establishes the change; there is a
standard operating procedure
4. THE NELSON DATA TO WISDOM CONTINUUM
*Data - raw and uninterpreted facts without meaning

*Information - facts with meaning
*Knowledge - trying to understand the information given
*Wisdom - there is knowledge used to make decisions
3 States of Data
• Data at rest - data in storage
• Data in use - a database program is reading or writing
• Data in motion* - moving between applications over the network
Databases
• Organized collection of related data
• The possibility of finding databases depends on the following factors
o Data naming (indexing) and organizational schemes
o Size and complexity of the database
o Type of data within the database
o Database search methodology**
Types of Data
(2 primary approached to classify data in a database system)
• Conceptual Data Type • Computer Based Data Type
o How the users will use the o Numbers, letters or
data combination
o Financial, patient or human o To build the physical
resource data database within the
o Has major impact on how computer system
the designer indexes the o Identifies the number of
data spaces and specific
functions that the system
can perform
o Numeric data perform
numeric functions
o Logic data are limited
Database Management System

• Computer programs that are used to input, store, modify, process, and access
data in a database*
• 3 Interacting Parts of a functioning DBMS:
o The Data
o The Designed Database
o The Query Language that is used to access data
• Examples of DBMS in everyday life:
o Computerized library system
o Automated teller machines
o Flight reservation system
• Advantages Of Automated DBMS
o Decreased data redundancy
o Increased data consistency
o Improved access to all data*
• Functions:
o Store the data
o Update the records
o Provide easy retrieval of the data
o Permit report generation
Data to Information
Common Database Operations
• Data Input Operations
o Input new data
o Update data
o Change or modify data
• Data Processing Processes

o The purpose is to extract information
o Discover new meanings
o Reorder data
• Data Output Operations

o Online and written reports
o Processed data as charts and graphs
Data Warehouses
• A large collection of data imported from several different systems into one
database*
• Data marts are smaller collections of data**
• Purposes
o Spares users from the need to learn several different applications
o Makes it possible to separate the analytical and operational processing
o Provides an architectural design for the data warehouse that supports
decisional information needs
o The user can slice and dice the data from different angles and at different
levels of detail
• Functions:
o Must be able to extract data from the various computer systems and
import those data into the data warehouse
o Must function as a database to store and process the data in the database
o Must be able to deliver data in the warehouse back to the users in the
form of information
Data/Information to Knowledge
• Data Mining – to find previously
unknown patterns and trends that
will assist in providing quality care,
predicting best treatment choices
and utilizing health resources in a
cost-effective manner
• Knowledge Discovery and Data
Mining (KDD)
o The process of extracting
information and knowledge
from large scale databases
o 7 Step Process: Task
Analysis, Data Collection,
Data Cleaning, Data
Transformation, Data
Mining, Pattern
Interpretation and
Evaluation, and
Deployment
o 3 Step Process by Bagga and Singh: Pre-Processing, Data Mining and
Post Processing*
Wisdom: Knowledge Application

• Decision support systems produce knowledge from information
• Expert systems use the knowledge from information and transform it to produce
wisdom
• A proposed theory of nursing knowledge/wisdom uses the formula NKW(IB)=P
Wisdom: Expert Support/ Systems

• Represent the present and future vanguard of nursing informatics
• Aim to help make the nurse more intelligent in providing quality care based on
evidence
• Use artificial intelligence (AI) to model the decisions an expert nurse would make*
Wisdom: Advantages of Expert Support/Systems

✓ Provide a solution more quickly than humans
✓ Reduce waste and cut costs
✓ Improve patient care by sharing the knowledge and wisdom of human experts
4 Main Components*
• Natural Language
• Knowledge Base
• Database
• Inference Engine
5. GRAVE & CORCORAN’S MODEL

• Nursing informatics as Linear*
• Progression from Data, Information to
Knowledge
• Management Processing is integrated in each
elements depicting Nursing informatics as the
proper management of Knowledge, from data as
it is converted to knowledge and information. **
6. SCHWIRIAN’S MODEL
• NI activity was depicted as an
interface between the computer
hardware and software, raw nursing
related information, and the user
within the context of their profession
or organization. All of these
elements led to a common goal or
objective. *
• *Raw material - nursing related
information
• *Technology - computing system
• *User - HCP
• *Goal – objective
7. TURLEY’S MODEL
• Nursing Informatics is the
interaction between the discipline
specific science/ Nursing Science
and Areas of Informatics. *
• Core Components of Informatics:
o Cognitive Science
o Information Science
o Computer Science
8. WERLEY AND GRIER MODEL

• *Their model integrated community
data, institutional data, interpersonal data, and patient data into a hierarchical
framework.
• It was suggested that these information sets were needed to assist nurses in
making decisions at various levels of functioning**
• *Harriet Werley - first nursing informatician
9. NURSE-COMPUTER INTERACTION
• model made by
Stagger’s and Park*
• Framework which has
been used to help
understand interactions
between nurses,
computers, and enabling
elements that optimize
the ability of nurses to
process information via
computerized systems.
• *Nurse-computer
interactions can change overtime.
• *The location of the phenomena along with the trajectory has implications for
the outcome.
• *User
• *Computer
• *Tasks
• *Interfaces
• *Environmental elements
10. BENNER NOVICE TO EXPERT MODEL

• Patricia Benner**
• Every nurse must be able to continuously
exhibit the capability to acquire skills and then
demonstrate specific skills beginning with the
very first student experience.
• According BENNER, there are 5 levels of
expertise:
o Novice
o Advanced Beginner
o Competent
o Proficient
o Expert
• *Advanced beginner - acceptable performance
• *Competent - enhanced mastery and ability to cope and manage
contingencies
• *Proficient - evolution through continuous practice of skills combined with
professional experience and knowledge
• *Expert - an individual with mastery of concepts and the capacity to
intuitively understand the situation, and immediately targets the problem with
minimal effort or problem solving
11. PHILIPPINE HEALTHCARE ECOSYSTEM MODEL
12. INTEL’S SHIFT LEFT MODEL

13. PATIENT MEDICAL RECORD INFORMATION MODEL: BASIS OF HER

• The type and pattern of documentation in the patient record will be
dependent on 3 interacting dimensions of health care:
o Personal Health Dimension
o Health Care Provider Dimension
o Population Health Dimension
• *ABC code - administrative, billing, and insurance claim
• *PNDS - Perioperative nursing data set; standard documents for perioperative
data
• *NANDA
II. HISTORICAL PERSPECTIVES OF NURSING INFORMATICS

COMPUTERS IN NURSING
- Nursing information systems (NIS), nursing applications and/or nursing
informatics (NI) affect all aspects of health care delivery
- Manage patient care information, monitor quality and evaluate outcomes
- Document and process real time plans of care, support nursing research and
advance the role of nursing in the healthcare industry
SEVEN TIME PERIOD
A. Prior To 1960s
• Nursing profession was undergoing major changes
• Computers were used for basic office administrative and financial accounting
functions only
• Used punch cards to store data and card readers to read computer programs
• Computers were linked together and operated by paper tape and used
teletypewriters to print output
B. 1960s
• Uses of computers in health care settings began to be explored*
• Nursing practice standards and resources were reviewed and analyzed
• Computer technology was advanced, and the number of health care facilities
increased
• Clinical practice presented nurses with new opportunities for computer use
C. 1970s
• Nurses began to value the computers to their profession
• Computer assisted in the design and development of nursing applications for
HIS and other environments where nurses functioned*
• Conferences helped public and home health nurses
• Hospitals and public health agencies embarked on investigating computers
and nursing
• The opportunity to improve education using computer technology began
D. 1980s
• Field of NI became visible in the healthcare industry and nursing
• Many mainframes HIS emerged with nursing subsystems*
• Discharge planning systems used as referrals
• Microcomputer or personal computer emerged
• In 1985, the ANA approved the formation of the Council on Computer
Applications in Nursing (CCAN)
E. 1990s
• Became an integral part of healthcare settings, nursing practice and
profession
• Policies and legislations were adopted
• Nursing profession became actively involved in promoting NI
• ANA approved NI as a new nursing specialty
• Laptops and notebooks
• LAN and WAN
• Internet and www
F. 2000s
• Data capture and data sharing technological tools
• Wireless, point of care, regional database projects and increased IT solutions
• Use of bar coding and radiofrequency identification
• Smaller mobile devices with wireless or internet access*
• Voice Over Internet Protocol (VoIP)
G. 2010s
• Genomic health care, shifting research paradigms and social technologies
• Complete digitalization in healthcare information
• “Meaningful use” legislation
• There are three basic components of meaningful use:
o The use of a certified EHR in a meaningful manner.
o The electronic exchange of health information to improve quality of
health care.
o The use of certified EHR technology to submit clinical quality and other
measures.
• The Meaningful Use Criteria are driven by Health Outcomes Policy Priorities
and Care Goals.
o Improve the quality, safety, efficiency of health care, and reduce health
disparities.
o Engage patients and families.
o Improve care coordination.
o Improve public health.
o Ensure adequate privacy and security protections for PHI.
LANDMARK EVENTS IN NURSING AND COMPUTERS

PATIENT SAFETY AND NI

- Patient safety is the biggest factor that drives information technology
- Initiatives legislations
o CPOE
o HIPAA
o NAHIT
A. Computerized Provider Order Entry (CPOE): The Basics

• Refers to the process of providers entering and sending treatment
instructions
• CPOE has several benefits:
o Reduce Errors and Improve Patient Safety
o Improve Efficiency
o Improve Reimbursements
B. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPPA)

• Is a federal law that required the creation of national standards to protect
sensitive patient health information from being disclosed without the patient’s
consent or knowledge.
C. NATIONAL ALLIANCE FOR HEALTH INFORMATION TECHNOLOGY

• Was formed in 2002 in an effort to promote the use of health IT.
• Its members consisted of health care providers, payers, pharmaceutical
companies and other industry organizations
III. IT SYSTEM APPLICABLE IN NURSING PRACTICE

A. BARCODE- ASSISTED MEDICATION ADMINISTRATION (BCMA)
• Verifies that the right drug is being administered to the right pt at the right dose
by the right route at the right time.
• 2 Unique patient identifiers (JCAHO)
Barcode-Assisted Medication Administration

