NURSING INFORMATICS

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HISTORICAL OVERVIEW OF
NURSING AND COMPUTER
 TERMINOLOGIES

COMPUTER
o Referred as Information
Tecnology.
o Synonymous to NIS, NCA, and NI.
o Used to manage information in
patient care, monitor quality of
nursing care and evaluate care
outcomes.
o With networks are now used in
communicating data via the internet,
accessing resources and interacting
with patients on the World Wide
Web (WWW).
 TERMINOLOGIES

NURSING
INFORMATICS
❑ Refers to integration of nursing, its
information and information
management with information
processing and information technology
to support the health of the people
worldwide (IMIA, 1998).
❑ A specialty that integrates nursing,
computer and information science to
manage and communicate data,
information and knowledge in nursing
practice (ANA, 2006).
 TERMINOLOGIES

NURSING
INFORMATICS
❑ Facilitates the integration of
data, information and
knowledge to support patients,
nurses and other providers in
their decision-making in all
roles and settings.
 TERMINOLOGIES
CLINICAL
INFORMATION
SYSTEM
❑ Refers to a set of components that
form the mechanism by which patient
records are created, used, stored and
retrieved and usually located within a
healthcare provider setting.
❑ Includes people, data, rules and
procedures, processing and storage
devices, communication and support
facilities (IOM, 1991).
MAJOR HISTORICAL PERSPECTIVE

SIX TIME PERIOD

FOUR MAJOR NURSING AREAS

STANDARD INITIATIVES

SIGNIFICANT LANDMARKS
 MAJOR HISTORICAL PERSPECTIVE

SIX TIME
PRIOR TO 1960s: PERIOD
SIMPLE BEGINNINGS

➢ Computers were first developed in the late 1930s to early

1940s, but use in the healthcare industry occurred in the 1950s

➢There are only few experts who attempted to adapt computers

to health care

➢ During this period the image of nursing profession is

undergoing major changes

➢ Initially, computers were used for business office transactions.

 SIX TIME PERIODS
PRIOR TO 1960s: SIMPLE BEGINNINGS

❑Early computers used punch cards

to store data and card readers to read
computer programs, sort, and
prepare data for processing.

❑Linked together and operated by

paper tape and used teletypewriters
to print their output.
 MAJOR HISTORICAL PERSPECTIVE
SIX TIME PERIOD

1960s: ISSUES AND NURSING INFORMATICS RESEARCHES

➢ The use of computer technology in healthcare

settings began to be questioned.
➢ Nursing standards were reviewed and
resources were analyzed.
➢Introduction of new computer technology such
as Cathode Ray Tubes (CRT).
➢HISs were primarily developed to process
financial transactions.
➢Computer vendors were beginning to penetrate
the healthcare field but progress is slow.
 MAJOR HISTORICAL PERSPECTIVE
SIX TIME PERIOD

1970s: GIANT LEAP FOR NI

➢ Nurses begin to recognize the value of the computer for

their profession.
➢Nurses assisted in the design of HISs.
➢ Computer applications for financial and management
functions of patient care systems were perceived as cost
saving technologies.
➢Several States & large Community Health Agencies in
the US developed and/or contracted their own computer-
based Management Information Systems (MISs).
 MAJOR HISTORICAL PERSPECTIVE
SIX TIME PERIOD

1980s: EMERGENCE OF INFORMATICS FIELD

➢ NI became an accepted specialty and many nursing experts

entered the field.
➢ The need for nursing software evolved and nursing education
identified the need to update practice standards, determine data
standards, vocabularies and classification schemes that could be
coded for Computer based Patient Record Systems (CPRs).
➢Nursing Education identified the need to update practice
standards, determine data standards, vocabularies and
classification schemes that could be coded for Computer-based
Patient Record Systems (CPRSs).
 MAJOR HISTORICAL PERSPECTIVE
SIX TIME PERIOD

1980s: EMERGENCE OF INFORMATICS FIELD

➢ Many mainframe HISs integrated nursing

subsystems that documented several aspects of
the patient record.

