NURSING INFORMATICS PRELIM LESSON # 1: HISTORY OF COMPUTERS

Steve Jobs and Steve Wozniak bought a microprocessor for $25 and built a very simple computer apple, they introduced it in 1976, the Apple Computer Company and the first PC were born.

Abacus , first used by the Babylonians for mathematical computations in 300 B.C Blaise Pascals Pascaline mechanical calculator in 1642 Joseph Marie Jacquards punched cards in 1801 - LOOM Charles Babbages steam driven calculating machine, called the Difference Engine in 1822 Later on was developed as Analytic Engine, which is more general in purpose and can be programmable. It has 2 main parts the store and mill, these same parts are called the memory unit and central processing unit (CPU) in the modern computer. Herman Holleriths Hollerith Desk, a punchedcard tabulating machine which was used in United States 1890 Census. Herman Hollerith built the Tabulating Machine Company which eventually became International Business Machine, or better known as IBM. The first true digital programmable computer is the Harvard Mark I which was built as a partnership between Harvard University and IBM in 1943.. It is used in airplane design and other complex engineering applications. After the war, Eckert and Mauchly produced the first vacuum tube computer first generation computers. ENIAC (Electronic Numerical Integrator and Computer) UNIVAC (Universal Automatic Computer). These early computers are called first generation computers. Second generation computers were introduced in the late 1950s. They include IBM 1401 and 1620 which use transistors instead of vacuum tubes. Third generation computers started the explosion in use of the computers with the invention of integrated circuit or microchip in 1958. IBM 360 and 370 were the classic computers in this generation. 1972 signalled the rise of the Modern Personal Computer when Intel corporation introduced Intel 8008, the first commercial microprocessor.

INFORMATICS AND NURSING INFORMATICS Informatika russian Oznovi Informatiki 1968 Information science within the context of computers. INFORMATICS is the management of information using cognitive skills and the computer Florence Nightingale was the first She collected and systematized record keeping. Pie graph

What is Nursing Informatics? Nursing informatics is the integration of nursing, its information and information management with information processing and communication technology to support the health of people worldwide. (International Medical Informatics Association, 1998). History of Nursing Informatics Prior to 1960s: Simple Beginnings Initially, computers were used for business office transactions. UNIVAC -12,000 digits EDVAC IC texas instuments In 1951 "UNIVAC" (Universal Automatic Computer) is developed. It can store 12,000 digits in random access mercury-delay lines. In 1952 "EDVAC" (Electronic Discrete Variable Computer) is completed under contract for the Ordinance Department. In 1959 Texas Instruments and Fairchild semiconductor both announce the integrated circuit. IC = manufactured by the patterned diffusion of trace elements into the surface of a thin substrate of semiconductor material. 1960s: Issues and NI Researches The use of computer technology in healthcare settings began to be questioned Nursing standards were reviewed and resources were analyzed

Computer vendors were beginning to penetrate the healthcare field BON = BOE board of examiners 1965 ammendment of the USA Social security act to include medicare and medicaid. This accelerated the use of computers The demand of federal agecies for more data continues to be the driving force for the use of computers in the healthcare industry

Computer technology became an integral part of the healthcare settings, nursing practice and nursing profession Development of smaller, faster computers and internet made it possible for the information and knowledge databases to be integrated in bedside systems.

