●​ 1980s

OVERVIEW -​ improvement of documentation (nurses chart,

Computerization and/or electronic processing affect all vital signs, etc.)
aspects of healthcare delivery including -​ mainframe HIS were designed and develop
(a) provision and documentation of patient care, management of care
(b) education of healthcare providers, -​ education use of computers began
(c) scientific research for advancing healthcare -​ early networks expanded awareness on
delivery, practice
(d) administration of healthcare delivery services,
(e) reimbursement for patient care, ●​ 1990s
(f) legal and ethical implications, as well as -​ the field of informatics emerged in the health
(d) safety and quality issues. care industry and nursing
-​ discharged planning system were developed
Since its inception there has been a shift from the use and used as referrals to community health care
of mainframe, mini- or microcomputers (PCs) facilities.
towards: -​ Updates on practice standards
a.​ integrating multiple technologies -​ Microcomputer or personal computer (PC)
b.​ invisible storage devices emerged.
c.​ user-friendly, menu drive, touchscreen -​ AMA developed Nursing Information and Data
d.​ telecommunication devices. Set Evaluation Standards (NIDSES)
-​ Computer technology became an integral part
COMPUTERS IN NURSING ARE USED FOR of health care settings, nursing practice, and
a.​ managing patient care the nursing profession.
b.​ monitoring quality -​ During 1892, NI was approved by the American
c.​ evaluating outcomes Nurses Association (ANA) as a new nursing
d.​ communicating data specialty.
e.​ accessing resources -​ Smaller and faster computers-laptops and
f.​ interacting with patients notebooks arise
g.​ documenting care -​ Workstations, local area networks (LANs), and
h.​ supporting nursing research wide area networks (WANs) were developed.
i.​ testing new system -​ Legislative action paved the way for Health
j.​ designing new knowledge database Insurance Portability and Accountability Ac
k.​ developing data warehouses (HIPPA)- 1996
I.​ advancing the role of nursing -​ ANA developed Nursing Information and Data
Set Evaluation Standards (NIDSES) - to evaluate
and recognize nursing information system.
Historical Perspective of Nursing & Computer
-​ Technology rapidly changed in the 90s:
●​ Prior 1960s ​ PCs became smaller
-​ computers were used for basic business office ​ Computer notebooks became affordable
functions ​ Computers were linked through networks
-​ used punch cards to store data and card ​ The Internet became mainstream
readers to read computer programs, sort, and ​ The World Wide Web (WWW) increased access
prepare data for processing. to information

●​ 1970s ●​ 2000s
-​ uses of computer technology in health care -​ Healthcare information became digitalized
setting began to be questioned -​ In 2004 Executive Order 13335
-​ nurses station in the hospital was viewed as ​ Established Office of the National Coordinator
the hub of information exchange. for Health Information Technology (ONC)
-​ during this period, computer technology ​ Recommendation issued for adoption of EHRs
advanced, while the number of health care -​ Development of clinical applications
facilities increased. -​ Integration of nursing data into HIT systems
-​ Increased time devoted to documentation
-​ Emerging computer-based information
systems
 02/05/26
●​ 2010s
-​ Impact of Nursing Minimum Data Set (HMDS)
CONSUMER-CENTRIC HEALTHCARE SYSTEM
showed need for continued effort 1.​ Shift due to escalating costs of healthcare
-​ New nursing research agenda emerged as 2.​ Consumers encouraged to be active partners
critical based on National Institute for Nursing in managing health
Research (NINR) 3.​ Variety of technologies have evolved
-​ Meaningful Use (MU) legislation outlined 4.​ Consumers can share across healthcare
-​ Ultimate goal is interoperable EHR in all providers
hospitals 5.​ Personal Health Records have multiplied
-​ MU designed to be implemented in three 6.​ Consumers increasingly healthcare literate
stages
-​ MU stage 1 focused on Computerized Physician NURSING STANDARDS INITIATIVES
Order Entry (CPOE) A. Nursing Practice Standards
-​ MU stage 2 focused on Quality Indicators 1. Standards developed by ANA
-​ Quality Indicators guide in patient safety 2. Nursing Scope & Standards of Practice (ANA, 2010)
-​ MU stage 3 - focused on outcome measures focused on:
-​ Center for Medicare and Medicaid Servlces a.​ The organizing principles of clinical nursing
(CMS) to increase reimbursement for MU practice
-​ CMS may penalize or failure to meet MU m. MU b.​ Standards of professional performance
made NI part of all nursing services 3. Nursing Scope & Standards of Practice (ANA, 2010):
a.​ Builds on clinical practice standards
b.​ Outlines importance of standards to support
nursing

