Nursing Informstics
Nursing Informstics
Nursing Informstics
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Outlines
• Introductie of computer
• Information technologie
• History of nursing informatics
• Definition of informatics, nursing informatics, pediatric
informatics.
• The main concepts in nursing informatics theory.
• Importance of nursing informatics
• The Role of Pediatric Nurse Informatics
• The Technological Challenges for Nursing Education
• Advantages of technology use in nursing education
• Disadvantages of technology usage in nursing education
• Application of nursing informatics
• Consideration to facilitate the application of nursing informatics in
pediatric care nursing.
• Application of information technology in hospitals (practice).
• Informatics Applications in Neonatology.
• Application of informatics in pediatric nursing education
• The impact of nursing informatics on the health care system.
• Impact of nursing informatics on the nursing profession
• Obstacles for application of nursing informatics.
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Introduction to Computer
Computer
A computer is an electronic device, operating under the control of
instructions stored in its own memory that can accept data (input),
process the data according to specified rules, produce information
(output), and store the information for future use.
Functionalities of a computer
Any digital computer carries out five functions in gross terms:
Computer Components
Any kind of computers consists of HARDWARE AND SOFTWARE.
Hardware:
Computer hardware is the collection of physical elements that constitutes
a computer system. Computer hardware refers to the physical parts or
components of a computer such as the monitor, mouse, keyboard,
computer data storage, hard drive disk (HDD), system unit (graphic
cards, sound cards, memory, motherboard and chips), etc. all of which
are physical objects that can be touched.
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Input Devices
Input device is any peripheral (piece of computer hardware equipment to
provide data and control signals to an information processing system
such as a computer or other information appliance.
Input device Translate data from form that humans understand to one
that the computer can work with. Most common are keyboard and mouse
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Joystick
19. Gamepad 20. Electronic Whiteboard 21.
Primary Memory:-
1. RAM: Random Access Memory (RAM) is a memory scheme within
the computer system responsible for storing data on a temporary basis,
so that it can be promptly accessed by the processor as and when
needed. It is volatile in nature, which means that data will be erased
once supply to the storage device is turned off. RAM stores data
randomly and the processor accesses these data randomly from the
RAM storage. RAM is considered "random access" because you can
access any memory cell directly if you know the row and column that
intersect at that cell.
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2. ROM (Read Only Memory): ROM is a permanent form of storage.
ROM stays active regardless of whether power supply to it is turned on
or off. ROM devices do not allow data stored on them to be modified.
Secondary Memory:-
Stores data and programs permanently :its retained after the power is
turned off
1. Hard drive (HD): A hard disk is part of a unit, often called a "disk
drive," "hard drive," or "hard disk drive," that store and provides
relatively quick access to large amounts of data on an
electromagnetically charged surface or set of surfaces.
2. Optical Disk: an optical disc drive (ODD) is a disk drive that uses laser
light as part of the process of reading or writing data to or from optical
discs. Some drives can only read from discs, but recent drives are
commonly both readers and recorders, also called burners or writers.
Compact discs, DVDs, and Blu-ray discs are common types of optical
media which can be read and recorded by such drives. Optical drive is
the generic name; drives are usually described as "CD" "DVD", or
"Bluray", followed by "drive", "writer", etc. There are three main types
of optical media: CD, DVD, and Blu-ray disc. CDs can store up to 700
megabytes (MB) of data and DVDs can store up to 8.4 GB of data.
Blu-ray discs, which are the newest type of optical media, can store up
to 50 GB of data. This storage capacity is a clear advantage over the
floppy disk storage media (a magnetic media), which only has a
capacity of 1.44 MB.
3. Flash Disk
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Output devices
An output device is any piece of computer hardware equipment used to
communicate the results of data processing carried out by an information
processing system (such as a computer) which converts the electronically
generated information into humanreadable form.
Note Basic types of monitors are a.Cathode Ray Tube (CRT). B. Liquid
Crystal Displays (LCD). c.light-emitting diode (LED).
Printer types: 1-Laser Printer. 2-Ink Jet Printer. 3-Dot Matrix Printer
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Software
Software is a generic term for organized collections of computer data and
instructions, often broken into two major categories: system software that
provides the basic nontask-specific functions of the computer, and
application software which is used by users to accomplish specific tasks.
Software Types
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computer software though it has
a wide scope now.
Example: 1) Opera
(Web Browser)
2) Microsoft Word (Word
Processing)
1) Microsoft Windows
3) Microsoft Excel (Spreadsheet
2) Linux
software)
3) Unix
4) MySQL (Database Software)
4) Mac OSX
5) Microsoft PowerPoint
5) DOS
(Presentation Software)
6) Adobe Photoshop (Graphics
Software)
Interaction: Generally, users do not interact Users always interact with
application software while doing
with system software as it works
different activities.
in the background.
Dependency: System software can run Application software cannot run
independently of the application without the presence of the system
software. software.
Unit of Measurements
Storage measurements: The basic unit used in computer data storage is
called a bit (binary digit). Computers use these little bits,
which are composed of ones and zeros, to do things and talk
to other computers. All your files, for instance, are kept in the
computer as binary files and translated into words and
pictures by the software (which is also ones and zeros). This
two number system, is called a “binary number system” since
it has only two numbers in it. The decimal number system in
contrast has ten unique digits, zero through nine.
Computer Storage units
Bit BIT 0 or 1
Kilobyte KB 1024 bytes
Megabyte MB 1024 kilobytes
Gigabyte GB 1024
9
megabytes
Terabyte TB 1024
gigabytes
Size example
Computers classification***
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• workstation : A powerful, single-user computer. A workstation is like a
personal computer, but it has a more powerful microprocessor and a
higher-quality monitor.
• minicomputer : A multi-user computer capable of supporting from 10
to hundreds of users simultaneously.
• mainframe : A powerful multi-user computer capable of supporting
many hundreds or thousands of users simultaneously.
• supercomputer : An extremely fast computer that can perform hundreds
of millions of instructions per second.
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designed for consuming media, and they are optimized for tasks
like web browsing, watching videos, reading e-books, and
playing games. For many people, a "regular" computer like a
desktop or laptop is still needed in order to use some programs.
However, the convenience of a tablet computer means that it
may be ideal as a second computer.
Smartphones: A smartphone is a powerful mobile phone that is
designed to run a variety of applications in addition to phone
service. They are basically small tablet computers, and they can
be used for web browsing, watching videos, reading e-books,
playing games and more.
Characteristics of Computer
Speed, accuracy, diligence, storage capability and versatility are some of
the key characteristics of a computer. A brief overview of these
characteristics are
• Speed: The computer can process data very fast, at the rate of millions
of instructions per second. Some calculations that would have taken
hours and days to complete otherwise, can be completed in a few
seconds using the computer. For example, calculation and generation
of salary slips of thousands of employees of an organization, weather
forecasting that requires analysis of a large amount of data related to
temperature, pressure and humidity of various places, etc.
• Accuracy: Computer provides a high degree of accuracy. For example,
the computer can accurately give the result of division of any two
numbers up to 10 decimal places.
• Diligence: When used for a longer period of time, the computer does
not get tired or fatigued. It can perform long and complex calculations
with the same speed and accuracy from the start till the end.
• Storage Capability: Large volumes of data and information can be
stored in the computer and also retrieved whenever required. A limited
amount of data can be stored, temporarily, in the primary memory.
Secondary storage devices like floppy disk and compact disk can store
a large amount of data permanently.
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• Versatility: Computer is versatile in nature. It can perform different
types of tasks with the same ease. At one moment you can use the
computer to prepare a letter document and in the next moment you may
play music or print a document. Computers have several limitations
too. Computer can only perform tasks that it has been programmed to
do.
Computer Viruses*
What are some tips to avoid viruses and lessen their impact?*
• Install anti-virus software from a reputable vendor. Update it and
use it regularly.
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• In addition to scanning for viruses on a regular basis, install an "on
access" scanner (included in most anti-virus software packages)
and configure it to start each time you start up your computer. This
will protect your system by checking for viruses each time you run
an executable file.
• Use a virus scan before you open any new programs or files that
may contain executable code. This includes packaged software that
you buy from the store as well as any program you might
download from the Internet.
• If you are a member of an online community or chat room, be very
careful about accepting files or clicking links that you find or that
people send you within the community.
• Make sure you back up your data (documents, bookmark files,
important email messages, etc.) on disc so that in the event of a
virus infection, you do not lose valuable work.
