Nursing Informatics

Nursing Information System

 INTRODUCTION:

• Health care is delivered in dynamic, complex, and ever changing environments.

Changes in medical treatments, regulations for federal and state reimbursement
and public knowledge about making individual and collective health care
choices create growing demands for information.
• To respond proactively for these changes and the growing demands for
clinical information, computer systems are being devised to collect, store,
retrieve, analyze and communicate health status and health care information.
• . It can aid in collecting, storing, retrieving and analyzing patient care data
when the systems are based on concepts from informatics. Appropriately
designed and deployed computerized systems of information can transform
patient care data into clinically relevant and useful information and knowledge.
 Introduction:
• Health sector is one of the largest consumer oriented fields which can device
substantial benefits from the computerization. Last few years have been
continually witnessing an increasing number of health professionals and set
ups using electronic and information technology to improvise the delivery of
healthcare at different levels such as primary care, ambulatory care and
tertiary level care.
• With modernization all hospitals eventually will have to implement some
form of Healthcare Information system: computer and communication system
used by health care providers to collect, process, store and analyze data. It
combines computer technology and communication technology to acquire
and integrate financial and clinical data.
 Nursing Information System Definition:
• By Joseph Liaskos 1, John Mantas 
• Nursing Information System (NIS) is a part of a health care information system that deals with
nursing aspects, particularly the maintenance of the nursing record.
• The several objectives that a Nursing Information system should meet in order to succeed its
aims, cover the users' needs and operate properly are described.
• The functions of such systems, which combine with the basic tasks of the nursing care process,
are examined.
• As Nursing Information System is part of the health care and hospital information system, the
different strategies and approaches for designing and developing Hospital Information
Systems followed from the decade of 1970 until the recent decade of 1990, are presented. The
three main approaches followed were the "centralized approach", the "departmental
approach", and the "distributed approach". The advantages and drawbacks of each different
approach are examined.
 • The three main approaches followed were the:
• "centralized approach"
• “departmental approach"
• "distributed approach"
The advantages and drawbacks of each different approach are examined.
• . For the implementation or upgrade of Nursing Information System a
NIS committee comprised by different health care professionals, is
necessary to be formed.
• The implementation and upgrade of a Nursing Information System
follows some specific phases. These steps, include planning phase,
analysis phase, design phase, development phase, implementation
phase, and upgrade phase.
• A paragraph at the end of this chapter summarizes the future trends of
Nursing Information Systems.
• Other Definition
• Hospital Information System are computer based software applications that
integrate many medical, nursing, and administrative and miscellaneous
functions of hospitals. It combines computer technology and communications
to acquire and integrate financial and clinical data. 
• Nursing Information System are computer systems that manage clinical
data from a variety of healthcare environments and made available in a timely
and orderly fashion to aid nurses in improving patient care.
 Importance of Nursing Information Systems
• The components of a healthcare information system allow for clinical and health
management decision making and provide for input of information from the clinical sciences
(medicine, pharmacy, dentistry, nursing, allied health and rehabilitation) as well as from the
management, behavioral, information and communication sciences. The role of information
sciences in medicine continues to grow, and the past few years have been informatics begin
to move into the main stream of clinical practice.
• The scope of this field is, however, enormous. Informatics finds application in the design of
decision supports for practitioners, in the development of computer tools for research and in
the study of the very essence of medicine its corpus of knowledge.
•  With the tremendous advances in medical science the challenge for nursing continues to be
the integration of many specialized resources in the care of patients.
•The main functions that can be found in current ward nursing information systems are:
•Care planning Nursing Clinical Record Care evaluation Discharge planning
•Workload assessment (prospective and or retrospective)
•Personnel management
•Staff rostering
•Attendance recording Skill mix management
•Costing
•Budget management
• Today, nurses around the world are rapidly increasing the extent to which
they use computers and information sciences to assist them in the
performance of their increasingly sophisticated and complex duties. Because
of the evolution of nursing informatics, new roles for nursing are developing
in industry, research, system development, nursing education, nursing
administration and indeed at the bedside.
• The reason that many nurses have ventured into the field of nursing
informatics is a common vision of information systems being used to enhance
the practice of nursing and to benefit the patient by extending and improving
the health care received.
 