Advantages ✓ Increased accountability &
✓ Up to date drug references capture of charges
information
✓ Customized comments or alerts Possible Drawbacks
✓ Monitoring for pharmacy &  Wrong dosage form
nurse’s response to  Omission
predetermined rules or standard  Extra dose
✓ Reconciliation for pending STAT  Wrong drug
orders  Wrong dose
✓ Capturing data for analysis &  Unauthorized drug
monitoring  Charting errors
✓ Verifying blood transfusion &
laboratory specimen collection
identification
B. AUTOMATED DISPENSING CABINETS

• Computerized point of use medication management system
• Allow the nurse to obtain patient- specific medication from drawers or bins that
open after a drug is chosen from a pick list
Automated Dispensing Cabinets

Reason Behind Its Wide Acceptance Possible Drawbacks
✓ Improved pharmacy productivity  Lack of pharmacy screening of
✓ Enhance nursing productivity medication order prior to
✓ Improved charge capture administration
✓ Automated inventory control  Choosing of the wrong
✓ Improved security of controlled medication from an alphabet pick
substance list
✓ Timelier drug availability  Problems in placing storing &
✓ Enhanced patient quality & safety returning of high alerts
medication’s
 Problems with look a-like & same
packaging drugs next to each
other.
C. SMART INFUSION PUMP

• Used to deliver parenteral medications through IV or epidural lines
• Found in a variety of clinical settings
• Programmed with patient & drug parameter
• Causes of error in programming
• Incorrect, inappropriate or miscalculation
D. COMPUTERIZED PHYSICIAN ORDER ENTRY (CPOE)

• Used for direct entry of one or more types of medical orders by a prescriber into
a system
• Allows to access record & enter orders remotely
• Includes passive & active feedbacks systems
Advantages
✓ Improves quality patient outcomes, and safety
✓ Reduces variation in care to improve disease management
✓ Improves drug prescribing & administration
CRITICAL CARE APPLICATIONS

IT Capabilities & Applications in Critical Care Settings
• Process, store, and integrate physiologic and diagnostic information from various
sources
• Present deviations from preset ranges by an alarm-or alert
• Accept and store patient care documentation in a lifetime clinical repository
• Trend data in a-graphical
presentation
Data Connectivity Infrastructure

- The term medical information bus
(MIB) is used to classify the
backbone of information exchange
PHYSIOLOGIC MONITORING SYSTEMS

• 1960s: the systems were developed
by NASA to oversee the vital signs of the astronauts
• 1970s: the systems were found in hospital setting replacing the manual methods
of gathering patients’ vital signs*
• 1980s: the technology became cheaper, smaller and significantly more
powerful**
• 1990s: the development-was focused on integration of monitoring data into
information systems
Physiologic Monitoring Systems Basic Components

1. Sensor
2. Signal Conditioner
3. File
4. Computer Processor
5. Evaluation or Controlling Component
HEMODYNAMIC* MONITORS
• Allow for calculation-of hemodynamic indices
• The expert collection and analysis of qualitative and quantitative data of
cardiopulmonary functions
• Include clinical observation, the use of electrical photometric, pressure
transducing equipment, and other non-invasive devices, as well as the application
of several intravascular catheters
Uses of Hemodynamic Monitors

✓ Measure hemodynamic parameters
✓ Closely examine cardiovascular problems
✓ Evaluate cardiac pumps and volume status
✓ Recognize patterns* and extract features
✓ Assess vascular system integrity
✓ Evaluate the patient’s physiologic response to stimuli
✓ Continuously assess respiratory gases
✓ Continuously evaluate blood gases and electrolytes
✓ Estimate cellular oxygenation
✓ Continuously evaluate glucose levels
✓ Automatically transmit selected data to a computerized patient database
Non-invasive Hemodynamic Monitors Invasive Hemodynamic Monitors

• Oscillometric Techniques • Pulmonary Artery Catheter
• Pulse Oximetry • Thermistor
• Doppler • Fiber-optic Technology
CRITICAL CARE INFORMATION SYSTEM (CCIS)

• Designed to collect, store, organize, retrieve, and manipulate all data related to
the care of a critically-ill patient
• Primary purpose: organization of patient’s current and historical data for use by
all care providers in patient care**
CCIS Components
1. Patient Management
2. Vital Signs Monitoring
3. Diagnostic Testing Results 4. Clinical Documentation
4. Decision Support
5. Medication Management
6. Interdisciplinary Plans of Care

7. Provider Order Entry
COMMUNITY HEALTH APPLICATIONS

Community Health Nursing
• A synthesis of nursing practice and public health practice applied to promote and
preserve the health of populations
• Focus: population as a whole
Computer Applications in CHN

• Population focused
• Continuity of care needs
• Billing of services
Computer System Development

• CHN agencies have used computers since the late 1960s when computers were
introduced into the healthcare industry
Computer System Development

Advancements led to four domains of concentration*
1. Public Health: population interventions and outcomes
2. Home-Health: skilled nursing care and the outcomes
3. Special Population Community Practices: specific diagnostic care/ treatments
and outcomes
4. Outpatient Care: intermittent, episodic or preventive care and outcomes
Public Health
- coordinated effort at different levels whose mission is to fulfill the society’s
interest in assuring conditions in which people can be healthy (IOM)
CLINICAL CARE CLASSIFICATION SYSTEM

• previously known as Home Health Care Classification (HHCC)
• a standardized language/ vocabulary designed to document, code, and classify
computer- processing patient care in any clinical care setting by healthcare
provider
COMMUNITY HEALTH SYSTEMS

• refer to computerized IT system specifically developed and designed for use by
community health agencies, local and state health departments, community
programs, and services
Some of the Typically Used Systems:

1. Categorical Program Systems 2. Screening Programs
- Designed to support data - Designed to support data
processing and tracking processing and tracking
specific programs such as specific programs such as
Cancer detection, mother and cancer detection, mother and
child immunization, and/or child immunization, and/or
family planning family planning
- collect longitudinal data for - Collect longitudinal data for
specific disease condition specific disease condition
3. Registration Systems 5. Statistical Reporting

- Designed to identify patients - Developed to collect and
eligible for CHN services in process statistical information
clinics and homes for health departments
- Can be accessed from
local/district units prior to 6. Special Purpose System
providing services - Developed to collect statistical
data for administering a
4. Management information specific program, regardless
System of what type of agency offers
- Focus on the management the program
statistical and operational
needs of the agency and 7. Public Health Information
professionals Network
- Enables consistent exchange
of response, health, and
disease tracking data between
public health partners
Modern Systems:
1. Automated IV PUMPS
- Control the dosages and drips given to patients. Software and medical tech
allow nurses to change the drip amounts and medication doses so patients
aren’t waiting for changes. There are IV pumps for nutrition that give needed
meals at the right times.
2. Portable Monitors
- Equipment allows nursing professionals to check on patients, even if they’re
on the move or busy helping someone else. Portable devices monitor vital
signs like ECG, respiratory rates, and oxygen saturations while transmitting the
information back to a central monitor.
3. Smart Bed Technology

- Can help nurses track movement, weight, and even vitals. Smart beds also
play a major role in keeping patients safe and comfortable during a long
hospital stay. With the number of falls and patient injuries inside hospitals,
smart beds are very important for patient safety. Smart bed technology gives
nurses a constant in-room monitor that provides them with regular updates
and communications on a patient’s activities.
4. Wearable Devices
- Devices that help track heart rates, exercise, sleep, respiration, and more are
helping people take their health into their own hands. With increased
accessibility to iPhones, nurses also benefit from apps and devices that help
them care for patients.
5. Electronic Health Record

- Are replacing older paper filing methods. Electronic Health Records allow
nursing experts to document care provided to patients and retrieve
information that can help prioritize care.
6. Centralized Command Centers

- Improved patient experiences and better ways for RNs and doctors to manage
supplies, clinical technology, and capacity. This is done through software
applications such as dashboards that provide real-time updates.
7. Telehealth Apps
- Is a valuable, newer element in healthcare. Hospitals and clinics allow patients
to virtually video chat with a doctor or nurse to describe their symptoms or
show doctors things like rashes or bumps. This helps patients with a quick
diagnosis without leaving the comfort of their own home
IV. INFORMATICS APPLICATION IN EVIDENCE-BASED NURSING PRACTICE

Evidence based nursing practice are the applications or the usage of the informatics in
the field of nursing wherein it is based from researchers or it is based from clinical
observations and clinical practices.
A. CARE PLANNING
• Computerized patient record facilitates the automation of the nursing care
planning process
• Today’s care planning process includes a mix of individual patient data standards
and data which can be used for decision making
Notes* defined as the documentation of the nursing process specifically problems,

nursing diagnosis, goals, interventions and evaluation. And then keeping of the clinical
record of the important facts about your patient and the progress of his/her illness.
• ADPIE use through the computerized nursing care planning.