•
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INFORMATION SYSTEMS AND ITS COMPONENTS 3.3
3.1 INTRODUCTION
Over the past few centuries, the world has moved on from connection amongst
individuals to more of connection amongst systems. We now have systems that are
constantly exchanging information about various things and even about us, many
a times without human intervention. This inter-networking of physical devices,
vehicles, smart devices, embedded electronics, software, sensors or any such device
is often referred to as IoT (Internet of Things).
What is interesting about various emerging technologies is that at its core we have
some key elements, namely, People, Computer Systems (Hardware, Operating
System and other Software), Data Resources, Networking and Communication
System. In this chapter, we are going to explore each of those key elements.
STORAGE
(Memory for storing and
retrieving information
FEEDBACK
(Information, new ideas, expertise, and customer feedback)
and other pointing devices for position-based input; Scanners and Bar Code, MICR
readers, Webcams Stylus/ touch screen for image-based input and Microphone for
audio-based input.
(ii) Processing devices are used to process data using program instructions,
manipulate functions, perform calculations, and control other hardware devices.
Examples include Central Processing Unit (CPU), Mother board, Network Card,
Sound Card etc.
The most common device is CPU which is the actual hardware that interprets and
executes the program (software) instructions and coordinates how all the other
hardware devices work together. It is like the brain of the computer which is built
on a small flake of silicon containing the equivalent of several million transistors.
We can think of transistors as switches which could be “ON” or “OFF” i.e. taking a
value of 1 or 0. It consists of following three functional units:
• Control Unit (CU): CU controls the flow of data and instruction to and from
memory, interprets the instruction and controls which tasks to execute and when.
• Arithmetic and Logical Unit (ALU): It performs arithmetic operations such
as addition, subtraction, multiplication, and logical comparison of numbers:
Equal to, Greater than, Less than, etc.
• Processor Registers: Registers are part of the computer processor which is
used to hold a computer instruction, perform mathematical operation as
storage address, or any kind of data. These are high speed, very small memory
units within CPU for storing small amount of data (mostly 32 or 64 bits).
Registers could be accumulators (for keeping running totals of arithmetic
values), address registers (for storing memory addresses of instructions),
storage registers (for storing the data temporarily) and miscellaneous (used
for several functions for general purpose).
(iii) Data Storage Devices refers to the memory where data and programs are
stored. Various types of memory are depicted in Fig. 3.3.3.
To bridge the huge differences of speed between the Registers and Primary
memory, the Cache Memory is introduced.
Cache memory is a smaller, extremely fast memory type built into a
computer’s Central Processing Unit (CPU) and that acts as a buffer
between RAM and the CPU. Cache Memory stores copies of the data from the
most frequently used main memory locations so that CPU can access it more
rapidly than main memory.
The differences between Processor Registers and Cache Memory are provided
below in the Table 3.3.2.
Table 3.3.2: Processor Registers vs Cache Memory
Processor Registers Cache Memory
These are high speed It is fast memory built into a computer’s CPU
memory units within CPU and is used to reduce the average time to
for storing small amount access data from the main memory. The data
of data (mostly 32 or 64 that is stored within a cache might be values
bits). that have been computed earlier or duplicates
of original values that are stored elsewhere.
The registers are the only Cache memory is an interface between CPU
Memory Units most and Main storage. It is not directly accessible
processors can operate for operations.
on directly.
(b) Secondary Memory: Secondary memory devices are non-volatile, have
greater capacity (they are available in large size), greater economy (the cost
of these is lesser compared to register and RAM) and slow speed (slower in
speed compared to registers or primary storage). Examples include Hard disk,
Pen drive, Memory card etc. Table 3.3.3 provides the key differences between
Primary Memory and Secondary Memory.
Table 3.3.3: Primary Memory vs Secondary Memory
Aspect Primary/Main Memory Secondary Memory
Basic Primary memory is directly Secondary memory is not
accessible by directly accessible by CPU.
Processor/CPU.
With respect to CPU, the memory is organized as follows (as shown in the Fig.
3.3.4):
• Registers that have small capacity, high cost, very high speed are placed
inside the CPU.
• Cache memory is placed next in the hierarchy followed by Primary
memory.
• Secondary memory is the farthest from CPU (large capacity, low cost,
low speed).
(iv) Output Devices: Computer systems provide output to decision makers at all
levels in an enterprise to solve business problems, the desired output may be in
visual, audio or digital forms. Output devices are devices through which system
responds. Visual output devices like - a display device visually conveys text,
graphics, and video information. Information shown on a display device is called
soft copy because the information exists electronically and is displayed for a
temporary period. Display devices include CRT monitors, LCD monitors and
displays, gas plasma monitors, and televisions. Some types of output are textual,
graphical, tactile, audio, and video.
• Textual output comprises of characters that are used to create words,
sentences, and paragraphs.
• Graphical outputs are digital representations of non-text information such as
drawings, charts, photographs, and animation.
• Tactile output such as raised line drawings may be useful for some individuals
who are blind.
• Audio output is any music, speech, or any other sound.
• Video output consists of images played back at speeds to provide the
appearance of full motion.
Most common examples of output devices are Speakers, Headphones, Screen
(Monitor), Printer, Voice output communication aid, Automotive navigation system,
Video, Plotter, Wireless etc.
II. Software
Software is defined as a set of instructions that tell the hardware what to do.
Software is not tangible; it cannot be touched. Software is created through the
process of programming. When programmers create software, what they are really
doing is simply typing out lists of instructions that tell the hardware what to
execute. Without software, the hardware would not be functional. Software can be
broadly divided into two categories: Operating System Software and Application
Software as shown in the Fig. 3.3.2.
(a) Operating System Software
An Operating System (OS) is a set of computer programs that manages computer
hardware resources and acts as an interface with computer applications programs.
The operating system is a vital component of the system software in a computer
system. Operating systems make the hardware usable and manage them by
creating an interface between the hardware and the user. Application programs
usually require an operating system to function that provides a convenient
environment to users for executing their programs. Computer hardware with
♦ File management: The operating system keeps a track of where each file is
stored and who can access it, based on which it provides the file retrieval.
(b) Application Software
Example 3.1: Consider the following examples:
• As the personal computer proliferated inside organizations, control over the
information generated by the organization began splintering. Say the
customer service department creates a customer database to keep track of
calls and problem reports, and the sales department also creates a database
to keep track of customer information. Which one should be used as the
master list of customers?
• As another example, someone in sales might create a spreadsheet to calculate
sales revenue, while someone in finance creates a different one that meets
the needs of their department. However, it is likely that the two spreadsheets
will come up with different totals for revenue. Which one is correct? And who
is managing all this information?
To resolve these issues, various specific purpose applications were created.
business or scientific or any other problem. Application Suite like MS Office 2010
which has MS Word, MS Excel, MS Access, etc.; Enterprise Software like SAP;
Content Access Software like Media Players, Adobe Digital etc. are some examples
of Application Software.
Internet but are instead installed on a device and work with a single user at a
time. Various operations that can be performed on these files include adding
new files to database, deleting existing files from database, inserting data in
existing files, modifying data in existing files, deleting data in existing files,
and retrieving or querying data from existing files. DBMS packages generally
provide an interface to view and change the design of the database, create
queries, and develop reports. Commercially available DataBase Management
Systems are Oracle, MySQL, SQL Servers and DB2 etc. whereas Microsoft
Access and Open Office Base are examples of personal DBMS.
Advantages of DBMS
♦ Permitting Data Sharing: One of the major advantages of a DBMS is that the
same information can be made available to different users.
♦ Minimizing Data Redundancy: In a DBMS, duplication of information or
redundancy is, if not eliminated, carefully controlled or reduced i.e. there is no
need to repeat the same data repeatedly. Minimizing redundancy significantly
reduce the cost of storing information on storage devices.
♦ Integrity can be maintained: Data integrity is maintained by having accurate,
consistent, and up-to-date data. Updates and changes to the data only must be
made in one place in DBMS ensuring Integrity.
♦ Program and File consistency: Using a DBMS, file formats and programs are
standardized. The level of consistency across files and programs makes it easier
to manage data when multiple programmers are involved as the same rules and
guidelines apply across all types of data.
♦ User-friendly: DBMS makes the data access and manipulation easier for the
user. DBMS also reduces the reliance of users on computer experts to meet
their data needs.
♦ Improved security: DBMS allows multiple users to access the same data
resources in a controlled manner by defining the security constraints. Some
sources of information should be protected or secured and only viewed by
select individuals. Using passwords, DBMS can be used to restrict data access
to only those who should see it. Security will only be improved in a database
when appropriate access privileges are allotted to prohibit unauthorized
modification of data.