1970s: Giant Leap for Nursing Informatics Nurses begin to recognize the value of the computer for their profession. Computer applications for financial and management functions of patient care systems were perceived as cost saving technologies. In late 1970 Intel introduces a 1K RAM chip and the 4004, a 4-bit microprocessor. In 1971 Bill Gates and Paul Allen form Traf-OData to sell their computer traffic-analysis systems. In 1971 Steve Jobs and Steve Wozniak are building and selling "blue boxes" in Southern California. In 1972 Intel introduces the 8008, the first 8-bit microprocessor. IN 1975 Microsoft is born when Paul Allen and Bill Gates develop BASIC for the Altair 8800. In 1979 Software Arts releases "Visicalc," the first spreadsheet program. 1980s: Emergence of Informatics Field NI became an ACCEPTED specialty and many nursing experts entered the field The need for nursing software evolved and nursing education identified the need to update practice standards, determine data standards, vocabularies and classification schemes that could be coded for CPRs By 1980 Apple has captured 50% of the personal computer market. In 1981 the IBM PC is released. In 1985 Microsoft Windows 1.0 hits the market. The microcomputer/PC 1. accessible 2. affordable 3. usable 4. By 1980 Apple has captured 50% of the personal computer market. 5. In 1981 the IBM PC is released. 6. In 1985 Microsoft Windows 1.0 hits the market. 1990s: Affirmation of Nursing Informatics as Specialty Field

Post 2000: Rapid Growth and Development of NI Clinical information systems became individualized in the EPR Mobile computing devices were also started to be utilized in providing healthcare.

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) Standardized transaction and code sets 1. protect security 2. ensure privacy 3. confidentiality The Health Insurance Portability and Accountability Act (HIPAA) was passed in 1996 and is intended to improve the public and private healthcare programs by establishing standards to facilitate the efficient transmission of electronic health information. SIGNIFICANT LANDMARK DATES

1961: Healthcare Information and Management Systems Society (HIMSS) is founded 1965: Development of one of the first Hospital Information System (HIS) at El Camino Hospital in Mountain View California 1973: First Invitation conference on Management Information Systems (MIS) for public/ community health agencies, held in Fairfax Virginia 1977: First research: state-of-the-art conference on Nursing Information Systems (NIS) held in Chicago 1979: First military conference on computers in nursing in Washington DC 1980: First workshop on computer usage in healthcare sponsored by the University of Akron Ohio 1981 o First national conference on computer technology and nursing held in Bethesda, MD o Nursing Information Systems Journal first published 1982

First National Nursing Computer Technology Conference, becoming an annual event, held in Newark, New Jersey First international meeting: Working Conference on Nursing Uses and Computers in Nursing held in London First workshop on computers in nursing held in Boston First nursing computer journal is published: Computers in Nursing Counsel in Computer Applications in Nursing (CCAN) formed in Kansan City First Nursing Minimum Data Set (NMDS) meeting Council on Nursing Informatics formed in New York First invitational NMDS conference held Essentials of Computer Electives initiated in graduate and undergraduate programs at Georgetown University School of nursing American Nurses Association recognizes NANDA as the first taxonomy in nursing

First International Nursing Informatics, Teleconference held in Melbourne, Australia, Auckland and New Zealand Credentialing in Nursing Informatics initiated by American Nurses Credentialing Center (ANCC)

1996 o o

1984 o o o

First Harriet Werley Award for best nursing informatics paper Online Journal of Nursing Informatics (OJNI) first published

1997: Nursing Information and Data Set Evaluation Center (NIDSEC) standards and scoring guidelines published to address documentation of nursing care 1999: Nursing Vocabulary Summit Conference Held 2001: Canadian Informatics Nurses Association received emerging group status from the Canadian Nurses Association 2002 o JCAHO identified clinical information systems as a way to improve safety and recommended that hospitals adopt technologies o Online MSN in Nursing Informatics offered by Duke University

1985 o o o

1989: Graduate program in Nursing Informatics introduced at Maryland University in Baltimore and University of Utah 1990: ANA Congress of Nursing Practice recognizes Nursing Informatics as a specialty area 1991 o International Classification of Nursing Practice (ICNP) was initiated o First Doctoral Specialty in Nursing Informatics sponsored by Maryland University 1992 o American Nursing Informatics Association is initiated at California, has since become international o ANA recognizes taxonomies: HHCC, OMAHA, NANDA, NIC o ANA recognizes Nursing Informatics as a specialty by delineating the scope of practice 1993: Electronic Library goes online 1995

THE IMPLICATION OF NURSING INFORMATICS TO THE 4 AREAS OF NURSING

Nursing practice has evolved and changed radically.