• Well concealed patient care plans are a crucial component of high-quality
nursing care.
• Writing care plans are difficult and time consuming.
• Computerization can significantly enhance the speed, the quality, the
comprehensiveness and effectiveness of creating the patient specific care plans.
• The benefits to nursing administrators include more efficient use of the nursing
resources, more effective use of nursing skills and expertise and improved your
patient management.
Ex. Plan of care or 485 consists of the following:

1. Doctor’s order
2. Care Plans
3. Pila ka visits ni nurse if si patient ara na sa community
4. Patient information
5. Physician information
B. DISCHARGE PLANNING
• Documentation starts with admission and ends with a discharge care plan
• Discharge Care Planning Systems provide for continuity of care from home to
hospital and back to the community, another care facility, outpatient department
or the home
Notes:
• America - Medicare
• Philippines - PhilHealth
• Medicare states that discharge planning is a process used to decide what a

patient needs for a smooth move from one level of care to another
• REMEMBER! ONLY A DOCTOR can authorize a patient’s release from the hospital,
but the actual process of the discharge planning can be completed by a social
worker, a nurse, or a case manager
• The use of terminologies in discharge planning should be clear and easy for the
client to understand
Components of a Typical Discharge Plan

1. Summary of Admission Assessment (Principal Diagnosis, Chief Complaints)
- Admission assessment is usually associated with the process of examining or
testing patient before they are admitted.
- This is the entire field of study that evaluates how patient aren’t tested and
whether improvements can be made using fundamental aspect of care.
- So initial nursing assessment usually involves the systematic and continuous
collection of data such as the sorting, analyzing and organizing the data and
documentation and
- communication of these data collected.
2. Summary of Learning Needs That the Patient Had at Discharge
3. Multidisciplinary Plan Including Problems Still Unresolved and Outcomes
Not Met During Hospitalization
- **(Di tanan na discharge ayu na si patient. We must specify the result in a
multidisciplinary plan if this specific na ginabatyag ni patient has been
RESOLVED or NOT because that will part of the discharge plan so that it
would be continuously monitored our patient for any progress)
4. Medications and Procedures That the Patient Must Continue
- It contains the medication preparation, administration and storage and some
of the side effects of the medications.
- Ex. Paracetamol 500mg twice a day with fever.
- Don’t use medical terms in writing the discharge plan because the patient or
its relative could not understand it.
- Withdrawal or withholding the times and requires use for the client who lacks
the ability to comply esp. if the patient engage in “polypharmacy” **biskan
ano lang nga bulong imnon kung galain ang matyag**. Usually, it could
possibly include in the discharge planning the monitoring some medications
on what time it should be administer.
5. Summary of Selected Patient
- outcomes that a multidisciplinary team desired as minimal criteria for patient
to have achieved during hospitalization
6. (Addition) Client Education
- These are the topics regarding the patient, their problem and needs and
description of what to do, how to do it and what not to do.
- Home care instructions and criteria for monitoring that may include the
demonstration of client’s ability to perform their home care procedures.
- Aside from giving our clients an electronic discharge plan. It is also better to
give our clients a written copy of the plan.
- The printed copy of the discharge plan of the client should be within their
level of knowledge.
- Don’t use medical terms in writing the discharge plan because the patient or
its relative could not understand it.
Advantages of a Computerized Discharge Plan

✓ Closely coordinated communication among healthcare providers *(May hawid si
doctor & nurse.)
✓ Can be used for QA, auditing, research, and coding at discharge for prospective
payment
✓ It is arranged. These care plans and discharge planning are within the concept of
clinical and critical pathways.
CLINICAL/CRITICAL PATHWAYS
• “Clinical Pathways (CP) are multidisciplinary plans of best clinical practice for
specified groups of patients with a particular diagnosis that aid the co-ordination
and delivery of high-quality care. They are both, a tool and a concept, which
embed guidelines, protocols and locally agreed, evidence-based, patient-
centered, best practice, into everyday use for the individual patient.”
• **“Pathway”, alagyan. Ano ayhan ang pasunod sang aton nga care para sa aton
patient.
• This is a tool that provides an evidence-based practice for patient care.
• A clinical management tool that helps medical care providers coordinate the
delivery of patient care for a particular case or type of conditions.
• **Ex. Diabetes then what to do to the diagnosis of the patient? per day, per week.
There is a pattern or pathway. (nakapattern na ang tanan mo nga hemuon para
kay patient)
• It stands as a guide to usual treatment of patterns and it gives us a big picture.
• The CP usually recommends a total treatment regimen. Treatment regimens are
formulated through the consensus of a multi-disciplinary collaboration of all
those involved in the patient’s care. So, if developed and implemented properly
the critical paths can lead to desirable outcomes for the patient and improved
operating effectiveness or efficiency in the delivery of health care for the health
care facility.
Why Clinical Pathways?

✓ To improve patient care.
✓ To maximize the efficient use of resources
✓ To help identify and clarify the
✓ clinical processes.
✓ To support clinical effectiveness, clinical audit and risk management
Clinical/Critical Pathways as Active Management Tools

*(ginagamit naton sa pagrender sang care)
• Eliminate prolonged lengths of stay arising from inefficiencies, allowing better
use of resources
• Reduce mistakes, duplication of effort and omissions
• Improve the quality of work for service providers
• Improve communication with patients as to their expected course of treatment
• Identify problems at the earliest opportunity and correct these promptly
• Facilitate quality management and an outcomes focus
Four Components of a Clinical Pathway

1. A timeline **(Ex. for 1-week ano ang ubrahon ni nurse kay patient)
2. Categories of care or activities and their interventions (Pang nurse work. PT
work)
3. Intermediate and long-term outcome criteria (Wound/wound care)
4. Variance record (checking changes)
Optimum Development and Implementation Strategies

• Select a topic:
o Topic of high-volume, high-cost diagnoses and procedures.
o For example: Critical pathway development for cardiovascular diseases and
procedures. *(i-specify)
• Select a team: *(communicate kay doctor)
o Active physician participation and leadership is crucial
o Representatives from all groups
• Evaluate the Current Process of Care
o Key to understanding current variation or changes
o A careful review of medical records
o Identify the critical intermediate outcomes, rate-limiting steps, and high-
cost areas on which to focus.
• Evaluate Medical Evidence and External Practices
o Evaluate the literature to identify evidence of best practices
o In the absence of evidence, comparison with other institutions, or
“benchmarking,” is the most reasonable method to use
• Document and Analyze Variance
o The most important processes in the critical pathway
o Identification of factors the key features in process improvement
o Variance in clinical pathways is a result of the omission of an action or the
performance of an action at an inappropriate (often, a late) time period
**(tsakto ang timing dapat)
o Team to concentrate on a few critical items in the pathway that have been
identified in advance
o For example: length of stay in the intensive care unit
Benefits
✓ Support the introduction of ✓ Can help ensure quality of care
evidence-based medicine and use and provide a means of
of clinical guidelines continuous quality improvement
✓ Support clinical effectiveness, risk ✓ Support the implementation of
management and clinical audit continuous clinical audit in clinical
✓ Improve multidisciplinary practice
communication, teamwork and ✓ Support the use of guidelines in
care planning (collaborative) clinical practice
✓ Can support continuity and ✓ Help empower patients
coordination of care across ✓ Help manage clinical risk
different clinical disciplines and ✓ Help improve communications
sectors between different care sectors
✓ Provide explicit and well-defined ✓ Disseminate accepted standards
standards for care of care
✓ Help reduce variations in patient ✓ Provide a baseline for future
care (by promoting initiatives
standardization) ✓ Not prescriptive: don’t override
✓ Help improve clinical outcomes clinical judgement
✓ Help improve and even reduce ✓ Expected to help reduce risk
patient documentation ✓ Expected to help reduce costs by
✓ Support training shortening hospital stays
✓ Optimize the management of
resources
Limitations of Clinical Pathways Potential Problems and Barriers to the

 Implementation of the care Introduction of Clinical Pathways
pathways has not been tested in  May appear to discourage
a scientific or controlled fashion personalized care **(na plastar na
 No controlled study has shown a daw di mo na mabag-o but it
critical pathway to reduce length should be associated to the
of stay, decrease resource use, or patient’s specific conditions)
improve patient satisfaction  Risk increasing litigation
 Most importantly, no controlled  Don’t respond well to unexpected
study has shown improvements in changes in a patient’s condition
patient outcome  Suit standard conditions better
than unusual or unpredictable
ones
 Require commitment from staff
and establishment of an
adequate organizational structure
 Problems of introduction of new
technology
 May take time to be accepted in
the workplace
 Need to ensure variance and
outcomes are properly recorded,
audited and acted upon
Distinguish Critical Pathways from Clinical Protocols

• Protocols are treatment recommendations that are often based on guidelines.
Like the critical pathway, the goal of the clinical protocol may be to decrease
treatment variation
• Guidelines or protocols and clinical pathway both include those clinical plans
intended for the patients with a particular disease. Some usually say they are the
same but they do have their differences.
• Protocols are most often focused on guideline compliance rather than the
identification of rate limiting steps in the patient care process
• Guidelines usually show all treatment options to allow for broader coverage for
this phenomenon. Whereas the pathway maybe developed to come to a
consensus around the treatment that they can deep superior in terms of
efficiency, side effects.
• In contrast to critical pathways, protocols may or may not include a continuous
monitoring and data evaluation component
• Clinical pathways have proven to reduce length of stay complications and cause.
And will provide increased patient satisfaction. While the guideline shows
improved quality of care when compared to clinical pathways, it includes the
benefits, harms and alternative care options.
• Both pathways and their guidelines will help the clinician defend themselves in
court. **Kay tungod nakaplastar na siya hapos nlng magpresent sa court if may
problems sa kay patient
Are Clinical Practice Guidelines and Clinical Pathways Related?

• Some physicians have difficulty assimilating or doing evolving scientific evidence
into practice as well as they want to provide a lot of options to the patient.
• So systematically, developed statements to assist the practitioner and patient
decisions about appropriate healthcare for circumstance.
Characteristics of Clinical Practice Guidelines

• Attempt to define practice knowledge about the disease.
questions and explicitly identify They can suggest what specific
all their decision options and treatment course they will
outcomes undergo
• Explicitly identify, appraise and • **Clinical pathways kay tungod
summarize the best evidence naka standardization siya so amo
about prevention, diagnosis, na na siya ang sundon. While sa
prognosis, therapy, harm, and practice guides ya may OPTIONS.
cost effectiveness • Evidence based medicine is the
• Identify the range of potential conscientious, explicit and
decisions and provide the judicious use of current best
physicians with the evidence • evidence in making decisions
which when added to individual about the care of individual
clinical judgement and patients’ patients. This is the source for the
values and expectations will help clinical practice guidelines
them their own decisions in the • This shows that clinical pathways,
best interest of the patient when used in combination with
• **Clinical pathways isa lang ang clinical practice guidelines, will
solution and ang pinakatested assist in reinforcing a clinical
and proven while protocol ya workflow, which can eventually
should open to the patient if help to improve the clinical
what are their other clinical practice and support the difficult
options nga gusto or papilion si decisions task for the clinicians.
patient. • Examples of guidelines that are
• The patient can make use their quick reference guide for a
own understanding and certain disease condition.
Clinical pathways composed of:

1. Patient and disease characteristic
2. Interventions
3. Professionals or all members of the health care team collaboration
4. Outcomes and goals
5. Healthcare setting
6. Patient booklet or info guide
Where can we still use our informatics?