♦ Achieving program/data independence: In a DBMS, data does not reside in
applications, but database program and data are independent of each other.
Preventive Control
Detective Control
Corrective Control
Environmental Control
Physical Access Control
Logical Access Control
(B) Detective Controls: These controls are designed to detect errors, omissions
or malicious acts that occur and report the occurrence. In other words,
Detective Controls detect errors or incidents that elude preventive controls.
They are basically investigative in nature. For example, a detective control
may identify account numbers of inactive accounts or accounts that have
been flagged for monitoring of suspicious activities. Detective controls can
also include monitoring and analysis to uncover activities or events that
exceed authorized limits or violate known patterns in data that may indicate
improper manipulation. For sensitive electronic communications, detective
controls indicate that a message has been corrupted or the sender’s secure
identification cannot be authenticated.
The main characteristics of Detective controls are given as follows:
• Clear understanding of lawful activities so that anything which deviates
from these is reported as unlawful, malicious, etc.;
• An established mechanism to refer the reported unlawful activities to
the appropriate person or group, whistle blower mechanism;
• Interaction with the preventive control to prevent such acts from
occurring; and
• Surprise checks by supervisor.
II. Electrical Exposures: These include risk of damages that may be caused
due electrical faults which may occur due to very short pulse of energy in a
power line. These include non-availability of electricity, spikes (temporary
very high voltages), fluctuations of voltage and other such risk.
Table 3.4.2(B): Controls for Electrical Exposure
♦ Electrical Surge Protectors: The risk of damage due to power spikes can
be reduced using Electrical Surge Protectors that are typically built into
the Uninterrupted Power System (UPS).
♦ Un-interruptible Power System/Generator: In case of a power failure,
the UPS provides the backup by providing electrical power from the
battery to the computer for a certain span of time. Depending on the
sophistication of the UPS, electrical power supply could continue to flow
for days or for just a few minutes to permit an orderly computer
shutdown.
♦ Voltage regulators and circuit breakers: These protect the hardware
from temporary increase or decrease of power.
♦ Emergency Power-Off Switch: When the need arises for an immediate
power shut down during situations like a computer room fire or an
emergency evacuation, an emergency power-off switch at the strategic
locations would serve the purpose. They should be easily accessible and
yet secured from unauthorized people.
(B) Physical Access Controls: The Physical Access Controls are the controls
relating to physical security of the tangible resources and intangible
resources stored on tangible media etc. Such controls include Access control
doors, Security guards, door alarms, restricted entry to secure areas, visitor
logged access, CCTV monitoring etc. Refer the Table 3.4.3.
Table 3.4.3: Controls for Physical Exposures
I. Locks on Doors
• Cipher locks (Combination Door Locks): Cipher locks are used in low
security situations or when many entrances and exits must be usable all
the time. To enter into a secured room, a person presses a four-digit
number and the door will unlock for a predetermined period, usually 10
to 30 seconds.
• Bolting Door Locks: In this, a special metal key is used to gain entry
and to avoid illegal entry, the keys should not be duplicated.
• Electronic Door Locks: A magnetic or embedded chip-based plastics
card key or token may be entered into a reader to gain access in these
systems.
II. Physical Identification Medium: These are discussed below:
• Personal Identification Numbers (PIN): A secret number assigned to
an individual, in conjunction with some means of identifying the
individual, serves to verify the authenticity of the individual. The visitor
will be asked to log on by inserting a card in some device and then enter
their PIN via a PIN keypad for authentication. His/her entry will be
matched with the PIN number available in the security database.
• Plastic Cards: These cards are used for identification purposes.
Customers should safeguard their card so that it does not fall into
unauthorized hands.
holding area. It helps to manage traffic and prohibits the intruder from
escaping the facility quickly.
• Non–exposure of Sensitive Facilities: There should be no explicit
indication such as presence of windows of directional signs hinting the
presence of facilities such as computer rooms. Only the general location
of the information processing facility should be identifiable.
• Computer Terminal Locks: These locks ensure that the device to the
desk is not turned on or disengaged by unauthorized persons.
• Controlled Single Entry Point: All incoming personnel can use
controlled Single-Entry Point. A controlled entry point is monitored by
a receptionist. Multiple entry points increase the chances of
unauthorized entry. Unnecessary or unused entry points should be
eliminated or deadlocked.
• Alarm System: Illegal entry can be avoided by linking alarm system to
inactive entry point and the reverse flows of enter or exit only doors, to
avoid illegal entry. Security personnel should be able to hear the alarm
when activated.
• Perimeter Fencing: Fencing at boundary of the facility may also
enhance the security mechanism.
• Control of out of hours of employee-employees: Employees who are
out of office for a longer duration during the office hours should be
monitored carefully. Their movements must be noted and reported to
the concerned officials frequently.
• Secured Report/Document Distribution Cart: Secured carts, such as
mail carts must be covered and locked and should always be attended.
(C) Logical Access Controls: These are the controls relating to logical access to
information resources such as operating systems controls, application software
boundary controls, networking controls, access to database objects, encryption
controls etc. Logical access controls are implemented to ensure that access to
systems, data and programs is restricted to authorized users to safeguard
information against unauthorized use, disclosure or modification, damage, or
loss. The key factors considered in designing logical access controls include
confidentiality and privacy requirements, authorization, authentication, and
incident handling, reporting and follow-up, virus prevention and detection,
firewalls, centralized security administration, user training and tools for
monitoring compliance, intrusion testing and reporting. Logical access controls
enterprise. The controls flow from the top of an organization to down; the
responsibility still lies with the senior management. Top management is responsible
for preparing a master plan for the information systems function. The senior
managers who take responsibility for IS function in an organization face many
challenges. The major functions that a senior management must perform are
Planning, Organizing, Leading and Controlling.
(a) Planning – This includes determining the goals of the information systems
function and the means of achieving these goals which could either be a short
term or long term one. The steering committee shall comprise of
representatives from all areas of the business, and IT personnel that would be
responsible for the overall direction of IT. The steering committee should
assume overall responsibility for activities of information systems function.
(b) Organizing – There should be a prescribed IT organizational structure with
documented roles and responsibilities and agreed job descriptions. This
includes gathering, allocating, and coordinating the resources needed to
accomplish the goals that are established during planning function. Unless
Top management performs the organizing function properly, the Information
systems function is unlikely to be effective and efficient.
(c) Leading – This includes the activities like motivating, guiding, and
communicating with personnel. The purpose of leading is to achieve the
harmony of objectives, i.e. a person’s or group’s objectives must not conflict
with the organization’s objectives. The process of leading requires managers
to motivate subordinates, direct them and communicate with them.
(d) Controlling – This includes comparing actual performance of the information
systems functions with their planned performance as a basis for taking any
corrective actions that are needed. This involves determining when the actual
activities of the information system’s functions deviate from the planned
activities.
II. Systems Development Management Controls
Systems Development Management has responsibility for the functions
concerned with analyzing, designing, building, implementing, and
maintaining information systems. System development controls are targeted
to ensure that proper documentations and authorizations are available for
each phase of the system development process. It includes controls at
controlling new system development activities. The activities discussed below
deal with system development controls in an IT setup.
to a DRP mainly deals with carrying on the critical business operations in the
event of a disaster so as to ensure minimum impact on the business.
• Insurance is a contract, represented by a policy, in which an individual or
entity receives financial protection or reimbursement against losses from an
insurance company. Adequate insurance must be able to replace Information
Systems assets and to cover the extra costs associated with restoring normal
operations.
VI. Operations Management Controls
Operations management is responsible for the daily running of hardware and
software facilities so that production application systems can accomplish their work
and development staff can design, implement and maintain application systems.
Operations management typically perform controls over the functions as discussed
below:
(a) Computer Operations: The controls over computer operations govern the
activities that directly support the day-to-day execution of either test or
production systems on the hardware/software platform available.
(b) Network Operations: Data may be lost or corrupted through component
failure. To avoid such situation, the proper functioning of network operations,
monitoring the performance of network communication channels, network
devices, and network programs and files are required.
(c) Data Preparation and Entry: Irrespective of whether the data is obtained
indirectly from source documents or directly from say customers, keyboard
environments and facilities should be designed to promote speed and
accuracy and to maintain the wellbeing of keyboard operators.
(d) Production Control: This includes the major functions like receipt and
dispatch of input and output; job scheduling; management of service-level
agreements with users; transfer pricing/charge-out control; and acquisition
of computer consumables.