 Computer systems with nursing, and patient care data, nursing care plans are no longer separate subsystems of the computerized HISs, but rather integrated into one interdisciplinary patient health record in the EHR. all require patient care data to track the care process. Further nursing practice data emerged with the introduction of several nursing terminologies that were recognized by the ANA as coded terminologies usable for the EHR. They are used to assess problems, document care, track the care process, and measure outcomes. Thus, the electronic version of nursing practice the computer has revolutionized and transformed nursing practice.

The computer has radically changed nursing education. Most universities and schools of nursing offer computer-enhanced courses, online courses (open university), and/or distance education. Campus wide computer systems are available for students to communicate via e-mail, transfer data files, access digital libraries, and retrieve online resources of millions of Internet sites. An email accounts is considered a gateway to these possibilities. New educational strategies require different methods of teaching. The advent of computers in educational technology has greatly revolutionized teaching methodologies and strategies. Today, most faculty members use the Internet to teach courses via the Web and communicate with other students via email. The students on the other hand have to be more active and assume more responsibility for their education that can be enhanced through the use of the Web. The WWW facilitates student-centered instructional settings creating a motivating and active learning environment. Finally, time, distance and cost are no longer barriers to educational programs.

Nursing administration in hospitals has also changed with the introduction of the computer that links nursing departments together. Most hospital policies and procedure manuals are accessed and retrieved by computers. The internet is being used by nurses to access digital libraries, online resources, and research protocols at the bedside.

NURS ING A N Pol

Impetus impelling force/ an impulse Software programs are available for processing both quantitative and qualitative research data. With the advancement of computer technology databases supporting nursing research emerged, principally for online searching and retrieving information from the electronic bibliographic information systems or other databases that contain relevant healthcare content, such as drug data. The internet also provides online access to millions of Web resources around the world which have increased the capabilities and expanded the field of nursing research
NURSING PRACTICE STANDARDS

NURS Qu IN

There are two professional organizations that pioneered the setting of standards in the nursing practice: ANA JCAHO PNA

(e.g. collection and organization of electronic data) though the publication of their recent manual.

The American Nurses Association (ANA) is considered as the official nursing organization that contributes in the development and recommendation of standards of nursing practice worldwide. In 1998, the ANA published the Standards of Clinical Nursing Practice which focused not only on the organizing principles of clinical nursing practice but also the standards of professional performance. They also recommend that the nursing process serve as the conceptual framework for the documentation of nursing practice.

In the Philippines, standardization of the nursing profession was instigated by the Philippine Nurses Association (PNA), as a member of the International Council of Nurses, founded way back September 2, 1922 and the Board of Nursing which was empowered by the Republic Act 9173.
NURSING DATA STANDARDS Nursing data standards has emerged as a new requirement for the EHR. There are 13 nursing terminologies that have been recognized by ANA such as the Critical Care Classification (CCC), Nursing Outcomes Classification (NOC) and Nursing Information Classification (NIC). American Society for Testing and Materials (ASTM) The ASTM facilitates student-centered instructional settings creating a motivating and active learning environment. International Health Terminology Standards and Development Organization (IHTSDO) is a not-for-profit association that develops and promotes use of SNOMED CT to support safe and effective health information exchange.

High Level Seven (HL7)

which focuses on the need for adequate records on patients in hospitals and practice of standards for the documentation of care by nurses. They also recommended acuity systems to determine resource use as well as required care plans for documenting nursing care. JCAHO described the required contents of an EHR

Health Level Seven is one of several American National Standards Institute (ANSI) -Standards Developing Organizations (SDOs)

National Committee on Vital and Health Statistics (NCVHS) The NCVHS is a statutory public advisory body to the Secretary of Health and Human Services

The members are leaders and experts in their fields

one arithmetic and logic unit a control unit memory

LESSON # 2: COMPUTER SOFTWARE AND HARDWARES Descriptive Terms for the Computer Automatic Electronic Speed Reliability Storage Architecture Automatic self instructed, automatically processes data using programs called software Electronic uses microelectrical components etched on silicon chips for circuitry. Its basic building blocks are MICROMINIATURIZED Speed split second processing of data Reliability silicon circuitry Storage- of large amounts of dATA that can be retrieved quickly Architecture platform; 2 main types IBM and APPLE COMPUTER Electronic components Instructions Perform calculations Repetitive and complex procedures Process text Manipulate data and signals. COMPUTER HARDWARE All of the physical components of the machine itself.