- Use for research
E-JOURNALS
• An edited package of articles that is distributed to most of its subscribers in
electronic form
• Some e-journals are freely accessible on the Web. This is most commonly the
case for those titles that have been created independent of a print counterpart.
• E-journal full-text will generally be of two types: HTML or PDF.
• Mode of delivery should be electronic.
• But the extent of what is delivered electronically varies. So, in its purest form and
e-journal is your edited package
• Publishers or printed journals usually limit free online access to the tables of
contents and abstract of articles.
• So, while these falls short of the desktop access to the full text or articles, it does
provide the convenience of browsing published issues to identify items of
interest.
• Made independently by individuals without benefit of subsidy from institutions or

professionals associations and usually offered without cost to the users
2 TYPES
1. HTML - Hypertext Markup - Documents viewed in this
Language format provide an image view
- It is the coding used to create that is the same as viewing it
web pages that can be published print equivalent.
displayed by web browsers. Therefore, this format is not
For ex. Internet Explorer, only pleasing to the eye but
Chrome or Firefox also nicely accommodates the
graphical materials such as
2. PDF - Portable Document File articles, tables, and figures
- A format that allows users to because it is an image format.
view the document in its - However, it is not possible to
original format without cut and paste as you can with
requiring the users to have the the text document.
originating software apps. For
ex. Adobe pdf reader.
• Focuses to promote excellence in nursing and health care through

• The dissemination of evidence-based, peer-viewed clinical information and
original research, discussion of relevant and controversial professional issues
• promotion of nursing perspectives to the health care community and the public
• This E-journal is an international open access online scientific journal, which
archives research and review studies of practical and professional nursing
• In E-journaling it covers the different aspect of nursing education.
OASIS – OUTCOME AND ASSESSMENT INFORMATION SET

• OASIS - Start of Care (60 days plan) all information of the patient and the
standard of care under home visit
• OASIS - Recertification
• **if wala pagid nag ayu then need pa japon imonitor
V. POLICIES, GUIDELINES, & LAWS IN NIF INTELLECTUAL PROPERTY LAW

Deals with laws to protect and enforce rights of the creators and owners of
inventions, writings, music, designs, and other works, known as "Intellectual Property.”
Intellectual Property Code of the Philippines was signed into law on June 6, 1997 and
became effective January 1, 1998.
BRIEF HISTORY
• 1879: Spanish Law on Intellectual Property, known as the first copyright law in
the Philippines.
• 1896: Our break of the Philippine revolution, defeat of Spain in the Spanish-
American War, Treaty of Paris was signed.
o Treaty of Paris mentions existent intellectual property system in the
Philippines
o “The rights of property secured by copyrights and patents acquired by
Spaniards in the Island of Cuba and in Puerto Rico, the Philippines and
other ceded territories, at the time of the exchange of the ratifications of
this treaty, shall continue to be respected…”
• ACT NO 3134 “AN ACT TO PROTECT INTELLECTUAL PROPERTY” passed in

1924 making it the main intellectual property law after PH independence from
US.
• PH enacted two laws to strengthen Intellectual Property System:
o Republic Act 165
o Republic Act 166 in 1947.
• Marcos Administration: Presidential Decree No. 49 which governed
Copyright works.
• 1950s - 1960s: Philippines joined in international conventions which helped
establish WIPO (World Intellectual Property Organization) in 1967.
• 1998: Passing of the Republic Act 8293, the Intellectual Property Code.
WHAT IS INTELLECTUAL PROPERTY (IP)?

- Refers to creations of the mind, such as inventions, literary and artistic works
(books, literatures etc.); designs; and symbols, names, and images used in
commerce.
- Property that arises from human intellect; product of human creation.
Divided into two distinct forms:

a. Literary or Artistic Works
b. Industrial Property (industrial, blueprints and business logo)
By protecting IP, it enables people to earn recognition or even financial benefit from
what they invent or create.
AIM of IP Laws: Foster an environment in which creativity and innovation can flourish.
WORD INTELLECTUAL PROPERTY ORGANIZATION (WIPO)

• Specialized agency of the United Nations
• It promotes the protection of Intellectual Property throughout the world
• Headquarters: Geneva, Switzerland
• April 26: World Intellectual Property Day
• To address the need for Intellectual property protection. The UN established the
WIPO.
• Founded on July 14, 1967.
• This organization’s mission is to lead the development of a balanced and
effective international IP systems that enables innovation and creativity for the
benefit of all.
WIPO 2 MAIN OBJECTIVES:

1. To promote worldwide protection of Intellectual Property
2. To ensure administrative cooperation among the IP unions established by the
treaties that WIPO administers
The WIPO classes specialized agency of the UN and it promotes the protection of the IP
throughout the world.
REPUBLIC ACT NO. 8293: INTELLECTUAL PROPERTY CODE OF THE PHILIPPINES

➢ The state recognizes that an effective intellectual and industrial property system
is vital to the development of domestic and creative activity, facilitates, transfer of
technology, attracts foreign investments, and ensures market access for our
products.
➢ It shall protect and secure the exclusive rights of scientists, inventors, artists and
other gifted citizens to their intellectual property and creations, particularly when
beneficial to the people, for such periods as provided in this Act.
➢ The State shall promote the diffusion of knowledge and information for the
promotion of national development and progress and the common good.
COPYRIGHT LAW (Still under Republic Act 8293)

• Copyright - legal protection extended to the owner of the rights to an original
work, including books, writings, musical works, films, painting, and other works
including computer programs
o Automatic Protection
o Work must be original and "fixed in a durable medium."
o Ideas are not protected but the expression of an idea is.
Cliché – an element that is found in artistic works or artworks that has become overused
to the point that it has become irritating
Ex. We have a damsel in distress.
However, people have constantly used these ideas and they can’t find because these
ideas or these are ideas. That is how the writer expresses it.
COPYRIGHT INFRINGEMENT
• Occurs when there is a violation of any of the exclusive economic or moral rights
granted to the copyright owner. Also included aiding/abetting such infringement.
• There is also liability of a person who at the time when copyright subsists in a
work has in his possession an article which he knows, or ought to know, to be an
infringing copy of the work for the following purposes:
o Selling/letting for hire,
o Distributing article for the purpose of trade or any prejudice against the
copyright owner's work,
o Trade exhibit of the article in public.
• The copyright owner can file a criminal, civil, or administrative action for
copyright infringement after giving the offender a Copyright Infringement Notice.
• This notice will be sent as a warning however after receiving the notice there was
no action taken, that is the time that you can sue them for copyright
infringement.
Under Philippine law, copyright infringement is punishable by the following:

• Imprisonment of between 1 to 3 years and a fine of between 50,000 to 150,000
pesos for the first offense.
• Imprisonment of 3 years and 1 day to six years plus a fine of between 150,000 to
500,000 pesos for the second offense.
• Imprisonment of 6 years and 1 day to 9 years plus a fine ranging from 500,000 to
1,500,000 pesos for the third and subsequent offenses.
Examples:
 Recording a film in a movie theater.
 Posting a video on your company's website which features copyrighted words or
songs.
 Using copyrighted images on your company's website.

 Downloading music or films without paying for their use.
 Creating merchandise for sale which features copyrighted words or images.
 Modifying an image then displaying it on your company's website.
Tips To Avoid Copyright Infringement

• Understand what copyright laws protect.
• If it's not your work, then don't use it.
• What you find on the internet is generally not fair game.
TRADEMARK
• A word, phrase, or symbol which represent a company or product. They
distinguish the products or services of one company or organization from those
of its competitors.
• Trademark is valid for 10 years from application date then it can be renewed
upon payment of fees.
• Ex. Disney - company that trademarks everything
• Prince Harry and Megan – trademark the name of their daughter, Lilybeth
• *They trademark things so that no one else can use them and if someone uses it
to gain money from it.
TM - FOR PRODUCT | UNREGISTERED TRADEMARK

R - FOR SERVICE; REGISTERED TRADEMARK
SM - UNREGISTERED SERVICE
TRADEMARK
Ex. Starbucks, McDonalds, San Miguel, Bluetooth, World Trademark Review
WHAT IS “FAIR USE”?

• Gives permission to use copyrighted materials if certain criteria are met.
• Protects freedom of speech.
• Promotes public benefits like education.
• So, with fair use, a party can use a copyright work without the copyright owner’s
permission for purposes such as criticism, comments, news reporting, teaching,
scholarship and research.
• Fair use is a legal doctrine that promotes freedom of expression by permitting
unlicensed use in a certain circumstance
• So, it gives permission to use copyrighted materials, especially in forms of
education.
How To Avoid Violating Fair Use

1. We use more original content that the content borrowed. You are just
supposed to use a small part to make a point or explore a topic. Not the whole
idea or whole work itself.
2. You use your different sources. Don’t just get from one source especially in
research. Read lots of books, E-journals and articles and incorporate them into
your work.
3. Always give credit to where it is due. Avoid using CTTO when posting
something especially if it contains artworks or writings and if you are able to try
find the original owner of the work you are using and credit them properly.
PRIVACY OF PERSONAL OR PUBLIC DOMAINS

• Network Domain – An administrative grouping of multiple computer networks
or host within the same infrastructure.
• Domain – Is a network of computers and devices that are controlled by one set
authority and have specific guidelines.
o For example, our computers in the computer lab are connected in one
center.
• More specifically, within the internet a domain is controlled by one particular
company that has its own internet presence and own IP address. So, the domain
is labeled by its domain name.
• For ex. webopedia,com, wikipedia.com, riverside.edu.ph
PUBLIC DOMAINS OR PERSONAL DOMAINS

• WHOIS – widely used internet record listing that identifies who owns a domain
and how to get in contact with them.
• ICANN – Internet Corporation for Assigned Names and Numbers; regulate
domain name registration and ownership. Non-profit organization that is
responsible for internet protocol address space allocation, protocol identifier
assignment, country code
PURPOSE AND VALUE OF WHOIS SYSTEM

