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Nursesarebecomingcomputerliterateand thenursingprofessionisimplementing practicestudentsforitsclinicalcareand datastandardsforitsnursinginformation technologysystems. NIrepresentsthetransitionofdata, informationandknowledgeintoACTION.

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T echnology Professor

Informaticsisthescienceandartof turningdataintoinformation (BemmelandMusen,1997). ItisanadaptationoftheFrenchterm informatique,whichreferstothe computermilieu(Saba,2001).

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T echnology Professor

It is a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, and knowledge in nursing practice. Nursing informatics facilitates the integration of data, information and knowledge to support patients, nurses, and other providers in their decisionmaking in all roles and settings.
AmericanNursesAssociation(ANA,2001)
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Computer in nursing are used to manage information in patient care, monitor the quality care, and evaluate the outcomes of care. Networks are now used for communicating (sending/receiving) data and messages via the Internet, accessing resources, and interacting with the patients on the World Wide World (www).
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Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T echnology Professor

Computer Technology emerged in nursing in response to the changing and developing technologies in the health care industry and in nursing practice. Nursing Informatics evolved in SIX TIMES Period: i.Priortothe1960s iv.The1980s ii.The1960s v.The1990s iii.The1970s vi.Post 2000
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Starting in the early 50s, and as the computer industry grew, the use of computer in the health care industry also grew. Only few experts who attempted to adapt computer to health care and nursing. As the image of nursing improved, nursing practices were expanding in scope and complexity. These events motivates the nursing professionals to embrace computers.
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Computerswereinitiallyusedinthehealth carefacilitiesforbasicbusinessoffice functions. Theearlycomputersusedpunchcardstostore dataandcardreaderstoreadcomputer programs,sortandpreparedatafor processing.

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T echnology Professor

Duringtheearly60s,theuseofcomputer technologyinhealthcarebegantobe questioned.Whycomputers?andWhat shouldbecomputerized? Studieswereconductedtodeterminethe effectiveutilizationofthecomputertechnology inhealthcareindustryandtoidentifytheareas ofnursingthatneedstobeautomated.

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T echnology Professor

Hospitalinformationsystems(HIS)were developedprimarilytoprocessfinancial transactionsandserveasbillingand accountingsystems. Vendorsystemswerebeginningtoenterthe healthcarefieldandmarketsoftware applicationsforvarioushospitalfunction

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Nurses began to recognize the value of computer for their profession and see computers potential in improving the documentation of nursing practices, the quality patient care, and the repetitive aspects of managing patient care. Giant steps were taken during this decade in both NURSING & COMPUTER Technology.
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Several mainframe HISs were designed and developed. Many of the early HISs were developed and funded by the contractor or grants from federal agencies (National Center for Health Service Research, 1980) Several states and large community health agencies developed and/or contracted for their own computerbased management information systems (MIS).
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During this decade, the field of informatics emerged in the health care industry and nursing. NI became an accepted specialty and many nursing experts entered the field. Technology challenged creative professionals and the use of computers in nursing became revolutionary. Many mainframe HISs emerged with nursing subsystems.
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Dischargeplanningsystemsweredeveloped andusedasreferralstocommunityhealth carefacilitiesinthecontinuumcare. Microcomputers/PCsemergedinthisperiod, makingmoreaccessible,affordable,and usablebynursesandotherhealthcare providers.

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In the early 1990s, computer technology became an integral part of health care servicing, nursing practice and the nursing profession. Policies and legislation were adopted promoting computer technology in health care including nursing. In 1992, NI was approved by the American Nurses Association (ANA) as a new nursing specialty (McCormick et al., 1994).
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This period brought the smaller and faster computerslaptops and notebooks to the beside and all of the pointofcare settings. Workstations and local are network (LANs) were developed for hospital nursing units, wide are networks (WANs) were developed for linking care across health care facilities, an the Internet started to be used. The WEB became means of communicating online services and resources to the nursing community.
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Clinical Information Systems became individualized in the electronic patient record (EPR) or electronic health record Information Technologies continued to advance with mobile technology such as with wireless tablet computer, personal digital assistants (PDAs), and cellular phones. Internet has also provided a means for development of clinical applications, like eICU
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Homehealthcarehasalsoincreasingly partneredwithinformationtechnologyforthe provisionofpatientcare. Telenursing,isincreasinginpopularityand providingpatientcareinanefficientand expeditiousfashion.