ARITHMETIC AND LOGIC UNIT (ALU) Controls the mathematical functions and functions that test logic (boolean) conditions. CONTROL UNIT Carries out the machine language functions called: Fetch Decode Execute Store MEMORY Read Only Memory (ROM) Random Access Memory (RAM) READ ONLY MEMORY (ROM) Is a form of permanent storage. Generally contains the program called firmware. Used by the control unit to oversee computer functions. Data and programs in ROMs can only be read by the computer and cannot be altered or erased even when the computer is turned off.

firmware is a term often used to denote the fixed, usually rather small, programs and/or data structures that internally control various electronic devices

DEVICES (input and output) Typically includes devices that are peripheral to the main computer box (CPU) such as input and output peripheral devices

RANDOM ACCESS MEMORY Working memory used for primary storage It is volatile, and used as temporary storage RAM can be accessed, used, changed, and written on repeatedly. Contains data that are stored and currently processed by the computer and programs applications that are currently running. Ram data are lost whenever the power is turned off. MOTHERBOARD Is a thin, flat sheet made of a firm, dielectric or nonconducting material, on which the internal components of the computer are mounted. The electric conductions are etched or soldered onto the perforations through which the components can be affixed. INPUT DEVICES

Minimum Requirements of a Computer System Central Processing Unit (CPU) Input peripheral Output peripheral Power source Must meet these minimum requirements in order to function correctly and efficiently CENTRAL PROCESSING UNIT (CPU) Brains of the computer

Allows the computer to receive information or any factor from the external environment that is taken into the system. Initiates system functioning.

OUTPUT DEVICES Allows the computer to report its results of system process to the external environment. STORAGE MEDIA Hard Drive Diskettes Zip Drive Jaz Drive CD-ROM DVD ROM Memory cards USB Flash Drive Blu-Ray Disc BITS AND BYTES Bit (Binary Digit)

10243 10244 10245 10246 10247 10248

1 gigabyte (Gb) 1 terabyte (Tb) 1 pentabyte (Pb) 1 exabyte (Eb) 1 zettabyte (Zb) 1 yottabyte (Yb)

Unit of data in the binary numbering

system

On equals to the value of 1 Off equals to the value of 0 Bits are grouped into collections of eight, which then function as a unit that describes a single character or representation of data in the computer. 10110100 Bit (Binary Digit)

COMPUTER SPEED Measured in cycle per second Hertz (Hz) or Clock Speed CPU Cycle Fetch, Decode, Execute and Store Cycles CISC RISC It takes time to the computer to perform these functions. The CPU speed is measured in cycles per second. For example, the original IBM PC introduced in 1981 had a clock speed of 4.77 MHz (4.77 million cycles per second). Nowadays, PC speeds are timed in billion cycles per second or gigahertz (GHz). CISC complex instruction set computers general purpose RISC reduced instruction set computers more specialized COMPUTER SOFTWARE Software can be thought of as the variable part of a computer. Software requires hardware, which is the physical substrate on which software exists and runs, and hardware is useless without software.

Unit of data in the binary numbering

system

On equals to the value of 1 Off equals to the value of 0 Bits are grouped into collections of eight, which then function as a unit that describes a single character or representation of data in the computer. 10110100 Unit Bit Byte Byte Kilobyte Megabyte Conversion 1 Character 8 Bits 1 Kb 1 Mb 1 Gb Term 1 kilobyte (Kb) 1 megabyte (Mb)

Computer programs and related data that provide the instructions telling a computer what to do. 2 TYPES SYSTEM APPLICATION SYSTEM SOFTWARE manages and supports computer resources while it executes various tasks BRIDGE operations of a computer system while it executes various tasks such as processing data and information, controlling hardware components, and allowing users to use application software. That is, systems software functions as a bridge between computer system hardware and the application software.