 Purpose of Nursing Information Systems

Ø  To make relevant patient data available in a usable form so patient care
problems can be solved
Ø  To process information to support management functions such as receiving
data from departments and supplying data to departments to make policy
decisions, operating decisions as well as patient care decisions
Ø  To provide a comprehensive automated information processing system for
all phases of the nursing process
Ø  To develop care plan for families and patients.
 Components of Nursing Information Systems

1. Hardware: Physical devices that provide handling function such as input, CPU, processing, storage or output
of computer data.
2. Software: Series of programming statements that perform a specific computer related application; categories
include systems, operating, application and programming (word processors, spreadsheets, databases,
multimedia applications and communication programs).
3. Network: Devices and software applications that provide communication and data transfer between 2 or
more computer systems. There are three types of networks:
·  Wide- Area Networks (WAN): Are links to the outside world. They connect computer users to other users
and systems through the telephone company’s communication infrastructure. WAN support voice, data and
image transmission.
·  Local- Area Network (LAN): Are used to connect user’s within a local, somewhat defined, geographic area
such as a building or closely grouped set of buildings.
·Wireless networks connect information system: Uses computer and communication hardware using wireless
transmission of data, example electrocardiogram and cell phones
 Examples of Nursing Information Systems:

1. A System (EmSTAT) at Hennepin County Medical Center (Minnaeapolis, Minnesota) improves

communication, facilitates continuity of care and decreases redundancy in documentation. 
2. The Nursing Case Management Computerized System – an interactive computer program that
enhances team planning of individualized care, decreased paperwork, aided the development of team
care plans and facilitated improvements in the quality of patient care. 
3. The Interactive Home Health Care systems- provide for audio and video interactions over local
cable systems, as well as patient monitoring and data input and retrieval by the nurse. 
4. Nurse Link – an electronic bulletin board operated by the School of Nursing at the
University of Colorado Health Sciences Center in Denver. 
5. An Expert system – developed to assess pregnant women’s risk of preterm birth. 
Tips to develop Nursing Information Systems

•  Choose software first

• Request software information from several vendors
•Provide vendor with pertinent information about size of agency, number of
departments, type of departments and number of patients
• Provide information about the capabilities of the system users
• Provide information about other computerized systems within the organization
• Have the planning committee make a site visit to an organization where the selected
software has been used
• Observe use of software in a similar organization
•  Have vendor install, maintain and duplicate system information and train personnel
• Have vendor phase out former system
 Nursing Information Systems Vs Emerging roles of nurses

• Advances in information technology emphasized the need for all nurses to:
1.  Involve information from assessing the health care needs of patients
2. Developing care plans
3. Communicating patient information to other health professionals
4. Analyzing staffing and budget reports-in fact, nurses work in a information-intensive environment
5. Become more knowledgeable about health information concepts and the technology that is designed to
manage and process information
6. As technology continues to evolve, nursing practice methods will also adopt to take advantage of automation
7. Nursing professionals will move frequently have key roles in integrating technology into patient care delivery
8. Nurses make excellent information systems people because they are data gathers and documenters, have global
systems views, set priorities, manage all care and understand the need to access patient information
 Nursing Information System:

• Internet Applications:
 Personal Digital Assistant (PDA) and wireless
Devices
Background

• Health care personnel need access to updated information anywhere and at any time, and
a Personal Digital Assistant (PDA) has the potential to meet these requirements. A PDA is
a mobile tool which has been employed widely for various purposes in health care
practice, and the level of its use is expected to increase. Loaded with suitable functions
and software applications, a PDA might qualify as the tool that personnel and students in
health care need. In Sweden today, despite its leadership role in mobile technologies, PDAs
are not commonly used, and there is a lack of suitable functions and software applications.
• This overview of the use of PDAs revealed a positive attitude towards the
PDA, which was regarded as a feasible and convenient tool. The
possibility of immediate access to medical information has the potential
to improve patient care. The PDA seems to be a valuable tool for
personnel and students in health care, but there is a need for further
intervention studies, randomized controlled trials, action research, and
studies with various health care groups in order to identify its
appropriate functions and software applications.
• Keywords: Informatics, medical informatics, computers, handheld,
health personnel, students, health occupations, personal digital assistant.
 Personal Digital Assistant Device:

• The PDA is a very small and portable, handheld computer, which has many more functions than a calculator, and the
capacity to store information much like a Personal Computer (PC)
Basic functionality available on most PDAs includes an:
• address book,
• schedule,
• calendar,
• note pad, and e-mail [5].
• The PDA is convenient to use in clinical and field situations for quick data management, and the information can be
synchronized with a PC [4,6]. By means of a wireless network, information can be exchanged anytime from anywhere to
and from a PDA [6], and the network will provide immediate access to all kinds of necessary clinical and administrative
data [5]. “PDA” is used as a generic name for all handheld computers in our review.
• The PDA is convenient to use in clinical and field situations for quick data management,
and the information can be synchronized with a PC.
• By means of a wireless network, information can be exchanged anytime from anywhere
to and from a PDA and the network will provide immediate access to all kinds of
necessary clinical and administrative data .
• “PDA” is used as a generic name for all handheld computers in our review.
• Previous medical and health care reviews have summarized the research covering the
use of PDAs , including adoption and barriers.
• PDAs have been employed widely in health care practice, and the level of their use is
expected to increase. The PDA is mainly a functional tool, but it is also associated with
barriers like insufficient security and technical support.
• Health care professionals need access to information several times a day, and the PDA
has the potential to provide this.
• For the PDA, there are numerous documents and medical software applications
available, with a wide variation in quality .
• A large number of medical students take advantage of the PDA for educational purposes
and patient care with great satisfaction.
• If loaded with suitable functions and software applications, the PDA might meet the
need for having access to up-to-date information on a just-in-time basis, thus making
the PDA a qualified support tool for personnel and students in health care.
• In Sweden today, PDAs are not commonly used by personnel and students in health
care, and there is a lack of suitable functionality and software applications designed for
PDAs. The aim of the present review was to obtain an overview of existing research on
the use of PDAs among personnel and students in health care.
Personal Digital Assistant Device
 2. Emails and Bookmarks
• E-mail (electronic mail) are messages transmitted and received by digital
computers through a network.
• Ray Tomlinson is a computer programmer who implemented the first email
program in 1971.
• An e-mail system allows computer users on a network to send text, graphics,
sounds, and animated images to other users. (Britannica)
• Emails make use of a server called Simple Mail Transfer Protocol through the
internet. This dedicated port is assigned to the server to help the client transfer
the messages through the mail.
Description
• Emails are used for the purpose of communication.
• Casual/Informal Purpose: Contacting friends, relatives and personal affairs
• Education Purpose: communicating with professors and supervisors,
students
• Information Purpose: requesting information,
• Professional Purpose: Applying for jobs, internships, and scholarships.
• Business communication:

May be used for:

• Take note that depending on your purposes, the messages you send will differ in their
formality, intended audience, and desired outcomes. Purpose:
• Allow users to send text, graphics, sounds, and images to other computer users.
• Information can be sent to selected groups, large group users, or individuals.
• Recipients can choose to print, save, view, forward, or react to communications.
• Best form of communicating with a person who is hard to get using other forms of
communication such as telephone.
• Addresses can be stored in an address book and retrieved instantly
 Function:

• Email communication has been acknowledged as a resource which improves access,

efficiency, responsiveness, patient focus, and the quality of healthcare. The use of this technology
has evolved prior to the dissemination of comprehensive guidelines, leaving the Advanced
Practice Nurse with a practice gap.
Considerations for safe usage:

• Nurses have a duty to protect patients’ confidentiality by avoiding any inappropriate disclosure of patient
information. Emails from patients should only be accessible to those directly involved either in patient
care or in the running of the service itself.

• Practitioners must also ensure that if they choose to communicate via email, they comply with statutory
regulations such as the Data Protection Act (1998) when storing emails or using patients’ contact details.
• Confidentiality
Practitioners are accountable for the information or advice they provide to patients, regardless of the method
used to communicate it. To ensure that email content is clinically accurate and evidence-based, many
organizations using email as a way of delivering healthcare information have a policy of peer review.
It reduces the chance of clients receiving an email that may be misleading. Having clear organizational guidelines
about the scope of email communication may also provide clinical staff with additional support and security.
• Accountability
Practitioners are accountable for the information or advice they provide to patients, regardless of the method used
to communicate it.
• Resources
Communicating by email can be time-consuming, and if peer review is also introduced, this increases the use of
healthcare professionals’ time even further. Organizations will have to consider their resources before offering
patients the opportunity to have email contact
 Bookmarks
• A web browser feature used to save a web site's URL address for future
reference. Bookmarks save user and browser time, which is especially useful for
Web pages with long URLs or accessing a specific part of the site that might not
be the homepage for the site.
Description
To allow users easy accessibility to a specific link or website they had visited or
frequently visit.
•Provides users convenience and efficient web surfing since they won't need to
type out the entire address and can instead, click an easily accessible link found in
the menu of your browser.
•Purpose:
• Provides customization and personalization of a browser depending on their web
activity
 Purposes of Bookmarks

• Create a shortcut for quick access to that web page.