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Maybeusedtorefertotheapplicationof informationscienceandtechnologytoacquire, process,organize,interpret,store,use,and communicatemedicaldatainallofitformsin medicaleducation,practiceandresearch, patientcareandhealthmanagementormore broadlytotheapplicationofinformaticstoall ofthehealthcaredisciplinesaswellasthe practiceofmedicine.

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T echnology Professor

Theapplicationofcomputerandinformation scienceinallbasicandappliedbiomedical sciencestofacilitatetheacquisition, processing,interpretation,optimaluse,and communicationofhealthrelateddata.The focusisthepatientandtheprocessofcare, andthegoalistoenhancethequalityand efficiencyofcareprovided.

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Theapplicationofcomputerandinformation technologytothemanagementofbiological informationincludingthedevelopmentof databasesandalgorithmstofacilitate research.

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Thescienceunderlyingtheacquisition, maintenance,retrieval,andapplicationof biomedicalknowledgeandinformationto improvepatientcare,medicaleducation,and healthsciencesresearch.

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Branchofmedicalinformaticsthatanalyzes consumerneedsforinformationandmethods formakinginformationaccessibleand implementsthosemethodsmodeling consumerpreferencesintomedical informationsystems.(Eysenback2000)

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Applicationofcomputerandinformation sciencestoimprovedentalpractice,research, education,andmanagement.(Schleyerand Spallek2001)

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Multidisciplinaryfieldthatfocusesuponthe enhancementofclinicalinformation managementatthepointofhealthcare throughimprovementofinformation processes,implementationofclinical informationsystems,andtheuseand evaluationofclinicaldecisionsupport(CDS) toolsasameanstoimprovetheeffectiveness, quality,andvalueofservicesrendered.

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Applicationofinformationandcomputer scienceandtechnologytopublichealth practice,research,andlearning.

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Acollectionofnumbers,characters,orfacts thataregatheredaccordingtosome perceivedneedforanalysisandpossibly actionatalargerpointintime.(Anderson, 1992)

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Acollectionofdatathatarearranged inalogicalorder.

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Thesynthesisofinformationderivedfrom severalsourcestoproduceasingleconceptor idea.Itisbasedonalogicalprocessof analysisandprovidesordertothoughtsand ideasanddecreasesuncertainty(Ayer1966; Englehardt1980)

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Ageneraltermusedtorefertothe managementandprocessingofinformation, generallywiththeassistanceofcomputers.

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Datagatherer Informationuser Knowledgeuser Knowledgebuilder

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Broadlydefinedastheuseofinformationand computertechnologytosupportallaspectsof nursingpractice,includingdirectdeliveryof care,administration,educationandresearch.

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Definitionswithaninformationtechnology focus Conceptuallyorienteddefinitions Definitionsthatfocusonroles

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Nursing Science

Cognitive Science

Information Science

Computer Science
Informatics

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Hasfundamentalinformationmanagement skills Canuseinformationsystems

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Isproficientinhis/herareaofspecialization andhighlyskilledintheuseofITand computerstosupportthatareaofpractice. Seestherelationshipbetweendataelements andmakesjudgmentsbasedonobserved trendsandpatterns. Usesinformationsystemsandworkswiththe informaticsspecialisttoenactimprovements ininformationsystems.

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T echnology Professor

Hasadvancedpreparationininformation management. Focusesoninformaticsapplicationstosupport allareasofnursingpractice. Usesskillsincriticalthinking,data managementandprocessing,decision making,andsystemdevelopmentand computerskills.

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Iseducationallypreparedtoconduct informaticsresearchandgenerateinformatics theory. Holdsthevisionofwhatispossibleandhas theabilitytomakethingshappen. Iscreativeindevelopingsolutions,possessing asophisticatedlevelofunderstandingand skillsininformationmanagementand computertechnology.