(e) File Library: This includes the management of not only machine-readable
storage media like magnetic tapes, cartridges, and optical disks of an
organization but also its fixed storage media.
(f) Documentation and Program Library: This involves that documentation
librarians ensure that documentation is stored securely; that only authorized
personnel gain access to documentation; that documentation is kept up-to-
date and that adequate backup exists for documentation. There should also
Top Mgt. Systems Development Mgt. Programming Data Resource Mgt. Controls: Data Security Mgt. Quality
Controls: Controls: Responsible for Mgt. Controls: To must be available to users at a Functions Assurance
Functions functions like analyzing, acquire & location and form in which it is Controls: Ensure Mgt.
performed designing, building, implement high- needed, data is modifiable & data that IS assets are Controls:
by Senior implementing, maintaining IS. quality programs. integrity is preserved etc. Includes secure, To
Management This includes Problem Includes phases controls like Definition Controls to recoverable achieve
that includes definition and Feasibility Planning that comply with database definition, after disaster quality
Planning to Assessment to find possible estimates the Existence Controls ensure existence occurs. Includes goals & IS
determine solutions and their economic required of database after data loss, Access DRP (how to comply
goals of justification to resolve resources for s/w Controls prevent unauthorized recover from with set of
information problems, Analysis of existing development, access, Update Controls to restrict disaster & quality
systems system to study the existing Design involves update of database to authorized returns to standards.
function and structure, culture of the systematic users only, Concurrency controls normalcy) &
means of system, existing product & approach to overcome data integrity problems & Insurance
achieving information flows, program design, Quality Controls ensure accuracy, (protection
goals; Information processing Coding use Top- completeness, & data consistency. against losses).
Organizing to system design involving down, Bottom-up
Gather, elicitation of detailed approach, Testing
allocate, requirements, design of data to ensure Operations Mgt. Controls: Responsible for daily running of h/w and
coordinate flow, database, user interface, developed software computer, n/w operations, file library etc. Includes Computer
resources to physical design, h/w and s/w program achieves Operations to directly support daily execution of test or production
accomplish platform etc., H/w & S/w its goals, systems on h/w or s/w platform, Network Operations involve
goals, acquisition & procedures Operation & functioning of n/w operations, monitoring communication channels,
Leading to development wherein Maintenance that devices etc., Data Preparation & Entry include keyboard environments
Motivate, vendors are selected based on could be Repair, designed to promote speed/accuracy to maintain wellbeing of
communicate evaluation criterion, Adaptive, & operators, Production Controls include functions like receipt/dispatch
with Acceptance testing/ Perfective of I/O; job scheduling; mgt. of SLAs etc., File Library includes mgt. of
personnel; conversion to identify Maintenance & storage media, Documentation and Program Library ensures
and deficiencies in the system Control phase documentation stored securely; up-to-date & adequate backup exists,
Controlling before its release, Operation that monitor Technical support assist end-users to employ h/w & s/w, Capacity
to compare and Maintenance in which progress against Planning & Performance Monitoring to identify resource deficiencies,
actual with new system run as production all phases using and Mgt. of Outsourced Operations involve monitoring contracts.
planned system & maintenance WBS, Gantt
performance. activities monitored carefully. Charts, PERT. Fig. 3.4.2: The Management Control Framework
Boundary Controls: Involves Input Controls: Ensure Processing Controls: To Database Controls: To protect integrity
access control mechanism. accuracy of data to be compute classify, sort and of database when app. s/w act as
This involves Cryptographic inputted into application summarize data. This includes interface b/w user & database. This
Controls to transform data system. This includes Processor Controls to reduce includes Access Controls to prevent
into codes that are Data Code Control to expected losses from errors & unauthorized access & use of data,
meaningless for a non- reduce user error during irregularities associated with Integrity Controls to ensure accuracy,
authenticated person, Access data feeding, Batch processors, Real Memory completeness, and uniqueness of
Controls that involves 3 steps: Controls to prevent/ Controls to detect/correct instances, Application S/w Controls
Identification, Authentication, detect errors in batch, errors that occur in memory cells that involve Update and Report
Authorization; PIN is a Validation of Data input and to protect areas of memory Controls, Concurrency Controls that
random number stored in Controls detect errors in assigned to a program from handles cases of concurrency and
database, Digital Signatures transaction data before illegal access, VM Controls that deadlock, Cryptographic Controls used
to establish authenticity of e- data are processed & maps VM addresses into real to maintain data integrity, File Handling
documents, Plastic Cards to Audit Trail Controls to memory addresses, App. S/w Controls to prevent accidental data
store information required in log events from time Control to validate checks to destruction on storage medium and
an identification process and data are captured and identify errors during data Audit Trail Controls to log events in
Audit Trail Controls to log of passed to other processing & Audit Trail Ctrls database definition or database itself.
user gaining system access. subsystem. that log events b/w data I/O.
Communication Controls: Discuss exposures in communication Output Controls: Ensure data delivered to users is presented, formatted,
subsystem, controls over physical components, & channel access delivered consistently. It includes Inference Controls to prevent compromise
controls. Physical Component Ctrsl to mitigate effects of exposures, of statistical database, Batch output production and distribution controls
Line Error Ctrl to detect/correct error of attenuation/distortion, Flow include controls over file spooling, printing controls, report distribution
Controls to control rate at which data flows b/w users, Link Controls controls, storage controls etc., Batch Report Design controls to ensure
to manage link b/w 2 nodes in a network, Topological Controls to compliance with control procedures laid during the output, Online output
specify location & way nodes are linked, Channel Access Controls to production and Distribution Controls deal with establishing the output at
handle contention in channel, Control over Subversive threat require source, distributing, communicating, receiving, viewing, retaining and
data to be rendered useless in case of intrusion, Internetworking destructing output and Audit Trail Controls to maintain log of events that
Controls to control n/w connecting devices and Audit Trail Controls occur b/w the time content of output is determined to disposal of output.
to log events from dispatch time of a message to its receival.
Fig. 3.4.3: The Application Control Framework
of the PIN; (f) Storage of the PIN; (g) Change of the PIN; (h) Replacement
of the PIN; and (i) Termination of the PIN.
A PIN may be exposed to vulnerabilities at any stage of the life cycle of
PIN and therefore, controls need to be put in place and working to reduce
exposures to an acceptable level.
(d) Digital Signatures: Establishing the authenticity of persons and
preventing the denial of message or contracts are critical requirements
when data is exchanged in electronic form. A counterpart known as
Digital Signature (a string of 0’s and 1’s) is used as an analog signature
for such e-documents. Digital Signatures are not constant like analog
signatures – they vary across messages and cannot be forged.
(e) Plastic Cards: We may recall that while PIN and Digital Signatures are
used for authentication purposes, plastic cards are used primarily for
identification purpose. This includes the phases namely - application for
a card, preparation of the card, issue of the card, use of the card and card
return or card termination.
(f) Audit Trail Controls: This maintains the chronology of events that occur
when a user attempts to gain access to and employ systems resources. The
events associated with both types of audit trail control are given below in
Table 3.4.6:
Table 3.4.6: Audit Trail Controls - Boundary Control
Accounting Audit Trail Operations Audit Trail
All material application-oriented events occurring This includes the details
within the boundary subsystem should be recorded like resource usage
that may include the data related to identity of the from log-on to log-out
would-be user of system; authentication information time and log of
supplied; resources requested/provided or denied; resource consumption.
terminal Identifier and Start/Finish Time; number of
Sign-on attempts; & Action privileges allowed/denied.
and are, therefore error and fraud prone. These are of following types as shown in
the Fig. 3.4.4:
until the time they are deemed valid and passed onto other subsystems within
the application system (Refer Table 3.4.7).
Table 3.4.7: Audit Trail Controls - Input Controls
Accounting Audit Trail Operations Audit Trail
This must record the origin, contents, and Some of the data that might
timing of transaction entered into be collected include time to
application system, thus involving the key in a source document or
details regarding the identity of the an instrument at a terminal;
person (organization) who was the source number of read errors made
of the data and who entered the data into by an optical scanning device;
the system; the time and date when the number of keying errors
data was captured; the identifier of the identified during verification;
physical device used to enter the data into frequency with which an
the system; the account or record to be instruction in a command
updated by the transaction; the standing language is used; and time
data to be updated by the transaction; the taken to invoke an instruction
details of the transaction; and the number using different input devices
of the physical or logical batch to which like light pen or mouse.
the transaction belongs.
