Objectives

 Highlight a brief historical perspective of

nursing and computers

 List the major landmark events and

milestones of nursing and computers
• INFORMATICS is essentially the
science and art of turning data into
information (Hebda, Czar & Mascara, 2005).

• The term informatics can be traced

back to a Russian document
published in 1968 and was derived
from the French term
informatique, referring to “the
computer milieu” (Saba, 2001, p. 177).
 Florence
Nightingale has
been recognized as
an early informatics
nurse because of
her use of data to
inform knowledge
and change nursing
practices.
In 1863 she wrote:
In attempting to arrive at the truth, I have
applied everywhere for information, but in
scarcely an instance have I been able to obtain
hospital records fit for any purpose of
comparison…if wisely used, these improved
statistics would tell us more of the relative value of
particular operations and modes of treatment than
we have any means of obtaining at present. They
would enable us, besides, to ascertain the influence
of the hospital …upon the general course of
operations and diseases passing through its wards;
and the truth thus ascertained would enable us to
save life and suffering, and to improve the
treatment and management of the sick and
maimed poor (as cited in Hannah, Ball & Edwards, 2006, p. 171).
Nightingale was clear in
her desire to COLLECT,
RETRIEVE and ANALYZE
DATA to be able to
recognize trends in
illnesses and treatments
to improve the quality of
care.
1950s and 1960s
 mid 60s nursing resources and
allocation started to be analyzed.
 Health care facilities increased in
number and the nurses’ station
started to be considered the centre
of communication activities and
information exchange.
During this time period, computers were
used primarily in health care facilities for
basic business, financial and accounting
operations.
1970s
 Nursing staff began to recognize
the value of integrating computer
applications into their practices
and processes...
 documenting care
 evaluation of the care delivered
 staff scheduling
 statistics collection
Nurses became instrumental in the
development of nursing applications for
hospital information systems
(Hannah et al, 2006; Saba & Erdley, 2006).
1980s
Nursing informatics became a
recognized specialty in the US and
experts in the field were beginning to
emerge – with job titles such as
informatics nurse or nurse
informatician.

The need for nursing-specific software

became increasingly evident – to
document aspects of care including lab
results, vital signs, nurses’ notes and
discharge plans.
1990s and beyond
 Computers became smaller, faster and
easier to use.
 The internet became a tool for web-
based clinical applications, communication
and access to evidence-based resources.

 Wireless technologies made it simpler

for nursing and other health care
professionals to access applications at the
point-of-care – where the patient was
(Saba & Erdley, 2006).
1990s and beyond
 nurses have become more recognized as
knowledge workers (Bickford & Hunter, 2006),
with the emphasis of nursing work being
more on knowledge than on tasks.

Knowledge work is non-repetitive, non

routine work that entails substantial
levels of cognitive activity, involves
analyzing information and applying
specialized expertise to solve
problems and generate ideas. (Kenney &
Androwich, 2009).
1990s and beyond
Nurses as knowledge
workers are data
gatherers, information
users, knowledge users
and knowledge builders
(Snyder-Halpern et al, 2001 as cited in Hebda et al, 2005, p. 7).
1999 National Nursing Informatics
Discussion Paper

March 10, 2008

CHED MEMORANDUM ORDER (CMO)
No. 5 - Series of 2008
SUBJECT: POLICIES AND STANDARDS FOR
BACHELOR
OF SCIENCE IN NURSING (BSN) PROGRAM
 Informatics, through the use of
computers, assists nurses as
knowledge workers within their four
domains of practice;

1. Nursing Practice
2. Nursing Administration
3. Nursing Education
4. Nursing Research
 Nursing Practice Domain Applications:
Nursing practice is now an integral
component of the electronic health record
system alongside the documentation of other
health care professionals.

 Computer-generated nursing care plans

that are frequently embedded within inter-
professional plans of care

 Clinical decision-making alerts/prompts

that provide indications for the nurse to
avoid specific interventions or actions with
the patient
 Electronic monitoring devices that record
and trend vital signs, as well as alert the
nurse to patient conditions that fall
outside of acceptable parameters

 Patient-specific discharge instructions to

assist the patient to provide self-care once
home

 Online evidence-based nursing resources

– e.g. information about administering
medications (CNA, 2001;Hebda et al, 2005; Saba,
2001; Saba & Erdley, 2006)
 Nursing Administration Domain Applications:
Nursing managers and administrators are required to report
on any number of indicators and statistics within their
departments, and use IT extensively for planning resources
and budgeting that drives patient services.

 Workload measurement systems

that collect statistics for internal
and external reporting
requirements

 Online computer policy and

procedure manuals that guide
organizational practices
 Staff scheduling systems that either
automate schedules or allow for self-
scheduling through rules-based
protocols

 Internal email and/or systems for

improved communication

 Cost analysis of specific patient

populations

 Patient tracking systems to ensure

timely movement through the health
care facility (CNA, 2001; Hebda et al, 2005; Saba,
2001; Saba & Erdley, 2006)
 Nursing Education Domain Applications:
A variety of media are used to educate nursing students
in universities or colleges, and staff nurses who require
ongoing professional development to stay current with
changes in practices and processes.

 Online registration, scheduling,

attendance tracking, test administration
and grade management of courses
through learning management systems
 Computer-based tutorials that enhance or
replace didactic lectures
 Remote access to libraries or online
publications
 Presentation software

 Webcasting capabilities and other

distance education technologies to
share knowledge between centres

 Computer labs or resource centres

 Simulation labs with lifelike

mannequins that mimic real patient
scenarios and respond to nurses’
interventions and actions (CNA, 2001;Hebda
et al, 2005; Saba, 2001; Saba & Erdley, 2006)
 Nursing Research Domain Applications:
Nurse researchers are experts at gathering,
analyzing and using data to inform practice
and improve patient outcomes.

 Computerized literature searches

 Software that processes quantitative
and qualitative information to find
trends in data
 Collaboration with other nurse
researchers
 Evaluation of nurse-sensitive
outcomes (CNA, 2001; Hebda et al, 2005; Saba, 2001; Saba
& Erdley, 2006)
NURSING INFORMATICS SPECIALIST
(NIS)
The NIS is a nurse who
has formal education,
certification and
practical experience in
using computers in
patient care settings.
FUNCTIONS OF NIS
1.Theory development
2.Analysis of information needs.
3.Selection of computer systems.
4.Design of computer systems and
customizations.
5.Testing of computer systems.
6.Training users of computer systems.
7.Evaluation of the effectiveness of
computer systems.
8.Ongoing maintenance and
enhancements.
9.Identification of computer technologies
that can benefit nursing.