➢ Microcomputers/PCs emerged that made

computers more accessible, affordable and
usable by nurses.
 MAJOR HISTORICAL PERSPECTIVE
SIX TIME PERIOD

1990s: AFFIRMATION OF NI AS A SPECIALTY FIELD

➢ Computer technology became an integral part of the

healthcare settings, nursing practice and nursing
profession.
➢Policies and Legislation were adopted promoting
computer technology in healthcare including Nursing.
➢NI was approved by ANA as a new Nursing specialty.
➢ Need for computer-based nursing practice standards,
data standards, nursing minimum data sets, and
National databases emerged concurrently with a need
for a unified nursing language.
 MAJOR HISTORICAL PERSPECTIVE
SIX TIME PERIOD

1990s: AFFIRMATION OF NI AS A SPECIALTY FIELD

➢Nursing Administrators demanded inclusion of Nursing

protocols in the HISs.
➢Nursing Educators require use of innovative technologies
for all levels and types of nursing and patient education.
➢Nurse Researchers required knowledge presentation,
decision support, and expert systems based on aggregated
data.
➢Development of smaller, faster computers and internet
connection made it possible for the information and
knowledge databases to be integrated in bedside systems.
 MAJOR HISTORICAL PERSPECTIVE
SIX TIME PERIOD

POST 2000: RAPID GROWTH AND DEVELOPMENT OF NI

➢Development of wireless point of care, open source

solutions, regional database projects and increased IT
solutions on healthcare environment.

➢Clinical information systems became individualized in the

EPR.

➢ Mobile computing devices were also started to utilize in

healthcare.
 MAJOR HISTORICAL PERSPECTIVE
SIX TIME PERIOD

POST 2000: RAPID GROWTH AND DEVELOPMENT OF NI

➢Health Insurance Portability and Accountability Act

of 1996 (HIPAA) was enacted.

➢ Standardized transaction and code sets were

implemented to protect security and ensure privacy
and confidentiality of healthcare data.
MAJOR HISTORICAL PERSPECTIVE

SIX TIME PERIOD

FOUR MAJOR NURSING AREAS

STANDARD INITIATIVES

SIGNIFICANT LANDMARKS
MAJOR HISTORICAL PERSPECTIVE

NURSING PRACTICE
FOUR MAJOR NURSING AREAS

NURSING ADMINISTRATION

NURSING EDUCATION

NURSING RESEARCH
 MAJOR HISTORICAL PERSPECTIVE

FOUR MAJOR NURSING AREAS

NURSING PRACTICE

❑ Integration of NCPs, patient care data, nursing

practice itself as part of the EHR/ HER.
❑ Nursing practice data emerged with the
introduction of several nursing terminologies usable
for the EHR.
 MAJOR HISTORICAL PERSPECTIVE

FOUR MAJOR NURSING AREAS

NURSING ADMINISTRATION
❑ Hospital policies and procedure manuals are
accessed and retrieved by computers.
❑ Work load measures, acuity systems and other
nursing department systems are online and integrated
with the hospital or patient’s HER system or in
separate nursing department systems.
❑ Digital libraries, online resources, and research
protocols at bedside.
 MAJOR HISTORICAL PERSPECTIVE

FOUR MAJOR NURSING AREAS

NURSING EDUCATION
❑ Computer-enhanced Courses, Online Courses,
and/ or Distance Education.
❑ Campus-wide computer systems are available for
students.
❑ New educational teaching methodologies and
strategies.
 MAJOR HISTORICAL PERSPECTIVE

FOUR MAJOR NURSING AREAS

NURSING RESEARCH
❑ Software programs are available for processing
both Qualitative and Quantitative reasearch data.
❑ Databases supporting nursing research emerged.
❑ Online access to millions of web resources around
the world.
MAJOR HISTORICAL PERSPECTIVE

SIX TIME PERIOD

FOUR MAJOR NURSING AREAS

STANDARD INITIATIVES

SIGNIFICANT LANDMARKS
 MAJOR HISTORICAL PERSPECTIVE

STANDARDS INITIATIVES

NURSING
NURSING CONFIDENTIALITY
PRACTICE &
CONTENT & SECURITY
EDUCATION STANDARDS
STANDARDS
STANDARDS
 MAJOR HISTORICAL PERSPECTIVE
STANDARD INITIATIVES