• Reinforces stability and security of the internet by providing network operators,
computer incident response teams with appropriate contacts.
• Regulates registration status of domain names
• Supports law enforcement officials participating in nation or international
investigations.
• Assisting in battle against abusive uses of information communication
technology, including illegal and other acts motivated by racial discrimination,
violence, hatred, xenophobia, intolerance, child abuse, child pornography,
pedophilia, and exploitation and human trafficking.
• Supports inquiries and necessary steps to carry out trademark clearances and to
help expose intellectual property infringement, theft, and misuse.
• Helps businesses and other uses to fight fraud and safeguard public interest.
• Upholds overall user confidence in the internet as an efficient and reliable means
of communication by helping users to identify which entities or persons are
responsible for services and content online.
• Tracks down spam or malicious behaviors.
VOCABULARY:
• URL - Uniform Resource Locator; distinguishes where an identified resource is
available along with the mechanism for retrieving it.
• UDRP - Uniform Domain Name Dispute Resolution Policy; resolves domain
name disputes in the case of abusive registrations or trademark infringement.
• TLD - Top Level Domains; names at the top of the DNS naming
o (DOMAIN NAME SYSTEM)
o hierarchy. Ex: .net, .com, .edu
• Subdomain - domain that is component of a larger domain.
• ccTLD - Country Code Top Level Domain; domains that have two letters to the
right of the last period in a domain name. Example: co.uk, .jp, .ar, .ph
• Cybersquatting - refers to the act of knowingly managing a domain name that is
confusingly similar or matches an established trademark.
• DNS - Domain Name System; hierarchical naming system that helps users find
their way around the internet.
• Domain Name - host names that the DNS uses to identify and map to websites.
NETIQUETTE RULES AND GUIDELINES

Netiquette or “Network Etiquette” | Core Rules of Netiquette is concerned with the
proper way to communicate in an online environment.
The following are "rules" adapted from Virginia Shea's The Core Rules of Netiquette:
1. RULE 1: REMEMBER THE HUMAN
a. GOLDEN RULE: Do unto others as you would have others do unto you.
2. RULE 2: ADHERE TO THE SAME STANDARDS OF BEHAVIOR ONLINE THAT
YOU FOLLOW IN REAL LIFE.
3. RULE 3: KNOW WHERE YOU ARE IN CYBERSPACE
a. "Netiquette varies from domain to domain" (Shea, 1994).
4. RULE 4: RESPECT OTHER PEOPLE’S BANDWIDTH
5. RULE 5: MAKE YOURSELF GOOD ONLINE
6. RULE 6: SHARE EXPERT KNOWLEDGE
7. RULE 7: HELP KEEP FLAME WARS UNDER CONTROL
a. "Flaming is what people do when they express a strongly held opinion
without holding back any emotion." (Shea, 1994)
8. RULE 8: RESPECT OTHER PEOPLE’S PRIVACY
9. RULE 9: DON’T ABUSE YOUR POWER
10. RULE 10: BE FORGIVING OF OTHER PEOPLE’S MISTAKES
VI. INFORMATION SYSTEM: TEAM ROLES FOR NURSES IN THE

INFORMATICS SPECIALTY
INFORMATIC NURSES VS. INFORMATIC NURSE SPECIALIST

Nursing Informatics as a Specialty
Nursing is a subspecialty in informatics, with roles and tasks in both disciplines
INFORMATICS NURSE
• are those who enter the nursing informatics field because of an interest or
experience. (Nursing Informatics Scope & Standards of Practice)
• Which means that these are your nurses that join informatics because they
experienced working on it or they have the interest in being an informatics nurse
or informatician.
INFORMATICS NURSE SPECIALIST

• are nurses with either a graduate education degree in nursing informatics or a
field relating to informatics. (American Nurses Association [ANA], 2015)
• Nurse specialist are graduates of informatics.
• The roles of Informatics nurses vary with their job and specialty in healthcare, but
the general foci of nursing informatics are the following seven areas, as set out in
seminal work by the National Institutes of Health, National Center for Nursing
Research (NCNR) Priority Expert Panel on Nursing Informatics (1993):
• Using data, information and knowledge for patient care;
o We take the data of our patient with the use of our informatics.
• Defining data in patient care.
o With the help of the patient’s information, we prioritize our care based on
the gathered evidences, information or data
• Acquiring and delivering patient care knowledge;
o From the gathered data we try to apply it where the delivery of our patient
care
• Creating new tools for patient care from new technologies
• Applying ergonomics to nurse-computer interfaces or also known as
terminologies
• Integrating systems
• Evaluating the effects of nursing systems
The practice in each of these areas requires different knowledge and skills on part of
the informatics nurse, so one of the main objectives of nursing informatics in the clinical
area is to integrate data from all areas pertinent to nursing care and present it in a
manner that enables the clinical nurse to provide quality care.
Many sources of information are needed for patient care. So, the overall goal of
nursing informatics is to optimize the information management and communication to
provide or to improve individual health care and the health of populations. (American
Nurses Association, 2015)
INFORMATICS NURSE
- are those who enter the nursing informatics field because of an interest or
experience. (Nursing Informatics Scope & Standards of Practice)
1. System Educator
2. Information Technology Nursing Advocate
3. Superusers
4. System Specialist
5. Clinical Systems Coordinator/Analyst
A. SYSTEMS EDUCATOR esp. when using the system and

• To educate translates these needs into IT
• Plans, coordinates, and facilitates specific solution
education for all computer
applications and computer C. SUPERUSERS
software for all user groups. • Supports the system for a
• Develops and trains all user specified unit **(ex. for operating
groups on clinical computer room system lang siya na
applications and online procedures, the superusers
documentations processes. facilitates the system that is
• If employed by a vendor, SE may specified for the OR)
be responsible for documenting a • Assists users with functionality,
new system and providing “train procedural issues, and basic
the trainer” education to troubleshooting
healthcare agency personnel. • Often holds a clinical position in
the assigned unit
B. INFORMATION TECHNOLOGY • **Ex. In the OR may gina specify
NURSING ADVOCATE or may gina assign na sila nga
• Assess the needs and superuser specific for that specific
opportunities for nurses with the field.
technology • **Ex. If sa ICU, there’s also
• Looks at both the functional and assigned for the ICU because not
operational needs of clinical users all the software or systems within
this software are similar among E. CLINICAL SYSTEMS

nursing departments. It also COORDINATOR/ANALYST
varies from department to • Responsible for coordinating
department. aspects of planning, designs,
development, implementation,
D. SYSTEM SPECIALIST maintenance, and evaluation of
• May work at many different levels the clinical information system
from the unit to the full agency. (CIS)
• Acts as a link between nursing • Troubleshoot issues with systems
and information services and is • Supports a clinical system
both a nursing resource and a • **They are the QA or quality
representative assurance that acts to ensure nga
tsakto pa ang processing sang
ara sa NIS when dealing with
patient care.
INFORMATICS NURSE SPECIALIST:

1. Project Manager
2. Consultant
3. Director of Clinical Informatics
4. Researcher
5. Product Developer
6. Policy Developer
7. Entrepreneur
A. PROJECT MANAGER o A consultant is an expert

• Plans and implements an who is called in to help a
informatics project. company solve a problem.
• Must be able to communicate As an informatics
effectively with all levels of consultant, you’ll help
management, users, and system healthcare facilities
developers. discover technology that
• Must also be cognizant of all can help them deliver
factors involved in the project better patient care. This
including, but not limited to, role allows you to have a
managing change assessing the lot of independence and
need for the new project planning work in many locations.
for its implementation ▪ **Ginapadala sa
iban na na
B. INFORMATICS CONSULTANT institution. Then
• What you’ll do: mabalik kag mahelp
o Advise companies on improve saila
healthcare technology that hospital.
can help them achieve
better patient outcomes. C. DIRECTOR OF CLINICAL
o Help companies INFORMATICS
implement the technology • Facilitates the development,
and educate staff. implementation, and integration
• Where you’ll work: for an agency information system.
o Medical offices • Assist in developing the strategic
o Hospitals and tactical plans of the system.
o Healthcare facilities
• What else you should know:
• Develops plan for • Must understand the needs of

implementation and gaining both business and nursing
acceptance of systems • Business Development of
• Act as the director. products, media, software and
devices.
D. RESEARCHER
• Uses informatics to create new F. POLICY DEVELOPER
knowledge. • Contributes to health policy
• Encompasses research in any area development by identifying
of nursing informatics. nursing data, its availability,
• May be involved in basic research structure, and content, which are
on the symbolic representation of used to determine health policy.
nursing phenomena, clinical • These policies encompass not
decision-making, or applied only information management
research of information systems. but also health infrastructure
• Could be involved in developing development and economics.
decision support tools for nursing • To check or to create policies.
or models of representation for • Properly usage of the system.
nursing phenomena.
G. ENTREPRENEUR
E. PRODUCT DEVELOPER • Analyzes nursing information
• Participates in the development needs in clinical areas, education,
of new information systems administration, and research
including designing, developing, • Develops and markets solutions
and marketing of informatics o Ex. Dr. Carl Balita
solutions for nursing problems. • Business
INFORMATIC NURSES & INFORMATICS NURSE SPECIALIST (for everyone)

Informatics Organizations
- This is worldwide multidisciplinary and nursing informatics specialty groups that
focus on the usage of informatics to improve healthcare.
AMERICAN NURSING INFORMATION ASSOCIATION (ANIA)

• In the United States, the largest nursing informatics professional association.
• Has annual educational conferences, provides continuing education forums, and
disseminates informatics updates with an organization newsletter
• ANIA members also receive a discounted subscription rate for Computers,
Informatics Nursing: CIN journal.
MULTIDISCIPLINARY GROUPS
A. INTERNATIONAL, MEDICAL o Promoting biomedical

INFORMATICS ASSOCIATION research
(IMIA) o Advancing international
• Established in 1967 as TC4, a cooperation
Technical Committee within the o Stimulating informatics
International Federation for research and education
Information Processing. o Exchanging information
• A nonpolitical, international • IMIA represents the US and the
scientific organization whose European Federation for Medical
goals include: Informatics (EFMI) which
o Promoting informatics in represents the Europe
healthcare
• American Medical Informatics understanding of healthcare