III. Communication Controls
These discuss exposures in the communication subsystem, controls over physical
components, communication line errors, flows and links, topological controls,
channel access controls, controls over subversive attacks, internetworking controls,
communication architecture controls, and audit trail controls. Some communication
controls are as follows:
(a) Physical Component Controls: In the communications subsystem, the
physical components shall have characteristics that make them reliable
and incorporate features and controls that mitigate the possible effects
of exposures. Major physical components that affect the reliability of
communication subsystem are Transmission media, Communication
lines, Modem, Port protection devices, Multiplexers, and Concentrators
etc.
(b) Line Error Controls: Whenever data is transmitted over a communication
line, it can be received in error because of attenuation, distortion, or noise
that occurs on the line. These errors must be detected and corrected.
(c) Flow Controls: Flow controls are needed because two nodes in a network
can differ in terms of the rate at which they can be sent, receive, and process
data. For example- data transmission between mainframe and
microcomputers may become erroneous because of difference in their speed
and storage capacity. Flow controls will be used therefore to prevent the
mainframe flooding the microcomputer and as a result, data being lost.
(d) Link Controls: In Wide Area Network (WAN), line error control and flow
control are important functions in the component that manages the link
between two nodes in a network. The way these link-management
components operate is specified via a protocol.
(e) Topological Controls: A communication network topology specifies the
location of nodes within a network, the ways in which these nodes will
be linked, and the data transmission capabilities of the links between the
nodes. The network must be available for use at any one time by a given
number of users that may require alternative hardware, software, or
routing of messages.
(f) Channel Access Controls: Two different nodes in a network can compete to
use a communication channel simultaneously, leading to the possibility of
contention for the channel existing. Therefore, some type of channel access
control techniques like polling method (defining an order in which a node
can gain access to a channel capacity) or contention method (nodes in
network must compete with each other to gain access to a channel) must be
used.
(g) Controls over Subversive threats: Firstly, the physical barriers are needed
to be established to the data traversing into the subsystem. Secondly, in
case the intruder has somehow gained access to the data, the data needs
to be rendered useless when access occurs.
(h) Internetworking Controls: Different internetworking devices like bridge,
router, gateways are used to establish connectivity between
homogeneous or heterogeneous networks. Therefore, several control
functions in terms of access control mechanisms, security and reliability
of the networks are required to be established.
(i) Audit Trail Controls: This maintains a chronology of the events from the time
a sender dispatches a message to the time a receiver obtains the message.
Few examples of data item that might be kept in both types of audit trail is
shown in Table 3.4.8.
(b) Real Memory Controls: This comprises the fixed amount of primary storage
in which programs or data must reside for them to be executed or referenced
by the central processor. Real memory controls seek to detect and correct
errors that occur in memory cells and to protect areas of memory assigned to a
program from illegal access by another program.
(c) Virtual Memory Controls: Virtual Memory exists when the addressable
storage space is larger than the available real memory space. To achieve this
outcome, a control mechanism must be in place that maps virtual memory
addresses into real memory addresses. When an executing program
references virtual memory addresses, the mechanism then translates these
addresses into real memory addresses.
(d) Application Software Controls: These perform validation checks to identify
errors during processing of data. These are required to ensure both the
completeness and the accuracy of data being processed. Normally, the
processing controls are enforced through database management system that
stores the data. However, adequate controls should be enforced through the
front-end application system also to have consistency in the control process.
(e) Audit Trail Controls: This maintains the chronology of events from the time
data is received from the input or communication subsystem to the time data
V. Database Controls
These controls are used within an application software to maintain the integrity of
data, to prevent integrity violations when multiple programs have concurrent
access to data, and the ways in which data privacy can be preserved within the
database subsystem.
(a) Access Controls: These controls in database subsystem seek to prevent
unauthorized access to and use of the data. A security policy has to be
specified followed by choosing an access control mechanism that will
enforce the policy chosen. If database is replicated, the same access
control rules must be enforced by access control mechanism at each site.
(b) Integrity Controls: These are required to ensure that the accuracy,
completeness, and uniqueness of instances used within the data or
conceptual modeling are maintained. Integrity Constraints are
established to specify the type of relationship and consistency among
rows (tuple) in relationship.
(c) Application Software Controls: When application software acts as an
interface to interact between the user and the database, the DBMS
shall facilitate its flow though the output process and execution of
controls.
(d) Online output production and Distribution Controls: It deals with the
controls to be considered at various phases like establishing the output
at the source, distributing, communicating, receiving, viewing, retaining
and destructing the output. Source controls ensure that output which can
be generated or accessed online is authorized, complete and timely;
Distribution Controls to prevent unauthorized copying of online output
when it was distributed to a terminal; Communication Controls to reduce
exposures from attacks during transmission; Receipt Controls to evaluate
whether the output should be accepted or rejected; Review Controls to
ensure timely action of intended recipients on the output; Disposition
Controls to educate employees the actions that can be taken on the online
output they receive; and Retention Controls to evaluate for how long the
output is to be retained and Deletion Controls to delete the output once
expired.
(e) Audit Trail Controls: The audit trail maintains the chronology of events that
occur from the time the content of the output is determined until the time
users complete their disposal of output because it no longer should be
retained. The data items that need to be considered are provided in Table
3.4.12.
Table 3.4.12: Audit Trail Controls - Output Controls
Accounting Audit Trail Operations Audit Trail
This includes what output This maintains the record of resources consumed
was assimilated for by components in the output subsystem to
presentation to the users; assimilate, produce, distribute, use, store and
what output was then dispose of various types of output like graphs,
presented to the users; who images etc., to record data that enables print times,
received the output; when response times and display rates for output to be
the output was received; determined and to manage the information that
and what actions were enables the organization to improve the timelines
subsequently taken with of output production and reduce the number of
the output. resources consumed in producing output.
(iii) System Control Audit Review File (SCARF): The SCARF technique involves
embedding audit software modules within a host application system to
provide continuous monitoring of the system’s transactions. The information
collected is written onto a special audit file- the SCARF master files. Auditors
then examine the information contained on this file to see if some aspect of
the application system needs follow-up. In many ways, the SCARF technique
is like the snapshot technique along with other data collection capabilities.
(iv) Continuous and Intermittent Simulation (CIS): This is a variation of the
SCARF continuous audit technique. This technique can be used to trap
exceptions whenever the application system uses a database management
system. During application system processing, CIS executes in the following
way:
• The DBMS reads an application system transaction. It is passed to CIS.
CIS then determines whether it wants to examine the transaction
further. If yes, the next steps are performed or otherwise it waits to
receive further data from the database management system.
• CIS replicates or simulates the application system processing.
• Every update to the database that arises from processing the selected
transaction will be checked by CIS to determine whether discrepancies
exist between the results it produces and those the application system
produces.
• Exceptions identified by CIS are written to an exception log file.
The advantage of CIS is that it does not require modifications to the
application system and yet provides an online auditing capability.
(v) Audit Hooks: There are audit routines that flag suspicious transactions. For
example, internal auditors at Insurance Company determined that their
policyholder system was vulnerable to fraud every time a policyholder
changed his or her name or address and then subsequently withdrew funds
from the policy. They devised a system of audit hooks to tag records with a
name or address change. The internal audit department will investigate these
tagged records for detecting fraud. When audit hooks are employed, auditors
can be informed of questionable transactions as soon as they occur. This
approach of real-time notification displays a message on the auditor’s
terminal.
Example 3.6: Consider an equipment database shown in Fig. 3.7.2 that has building
records, room records, equipment records, and repair records. The database
Repair
Repair Repair Repair Repair Repair
Invoice 6
Invoice 1 Invoice 2 Invoice 3 Invoice 4 Invoice 5
• Equipment 6 record does not own any record now because it is not required
to be fixed yet.
Example 3.8: A company manufactures black and blue ball pens and stores its data
using relational database wherein the data is stored in table structures defined below
in table 3.7.2.
Table 3.7.2: Description of Example 3.8
Table 1: Product_table that Table 2: Invoice_table has the description
contains the detail of all products. of invoices. Invoice table has Invoice_code,
Each product is assigned a unique Quantity(Qty) and total amount
code represented as Prd_code in (Total_Amt) with respect to products sold.
the table. Each invoice has unique number as
Invoice_code.
Prd_code Description Price Prd_code Invoice_code Qty Total_Amt
Example 3.9: Refer the Fig. 3.7.4. The light rectangle indicates that ‘Engineer’ is an
object possessing attributes like ‘date of birth’, ‘address’, etc. which is interacting
with another object known as ‘civil jobs’. When a civil job is executed commenced,
it updates the ‘current job’ attribute of the ‘Engineer’ object, because ‘civil job’
sends a message to the latter object.