Frequency 1 1 1000 1000 1000 Number of Bytes 1024 10242

BIOS Basic Input and Output System LOADING but its most important role is to load the operating system. When you turn on your computer and the microprocessor tries to execute its first instruction, it has to get that instruction from somewhere. It cannot get it from the operating system because the operating system is located on a hard disk, and the microprocessor cannot get to it without some instructions that tell it how. The BIOS provides those instructions. OS Operating Software management and coordination The operating system acts as a host for applications that run on the machine. system is to handle the details of the operation of the hardware. This relieves application programs from having to manage these details and makes it easier to write applications. DISK OPERATING SYSTEM (DOS) Medium For Communication (user and external devices) DOS is the medium through which the user and external devices attached to the system communicate with the system. DOS translate the command issued by the user in the format that is understandable by the computer and instruct computer to work accordingly. It also translates the result and any error message in the format for the user to understand. UTILITY PROGRAMS Management Of Computer Functions Resources Files Password Protection Memory Management Virus Protection File Compression A program that performs a specific task related to the management of computer functions, Common examples are Disk Defragmenters, Application Launchers and Web Browsers.

APPLICATION SOFTWARE Programs that specify the information processing activities required for the completion of specific tasks of computer users. Examples are electronic spreadsheet and word processing programs or inventory or payroll programs DATA BASE SOFTWARE A list of information that are similar in format/nature. information can be retrieved in several ways, using reports and queries An example is a phone book that lists a name, address, and phone number for each entry. Once stored in a database, information can be retrieved in several ways, using reports and queries. For example, all the names listed for a given area code could be printed out and used for a commercial mailing to that area. DESKTOP PUBLISHING SOFTWARE WORD PROCESSING SOFTWARE entering revising supplementing This software permits the user to prepare documents by using both word-processing devices and graphics. Desktop publishing software uses word-processing software, with all its ease of entering and revising data, and supplements it with sophisticated visual features that stem from graphics software. For example, one can enhance a printed message with virtually any kind of illustration, such as drawings, paintings, and photographs. PRESENTATION SOFTWARE Text Graphics Movie Clips and Sound Clips A speaker may use presentation software to organize a slide show for an audience. Text, graphics, sound, and movies can easily be included in the presentation. An added feature is that the slide show may be enhanced by inclusion of handouts with two to six slides printed on a page. The page may be organized to provide space for notes to be written in by the audience as the presentation ensues. An example of this is Power Point. Preparation of the software is simplified by the use of 'wizards' that walk the user through the creation of the presentation

As a host, one of the purposes of an operating

OPEN SOURCE DEFINITION Free access to the programmers instruction to the computer in the programming language in which they are written. Development method for software that harnesses the power of distributed peer review and transparency of the process. Must satisfy the 10 criteria by Open Source Initiative (OSI). 4 FREEDOMS

Freedom 0: Freedom to RUN the program for any purpose. Freedom 1: Freedom to STUDY how the program works and adopt it to your needs. Freedom 2: Freedom to REDISTRIBUTE copies so you can help your neighbors. Freedom 3: Freedom to IMPROVE the program and release your improvements to the public so that the whole community benefits.

PROPRIETARY Exclusive copyright Source code Copy Modify Study Make money from its license and use FREEWARE Free Software SHAREWARE Trial, try before you buy basis TYPES OF COMPUTERS Supercomputer machines with the capacities beyond large computer systems with the speed of 100 million instructions per second. Mainframes the largest, fastest and most expensive type of computer for processing, storing and retrieving data and can access billions of characters of data. Microcomputers/ Personal Computers is a digital computer system under the control of a stored program that uses a microprocessor, a programmable ROM and RAM. Handheld Computers/ PDAs - is a handy computer which can be brought from one place to another.