Association (AMIA), represent information and management
United States and European systems.
Federation for Medical • In 2003, formed a Nursing
Informatics (EFMI), represents Informatics Community*
Europe* • Offer accreditation as a Certified
• Members have national meetings Professional in Healthcare
to focus on issues pertaining to Information and Management
their nation which allow members Systems (HIMS)
to establish a national network • The NIC or Nursing Informatics
where ideas can be shared and Community provides support to
also provide place to gain the nursing rule in informatics.
information for specific national • HIMS meet annually and
problems. publishes a quarterly journal and
• This organization also provide several guides to the field.
journals and are source of up-to- • Also with this organization, they
date information for their provide best practices as an
country. information regarding to updates
• Adaptation of best practices with nursing informatics
• Members of IMIA also take part in
MedINFO** C. AMERICAN HEALTH
o MedINFO - a feature of INFORMATION MANAGEMENT
IMIA which is held every 3 ASSOCIATION (AHIMA)
years or medical • Formed in 1928 by American
informatics. College of Surgeons to improve
clinical records.
B. HEALTHCARE INFORMATION AND • The name, AHIMA, reflects
MANAGEMENT SYSTEMS SOCIETY today's situation in which clinical
(HIMSS) data have expanded beyond
• International organization either a single hospital or a
• Has offices in Chicago; provider.
Washington, DC; and other • Offers credentials programs in
locations across the United States health information management,
and Europe coding, and healthcare privacy
• Founded in 1961 and security.
• Not-for-profit organization
dedicated to promoting a better
VII. HOSPITAL INFORMATION SYSTEM (HIS)

➢ An application software used by healthcare organizations to simplify clinical,
financial and administrative processes
➢ Facilitates the seamless flow of data across various departments of hospitals and
helps them to do their jobs more effectively in a paper-less manner
➢ Enables Physicians, Management and authorized users to share data and
streamline processes across an organization.
➢ A Hospital Information System (HIS) is a computer system that can manage all
the information related to health care providers allowing them to do their job
effectively
➢ In most hospitals, most software systems used by nurses are based in a Hospital
Information System. The HIS is a multipurpose program, designed to support
many applications in hospitals and their associated clinics.
HISTORY OF HIS
• 1960s: Computers and storage were large and expensive; hospitals usually
shared their networks with each other; hospital accounting systems were the
main thing that was emerging
• 1980s: HIS began to improve; smaller and much cheaper and quicker
computers; hospitals were able to get large amount of information from both
clinical and financial systems
• 2000s: Technology has advanced; hospitals created applications that would
assist in commercial and real-time decisions; the software had become much
more accessible due to the widespread use of personal computers.
HEALTH INFORMATION SYSTEM

• Refers to a system designed to manage healthcare data includes systems that
collect, store, manage, and transmit a patient’s electronic medical record, a
hospital’s operational management or a system supporting healthcare policy
decisions
• Includes systems that handle data related to activities of providers and health
organizations as an integrated effort, these may be leveraged to improve patient
outcomes, inform research, and influence policy-making and decision-making.
• Because health systems commonly access, process, or maintain large volumes of
sensitive data, security is a primary concern
Key Components of a Health Information System

1. Resources: the legislative, 3. Data Sources: refer to both
regulatory, and planning periodic and continual sources
frameworks required for system that provide quality information
functionality. This includes for the information system. A
personnel, financing, logistics, strong HIMS also requires data to
support, information and be gathered from a variety of
communications technology (ICT), sources. In health systems this
and mechanisms for coordinating may include; patients medical
both within and between the six records, service records, resource
components. records and so forth.
2. Indicators: a complete set, refer 4. Information Products: accurate
to measurable sets of data that and reliable data available for
help to monitor the system’s health status, health systems and
effectiveness by quantifying determinants of health.
change that has taken place in a 5. Dissemination and use:
country’s health profile over time. dissemination of information and
These determinants should be effective use of data for advocacy,
valid, reliable, sensitive, specific planning and decision-making
and feasible.
Examples of Health Information System:

• Electronic Health Record – Includes health data, test results, and treatments and
designed to share data with other EHRs so other healthcare providers can access
a patient’s healthcare data. Used interchangeably with electronic medical record –
which replaces the paper version of a patient’s medical history. The electronic
health record includes more health data, test results, and treatments.
• Practice Management Software – helps healthcare providers manage daily
operations such as scheduling and billing healthcare providers, from small
practices to hospitals use practice management systems to automate many of the
administrative tasks.
• Master Patient Index – connects separate patient records across databases;

contains a record for each patient that is registered at a healthcare organization
and indexes all other records for the patient. MPIs are used to reduce duplicate
patient records and inaccurate patient information that can lead to claim denials.
• Patient Portals – allow patients to access their personal health data such as
appointment information, medications, and lab results over an internet
connection Some patient portals allow active communication with their
physicians, prescription refill requests, and the ability to schedule appointments.
• Remote Patient Monitoring – allows medical sensors to send patient data to
healthcare professionals. It frequently monitors blood glucose levels and blood
pressure for patients with chronic conditions. The data are used to detect medical
events that require intervention and can possibly become part of a larger
population health study.
• Clinical Decision Support – analyze data from various clinical & administrative
systems to help healthcare providers make clinical decisions the data can help
prepare diagnoses or predict medical events – such as drug interactions; these
tools filter data and information to help clinicians care for individual patients.
Benefits of Health Information System

✓ Data Analytics: The healthcare industry constantly produces data. Health
information systems help gather, compile, and analyze health data to help
manage population health and reduce healthcare costs. Then the healthcare data
analysis can improve patient care.
✓ Collaborative Care: Patients often need to treatments from different healthcare
providers, health information systems – such as health information exchanges
(HIEs) – allow healthcare facilities to access common health records.
✓ Cost Control: using digital networks to exchange healthcare data creates
efficiencies and cost savings. When regional markets use health information
exchanges to share data, healthcare providers see reduced costs. On a smaller
scale, hospitals aim for the same efficiencies with electronic health records.
✓ Population health management: health information systems can aggregate
patient data, analyze them and identify trends in populations. The technology
also works in reverse. Clinical decision support systems can use big data to help
diagnose individual patients and treat them.
VIII. NURSING INFORMATICS AND LEADERSHIP

COMMON TRAITS SUCCESSFUL LEADERS HAVE:
1. Self-awareness and puts importance on personal development.
2. Focused on Helping Others.
3. They have confidence in themselves and their skills.
4. They hone their communication skills.
5. They lead by example.
6. Able to make tough decisions.
7. They are ethical and civic minded.
8. They are responsible and dependable.
9. They have goals and are patient and tenacious when it comes to reaching
said goals.
ESSENTIAL INFORMATICS COMPETENCIES FOR NURSE LEADERS:

1. Mastery of basic Computer Competencies – Nurses need basic computer skills
to assist patients focusing on the following concepts:
a. ICT
b. Using computers and managing files.
c. Using word processing and spreadsheet applications

d. Making presentations
e. Web browsing and basic communication
2. Comprehension of Information Literacy – Ability to recognize information is
needed and to be able to locate, evaluate and use the information as necessary
focusing on the following concepts:
a. Determining the nature and the amount of information needed.
b. Accessing the information quickly and efficiently
c. Evaluating the information and sources.
d. Using the information for specific purposes
e. Assessing the value of the information used.
3. Understanding Information Management Literacy – Able to collect, process,
present and communicate the data as knowledge and information Focusing on:
a. Understanding and verbalizing the importance of various types of
health information system
b. Using due care to protect the patient privacy and the security of
Health Information systems. According to the 13 Patient's Right, our
patient has the right to privacy and confidentiality. The moment the
patient will step into the hospital/health care facility, they are entitled
to privacy. Their hospital records become the responsibility of the
hospital. The hospital will hire programmers or a nurse Informaticist
to set up protection on the patients' information by setting up
firewalls, antivirus, or encryption technology. It means that you can
only access that information if you have a password or an access
code.
c. Understanding the principles, policies and procedures that HIS use to
manage data.
NURSING AND INFORMATICS:

• As Nurses, we collect information about our clients, use this data to develop
nursing care plans, implement the plan and communicate the findings with other
healthcare providers. The advances of Technology allow nurses and nursing
students to access vital information with the click of a button.
• Services such as telehealth provide a means for client education, as well as
medical and health care services such as health monitoring or clinical diagnosis.
Social media is also being used in to provide a means for clients to share
experiences with one another or learn more about the condition.
• Nursing leaders are required to merge their own idealistic expectations of being a
strong leader with the challenges of a practice environment in a constant state of
technological evolution. Nurse leaders require a variety of unique skills, including
informatics, to support the delivery of safe and effective patient care. According
to the Canadian Nurses Informatics Association (2017), they said that it is
essential for all nurses to develop informatics competencies.
• Healthcare’s continuous state of transformation now requires nurse leaders to
develop informatics skills and competencies; it is no longer optional if one wants
to lead effectively in the technological age. Nursing leaders who develop
informatics competencies can work more effectively in ensuring the “successful
selection, development, and competent use of devices and clinical systems”.
Additionally, nurse leaders with informatics competencies and knowledge will be
needed at higher levels to inform policy and decision making related to ICT
implementation.
• Nursing leaders need to be aware of and skilled at using big data to advance
nursing practice. Currently nursing is considered the single largest user of health
informatics technology, yet the profession receives little information back that
can be used to inform practice. For nursing, the utilization of data provides an
opportunity to generate a deeper understanding of the impact of nursing care.
LEADERSHIP STYLES: Why It’s Important to Know Your Leadership Style?

