1. MAJOR HISTORICAL
PERSPECTIVES of NURSING
and COMPUTERS

2. Computer technology emerged in nursing
in response to the changing and
developing technologies in the health
care industry and in nursing practice.

3. SIX TIME PERIODS

4. Prior to the 1960s
The use of computers in the health care
industry grew
Computers were initially used in health care
facilities for basic business office
functions
Use punch cards to store data and card
readers to read computer programs, sort
and prepare data for processing

5. 1960s
Uses of computer technology in health care
setting began to be questioned
The nurses’ station in the hospital was viewed as
the hub of information exchange
The introduction of cathode ray tube (CRT),
online data communication, and real-time
processing added important dimensions to
the computer system

6. Hospital information system (HIS) were
developed primarily to process financial
contractions and serve as billing and
accounting systems

7. 1970S
Nurses began to recognize the value of the
computer for their profession
Several mainframe HISs were designed and
developed, a few of which eventually
became forerunners of a number of
today’s system

8. Several states and large community health agencies
developed and/or contracted for their own
computer-based management information system
(MISs)
MISs provided statistical information required by
local, state, and federal agencies for specific
program funds
Home health agencies provided billing and other
financial information required for reimbursement
of patient services by Medicare, Medicaid, and
other third-party payers

9. 1980s
NI became an accepted specialty and many
nursing experts entered the field
Many mainframe HISs emersion
- Documents patient’s record
- Kardex
- vital signs - discharge plan
- -online source
- -nurse’s notes

10. Microcomputer or personal computer emerged
They were user-friendly and allowed nurses to
create their own applications

11. 1990s
Computer technology became an integral part of
health care setting, nursing practice and the
nursing profession
NI was approved by the American Nurses
Association (ANA) as a new nursing specialty

12. Smaller and faster computers laptops, and
notebooks
Workstations and local area networks or (LANs)
were developed for hospital nursing units
Wide area networks were developed for linking
care across health care facilities
Internet started to be used for linking across the
different systems

13. Post 2000
-Development of wireless point-of-care
-clinical information system became
individualizes in Electronic Patient Record
(EPR)
-Electronic Health Record (EHR)- life longitudinal
record
-Personal Digital Assistant (PDA)

14. -Use of Voice-over Internet Protocol (VoIP)
-Health Insurance Portability and Accountability
Act (HIPAA) of 1996 was enacted
-Critical Care Units are monitored remotely by
health care providers (eICU)

15. FOUR MAJOR NURSING AREAS

16. NURSING PRACTICE
-It has become an integral part of the EHR
-used to assess problems, document care, track
the care process, and measure outcomes
-electronic version of nursing practice has
revolutionized and transformed nursing
practice

17. NURSING ADMINISTRATION
-Workload measures, acuity systems, and other
nursing department systems are online and
integrated with the hospital for patients EHR
system or in separate nursing department
system

18. NURSING EDUCATION
Campus-wide computer systems are available
for students to communicate via e-mail,
transfer data files, access the digital libraries,
and retrieve online resources of millions of
Internet WWW sites.

19. NURSING RESEARCH
Nursing research provides the impetus to use
the computer for analyzing data

20. Standard Initiatives
- Influenced the nursing profession and its need
for computer systems, information
technology, and terminologies to gain
acceptance among the healthcare policy
makers

21. Nursing Practice Standards
- have been developed and recommended by
the ANA
- Have also been set by the Joint Commission
on Accreditation of Hospital Organizations
(JCAHO)
- Included the contents of EHR, such as what
data should be collected and how the data
should be organized in the electronic database

22. Nursing Data Standards
- Emerged as a new requirement for the EHR
- ANA is responsible for the recognition of the
terminologies and for determining if they have
meet the criteria to be included in the
National Library of Medicine

23. Health Care Data Standards
Organizations
• American National Standards Institute (ANSI)
• American Society for Testing and Materials
(ASTM)
• SNOMED
• National Committee on Vital and Health
Statistics (NCVHS)

24. Early Computer-Based Nursing
Applications
• Developed before the mid-1970s as part of
larger HISs
• Focused on documentation of nursing
practice and management of patient care
• Designed for hospitals, ambulatory care
settings, and community health agencies

25. Landmark Events in Nursing and
Computers
• Introduced into the nursing profession over 35
years ago
• Major milestones of nursing are interwoven
with the advancement of computer and
information technologies, the increased need
for nursing data, development of nursing
applications, and changes making the nursing
profession an autonomous discipline