B. Nursing Education Standards

1. NLN's Nursing Forum on Computers in Healthcare and
Nursing supported integration of computers in nursing
curriculum

ANA Standards of Nursing Practce

1. Assessment: The registered nurse collects
comprehensive data pertinent to the patient's health
and/or the situation.
2. Diagnosis: The registered nurse analyzes the
assessment data to determine the diagnoses or
issues.
3. Outcomes Identification: The registered nurse
identifies expected outcomes for a plan
individualized to the patient or the situation.
4. Planning: The registered nurse develops a plan
that prescribes strategies and alternatives to attain
expected outcomes.
5. Implementation: The registered nurse implements
the identified plan.
​ 5a. Coordination of Care: The registered
nurse coordinates care delivery.
​ 5b. Health Teaching and Health Promotion:
The registered nurse uses Strategies to promote
health and a safe environment.
​ 5c. Consultation: The graduate
level-prepared specialty nurse or advanced practice
registered nurse provides consultation to influence
the identified plan, enhance the abilities of others,
and effect change.
​ 5d. Prescriptive authority and treatment:
The advanced practice registered. nurse uses
 prescriptive authority, procedures, referals,
●​ In 1999, a study group was formed headed by
treatment, and therapies in accordance with state
the National Institute of Health of the University
and federal laws and regulations.
of the Philippines Manila.
6. Evaluation: The registered nurse evaluates
●​ This group identified international standards for
progress toward attainment of outcomes.
health information and their adaptability in the
Philippines
2. The American Association of Colleges of Nursing ●​ SHIP99 - the "Standards of Health Information in
(AACN) revised The Essentials for Doctoral Education for the Philippines, 1999 version"
Advanced Nursing Practice (AACN, 2006) and The
Essentials of Baccalaureate Education for Professional By the year 2003, a Master of Science in Health
Nursing Practice (AACN, 2008) to require the use of Informatics was proposed to be offered by UP-Manila
computers College of Medicine (major in medical informatics) and
the College of Arts and Science (major in
C. Confidentiality & Security Standards bioinformatics) and was later approved to be offered
1. Electronic exchange of data raises privacy concerns starting academic year 2005-2006.
2. 2009 HIPAA strengthened in HITECH Act (Health
Information Technology for Economic and Clinical CHED as a Catalyst.
Health) Act ●​ In 2008, Nursing Informatics course in the
undergraduate curriculum was defined by the
ELECTRONIC HEALTH RECORDS FROM A HISTORICAL Commission on Higher Education (CHED)
PERSPECTIVE Memorandum Order 5 Series of2008.
A. The Institute of Medicine (10M) ●​ This was later revised and included as Health
1. Raised awareness of paper patient records Informatics course in CHED Memorandum
B. The computer based Patient Record Institute Order 14Series of 2009.
1. Made criteria to evaluate Computerized Patient ●​ This was first implemented in the summer of
Records (CPR) accomplishments 2010

LANDMARK EVENTS IN NURSING AND COMPUTERS Organization

A. Major Milestones ●​ Early in 2009, Mr. Kristian R. Sumabat and Ms.
1. Computers introduced over 40 years ago Mia Alcantara-Santiago, both nurses and
2. Major milestones in nursing and computers graduate students of Master of Science in
interwoven Health Informatics at the University of the
3. Increased need for nursing data makes nursing Philippines, Manila began drafting plans to
profession an autonomous discipline create a nursing informatics organization.
4. Conferences and symposia provide chances for ●​ In February 2010, they began recruiting other
nursing informatics to network nursing informatics specialists and
practitioners to organize a group which later
became as the Philippine Nursing Informatics
NURSING INFORMATICS IN THE PHILIPPINES Association (PNIA).