- Knowing your leadership style is critical because it can help you determine how
you affect those whom are under your direct influence. It’s always important to
ask for feedback to understand how you’re doing, but knowing your leadership
style prior to asking for feedback can be a helpful starting point. Knowing your
leadership style may also remove the need for getting feedback. Each leadership
style has its pitfalls, allowing you to proactively remediate areas of improvement.
1. Democratic Leadership can support at one and what best

• Commonly Effective, since it direction for the company really
allows lower-level employees to is.
exercise authority.
• The leader makes decisions based 5. Transformational Leadership
on the input of each team • Sometimes effective.
member. Although the leader will • It affects both the members and
be the one to make the final call, societal systems. Its ideal form
everyone has an equal say on the produces a meaningful and
decision. beneficial change in its members,
with the ultimate objective of
2. Autocratic Leadership turning members into leaders.
• Rarely Effective • It improves members' motivation,
• Inverse of democratic leadership. morale, and performance through
The leader makes decisions several processes. These include
without taking input from anyone integrating the members’ sense
who reports to them. No one is of identity and self into the
considered or consulted prior to a mission and the collective identity
change in direction. of the organization; inspiring
• Those who are working in this members by being a role model;
type of leader are expected to challenging members to take
adhere to the decisions made by greater ownership of their work,
the leader. and understanding the strengths
and weaknesses of followers so
3. Laissez- Faire Leadership that the leader can align
• Sometimes effective members with tasks that optimize
• Directly translates to “Let them their performance.
do it”. Leaders afford nearly all • This style is a highly welcomed
authority to their employee. kind of leadership among
• It can limit employee’s growth-minded teams since it
development and overlook critical inspires members to perceive
company growth opportunities. their own potential
4. Strategic Leadership 6. Transactional Leadership

• Commonly effective • Sometimes effective.
• The leader accepts all the burden • It focuses on the specific work
while ensuring that current accomplished by the employee.
working conditions remain stable Roles and responsibilities are
for everyone else. more clearly determined through
• The leaders support multiple this type of leadership.
employees at once, they set a • a transformational leader might
dangerous precedent with only offer you a bonus if your
respect to how many people they
work results in a large number of strengths by giving them new

newsletter subscriptions. tasks to try, offering them
• It helps establish roles and guidance, or meeting to discuss
responsibilities for each constructive feedback. They
employee, but it can also might also encourage one or
encourage bare-minimum work if more team members to expand
employees know how much their on their strengths by learning
effort is worth all the time. This new skills from other teammates.
leadership style can use incentive
programs to motivate employees, 8. Bureaucratic Leadership
but they should be consistent • Rarely effective.
with the company's goals and • Bureaucratic leaders go by the
used in addition to unscheduled books. This style of leadership
gestures of appreciation. might listen and consider the
input of employees — unlike
7. Coach – style Leadership autocratic leadership — but the
• is commonly effective. leader tends to reject an
• This style is similar to a sports employee's input if it conflicts
team's coach as this leader with company policy or past
focuses on identifying and practices.
nurturing the individual strengths • Members under this leadership
of each member of his/her team. style might not feel as controlled
• Coach style leaders also focus on as they would under autocratic
strategies that will enable their leadership, but there is still a lack
teams to work better together. In of freedom in how much people
the long run, these leaders focus can do in their roles. This can
on creating strong teams that can quickly shut down innovation and
communicate well and embrace is not encouraged for teams who
each other's unique skillsets to are chasing ambitious goals and
get work done. quick growth.
• A leader style might help the
members improve on their
IX. NURSING INFORMATICS: INTERNATIONAL PERSPECTIVES

A. NURSING INFORMATICS IN CANADA
• Nursing Role in managing Information in the health service organization and care
facilities in Canada is similar to that of other developed countries. CAN believes
that registered nurses should advocate and lead in implementing the collection,
storage and retrieval of nursing data at a national level.
• The information revolution has prompted initiatives by organizations to develop
an automated information system focused on utilization of data, for the purpose
of: resource allocation, patient specific costing and outcomes of services.
• The evolution started when they developed Canadian Institute for Health
Information (CIHI). The establishment of CIHI in the late 1980’s led to the
national task force on health information known as the “wilk task force” which
presented comprehensive goas, strong vision for nationwide HIS.
• As CIHI evolved and matured, the healthcare community came to realize that
they need health systems that will support them in decision making related to
clinical care of individuals and group of clients then pan-Canadian EHR gradually
emerged.
• Many obstacles they did encounter while making use of Pan-Canadian EHR so
they have decided to make a new one which is known as “CANADA HEALTH
INFOWAY” IN 2001 but the operation begun in April: the info way mission was
to foster and accelerate the development and adoption of HER with compatible
standards and communication technologies on pan Canadian basis but with
tangible benefits for Canadians. They also incorporate data related to patient
assessment and interventions and practice patterns are also included because
nursing is the single largest group of healthcare providers.
B. NURSING INFORMATICS IN EUROPE

• The National Nursing Association worked jointly on quality assurance during
the late 1980s which was one of the foundations for the awareness of their need
of a system. In 1990s Danish nurses initiated the joint project “tele-nurse” within
Europe to promote standardization of Nursing data in EHR.
• In Sweden, Finland, Norway, Denmark, Estonia and Latvia made their own System
which they call as the VIPS model. the VIPs model acronym for the Swedish
spelling of well-being, Integrity, prevention and safety; with the purpose of
conceptualizing the essential elements of nursing care clarifying and facilitating
systematic thinking and nursing recording. This model is based on the structure
of the nursing process, and in addition includes other areas, for which the nurse
has responsibility in recording. The focus of this model is on patients functioning
in daily life activities rather than pathophysiologic problems.
C. NURSING INFORMATICS IN NEW ZEALAND

• As part of ensuring standard of practice the government passed the HEALTH
PRACTITIONER COMPETENCE ASSURANCE ACT (HPCA) last 2003. This act
requires all healthcare practitioners to describe its scope of practice to ensure the
safety of the public by defining the health services that they can perform.
• The NZ Ministry of Health is invested in information collection so they started
with New Zealand Health Information Service (NZHIS). This body controls the
database which holds registration for 95%of new Zealanders. This database uses
unique identifiers which assigned at birth and is designed to follow individual
through each healthcare event in his or her life. The identifier is called National
Health Index or NHI. It allows easier tracking of information through healthcare
episodes.
D. NURSING INFORMATICS IN AUSTRALIA

• Australia has more than 50 such specialty national nursing organization one of
which is Health Informatics Society Australia’s Nursing Informatics special
group (HISA NI). HISA NI has been funded by the government to develop a
strategic plan for NI capacity builder and a plan for nursing professional to
engaged in its agenda.
• Together with HISA NI, The Australian Institute for Health and Welfare
provides research and statistical support to Australian Government (AIH&W).
• AIH & W has developed the National Health Information Knowledgebase, an
Internet based interactive electronic storage site. in 1993, AIH & W signed an
agreement to improve quality and cooperation in development of national health
information. this now provides national infrastructure needed to provide high
quality health data and electronic health records.
E. NURSING INFORMATICS IN ASIA

• Asia-Pacific Association for Medical Informatics actively promotes
telemedicine, bioinformatics and public health informatics
• Addresses public health informatics research and development such as
informatics deployed in contact tracing, epidemiological reporting and
monitoring to tackle acute disease outbreaks.
• Established in 1993 as IMIA regional member of IMIA to promote regional

cooperation and development of health informatics. It provides leadership and
expertise to the multidisciplinary, health focused community and to policy
makers. IMIA’s vision is that there will be a world-wide systems approach for
healthcare.
F. NURSING INFORMATICS IN SOUTH KOREA

• In the late 1970s in hospital finance and administration systems to expedite
insurance reimbursements. The national health insurance system expanded to
cover the whole population and computers became necessary equipment in
healthcare organizations.
• NI were first introduced in 1987 it was called (KOSMI) Korean Society of
Medical Informatics. Nursing has been highly visible in the KOSMI by the
presentation and publishing of papers on the use of computers in nursing.
KOSMI is always offering workshops, seminars and open forums they also offer
educational programs for beginners in health informatics.
• MEDINFO98 and NI2006 conferences held in Seoul provided excellent
opportunities for Korean nurses to become acquainted with nursing informatics
at the global level.
G. NURSING INFORMATICS IN JAPAN

• Began to pay attention to the use of computers in healthcare during the late
1970s following the increase used of computers.
• Hosted the MEDINFO80 and during this time the Japanese Association of
Medical Informatics (JAMI) was founded with the aim of supporting health
informatics in Japan. JAMI has held annual and biannual academic conferences
and these conferences have contributed considerably to the progress of health
informatics in Japan. The focus was first more on billing system then shifted to
research and development.
• E-Japan strategy is progressing in the country and the adoption of EHR is one of
the main themes in healthcare sector
H. NURSING INFORMATICS IN CHINA AND TAIWAN

• China Medical Informatics Association was founded in 1981 they started
holding seminars, training, conferences. They also establish rules and standards
of national hospital management.
• Other professional societies related to medical informatics: Chinese Society of
Medical Information under the China Medical Association and the Chinese
Hospital Information Management Association under the Chinese Hospital
Association
• Taiwan Nursing Informatics Association (TNIA) was first used in Taiwan in
1990 the focus was on hospital information system providing nursing data such
as nursing personnel information, care planning, scheduling.
I. NURSING INFORMATICS IN TAIWAN AND HONGKONG

• Many nursing schools in Taiwan provide NI courses and some have set up NI
programs.
• Hong Kong hospitals have a well-established clinical management and numerous
other associated systems widely used by nurses.
• Hong Kong nurses established NURSINFO in 1991 with motto, “Nursing
Informatics for Excellence in Patient Care”. They organize regular educational
activities use a communication network, produce regular newsletter and are
actively involved with Hongkong Society of Medical Informatics and
Hongkong Computer Society, together hey participate in organization of trade

exhibits and conferences.
• NURSINFO also includes clinical management system focusing on patient-
oriented data sharing. It also provides medical profile for patients and can be
accessed by healthcare professionals on a need-to-know basis. Telemedicine and
videoconferencing are also in use that helps to speed up work process and
strengthen services in clinical areas.
J. NURSING INFORMATICS IN PHILIPPINES

