1. nursing informatics lecture

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lecture for nursing informatics

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Page 1: 1. nursing informatics lecture

LET US PRAY

Page 2: 1. nursing informatics lecture

NursingInformatics

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Lets Take The Relationships Deeper, Simpler & sweeter This

time Around…

True or false

1- if both statements are true2 – if statements are contradicting3 – if both statements are false

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1. - the binary symbol of number 6 is 110 - the binary system was influenced from von Leibniz mechanical device.

2. - the Boolean Algebra is used for searching bibliography - the Boolean Algebra is used in searching for

database

3. - Hollentin machine is a descendant of the Jacquard loom concept . - Charles Babbage is the father of modern calculator.

4. – Hollerith machine is the origin of the Y2K - ENIAC is the exact replica of MARK 1

5. - the intuitive way for calculation is the Abacus - the Antikythera is the most intuitive machine

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6. - the Pascaline was influenced by von Liebniz - the Pascaline was accepted and widely used

7. - the primary language of modern computer is the Binary system. - the logarithm inscription is currently used by modern computer.

8. - the major characteristics of the ENIAC are its movable parts. - the first generation computers used vacuum tubes.

9. - the vacuum tubes was smaller than the transistor. - the ENIAC help the US census to more faster

10. - Mark 1 is the 1st to used cathode ray tubes - Abacus on stores the computation result step by step.

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Match Everything!!!1. Communicating & Interacting

with Patients2. Slide Rule3. Requires Extensive Training4. 1,000: 10 = 10x 10x105. Weaving machine6. 1st Calculator7. Equation Stating True or False8. Charles Babbage9. Charles Xavier Thomas

Colmar10.First Generation Computer

A. ArithometerB. AbacusC. Punch cardsD. Boolean AlgebraE. “Human should be in parallel

with machine”F. LogarithmsG. 1820H. ENIACI. William OughtredJ. Computer NetworkingK. Binary System

3

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History of Nursing Informatics 1950 – UNIVAC 1 aka giant brains1956 – transistor was used; smaller, energy efficient1958 – Integrated Circuit (IC) by Jack Kilby

- predecessor of all micro chips1960 – mouse was invented by Douglas Engelbert

- video conferencing, multiple window screen1964 – 23RD Generation Computer using Operating System1977 – Basic Programming Language1980- Micro Soft Sytem by Bill Gates (16 bit)1981 – IBM release first PC with MS DOS

- Color graphics were extra - intel were first used

1984- Apple introduces Macintosh with 32 bit - graphics and wide screen

1992 – Apple introduced the Personal Digital Assistant2007 – first time PDA was in clinical area

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UNIVAC 1

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the two 19th century women• Lady Ada Lovelace – 1st computer programer

- aka Ada Byron- met Charles Babbage the developer of first computer

• Florence Nightingale – the founder of modern nursing- Birth: May 12, 1820; Florence- Start: Crimean war; she develop a pie graph,

uses statistical analysis, and develop a form for the hospitals in order to generate data and

statistics- considered the early informatics nurse

* both are mathematicians

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1950s & 1960

• Prior to 1960- image of the nurses improved- nurses practice grew in scope and complexity- Increase in number of professional nurses- Growth in computer industry- Computers first use in the health facility a. office functions c. paper tape

b. punch cards d. teletypewriters

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1950s & 1960

• 1960 - increase in number of health care facility

- nurse are started to be considered the centre of communication activities & information exchange- Desktop terminals were developed called CRT- Email was used 1965- HIS mainly for;

a. Accounting b. basic business c. finance

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1970

• HIS - integrated more into the hospital system• MIS ( Mngt. Information System)– statistical information– billing– insurance reimbursement- chip was develop- Microprocessors introduced (1971)

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1980• 1982: First international medical informatics Association

Working Conference (London, England)• 1985: Another conference in Calgary, Canada• 1985: MS release windows 1; as well as intel 386• 1986: Informatics field introduced

• PC/ Micro Computer• HIS CPRS( computer based patient record

system)• Incorporated – Documentation

– Doctors Order - Lab results– Kardex - Nurses Notes– V/S or TPR– Discharge Planning

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1990 and beyond

• NI was approved by ANA (1992)• Computer become smaller, faster, and easier

to use• Internet become a tool for clinical application• Knowledge if the focal point in nursing; as

knowledge workers nurses are:a. Data gatherer d. knowledge buildersb. Information usersc. Knowledge users

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Nursing Informatics the Philippines

nursing informatics.. • word were mostly unfamiliar with in the nursing

community up until 2007-2008.• Not yet found & recognized as a sub-discipline• Founded by pioneers: Philippine Medical

Informatics Society (PMIS)• PIMA official registered in 1996 mainly

composed of 11 physicians• 1st head: Dr. Alvin Marcelo

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Nursing Informatics the Philippines

nursing informatics.. • 1998: several faculty of UO began formal

education & training• Dr. Herman Tolentino took postdoctoral

fellowship in medical informatics @ University of Washington.

• Dr. Alvin Marcelo later trained @ National Library of Medicine.

