historical perspective

of
Nursing and computer
1980s
 introduction
Health care is delivered in dynamic, complex, and
ever changing environment. Changes in medical
treatments, regulations for federal and state
reimbursement and public knowledge creat growing
demands for information.

The computer help transform the nursing profession

prior to the new century. It includes the transformation of
paper-based records to computer-based records. It is use to
manage information in patients care, monitor the quiality
of care and evaluate the outcomes of care. It can be used for
communication and enhancing the nursing education and
support nursing research,
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 1980s
In the 1980s, the field of nursing informatics exploded
and became visible in the healthcare industry and nursing.
Technology challenged creative professionals in the use of
computers in nursing, which became revolutionary. As
computer systems were implemented, the needds of nursing
took on a cause-and-effect modality; the is, as new computer
technologies emerged and as computer architecture advanced
for nursing software evolved.
It became apparent that the nursing profession needed
to update its practice standards and determine specific data
standards, vocabularies, and classification schemes that could
be used for the computer-based patient record systems.
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 In the 1980s, the microcomputer or
personal computer (PC) emerged. This
revolutionary technology made computers
more accessible, affordable, and usable by
nurses and other healthcare providers. The
PC brought computing power to the
workplace and, more importantly, to the
point of care. Also, the PCs served as dumb
terminals linked to the mainframe
computers and as stand-alone systems
(workstations).
 The PCs were user-friendly and allowed nurses
to design and program their own applications. The
influence of computer technology extended to the
introduction of devices to improve patient safety.
For example, the automated dispensing cabinets
(ADCs) were introduced in the 1980s (Grissinger,
2012). The computercontrolled ADCs replaced
medication carts and drug floor stock. Tracking of
medications occurred at the point of care. The use
of ADCs in the clinical setting has resulted in the
reduction of medication errors.

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 Starting in 1981, national and international conferences
and workshops were conducted by an increasing number of
nursing pioneers to help nurses understand and get involved in
this new emerging nursing specialty. Also during the 1980s,
invitational conferences were conducted to develop nursing
data sets and vocabularies as well as numerous workshops were
conducted at universities to introduce this new specialty into
nursing education.

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 During this period, many mainframe healthcare
information systems (HISs) emerged with nursing subsystems.
These systems documented several aspects of the patient record,
namely, provider order entry and results reporting, the Kardex
reporting, vital signs, and other systems-documented narrative
nursing notes using word-processing software packages.
Discharge planning systems were developed and used as
referrals to community, public, and home healthcare facilities
for the continuum of care.

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 Nurses began presenting at multidisciplinary conferences and
formed their own working groups within HIT organizations, such as
the first Nursing Special Interest Group on Computers which met for
the first time during SCAMC (Symposium on Computer Applications
in Medical Care) in 1981. As medical informatics evolved, nursing
began focusing on what was unique about nursing within the context
of informatics. Resolutions were passed by the American Nurses
Association (ANA) regarding computer use in nursing and in 1985, the
ANA approved the formation of the Council on Computer
Applications in Nursing (CCAN). One of the first activities the CCAN
executive board initiated was to solicit several early pioneers to develop
monographs on the status of computers in nursing practice, education,
research, and management.

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 The CCAN board developed a yearly Computer Nurse
Directory on the known nurses involved in the field, conducted
computer applications demonstrations at the ANA annual
conferences, and shared information with their growing members
in the first CCAN newsletter Input-Output. During this time NI
newsletters, journals, and several books, such as the first edition of
this book Essentials of Computers for Nurses published in 1986,
were used for educational courses introduced in the academic
nursing programs, and workshops conducted on computers and
nursing.
 The CCAN became a very powerful force in
integrating computer applications into the nursing
profession. In 1988, the CCAN commissioned three
NI experts to prepare a set of criteria on the
integration of nursing practice for EHR vendors to
follow (Zielstorff, McHugh, & Clinton, 1988). In
1989, the ANA renamed the CCAN to the Steering
Committee on Databases to Support Clinical
Nursing Practice, which later became the
Committee for Nursing Practice Information
Infrastructure (CNPII). The purpose of the CNPII
was to support development and recognition of
national health data standards (Coenen et al., 2001).
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 SUMMARY
⬗ Nursing Informatics emerged
⬗ Need of data standards, vocabularies, and
classification schemed for computer based patient
record system (CPRS which is an EHR) identified.
⬗ Microcomputer/ Personal Computer emerged
- has brought computing power to workplace,
especially the point of care
- served as stand alone system (workstation)
User-friendly and allowed nurses to creat their own
applications
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 1980s

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