NCMB 210: Historical Perspectives of Nursing and the Computer

COMPUTER

→ Referred as Information Technology. MAJOR HISTORICAL PERSPECTIVE

→ Synonymous to NIS, NCA, and NI.
SIX TIME PERIOD
→ Used to manage information in patient
FOUR MAJOR NURSING AREAS
care, monitor quality of nursing care
STANDARD INITIATIVES
and evaluate care outcomes.
SIGNIFICANT LANDMARKS
→ With networks are now used in
communicating data via the internet,
accessing resources and interacting PRIOR TO 1960s: SIMPLE BEGINNINGS
with patients on the World Wide Web
 Computers were first developed in the
(WWW).
late 1930s to early 1940s, but use in
NURSING INFORMATICS the healthcare industry occurred in the
1950s
→ Refers to integration of nursing, its
 There are only few experts who
information and information attempted to adapt computers to
management with information health care
processing and information technology  During this period the image of nursing
to support the health of the people profession is undergoing major changes
worldwide (IMIA, 1998).
 Initially, computers were used for
→ A specialty that integrates nursing,
business office transactions.
computer and information science to
manage and communicate data, SIX TIME PERIODS
information and knowledge in nursing
PRIOR TO 1960s: SIMPLE BEGINNINGS
practice (ANA, 2006).
→ Facilitates the integration of data, ʘ Early computers used punch cards to
information and knowledge to support store data and card readers to read
patients, nurses and other providers in computer programs, sort, and
their decision-making in all roles and prepare data for processing.
settings. ʘ Linked together and operated by
paper tape and used teletypewriters
CLINICAL INFORMATION SYSTEM
to print their output.
→ Refers to a set of components that
1960s: ISSUES AND NURSING
form the mechanism by which patient
INFORMATICS RESEARCHES
records are created, used, stored and
retrieved and usually located within a ɷ The use of computer technology in
healthcare provider setting. healthcare settings began to be
→ Includes people, data, rules and questioned.
procedures, processing and storage ɷ Nursing standards were reviewed and
devices, communication and support resources were analyzed.
facilities (IOM, 1991). ɷ Introduction of new computer
technology such as Cathode Ray
Tubes (CRT).

Dela Cruz, Leigh Angelika F.

NCMB 210: Historical Perspectives of Nursing and the Computer
ɷ HISs were primarily developed to ɷ Microcomputers/PCs emerged that
process financial transactions. made computers more accessible,
ɷ Computer vendors were beginning to affordable and usable by nurses.
penetrate the healthcare field but
1990s: AFFIRMATION OF NI AS A
progress is slow.
SPECIALTY FIELD
1970s: GIANT LEAP FOR NI
ʘ Computer technology became an
ʘ Nurses begin to recognize the value integral part of the healthcare
of the computer for their profession. settings, nursing practice and nursing
ʘ Nurses assisted in the design of HISs. profession.
ʘ Computer applications for financial ʘ Policies and Legislation were adopted
and management functions of patient promoting computer technology in
care systems were perceived as cost healthcare including Nursing.
saving technologies. ʘ NI was approved by ANA as a new
ʘ Several States & large Community Nursing specialty.
Health Agencies in the US developed ʘ Need for computer-based nursing
and/or contracted their own practice standards, data standards,
computer-based Management nursing minimum data sets, and
Information Systems (MISs). National databases emerged
concurrently with a need for a unified
1980s: EMERGENCE OF INFORMATICS
nursing language.
FIELD
ʘ Nursing Administrators demanded
ɷ NI became an accepted specialty and inclusion of Nursing protocols in the
many nursing experts entered the HISs.
field. ʘ Nursing Educators require use of
ɷ The need for nursing software innovative technologies for all levels
evolved and nursing education and types of nursing and patient
identified the need to update practice education.
standards, determine data standards, ʘ Nurse Researchers required
vocabularies and classification knowledge presentation, decision
schemes that could be coded for support, and expert systems based on
Computer based Patient Record aggregated data.
Systems (CPRs). ʘ Development of smaller, faster
ɷ Nursing Education identified the need computers and internet connection
to update practice standards, made it possible for the information
determine data standards, and knowledge databases to be
vocabularies and classification integrated in bedside systems.
schemes that could be coded for
POST 2000: RAPID GROWTH AND
Computer-based Patient Record
DEVELOPMENT OF NI
Systems (CPRSs).
ɷ Many main frame HISs integrated
nursing subsystems that documented
several aspects of the patient record.

Dela Cruz, Leigh Angelika F.