The Philippine nursing community have long sought to

keep up with increasing use of information and
technology in the healthcare system. ISSUES AND CHALLENGES OF NURSING
●​ Nursing informatics - unfamiliar until 2008 TINFORMATICS IN THE PHILIPPINES
●​ The origin of this budding discipline in directly ISSUES AND CHALLENGES OF NI IN PHILIPPINES
came from the pioneers of HEALTH INFORMATICS - The inclusion of informatics as an integral part of the
in the Philippines. undergraduate curriculum has been one of the most
●​ The Philippine Medical Informatics Society influential factors for the increased awareness and
(PMIS) and its founders had strong influence in interest in this field of nursing.
the development of health informatics in the - However, the contents of the curriculum were
Philippines. adapted from international materials which does not
●​ The PMIS was officially registered under the match the local needs.
Securities and Exchange Commission in 1996 by - A community-centered approach to the use of
its board composed of eleven physicians. The information, communication and technology in nursing
organization was headed by Dr. Alvin Marcelo. practice must be adapted to ensure the impact of the
●​ Since 1998 - several faculty members of UP program in the local healthcare system.
began formal education and training.
- Lack of certification and credentialing programs in
post-graduate levels are also absent with the scarcity THEORIES, MODELS, AND FRAMEWORKS
of local nursing informatics experts. This new field has - A theory seeks to both describe and explain. It's the
yet to gain acceptance and recognition in the nursing most complex and it's testable. A theory should help
community as a sub-specialty. you predict and examine which factors influence your
outcome.
FUTURE DIRECTION OF PHILIPPINE - A model describes but doesn't explain. It's commonly
NURSING INFORMATICS used to describe, or even simplify, the process of
translating research into practice.
FUTURE DIRECTION OF PHILIPPINE NI - A framework describes but doesn't explainfactors
• PNIAS CORE X strategic platform which stands for believed to influence an outcome. It provides a big
Competency, Organization, Recognition, Experience picture overview of various descriptive categories and
and Expertise. how they might relate to one another.
• It is also a major drive to support the use of health
information standards in the Philippines and to have
nursing informatics specialists in every hospital in the Framework is used to show the relations of concepts, it
country. give an overall picture of the possible courses of action.
A model is something used to represent or explain the
operation and mechanism of something else. Theories
are diferent They can emerge from models but chey
are prescriptive not merely descriptive ; cherefore, they
cam be tested.
Historical Perspectives of Nursing
Informatics HEALTHCARE ENFORMATECS
Integration of:
Who Should Become a Nurse Informaticist? ●​ healthcare sciences
You do not have to be a computer expert to consider a ●​ computer science
career as a nurse informaticist. Everyone must start ●​ information science
somewhere. If you see the computer as a ●​ cognitive science
problem-solving tool instead of an inconvenience, then to assist in the management of healthcare information
you are a prime candidate to be a nurse informaticist -​ subdiscipline of informatics
(Bridges, 2007).

What's in it for us, Nurses?

​ Nursing informatics is a growing field. As nurses,
we face ever changing and challenging practice
situations; competency in nursing informatics promises
to strengthen our clinical decision-making skills.
Although new technology may be a challenge for
some, informatics will enhance nursing practice. We'll
have quicker access to patient information, improve
overall emiciency ana see a reducilor in potential
errors.
​ As our profession continues to advance,
nursing informatics has the potential to change our
practice for the better, not only for us as nurses, but
also for our patient population.
"Computers are incredibly fast, accurate and stupid.
Human beings are incredibly slow, inaccurate and
brilliant. Together they are powerful beyond
imagination."
​ ​ ​ ​ ​ - Albert Einstein
HUMAN-COMPUTER INTERACTION The model contains four primary elements arranged to
- HCI, concerned with interactions between people and form a pyramid. These elements are:
computers, is an area of study concentrated on by 1.​ the "raw material, which is nursing related
human factors experts (Staggers, 2002). information
- HCI is defined as the study of how people design, 2.​ the technology, which is a computing system
implement, and evaluate interactive computer systems 3.​ the users, who are nurses/students within the
in the context of users' tasks and work (Nelson & context of their personal and professional
Staggers, 2014). systems
• Human factor is important. 4.​ the goal or objective toward which the three
preceding elements are directed.
HUMAN FACTOR
-​ is a discipline that optimizes relationships
between technology and humans (Kantowitz &
Sorkin, 1983; McCormick & Sanders, 1982)

NI MODELS
Nursing Informatics models is composed of 5 general
models.
●​ Graves and Corcoran's model
●​ Schiwirian's model
●​ Turley's model -Data Information Knowledge
(D-I-K) model.
●​ Benner's Novice to Expert model.