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Workliststoremindstaffofplannednursing interventions Computergeneratedclientdocumentation includingdischargeinstructionsandmedication information Monitoringdevicesthatrecordvitalsignsand othermeasurementsdirectlyintotheclient record Computergeneratednursingcareplansand criticalpathways
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Automaticbillingforsuppliesorprocedures withnursingdocumentation Remindersandpromptsthatappearduring documentationtoensurecomprehensive charting Quickaccesstocomputerarchivedpatientdata frompreviousencounters Onlinedruginformation

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Automatedstaffscheduling Onlinebiddingforunfilledshifts Electronicmailforimprovedcommunication Costanalysisandfindingtrendsforbudget purposes Qualityassuranceandoutcomeanalysis Patienttrackingandplacementforcase management

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Onlinecourseregistrationandscheduling Computerizedstudenttracking,andgrade management Computerassistedinstruction CoursedeliveryandsupportforWebbased education Remoteaccesstolibraryandinternetresources TeleconferencingandWebcastcapability Presentationsoftwareforpreparingslidesand handouts Onlinetestadministration Communicationwithstudents
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Computerizedliteraturesearching Theadoptionofstandardizedlanguage relatedtonursingterms Theabilitytofindtrendsinaggregatedata, whichisdataderivedfromlargepopulation groups Useoftheinternetforobtainingdata collectiontollsandconductingresearch Collaboratewithothernurseresearchers

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T echnology Professor

Patientsafetyandmedicationerrors Nursingshortage Consumerdemandsforcosteffective,quality carebasedonbestpractices,managedcare, economicsurvival,andpressuretoimplement ITsolutionsthatincludecomputerized physicianorderentrywithdecisionsupport, barcodemedicationadministration, electronicorcomputerizedpatientrecords, andeprescribing.
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Improvedaccesstoinformation Errorreductionandimprovedcommunication Decreasedredundancyofdataentry Convenience Decreasedtimespentinmedication administrationanddocumentation Increasedtimeforclientcare Facilitationofdatacollectionforresearch

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Improvedqualityofdocumentation Improvedcompliancewithregulatory requirements Improvedrecordsecurity Improvedqualityofcareandpatient satisfaction Decreasedadministrativecostsforlocationand maintenanceofclientrecords Creationofalifetimeclinicalrecordfacilitated byinformationsystems.
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Theorydevelopment Analysisofinformationneeds Selectionofcomputersystems Designofcomputersystemsand customizations Testingofcomputersystems Trainingusersofcomputersystems Educationofusersoninformationpolicies Evaluationoftheeffectivenessofcomputer systems
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Ongoingmaintenanceandenhancements Identificationofcomputertechnologiesthat canbenefitnursing Compliancewithregulatoryrequirements forinformationhandling Projectmanagement Research

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Thenewgenerationofnurseswillbringtheir familiaritywithtechnologyandinformation literacytoexerttheirpowerandinfluencein healthcare.Thenewgenerationofnurseswill understandandexercisetheirpowerto transformresearchintopractice.Theywill alsoexhibittheircreativity,innovation,and practicalknowhowinthewaytheyuseIT.

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Computer Hardware Software Inputdevices CentralProcessingUnit ReadOnlyMemory(ROM) RandomAccessMemory(RAM) Secondarystoragedevices Outputdevices

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Supercomputers Mainframecomputers Minicomputers Microcomputers(PCs) Laptopornotebookcomputers Tabletcomputers PDAsandotherhandhelddevices

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Monitors Keyboards Terminals Mouseandother pointingdevices Secondary storagedevices Backupsystems

Externalmodems Printers Scanners Digitalandweb cameras (webcams) Multifunction devices

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LocalAreaNetworks MetropolitanAreaNetwork WideAreaNetwork Thinclienttechnology

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Thetypesofapplicationsrequired Theprogramexecutiontimeandcomputer capacityneededtoprocessjobs Thenumberofworkerswhoneedcomputer accessatanyonetime Storagecapacity Backupoptions Budgetconsiderations Maintenanceconsiderations

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T echnology Professor

Ergonomics thestudyanddesignofawork environmentthatmaximizesproductivityby reducingoperatorfatigueanddiscomfort. RepetitiveStressInjuries(RSIs)orRepetitive MotionInjuries resultfromusingthesame musclegroupsoverandoveragainwithout rest(carpaltunnelsyndrome)