Objects can be organized by first identifying them as a member of a class/subclass.
Different objects of a particular class should possess at least one common attribute.
The dark rectangles indicate ‘Engineer’ as a class and ‘Civil Engineer’ and ‘Architect’ as
both subclasses of ‘Engineer’. These subclasses possess all the attributes of ‘Engineer’
over and above each possessing at least one attribute not possessed by ‘Engineer’. The
line intersecting particular object classes represents the class of structure.
Secondly, objects can be identified as a component of some other object. ‘Engineer’
is components of a ‘Civil Job Team’ which may have one to more than one number
of member(s). An ‘Engineer’ may not be a member of the ‘Civil Job Team’ and may
not be a member of more than one team. The dotted line intersecting particular
object classes represents the part of structure. Apart from possessing attributes,
objects as well as possess methods or services that are responsible for changing
their states. Like the service ‘Experience’ as a Civil Engineer or Architect for the
object ‘Engineer’ calculates how much experience the engineers of these particular
two subclasses have as professionals.
Part of Structure
Engineer
Engineer ID No.
Date of Birth
Address Civil Jobs
Employment Date
Current Job
Experience
Class of Structure
operations of the company more than we need to. Further, organizations also want
to analyze data in a historical sense: How does the data we have today compare
with the same set of data of last month, or last year? From these needs arose the
concept of the data warehouse. The process of extracting data from source systems
and bringing it into the data warehouse is commonly called ETL, which stands for
Extraction, Transformation, and Loading. The process is described below and
shown in the Fig. 3.7.5:
♦ In the first stage, the data is Extracted from one or more of the organization’s
databases. This stage involves extracting the data from various sources such
as ERP systems used, databases, flat files including plain text files, Excel
spreadsheet etc.
♦ In the second stage, the data so extracted is placed in a temporary area called
Staging Area where it is Transformed like cleansing, sorting, filtering etc. of
the data as per the information requirements.
♦ The final stage involves the Loading of the transformed data into a data
warehouse which itself is another database for storage and analysis.
♦ The information loaded on to the data warehouse could further be used by
different data marts which are nothing but databases pertaining to specific
departmental functions like Sales, Finance, Marketing etc. from where the
information is used for further reporting and analyzes to take informed
decision by the management.
However, the execution of this concept is not that simple. A data warehouse should
be designed so that it meets the following criteria:
It uses non-operational data. This means that the data warehouse is using a
copy of data from the active databases that the company uses in its day-to-
day operations, so the data warehouse must pull data from the existing
databases on a regular scheduled basis. Relevance and nature of the data in
the data warehouse depend on the time the jobs are scheduled to pull data
from the active databases.
The data is time-variant. This means that whenever data is loaded into the
data warehouse, it receives a time stamp which allows for comparisons
between different time periods.
The data is standardized. Because the data in a data warehouse usually
comes from several different sources, it is possible that the data does not use
the same definitions or units. For example- Events table in a our Student Clubs
database lists the event dates using the mm/dd/yyyy format (e.g.,
b. Data Selection: It may be possible that all the data collected may not be
required in the first step. So, in this step we select only those data which we think
is useful for data mining.
c. Data Cleaning: The data that is collected are not clean and may contain errors,
missing values, noisy or inconsistent data. Thus, we need to apply different
techniques to get rid of such anomalies.
d. Data Transformation: The data even after cleaning are not ready for mining as
it needs to be transformed into an appropriate form for mining using different
techniques like - smoothing, aggregation, normalization etc.
e. Data Mining: In this, various data mining techniques are applied on the data to
discover the interesting patterns. Techniques like clustering and association
analysis are among the many different techniques used for data mining.
f. Pattern Evaluation and Knowledge Presentation: This step involves
visualization, transformation, removing redundant patterns etc. from the
patterns we generated.
g. Decisions / Use of Discovered Knowledge: This step helps user to make use of
the knowledge acquired to take better informed decisions.
In some cases, a data-mining project is begun with a hypothetical result in mind. For
example, a grocery chain may already have some idea that buying patterns change
after it rains and want to get a deeper understanding of exactly what is happening. In
other cases, there are no pre-suppositions and a data-mining program is run against
large data sets to find patterns and associations. Table 3.7.3 provides the basic
differences between Database, Data Warehouse and Data Mining.
Table 3.7.3: Differences between Database, Data Warehouse & Data Mining
depend upon the talent and experience of existing leaders, in addition to each
leader’s workload and other factors. For example, if the director of IT program
management leaves the organization, the existing department could
temporarily be placed under the IT operations department, in this case
because the director of IT operations used to run IT program management.
Senior management can see how that arrangement works out and later
decide whether to replace the director of IT program management position
or to do something else.
3.8.1 Roles and Responsibilities
The topic of roles and responsibilities is multidimensional; it encompasses positions
and relationships on the organization chart, it defines specific job titles and duties,
and it denotes generic expectations and responsibilities regarding the use and
protection of assets. Several roles and responsibilities fall upon all individuals
throughout the organization. Some of them are discussed below:
♦ Owner: An owner is an individual (usually but not necessarily a manager) who
is the designated owner-steward of an asset. Depending upon the
organization’s security policy, an owner may be responsible for the
maintenance and integrity of the asset, as well as for deciding who is
permitted to access the asset. If the asset is information, the owner may be
responsible for determining who may access and make changes to the
information.
Fig. 3.8.1 provides an illustrative overview of positions that report to CIO in general.
Database This position performs tasks that are junior to the database
Analyst administrator, carrying out routine data maintenance and
monitoring tasks.
Security S/he is responsible for the design of security controls and systems
Architect such as authentication, audit logging, intrusion detection systems,
intrusion prevention systems, and firewalls.
Security S/he is responsible for designing, building, and maintaining security
Engineer services and systems that are designed by the security architect.
(g) Service Desk: Positions at the service desk are responsible for providing front
line support services to IT and IT’s customers.
• Help desk Analyst: This position is responsible for providing front line
user support services to personnel in the organization.
• Technical Support Analyst: This position is responsible for providing
technical support services to other IT personnel, and perhaps also to IT
customers.
SOLUTION
Question Answer Question Answer
No. No.
1 (ii) Many-to-One 2 (iii) Relational
Database structure
3 (ii) Data Redundancy 4 (i) Preventive
5 (iii) User Access 6 (ii) Enforced Path
Management
ILLUSTRATION 3.2
Bianc Computing Ltd. has implemented a set of controls including those with
respect to security, quality assurance and boundary controls to ensure that the
development, implementation, operation and maintenance of information systems
takes place in a planned and controlled manner. It has also ensured that logs are
designed to record activity at the system, application, and user level.
Along with the implementation of controls and maintenance of logs, it has
approached a leading firm of IS auditors to conduct a comprehensive audit of its
controls. Within the organization also, it has opened new job roles and has hired
people with the required skill sets for the same.
Answer the following Questions:
1 The team of network engineers of Bianc Computing Ltd. recommended
certain controls to be implemented in the organization to bridge the rate of
data reception and transmission between two nodes. Which types of controls
are being referred to here?
(i) Link Controls
(ii) Flow Controls
(iii) Channel Access Controls
(iv) Line Error Controls
2 Which control is used to ensure that the user can continue working, while
the print operation is getting completed? This is known as ___________.
(i) Printing Controls
(ii) Spooling File Control
SUMMARY
In the present contemporary world, apart from change the thought-provoking
terminology is business which is a driving force behind change and how to insight
into trade is a dynamic called integration. Organizations of the 1990 were
concentrated on the re-engineering and redesign of their business processes to
endorse their competitive advantage. To endure in the 21st century, organizations
have started paying attention on integrating enterprise-wide technology solutions
to progress their business processes called Business Information Systems (BIS).
Now, every organization integrates part or all of its business functions together to
accomplish higher effectiveness and yield. The thrust of the argument was that
Information Technology (IT), when skillfully employed could in various ways
differentiate an organization from its competition, add value to its services or
products in the eyes of its customers, and secure a competitive advantage in
comparison to its competition.
Although information systems have set high hopes to companies for their growth
as it reduces processing speed and helps in cutting cost but most of the research
studies show that there is a remarkable gap between its capabilities and the
business-related demands that senior management is placing on it. We learnt how
any enterprise to be effective and efficient must use Business Process Automation
(BPA), which is largely aided by Computers or IT. Information systems, which forms
the backbone of any enterprise comprises of various layers such as: Application
software, Database Management Systems (DBMS), System Software, Operating
Systems, Hardware, Network Links and People-Users.