• The Philippine Nursing Informatics Association (PNIA) is a sub-specialty of
Philippine Nurses Association (PNA).
• PNIA envisions to advance nursing informatics in the Philippines through
practice, education, research and public awareness.
• Some of the Major Milestones
o 1999: Philippine Nurses Association (PNA) participated in the
development of Standards for Health Information in the Philippines
(SHIP)
o 2005: formation of Master of Science in Health Informatics
o 2010: formation of Philippine Nursing Informatics Association (PNIA)
as subspecialty organization of PNA for nursing informatics
K. NURSING INFORMATICS IN SINGAPORE

• The Singapore Nurses Association (SNA)
• Objectives:
o Create a platform where nurses with a passion for healthcare informatics
share ideas, best practices and key challenges
o Organize or participate in nursing it conferences and invite speakers from
non-healthcare industries for learning
o Organize and conduct courses for nurses
o Submit publications locally and internationally
o Identify the levels of informatics competencies so as to accomplish their
roles as informatics nurses
o Utilize data analytics to generate data to improve patient outcomes
o Provide resources to those seeking advice or opinions on matters related
to technology used in healthcare
o Field of nursing informatics based on the standards set by SNA: clinical
information, education and research and administrative decision support
• Goals established by SNA in relation to Nursing Informatics:
o Provide nursing leadership for the development of nursing or health
informatics in Singapore
o Expand awareness of nursing informatics to all nurses and the healthcare
community
o Establish international networking opportunities for nurse informaticians
L. NURSING INFORMATICS IN INDIA

• Indian Association for Medical Informatics (IAMI)
• Objectives of IAMI:
o Sensitive the Indian medical community to the benefits of Information
Technology
o Bring about awareness and ensure greater utilization of IT in healthcare
facilities across the length and breadth of India
o Provide necessary assistance and guidance to other organizations to
implement and reap the benefits of IT for healthcare
M. NURSING INFORMATICS IN SOUTH AFRICA

• In 1978, an International Medical Informatics Association (IMIA) working
conference was held in Cape Town on hospital information systems led by Dr.
Marion J. Ball
• In 1988, the first nursing informatics workshop was held in Rustenburg
• The Western Cape province of South Africa was the focus area for health
informatics and an informatics department established at the Groote Schuur
Hospital
• At MEDINFO 95, the paper entitled, “Recognizing Nursing Informatics” was
presented*
• The current emphasis is to find enough nursing and medical staff to provide the
basic healthcare.
• The South African Health Informatics Association (SAHIA) was formed to
promote the professional application of Health Informatics in South Africa.
• The goals of the organization include:
o To represent South African Health Informatics nationally and
internationally;
o To stimulate the advancement of Health Informatics in South Africa;
o To promote and uphold the status of the Health Informatics profession by
o Striving for the recognition of Health Informatics as a specialty registrable
with the Health Professions Council of South Africa
o Stimulating appropriate conditions of service for Health Informaticians
o Promoting the use of Health Informatics in the planning and delivery of
health services
X. VIRTUAL LEARNING ENVIRONMENT: NURSING INFORMATICS IN

EDUCATION
WHAT IS VIRTUAL LEARNING WHAT IS MANAGED LEARNING

ENVIRONMENT (VLE)? ENVIRONMENT (MLE)?
- A Virtual Learning Environment - Managed Learning
(VLE) is an online platform used Environment (MLE) includes the
for educational purposes. It whole range of information
encapsulates all the online systems and processes of the
environments that act as school (including its VLE if it has
supplements to the course, one) that contribute directly or
whether they are online courses, indirectly to learning and learning
reading resources and management. An MLE might
informational sites with stand- consist of a whole range of
alone skill assessments, or other different software and systems
forms of virtual learning. that interrelate, share data and
contribute to learning
management.
WHAT IS E-LEARNING?
- E-learning, or Online Learning, occurs outside of a traditional classroom and
uses electronic educational technologies to provide the content, pedagogical
methodology, and assimilation of digital tools and resources that support
teaching and learning.
The advantages of current eLearning software programs include:

✓ Educators receive real-time data on the success (or lack thereof) of the students.
✓ Students communicate with their peers as well as their teacher.

✓ Coursework schedules can be personalized for each student.
✓ Work can be completed anywhere a student can log onto the site – many
learning platforms even include offline capabilities.
Platforms to Deliver E-Learning:

1. Learning Management System • CMS functions allow the content
(LMS) owner to decide which content
• A Learning Management should be displayed privately or
System (LMS) is a software publicly.
application for the administration,
documentation, tracking, 3. Learning Content Management
reporting and delivery of System (LCMS)
electronic educational technology • A Learning Content
(also called e-learning) courses or Management System (LCMS) is
training programs. a combination of a CMS and an
• An LMS provides a platform for LMS. Content is stored,
housing all types of eLearning organized, and tracked like on the
courses, as well as tracking who LMS.
has completed them, when, and • The difference between the two is
what kind of score they received that content is created on LCMS,
on assessments. which is like the CMS. Unlike a
CMS, the content that is created
2. Content Management System is designed for the sole purpose
(CMS) of learning.
• A Content Management System • LCMS system usually allows
(CMS) is a software application or multiple collaborators to work
set of related programs that are together to create content that
used to create and manage can then be published in a variety
digital content. of formats.
• It creates the framework for how
content is stored and displayed.
VIRTUAL SIMULATIONS IN NURSING EDUCATION

• Simulation is a replication of a real-life event or situation.
• In nursing education, simulation refers to a practice setting scenario developed to
provide an opportunity for learners to perform in an artificial situation in a safe
environment. Simulation can consist of role play, scenarios, and assumption of
nursing duties.
• Simulation scenario is an episode, event or case developed in a simulation setting
to imitate an authentic practice situation. A game is a structured activity initiated
for enjoyment.
• A serious game is a game with an intent such as for learning and not just for
entertainment. When we make learning fun, it is referred to as edutainment.
Therefore, if our learner is having fun, we have edutained our learner.
• The rules, directions, and concepts that the learner interacts with while playing
the game are referred to as game mechanics. As nurse educators, we must ensure
that our game mechanics not only engage. but are also satisfying to, the learner.
The interactions with the game or the playing of the game is known as gameplay.
NURSING INFORMATICS AS A SCIENTIFIC FOUNDATION

• NI helps all areas of nursing practice to improve patient care and evolve the
profession.
• NI is being integrated into nursing education; this integration is helping to

advance nursing education. The technology tools that are available must be used
carefully and selected by reflecting on and applying knowledge and wisdom to
the learning process. The teacher must consider teaching and learning styles.
• Nurse educators are gaining competence in NI, and VR in education is becoming
a reality in academia.
• Students, educators, and administrators are moving from the simple applications
of email, presentation packages, word processing, or spreadsheets, to leverage NI
competencies to provide simulations, VR, and game mechanics.
• Virtual worlds immerse students into the learning episode to practice complex
skills in a safe environment while receiving feedback and engaging in self-
reflection to assess their own learning.
• Using NI skills and educational prowess, nurse educators carefully select
technology that enhances the learning episode.

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ENDTERM Reviewer - 2nd Semester (NCM110NIF)

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Alijah Abigail R.

Jayme BSN2 – Henderson B – 2nd Semester ENDTERM Reviewer

ENDTERM 2nd Semester – COMPREHENSIVE EXAMS

NCM110NIF – NURSING INFORMATICS

I. CONCEPTS, PRINCIPLES, & THEORIES

4. THE NELSON DATA TO WISDOM CONTINUUM

*Data - raw and uninterpreted facts without meaning

Database Management System

• Data Processing Processes

• Data Output Operations

Wisdom: Knowledge Application

Wisdom: Expert Support/ Systems

Wisdom: Advantages of Expert Support/Systems

5. GRAVE & CORCORAN’S MODEL

8. WERLEY AND GRIER MODEL

10. BENNER NOVICE TO EXPERT MODEL

11. PHILIPPINE HEALTHCARE ECOSYSTEM MODEL

12. INTEL’S SHIFT LEFT MODEL

13. PATIENT MEDICAL RECORD INFORMATION MODEL: BASIS OF HER

II. HISTORICAL PERSPECTIVES OF NURSING INFORMATICS

SEVEN TIME PERIOD

LANDMARK EVENTS IN NURSING AND COMPUTERS

PATIENT SAFETY AND NI

A. Computerized Provider Order Entry (CPOE): The Basics

B. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPPA)

C. NATIONAL ALLIANCE FOR HEALTH INFORMATION TECHNOLOGY

III. IT SYSTEM APPLICABLE IN NURSING PRACTICE

Barcode-Assisted Medication Administration

B. AUTOMATED DISPENSING CABINETS

Automated Dispensing Cabinets

C. SMART INFUSION PUMP

D. COMPUTERIZED PHYSICIAN ORDER ENTRY (CPOE)

CRITICAL CARE APPLICATIONS

Data Connectivity Infrastructure

PHYSIOLOGIC MONITORING SYSTEMS

Physiologic Monitoring Systems Basic Components

Uses of Hemodynamic Monitors

Non-invasive Hemodynamic Monitors Invasive Hemodynamic Monitors

CRITICAL CARE INFORMATION SYSTEM (CCIS)

6. Interdisciplinary Plans of Care

COMMUNITY HEALTH APPLICATIONS

Computer Applications in CHN

Computer System Development

Computer System Development

CLINICAL CARE CLASSIFICATION SYSTEM

COMMUNITY HEALTH SYSTEMS

Some of the Typically Used Systems:

3. Registration Systems 5. Statistical Reporting

3. Smart Bed Technology

5. Electronic Health Record

6. Centralized Command Centers

IV. INFORMATICS APPLICATION IN EVIDENCE-BASED NURSING PRACTICE

Notes* defined as the documentation of the nursing process specifically problems,

• ADPIE use through the computerized nursing care planning.

Ex. Plan of care or 485 consists of the following:

• Medicare states that discharge planning is a process used to decide what a

Components of a Typical Discharge Plan

Advantages of a Computerized Discharge Plan

Why Clinical Pathways?

Clinical/Critical Pathways as Active Management Tools

Four Components of a Clinical Pathway

Optimum Development and Implementation Strategies

Limitations of Clinical Pathways Potential Problems and Barriers to the

Distinguish Critical Pathways from Clinical Protocols