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Nursing Informatics the Philippines

nursing informatics.. • Dr. Cito Maramba went to Coventry for

Masters in Information Science @ University of Warwick

• 2003: Proposed course in NI @ UP• 2005-2006: College of Arts & Science

(major in bioinformatics) and Master of Science in Health Informatics was offered.

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Nursing Informatics the Philippines

nursing informatics.. • 1999: National Institute of Health –UP Manila

form a study group to identify the international standards for health promotion and its adaptability in the Philippines,

• “Standards of Health Information in the Philippines, v. 1999” or “SHIP99”.

• PNA was included in the group by Ms. Evelyn Protacio.

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Nursing Informatics the Philippines

nursing informatics.. • despite that representation & inclusion in the

curriculum nurses in the Philippines still lag behind our foreign counterparts.

• 2008: Nursing Informatics in the undergraduates was defined by CMO#5 s.2008.

• 2009: revised & included as Health informatics in the CMO#14 first implemented in 2010 summer

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Nursing Informatics the Philippines

problem encountered adaptation of an international materials which does

not suit the local needs which should be community-centered using information, communication & technology.

Lack of certification & credentialing programs in post-graduates level

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Nursing Informatics the Philippines

nursing informatics.. future• due to the integration in the curriculum made an

increase in awareness & interest of NI.• Development of training, certification and credentialing

are on the process by PNIA.• Partnership with local & international NI organization• CORE X strategic platform (Competency, Organization,

Recognition, Experience & Expertise ) *thrust: - support use of health information standards

- have a nursing informatics specialist inevery hospital

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Nursing Informatics the Philippines• persistent issues :

- inequities in access, cost, inefficiency - maldistribution of health care providers, and public health systems managers,

• Information and communications technologies (ICT) offer - accessible, - affordable - standard tools in the health arena.• Since 1998, the National Telehealth Center has championed its use in health

and development in the field now known as eHealth. • Theme: Putting health in the hands of the people, • Learning in four strategic areas;

a. assisting remote health professionals in their clinical decision making (telemedicine),

b. developing relevant electronic health record systems intended for government primary care centers where the poor seek care,

c. building capacities of health care and eHealth practitioners (eLearning and trainings)

d. actively advocating for policies that promote the relevant and meaningful use of ICT in health.

Page 24: 1. nursing informatics lecture

Nursing Informatics the Philippines• persistent issues :

- inequities in access, cost, inefficiency - maldistribution of health care providers, and public health systems managers,

• Information and communications technologies (ICT) offer - accessible, - affordable - standard tools in the health arena.• Since 1998, the National Telehealth Center has championed its use in health

and development in the field now known as eHealth. • Theme: Putting health in the hands of the people, • Learning in four strategic areas;

a. assisting remote health professionals in their clinical decision making (telemedicine),

b. developing relevant electronic health record systems intended for government primary care centers where the poor seek care,

c. building capacities of health care and eHealth practitioners (eLearning and trainings)

d. actively advocating for policies that promote the relevant and meaningful use of ICT in health.

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Nursing Informatics the Philippines

• National Telehealth Center (NTHC) conducted a “webinar” • eRecords – national database• eMedicine - tele-referrals between Doctors-to-the-barrios

and PGH using mobile phones and internet technologies.• eLearning - systematic deployment of scarce trainers where

there is a greater need while providing access to up-to-date knowledge.

• eHealth Training for Educators of the Health Profession was held the National Telehealth Center, UP Manila.

• Philippine Undergraduate Research on eHealth (PUReHealth) Awards Student Orientation

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Nursing Informatics the Philippines

eRecords • Data not managed is useless.• Improve efficiency of health records collection through electronic

systems for organizing health data. eReordssystem

• developed by NThC is CHITS

• a free and open source (FOSS) software designed specifically for local government health centers

• collects existing routine health data in the Field Health Services Information System (FHSIS) of the Department of Health

• Integrates them into a unified computerized system.Community Health Information Tracking System

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Nursing Informatics more future..world spectrum

a. Quantity of electronic resources will multiply, as mobile device increasing power

b. Variety of devices will increase to meet the diverse needs of the practicec. Clinical decision support software will become increasingly sophisticated d. Smart cards that authenticate the user’s identitye. Increasingly life like simulation & virtual reality for educating nursing staff &

studentsf. Development in sophisticated distance patient visits (convenient home visits

follow up)g. Bioinformatics will continue to unravel information related to genetics to

formulate gene therapy h. Speech recognition will enable providers to dictate system for accurate

documentation.i. More online health services

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QUIZ COVERAGE

1-20. FROM SIR CANDOG 21- 60 . THESE WEEK’S DISCUSSIONS

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4 Domain Applications

1. Nursing Practice Domain Application - Electronic Health Record uses such as; a. computer generated nursing care plan

b. clinical decision making alertsc. electronic monitoring devicesd. patient specific discharge

instructionse. online evidenced based nursing resources

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4 Domain Applications2. Nursing Administration Domain Application

-reporting statistical data- planning resources- budgeting- documentation such as;a. workload measurement systemb. online policy, manual and procedurec. staff scheduling systemsd. internal emaile. cost analysisf. patient tracking system

