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TRANSCRIPT
MAJOR HISTORICAL PERSPECTIVES of NURSING
and COMPUTERS
Computer technology emerged in nursing in response to the changing and developing technologies in the health care industry and in nursing practice.
SIX TIME PERIODS
The use of computers in the health care industry grew
Prior to the 1960s
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
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
Hospital information system (HIS) were developed primarily to process financial contractions and serve as billing and accounting systems
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
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
1980s
Many mainframe HISs emersion- Documents patient’s record- Kardex- vital signs - discharge plan- -online source- -nurse’s notes
NI became an accepted specialty and many nursing experts entered the field
Microcomputer or personal computer emerged
They were user-friendly and allowed nurses to create their own applications
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
Workstations and local area networks or (LANs) were developed for hospital nursing units
Smaller and faster computers laptops, and notebooks
Wide area networks were developed for linking care across health care facilities
Internet started to be used for linking across the different systems
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)
-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)
FOUR MAJOR NURSING AREAS
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
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
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.
NURSING RESEARCH
Nursing research provides the impetus to use the computer for analyzing data
Standard Initiatives
- Influenced the nursing profession and its need for computer systems, information technology, and terminologies to gain acceptance among the healthcare policy makers
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
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
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)
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
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