This Chapter has provided an overview on the importance of information systems in an
IT environment and how information is generated. There has been a detailed discussion
on Information System Audit, its need, and the method of performing the same. Chapter
outlines the losses that an organization may face, incase, it does not get it audited.
3. Discuss the term ’Operating System’ and various operations performed by it.
(Refer Section 3.3.2 [Point II])
4. Database Management Systems (DBMS) is a software that aids in organizing,
controlling and using the data needed by the application program However,
there are many advantages and disadvantages associated with it. Discuss them.
(Refer Section 3.3.3)
5. Discuss Boundary Controls under the Application Control Framework in detail.
(Refer Section 3.4.3B[I])
6. Discuss Corrective Controls with the help of examples. Also, discuss their broad
characteristics in brief. (Refer Section 3.4.1[Point C])
8. Describe the term Preventive Controls and provide suitable examples. Also,
discuss their broad characteristics in brief. (Refer Section 3.4.1[Point A])
9. Discuss in brief the following terms:
(i) Snapshots (Refer Section 3.5.2)
(ii) Audit Hooks (Refer Section 3.5.2)
10. Recognize various factors influencing an organization towards control and audit
of computers. (Refer Section 3.5.1)
11. Data warehouse and Data Mining are terms related to better management of
information to enable quicker and effective decision-making in organizations.
Critically evaluate the statement. (Refer Section 3.7.3 & 3.7.4)
12. Explain the concept of Segregation of Duties (SoD) controls and its examples.
(Refer Section 3.9.1)
13. An internet connection exposes an organization to the harmful elements of
the outside world. As a network administrator, which Network Access controls
will you implement in the organization to protect from such harmful
elements? (Refer Section 3.4.2[C-III])
14. A company XYZ is developing a software using the program development life
cycle methodology and applying control, phases in parallel to the
development phases to monitor the progress against plan. Being an IT
developer, design the various phases and their controls for program
development life cycle. (Refer Table 3.4.5)
15. Discuss the key activities which require special attention for auditing the user
access provisioning. (Refer Section 3.6.3[(b - I)]
There are strong relationship between informatics and computer but the
computer alone doesn't define informatics there are many other
dimensions.
117
Technology: -
Informatics:
Informatics generally can be defined as" the art and science of turning
data into information".
Nursing informatics:
Nursing Informatics is a specialty that "integrates nursing science,
computer science, and information science to manage and communicate
date, information, knowledge and wisdom in nursing practice to support
patient, nurses and other health care providers in their decision making in
all roles and setting, to produce effective and efficient client outcomes for
individuals and communities."
Nursing informatics framework
118
2) Data verification techniques.
3) Measures to minimize the entry of fraudulent information.
Pediatric Informatics:
It has been defined as the systematic application of information and
computer science and technology to pediatric nursing practice,
research, and education. Pediatric Informatics explores how the
management of biomedical data, information, and knowledge can
optimize child health.
F Data must be accurate, have utility and integrity which is a key
issue in health care informatics.
119
Information must be:
F Complete, accurate and clear in its descriptions with date and time.
F Measurable, preferably by objective means such as numbers
F Comprehensive, including all necessary information in sequence
F Rapidly and easily available when needed
F Objective, rather than subjective
F Appropriate to each user's needs.
F Easy and convenient form to interpret, classify, store, retrieve and
update.
F Correct spelling.
F Legal prudence.
120
12- Improvement in key relationships with providers & care recipients.
13- Enhance continuity of care.
14- Provides content to standardized nursing language (i.e. Nursing
Intervention Classification (NIC), NANDA -North American Nursing
Diagnosis Association (NANDA), and Nursing Outcome Classification
(NOC).
121
The Technological Challenges for Nursing Education
122
• The use of technology in nursing education is one of the facilitators
of self-directed and life-long learning.
• Online discussion forums allowed students to study with their
peers.
• Inclusion of information management and interactive technology
facilitates learner engagement.
• Promoting critical thinking and improving clinical judgment.
• Fundamental to inclusion of technology in nursing education is
information literacy and informatics.
• When using technology for teaching and learning, tasks are usually
completed at their own time and pace and that facilitates learner
independence.
• Its flexibility of the location and time when completing tasks. This
implies that teaching and learning can happen at any time when
either party is at the comfortable location because it is neither time
nor space bound.
• To prepare nurses for the challenge of the complex, dynamic
healthcare environment, the faculty envisioned curricula infused
with technological innovations.
• Multiple interactive technologies such as personal response
systems (PRS), human patient simulation (HPS) personal digital
assistants, and web conferencing, podcasting, and course
management systems were integrated within the curriculum.
• The use of applications, such as virtual reality and virtual patients,
is perceived to be convenient, speed up the skills learning process
and create a stress-free learning environment.
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• The shift to virtual approach of teaching and learning from
traditional teaching overnight amidst COVID-19 lockdown
regulations came as a huge challenge for many educational
institutions to adapt to such sudden change.
• Network-related issues which include audio virtual disparities,
interruption of sessions because of unexpected logging out from
network and continuous buffering are amongst the challenges
experienced when using technology for teaching and learning.
• Moreover, poor connectivity and technological illiteracy are also
the challenges related to the use of technology for teaching and
learning in nursing education.
• Participants reported lack of time management between family
responsibilities and online learning amongst married couples,
which was seen as a disadvantage of technology use in classroom
nursing education.
• It seems to be lacking human interaction. This is seen as a
disadvantage when using technology for clinical nursing education,
in a sense that, in the nursing profession, nurse-patient interaction
and relation is vital as it plays a role in facilitating the tridomains
of competence, namely, psychomotor, affect, and cognitive
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Application of nursing informatics
1. Nursing Practice
2. Nursing Education
3. Nursing Research
1. Nursing Practice
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2. Nursing Education
3. Nursing Research
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Consideration to facilitate the application of nursing informatics in
pediatric care nursing:
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A typical computer (Personal Computer, PC) contains in a desktop or
tower case the following parts:
• Motherboard which holds the CPU, main memory and other parts, and
has slots for expansion cards
• Power supply - a case that holds a transformer, voltage control and fan
• Storage as floppy disk, CD-ROM and other drives
• Graphics controller that produces the output for the monitor.
Any health care institutions which apply the information system should
follow the ethical principles that govern its conduct to protect from legal
liability.
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5. Autonomy: We have the right to self-determination.
Members of society ought to be given independence in
making decisions and judgments.
Health informatics is about using computers to enhance the way
health information is processed. There are three aspects of health
informatics that can be identified: healthcare, information,
software
q Informatics Ethics
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arising from use of computer for a long period of time such as eye strain,
musculoskeletal disorders, disk amnesia and deficient communication, for
this reason
§ monitor in the level of the user’ s eyes, away from direct light and
from user’ s face by 18-24 inches with adjustable brightness and
contrast and a protective filter should be used to display of infra-
red and ultra violet radiations.
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v Use proper posture to reduce stress on the muscles, bones and
tendons.
v Use as little force as possible - avoid pounding the keys on the
keyboard or holding the mouse or pens and pencils in a death grip.
v Use a telephone headset or a shoulder rest on the telephone
receiver to avoid bending the neck and raising the shoulder to hold
the phone.
v Keep the shoulders and arms relaxed while typing. Keep your
whole body as relaxed as possible.
v Breathe regularly and deeply. This can help keep you relaxed and
alert.
v Alternate non-computer jobs with computer jobs to keep your work
routine varied and give yourself a break from computer use.
v Try to relax mentally. Stress can make your body tense and your
work less efficient.
v Use your eyes properly: blink, see more than the computer screen,
and look into the distance frequently.
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I. Application of information technology in hospitals
(practice)
1- Telehealth
Definition:
Advantages:
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ü Some nursing students have reported using telehealth has
improved their clinical experience and patient care.
ü Students’ using of telehealth enhanced their care performance
Improving the quality and effectiveness of performing tasks.
ü Decreasing errors in communication and information sharing.
ü Once nursing students graduate, they will have telehealth skills
that enhance their job performance because they had theoretical
and clinical fundamental of telehealth technique in nursing
school.
ü This level of familiarity adds to their comfort in using telehealth
ü The use of telehealth can reduce barriers to health care such as
cost, transportation, long wait times at clinics, and disease
transmission.
ü It increases access to care for patients who are unable to leave
their homes if they are immunocompromised and/or immobile.