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4 Domain Applications 3. Nursing Education Domain Application

- computer revolutionized education process- online courses/distant education- home study/university without walls- services such as;a. online registration, scheduling, attendance, grade managementb. computer based tutorialsc. remote library accessd. webcastinge. simulation labs

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4 Domain Applications

4. Nursing Research Domain Application- analyze nurses data (stats and trends)- this includes;a. computerized literature b. software that process quantitative & qualitativec. reference and other related studies

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Standards Initiative 1. Nursing practice standard2. Nursing Data standard3. Health Care Data Standards Organization

type of HISa. early HISb. early ambulatory care information systemc. early computerd. early educational application

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Standards Initiative 1. Nursing practice standard2. Nursing Data standard3. Health Care Data Standards Organization

type of HISa. early HISb. early ambulatory care information systemc. early computerd. early educational application

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Electronic Health Recorda. Patient safety - Computerized Provider Order Entry (CPOE) allows

physician to enter orders or findings directly to the computer. With most includes ;-electronic medication administration record preventing errors in medication administration. -bar coding vs clients ID band

- associated with written orders 1. illegibility2. inaccurate abbreviations

- Clinical decision support software provides;1. dose calculations 2. warns the prescriber of any patients allergy, drug to drug interaction3. drug contra indication4. considers relevant lab result

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Electronic Health Record

1974 – Marc Lalonde indicated that;“there is a lack of a uniform and integrated system for maintaining health records of individuals because essential data were scattered in many location”

2002 – Roy Romanow “to take full advantage of the potential of information, evidence and ideas in the health care system, thus infrastructure must be in place, in support it recommended the HER”

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…to the futurea. Quantity of electronic resources will multiply significantly due to

mobile devicesb. Devices will increase to meet the four domains of nursingc. Support software will become increasingly sophisticated like;

- Recognizing when patient assessment falls outside the normal ranges, prompting communication to the physician.

d. Smart card- authenticate users identity allowing access to computers.

e. Use of virtual reality for educating studentsf. Telecommunication – TELEHEALTHg. Bioinformatics – gene functions or gene therapiesh. Speech recognition – saves timei. Online health care services – information for self management

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EHR & EMR

• primarily on storage of patients record electronically• Downside: medico-legal issues exposure by practitioners

such as violation of right to privacy• From paper based to electronic version of patient record• Issues:• 1. Who is responsible for Management of data• 2. What are patients rights and expectations• 3. How to obtain consent without physician• 4. How to make it inaccessible to unauthorized people• 5. Are the information reliable• 6. What are the medical liability issue arising from this

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EHR vs EMR

• HER is a secure and private lifetime record of an individual’s health and care history, available electronically to authorized health care providers

• Distinctions:- EMR refers to an electronic version of the paper record that doctors have long

maintained;- EMR holds all medical information gained from individual physician’s care;- EMR has depth- EHR is a compilation of core data from multiple sources and it may be

comprised of many different e-records submitted by different providers in different jurisdictions;

- EHR has breathed because it contains all record from EMR - EHR does not necessarily contain all the information from EMR

• accountability, privacy, security, confidentiality, accountability, liability

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Davies Award of Excellence• Named after Dr. Nicholas E. Davies; advocated for the

development of patient record• Its is as award program that bring to national attention

excellence in the implementation of computerized medical records

• Philosophy: health care organization benefit when collective experiences and lessons are shared.

• Criteria1. Organizational/Acute Care2. Ambulatory Care3. Public Health care

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Informatics

• French word “informatique”; the computer milieu

• 1970-1980 : nursing informatics broadly defined as the use of computer technology to support all aspects of nursing practice

• 1996: Turley introduced the Nursing informatics model

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History of Nursing Informatics

150 & 100 BC – Antikythera mechanism3000 – 500 BC – Abacus (Greeks,Romans, Chinese, aztecs)1632- Slide rule by William Oughtred1642- Pascaline by Blais Pascal1694- Binary System by Gottfried Wilhem von Leibniz

(computer language)1804 – Weaving Machine by Joseph Marie Jacquard

using punch cards.1820 – Arithometer by Charles Xavier Thomas de Colmar

(first real calculator)

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Antikythera mechanism

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History of Nursing Informatics 1822-1871 – Difference engine; analytical engine;

connected relationship between mathematics & machines

1854 – Boolean Algebra or Arithmetic; that any equation can be stated as either true or false

1889- Punch Cards by Herman Hollerith; used first for US census (from 7 years to 6 mos.)

-IBM was founded1931- Bush Differential Calculator1944- Mark I by Howard H. Aiken ( a 150 feet long with

500 miles of wiring)

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History of Nursing Informatics 1946 –First Generation Computers (1st electronic

computers) ENIAC (Electronic Numerical Integrator & Computer)-18,000 vacuum tubes, 70,000 computer resistor and 5 million soldered joints- 1,000 more faster-world first complete computer

1947 – Transistors by William Shockely, John Bardeen, Walter Brattain- smaller that vacuum tube- started the 2nd generation computer

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Computers

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NursingInformatics