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Determinehowaworkstationwillbeused. Determinethelengthoftimetheusewillbeatthe workstation. Configureworkareasforspecifictypesof equipment. Selectsturdysurfacesorfurniturewithsufficient workspace. Providechairswithgoodlumbarsupport. Educateallworkersontheneedforgoodbody mechanicswhenworkingwithcomputers. Positionmonitorsjustbeloweyelevel approximatelyonearmslengthaway.
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Adjustscreenresolutionandfontsizeas needed. Periodicallylookawayfromthemonitorto distantobjects. Minimizescreenglare Takefrequentbreaks Avoidnoisylocations. Placetheworkstationinawellventilatedarea. Useergonomicdeviceswithcaution.

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T echnology Professor

GlareFilter NegativeTiltKeyboard DocumentHolder ErgonomicMouse LumbarSupport WristRests SupportBraces/Gloves ErgonomicKeyboards FootRest

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T echnology Professor

MobileComputing devicesthatcanbe carriedorwheeledfromplacetoplace.May nothavethecapabilitytoreceiveandtransmit informationwhilemobile. WirelessDevices areequippedwithaspecial cardenablingittobroadcastandreceiveradio orcellularsignalsthatreachthenetworkvia accesspoints.

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Bothtechnologiesbringcomputingtothe bedside Cost Improveddatacollection Moreefficientworkprocesses Errorreduction

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Theftandloss Threatstodatasecurity Batterylife Dataloss Memorylimitations Limitedabilitytodisplayandseeinformation Deadzones Lackofameanstoreadilyexchangedata betweenhospitalinformationsystemsand handhelddevices
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OperatingSystems ApplicationSystems UtilityPrograms

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Additionalcomputerexperienceoverthe averageemployeeandservesasalocal resourceperson.

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Firstlineofusersupportwithin anorganization.

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ProvidesuserswithPCinformation andtraining,enablingthemto performroutinetasks.

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Healthcareinformationsystemanalystsare responsibleforawiderangeofactivitiesrelated tothesuccessfulautomationofinformation management. Interviewstaff,determineuserneeds,write specificationsforsoftwareperformance, participateinsomecomputerprogrammingand debugging,implementnewautomated functions,anddocumentprogramspecifications andchanges.
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Clinicianswhorepresenttheinterests andneedoftheusersandworkwiththe informationsystemteamtoaddress theseissuesduringsystemdesignand implementation.

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Writethecode,orinstructions,that tellthecomputerwhattodo.Often lackaclinicalbackground.

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Responsibleforplanning,management,and expansionofnetworks.

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Responsibleforeducatingclinicalusersinone formoreapplicationsandmayalsobe requiredtodefineandmonitoruser competences.

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Responsibleforensuringthatmeasuresexist toprotectinformationprivacy.

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Shouldhaveabroadviewoftheneedsofthe institutionandthedesign,implementation, andevaluationofinformationsystems. Responsibilitiesincludestrategicplanning, policydevelopment,budgeting,information security,recruitment,andretentionof informationservicesstaff,andoverall managementoftheenterprisesinformation systems.

Compiled & Designed by: Sonny C. Chiu, MA.Ed. CNU-Information T echnology Professor

Responsibleforthedesign,maintenance,and securityofmaterialsplacedontheInternet, intranet,and/orextranet.

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Protectsthepersonalhealthinformationof patients.Thisincludespaperandelectronic information.

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Existsinorganizationsthatareexpanding theiruseoftheInternetbeyondWebsitesthat provideinformationtoastrategythatincludes interactiveservices.

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Designatedtoensurethatstateandfederal regulationsandaccreditingrequirementsare metbothviapaperandautomatedrecords andsystems.

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Designatedtoensurethatplansareupto dateandthatallcontingencieshavebeen covered.Coordinatesandupdateplansfor naturalandmanmadedisasters,including actsofterrorisms.

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Ensuresthatinformationisexchanged betweendisparatesystemsandisolatesand correctsproblemsbehindthescenesinvisible totheusersoftheindividualsystems.

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