ü Telehealth usage has increased during the COVID-19 because
of its ability to decrease face-to-face interaction and potentially
limit the spread of infection while providing vital care for
patients.
ü The use of telemonitoring interventions have reduced hospital
admissions and mortality associated with heart failure and
chronic disease among older individuals.
ü People with disabilities and mental health disorders in rural and
urban areas have also reported improved quality of health care
as a result of telehealth services.
ü Telehealth in nursing has contributed to efficient, quality
services and better health outcomes.
Example:
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Asthma Academy: A student nurse-led telehealth education program for
low-income family caregivers of children with asthma
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Advantages
The home health clinician was better able to focus one-on-one care by
actually reducing the daily visit schedule and eliminating unnecessary
visits.
Disadvantages
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o Comfortable access to patient data: HIS helps keep tracks of
various patients, their records, including classification depending
on demographic, age, gender, previous history and so on.
o It’s cost effective: as its application results in better performances
and improved functions which consequently decrease costs.
o Betters interaction with patients: Through images and graphics,
HIS helps doctors to educate patients about their ailments, their
surgical procedures. These in turn, improves the doctor patient
communication.
o Improves efficiency: HIS upgrades the level of efficiency both on
the cost and the clinical care viewpoint. This is accomplished by
shunning duplications, repetitions, delays, missing records and
confusions. Not only that, it also aids well-organized and precise
administration offinance, diet of various patient according to
specific needs, engineering, and distribution of medical aid.
o Lessens scope for error: With the help of HIS nurses and
caretakers monitor drug usage more effectively. This leads to the
decrease of unfavorable drug deliverable while encouraging more
fitting utilization of medicines.
Components of HIS
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Ä Picture Archiving Communication System (PACS).
Ä Radiology Information System (RIS).
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signs/symptoms, etiologies/related factors and patient populations.
Online access to medical resources can also be made available.
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6- Improve communication between the health care teams
7- Enhance and facilitate collaboration among all health care
teams.
8- Help the staff to achieve goals and the standard of care.
Pediatric Electronic medical record
Special form of EMR software designed for the use in pediatric
care (Pediatric EMR is tailored to the pediatrician and pediatric
nurses input ) contains items related to children care such as
Demographics and family structures
§ Medication orders
§ VIS (Vaccine Information Sheet)
§ Pediatric protocols for pediatric triage
§ Behavioral tools
§ Age Specific
§ School & Daycare
§ Sports
§ Demographics and family structures
§ Birth Data
§ Immunization administration and management
§ Growth Charts
§ Reportable Communicable Disease management
§ Child abuse reporting forms
§ Referral entry and tracking
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Pediatric EMR
5-Robots
Definitions:
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reproduction of several human clinical conditions and emotions
when compared to high-fidelity patient simulators.
In the last ten years, three type of robotic technologies have been
applied in nursing education: Humanoid Robot Patient (HRP), the
Humanoid Rehabilitation Robot (HRR), and the Remote Presence
Robot (RPR).
1-Both HRP and HRR are humanoid robots with the body shape
built to resemble the human body. They are prototypes utilized for
the acquisition of practical skills, they generally embedded voice
recognition, speech processing, and movement abilities. In one
study, visual abilities, eye and head movements, as well as facial
expressions have been embedded in the robot, in order to reproduce
recognition abilities and emotional states.
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stethoscopes, otoscopes, and other equipment allowing a remote
clinical assessment.
Advantages:
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Ø HAL has a lifelike appearance, but under the skin he’s a mass of
complex circuitry, sensors, pumps, compressors, liquids, and
more.
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II. Application of informatics in pediatric nursing education
ü Virtual simulation
ü Distance learning/ E-learning course
ü Electronic portfolio
ü Simulation in pediatric nursing education.
1- Virtual Simulation
Definitions:
Uses:
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According to the Healthcare Simulation Dictionary, virtual
simulation is “the recreation of reality depicted on a computer
screen.” When participating in virtual simulations, learners
experience simulated clinical scenarios from a computer screen
while often using a mouse or keyboard to interact with the
environment and maneuver their avatars. Learners often select
actions and communications from a menu as they provide nursing
care to the virtual patient. Upon completion of the simulation, an
automated report provides standardized feedback on whether the
student met the scenario learning objectives.
Example:
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training with the virtual platform, the intervention group was
given a test on basic concepts of pharmacology,
pathophysiology and nursing interventions.
The intention was to establish the baseline in terms
of knowledge of the topics to be treated in the clinical cases.
Phase 2. Experimental
3) Clinical cases: each student was given individually five clinical
scenarios: two fundamental nursing cases (hip fracture and
pneumonia) and three medical-surgical cases (asthma, diabetes and
intestinal obstruction). Before carrying out each case, the students
had to review the case and study its contents provided by the
platform. These contents are based on various Wolters Kluwers
publications. The platform provides different external links so that
the student can access updated content. They then proceeded to
perform the simulation for a maximum of 30 minutes. Finally, the
program gave feedback on those aspects that were done properly
and on those that could be improved. The targets were: each case
had to be repeated until a score of at least 80% was achieved and
the students were not allowed to have any error classified as high
or moderate risk to the patient. Each case could be carried out for
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six days.
4) Online debriefing: these were programmed on the seventh day
of each case by the simulation instructor. The debriefing format
proposed by the platform was used: opening questions, scenario
analysis questions and concluding questions. Each session lasted
approximately 90 minutes.
Advantages:
Challenges:
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Ø Lack of infrastructure
Ø Decoupling users from reality
Ø Shortages of funding and simulator technologies
Ø The lack of full-time trained staff
Ø The poor motivation and experience limitations of instructors
Ø How to increase students’ motivation and engagement, should
be addressed
Ø The time-intensive characteristic.
2- Distance learning
§ Synchronous technologies
• Is a mode of online delivery where all participants are "present"
at the same time. So it requires a timetable to be organized.
• For example:
1. Telephone .
2. Videoconferencing.
3. Web Conferencing.
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§ Asynchronous technologies.
• Is a mode of online delivery where participants access course
materials on their own schedule. Students are not required to be
together at the same time.
• For example:
1. Audiocassette.
2. E-mail .
3. Message Board Forums
4. Printed Materials.
5. Voice Mail/fax.
6. Videocassette.
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great deal of difficulties if try to attend his school with ordinary
classes.
3-Electronic portfolio
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• Artifacts or evidences: examples of student work, including
documents, images, video – mother class- case study- child study.
• Observational checklists: which were used in evaluating nursing
procedures.
• Rubric: can be used to assess student work. A rubric is a criterion
–rating scale, which provides the instructor with a tool to track
student performance
• Reflections: self-evaluation.
Benefits of E- portfolio:
Definition of Simulations:
Simulator:
Replicates a task environment with sufficient realism to serve a desired
purpose.
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§ Types of simulation
1. Screen-based/PC-based simulation
2. Virtual patients
3. Partial task trainers
4. Human patient simulator
5. Standardized patients
6. Integrated models
Until now, opportunities for hands-on practice have either been left to
chance or have been created using static mannequins with indirect patient
feedback from an instructor. Because these experiences lacked the
realism of actually assessing and treating an acutely ill or injured child,
there are significant limitations in terms of the knowledge, clinical skills
and confidence. By comparison, the immersive nature of simulation
training allows participants to practice in an environment that closely
mimics the assessment and treatment of real patients.
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a. Low fidelity: Allows user to practice skills in isolation, such as
administration of an intramuscular injection into an orange or injection
pillow.
b. Moderate fidelity: Offers more realism but does not have user
completely immersed in situation, static mannequins and partial task-
trainers (designed to teach one specific skill such as intubations.
c. High fidelity: Provides user with cues necessary to be immersed in
hands-on scenarios. Such as simulators with life-like mannequins
connected to computer systems designed to control the mannequin’s
physical and physiological responses. These high-fidelity simulators
facilitate student interaction by providing direct feedback and response
to provided nursing interventions in the form of physical findings such
as heart sounds, breath sounds, palpable pulses, blinking eyes and
even speech.
Benefits of simulation for pediatric nursing students:
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ü Simulation incorporates the cognitive, psychomotor, and affective
domains of learning in which emphasis is on the development of
student knowledge.
ü Allows for ongoing direction, feedback& collaboration among
students.
ü Simulation Increases student confidence through.
Acquire Skills
Critical Thinking
For educators
155
The impact of nursing informatics on the health care system
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2. Computer order entry systems help nurses easily interpret orders from
physician in the management of a patient.
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References :
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from:http://www.aacn.nche.edu/education/pdf/BaccEssentials08.
pdf.
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