• Stores the title and URL of the page.
• Allow users to save and share websites or articles with others.
• It can be organized in folders and can be accessed through the browser's
menu.
• Allows you to access your websites anywhere.
Function:
• If you share your computer with other users, there may be times when you want to create a
bookmark and keep it private.

• Here are some Chrome Extensions that will password protect your bookmarks.

• Secure Bookmarks allows you to store such bookmarks in a separate list, safely encrypted on your hard
drive. Secure Bookmarks includes a ten second set-up page and a clean and intuitive interface,
allowing you to create, edit, and rearrange bookmarks easily.
• Use folders to organize your bookmarks. Plus, you can exchange bookmarks between
• Chrome and Secure Bookmarks effortlessly from the Settings page. You can export your data
to an encrypted text file, which can be used to restore information or share between
computers.
Secure Bookmark
• Save your websites, where no one can see them. This extension adds a button to your browser toolbar.
Click to open and set a new password or login if you already have one set. After that, you are able to add
websites by right-clicking on a page or by opening the extension and clicking <Add to private
bookmarks=.

• Private Bookmarks gives you the ability to save your bookmarks where no one can see them. It’s
password protected, so you’re safe.

Private Bookmark
• Create and manage hidden bookmarks that are visible only for you through a configurable keys-
shortcut. Enhance your privacy on several levels up.

• This extension provides you an ability to create bookmarks which are hidden from prying eyes, only you
will be aware of the existence of these bookmarks.
Wireless phones
 Two way video conferencing
• Teleconferencing uses communications network technology to connect participant's voices. In many
cases, speaker telephones are used for conference calls among the participants. A two-way radio system
can also be used. In some areas, satellite enhancement of connections is desirable.

• A teleconferencing can also be defined as a group communication through an electronic meeting.

 Functions and Purposes of Using Teleconferencing

• Use a telecommunications channel

• Link people at multiple locations
• Interactive to provide two-way communications
• Dynamic to require users' active participation
• Share news and information
• Make decisions
• Coming to agreement teleconference is a useful way to communicate with people remotely
using a conferencing platform.
 Internet Application

• Face time
• Text massaging
• Twitter
• Google, internet
• Face book
 B. Web 2.0, blogs, wikis
• Web 2.0 describes the current state of the internet, which has more user-
generated content and usability for end-users compared to its earlier
incarnation, Web 1.0. In general, Web2.0 refers to the 21st-century Internet
applications that have transformed the digital era in the aftermath of the
dotcom bubble.
• -Examples of WEB 2.0Hosted services (Google Maps),Web applications
( Google Docs, Flickr),Video sharing sites (YouTube),Wikis (MediaWiki),Blogs
(WordPress),Social networking (Facebook), Folksonomies
(Delicious),Microblogging (Twitter),Podcasting (Podcast Alley)
 Blogs
• A blog is a web log, an online journal where the owner presents information in reverse
chronological order. It can be a section within a website or a standalone project. According
to Britannica, blog, in full Web log or Weblog, online journal where an individual, group, or
corporation presents a record of activities, thoughts, or beliefs.
• Some blogs operate mainly as news filters, collecting various online sources and adding
short comments and Internet links. Other blogs concentrate on presenting original
material. In addition, many blogs provide a forum to allow visitors to leave comments and
interact with the publisher.
• <To blog= is the act of composing material for a blog. Materials are largely written, but
pictures, audio, and videos are important elements of many blogs. The <blogosphere= is
the online universe of blogs
• Elements
• However, most bloggers still follow a standard structure by dividing their blog layout into these
• elements:
• It consists of the blog’s title or logo and main navigation menus to places such as the Home, About, and Contact pages.
• Headers
• The main content area, where you find the latest or highlighted blogposts.
• Body
• This area generally includes widgets and highlights Blogspot, .
• Sidebar
• It rests at the bottom of a blog’s page and gives easy access to important pages like the privacy policy and disclaimers.