NCMB 210: Historical Perspectives of Nursing and the Computer
ɷ Development of wireless point of
care, open source solutions, regional
database projects and increased IT
solutions on healthcare environment. NURSING EDUCATION
ɷ Clinical information systems became
individualized in the EPR. □ Computer-enhanced Courses, Online
ɷ Mobile computing devices were also Courses, and/ or Distance Education.
started to utilize in healthcare. □ Campus-wide computer systems are
ɷ Health Insurance Portability and available for students.
Accountability Act of 1996 (HIPAA) □ New educational teaching
was enacted. methodologies and strategies.
ɷ Standardized transaction and code NURSING RESEARCH
sets were implemented to protect
security and ensure privacy and □ Software programs are available for
confidentiality of healthcare data. processing both Qualitative and
Quantitative research data.
NURSING PRACTICE □ Databases supporting nursing research
NURSING ADMINISTRATION emerged.
NURSING EDUCATION
□ Online access to millions of web
NURSING RESEARCH
resources around the world.

STANDARDS INITIATIVES
FOUR MAJOR NURSING AREAS
NURSING NURSING CONFIDENTIALIT
NURSING PRACTICE
PRACTICE & CONTENT Y & SECURITY
□ Integration of NCPs, patient care data, EDUCATION STANDARD STANDARDS
nursing practice itself as part of the STANDARD S
EHR/ HER. S
□ Nursing practice data emerged with the
introduction of several nursing NURSING PRACTICE STANDARDS
terminologies usable for the EHR.
ANA
NURSING ADMINISTRATION
 Contributes in the development and
□ Hospital policies and procedure
recommendation of standards of
manuals are accessed and retrieved by nursing practice worldwide.
computers.  Nursing Scope & Standards of Practice
□ Work load measures, acuity systems (2004).
and other nursing department systems  Recommended that the nursing
are online and integrated with the process serve as the conceptual
hospital or patient’s HER system or in framework for the documentation of
separate nursing department systems. the Nursing practice.
□ Digital libraries, online resources, and  Nursing Informatics Scope and
research protocols at bedside. Standards of Practice (2008)

Dela Cruz, Leigh Angelika F.

NCMB 210: Historical Perspectives of Nursing and the Computer
 Builds on clinical practice standards, security of personal health information
outlining further the importance for (PHI).
implementing standardized content to  HITECH Act of 2009
support nursing practice by NI  Included the provisions for
specialists. strengthening the original HIPAA
legislation (patient consent,
JCAHO organizations handling PHI, and
 Focuses on the need for adequate increased penalties for security
records on patients in hospitals and breaches).
practice of standards for the YEAR EVENT
documentation of care by nurses. Health Information
 Recommended acuity systems to & Management
determine resources use as well as 1961 System Society
required care plans for documenting (HIMSS) was
nursing care. founded.
1st Hospital
PNA and BON Information
1965
System (HIS) at El
PNA
Camino Hospital.
 Founded on September 2, 1922. First Invitation
 Member of the International Council conference on
for Nurses. 1973 Management
Information
 Instigated the standardization of the
Systems (MIS) for
nursing profession in the Philippines.
public/ community
BON health agencies @
Fairfox Virginia.
 Empowered by RA 9173. First Research:
State of the Art
NURSING DATA STANDARDS
1977 Conference on
NURSING TERMINOLOGIES APPROVED BY Nursing
ANA Information
System (NIS),
 One of the American National Chicago
Standards Institutes (ANSI) that First Military
accredits Standards Developing 1979 Conference for
Organizations (SDOs) operating in the Computer,
Washington
healthcare arena.
First Workshop,
CONFIDENTIALITY & SECURITY 1980 University of
STANDARDS Akron, Ohio
First National
 Increasing access through electronic 1981 Conference,
capture and exchange of information Bethesda, NIS
raised concerns about the privacy and Journal

Dela Cruz, Leigh Angelika F.

NCMB 210: Historical Perspectives of Nursing and the Computer
The National Nursing
1982 Conference 1997 Information and
became an Data Set
ANNUAL EVENT, Evaluation Center
New Jersey (NIDSEC) standards
Computers in and scoring
1984 Nursing: First guidelines
Nursing Computer published to
Journal address
Council on Nursing documentation of
1985 Informatics was nursing care.
formed in New Nursing
York 1999 Vocabulary
Graduate Program Summit
for NI was Conference Held
1989 introduced Canadian
(Maryland Univ Informatics Nurses
and Univ of Utah) Association
ANA Congress of 2001 received emerging
Nursing Practice group status from
1990 recognizes Nursing the Canadian
Informatics as a Nurses
specialty area Association.
International JCAHO identified
Classification of clinical information
1991 Nursing Practice systems as a way
(ICNP) was to improve safety
initiated. and recommended
ANA recognizes 2002 that hospitals
Nursing adopt technologies
1992 Informatics as a HIPAA deadline for
specialty by electronic
delineating the transaction
scope of practice. standards enacted
1993 Electronic Library in October.
goes Online President calls for
First International widespread
Nursing 2003 adaptation of
1995 Informatics, Electronic Health
Teleconference Record (EHR) in 10
(Melbourne years.
Australia) The office of the
First Harriet National Health
1996 Werley Award for 2004 Information
best nursing Coordinator
informatics paper. established.

Dela Cruz, Leigh Angelika F.