ANA
❑ Contributes in the development and
recommendation of standards of nursing practice
worldwide.
❑ Nursing Scope & Standards of Practice (2004).
NURSING ❑ Recommended that the nursing process serve
PRACTICE as the conceptual framework for the
documentation of the Nursing practice.
STANDARDS ❑ Nursing Informatics Scope and Standards of
Practice (2008)
❑ Builds on clinical practice standards, outlining
further the importance for implementing
standardized content to support nursing practice
by NI specialists.
 MAJOR HISTORICAL PERSPECTIVE
STANDARD INITIATIVES

JCAHO
❑ Focuses on the need for
adequate records on patients in
hospitals and practice of
NURSING standards for the
PRACTICE documentation of care by
nurses.
STANDARDS ❑ Recommended acuity
systems to determine resources
use aas well as required care
plans for documenting nursing
care.
 MAJOR HISTORICAL PERSPECTIVE
STANDARD INITIATIVES

PNA and BON

❑ PNA
o Founded on September 2,
1922.
NURSING o Member of the
International Council for
PRACTICE Nurses.
o Instigated the
STANDARDS standardization of the
nursing profession in the
Philippines.
❑ BON
o Empowered by RA 9173.
 MAJOR HISTORICAL PERSPECTIVE
STANDARD INITIATIVES

NURSING TERMINOLOGIES
APPROVED BY ANA

•One of the American

National ASTM Institutes
Standards NURSING DATA
(American Society for Testing and Material)
(ANSI) that accredits
•FacilitatesDeveloping
Standards student-centered
STANDARDS
Organizations
HL7
instructional settings (SDOs) creating
(High Level Seven)
operating
a motivational in theand healthcare
active
arena.
learning environment.
 MAJOR HISTORICAL PERSPECTIVE
STANDARD INITIATIVES

❑Increasing access through

electronic capture and exchange
of information raised concerns
about the privacy and security of
personal health information (PHI).
CONFIDENTIALITY NURSING
❑HITECH Act of 2009
❑Included the provisions for
& SECURITY CONTENT
strengthening the original
STANDARDS STANDARDS
HIPAA legislation (patient
consent, organizations
handling PHI, and increased
penalties for security
breaches).
MAJOR HISTORICAL PERSPECTIVE

SIX TIME PERIOD

FOUR MAJOR NURSING AREAS

STANDARD INITIATIVES

SIGNIFICANT LANDMARKS
MAJOR HISTORICAL PERSPECTIVE
YEAR EVENT
Health Information & Management System
1961 Society (HIMSS) was founded.
1st Hospital Information System (HIS) at El
1965 Camino Hospital.
First Invitation conference on Management
Information Systems (MIS) for public/
1973 community health agencies @ Fairfox
Virginia.
First Research: State of the Art Conference
SIGNIFICANT LANDMARKS
1977 on Nursing Information System (NIS),
Chicago
First Military Conference for Computer,
1979 Washington

1980 First Workshop, University of Akron, Ohio

First National Conference, Bethesda, NIS

1981 Journal
MAJOR HISTORICAL PERSPECTIVE

YEAR EVENT
The National Conference became an
1982 ANNUAL EVENT, New Jersey
Computers in Nursing: First Nursing
1984 Computer Journal
Council on Nursing Informatics was formed
1985 in New York
Graduate Program for NI was introduced
1989 (Maryland Univ and Univ of Utah)
ANA Congress of Nursing Practice
1990 recognizes Nursing Informatics as a
specialty area
International Classification of Nursing
1991 Practice (ICNP) was initiated.
ANA recognizes Nursing Informatics as a
1992 specialty by delineating the scope of
practice.
MAJOR HISTORICAL PERSPECTIVE

YEAR EVENT

1993 Electronic Library goes Online

First International Nursing Informatics,

1995 Teleconference (Melbourne Australia)
First Harriet Werley Award for best nursing
1996 informatics paper.
Nursing Information and Data Set Evaluation
Center (NIDSEC) standards and scoring
1997 guidelines published to address documentation
of nursing care.
Nursing Vocabulary Summit Conference Held
1999
Canadian Informatics Nurses Association
2001 received emerging group status from the
Canadian Nurses Association.
JCAHO identified clinical information systems as
2002 a way to improve safety and recommended that
hospitals adopt technologies
MAJOR HISTORICAL PERSPECTIVE

YEAR EVENT
HIPAA deadline for electronic transaction
standards enacted in October.
2003 President calls for widespread adaptation
of Electronic Health Record (EHR) in 10
years.
The office of the National Health
2004 Information Coordinator established.