​ The 2 specific informatics models are Philippine

• It may seem in the model that the interactivity of all
Health Ecosystem model and Shift Left model.
the elements is bidirectional in nature meaning that,
one element is not necessarily a precursor of the other,
1. GRAVES AND CORCORAN'S MODEL (1989)
and changes in one element will result in changes in at
- Nursing informatics is like a linear progression, from
least one of the other elements as well.
data into information and knowledge.
- Management processing is integrated within each
3. TURLEY'S MODEL (1996)
elements, depicting nursing informatics as the proper
1.​ By James P. Turley according to this model
management of knowledge, from data as it is
nursing informatics is the intersection between
converted into information and knowledge.
the discipline-specific science (nursing
1.​ Data are discrete, uninterpreted entities
science) and the area of informatics. And in this
2.​ Information is interpreted, organized, and
model, there are 3 core components of
structured data
informatics, namely:
3.​ Knowledge is the combination of information.
●​ Cognitive science
Using data that are combined to produce
●​ Information science
information and information is collected to
●​ Computer science
produce knowledge this way it is possible to
see relationships, formulate opinions, and make
James P. Turley, presents "cognitive science", without it,
predictions
decision-making, information processing, construction
of tools and computer interfaces would be difficult.
2. SCHIWIRIAN'S MODEL (1986)
-​ These concepts can help nurses understand
- Nursing informatics involves identification of
the decision
information needs, resolution of the needs, and
-​ making and information processing done by
attainment of nursing goals/objectives.
nurses and, subsequently, assist in the creation
- Patricia Schwirian proposed a model intended to
appropriate tools to support nursing processes.
stimulate and guide systematic research in nursing
informatics, model/framework that enables
identification of significant information needs, that can 4 FIELDS OF SCIENCE TO THE NURSING INFORMATICS
foster research
●​ Nursing Science
●​ Computer Science
●​ Information science
●​ Cognitive science
1. NURSING SCIENCE • And the government, different nursing associations
-​ A branch of science that deals with the and developmental agencies maintain and balance
principles and applications of nursing and the network.
related services. INTEL’S SHIFT LEFT MODEL:
-​ Knowledge base for understanding the other 3 -​ Patient care shifts from a high quality delivery
sciences of life through technology with increased costs
-​ Overarching goal for the use of the other 3 into quality of life with minimal health costs.
sciences within the sphere of the nursing
science
Assumptions
2. COMPUTER SCIENCE
-​ The ability to program the hardware to process Persons are caring by virtue of their humanness
nursing information ​ In nursing, caring is understood as the
-​ The skill in using software and understanding substantive focus of the discipline. It is not simply the
how they can work for processing nursing act or emotion one may portray toward another person
knowledge but also the substance of the domain that directs the
integral nature of nursing as a discipline of knowledge.
3. INFORMATION SCIENCE In the assumption, "persons are caring" is studied as
-​ The ability to access information, research and fundamental to the practice of nursing.
knowledge
-​ The ability to evaluate the quality of The ideal of wholeness is a perspective of unity
information and applicability ​ Derived from the ideal that persons are known
as wholes in ways shaped by philosophical truths and
4. COGNITIVE SCIENCE realities. The conceptualization of wholeness allows for
●​ Critical Thinking the recognition of human beings as complete in their
●​ Decision Making being without reference to the composition of parts.
●​ Problem Solving This ideal allows the nurse to focus on nursing as a
Cognitive science includes memory, problem solving, shared lived experience between the nurse and the
mental models, skill acquisition, language processing, person being nursed, rather than focusing on fixing the
and visual attention. person or completing the person's lack or missing
"parts."
DATA-INFORMATION-KNOWLEDGE MODEL
(DIKW THEORY)
​ Nursing Informatics is a specialty that Relationship between Structure & Function
integrates nursing science, computer science and Clarity
information science to manage and communicate -​ Locsin define Technological competence as
data, information, knowledge and wisdom into nursing caring in nursing
practice. Simplicity
​ Nursing informatics is an evolving, dynamic -​ Locsin's theory is simple using on knowing
process involving the conversion of data into framework for nursing care
information, and subsequently knowledge. Tautology

4. BENNER'S LEVEL OF EXPERTESE MODEL

Said that nurse must be able to continuously exhibit the
capability to acquire skills, and then demonstrate
specific skills beginning with the very first student
experience.
-​ novice, advanced beginner, competent,
proficient, expert

PHILIPPINE HEALTH CARE ECOSYSTEM

• Nursing informatics is a huge network that surround
all the sectors of the health care delivery system
-government agencies, health care facilities,
practitioners, insurance companies, pharmaceutical
companies, academic institutions, and suppliers.
02/12/26
●​ INPUT & OUTPUT
COMPUTER SYSTEMS Input Devices
●​ COMPUTER HARDWARE -​ These devices allow the computer to receive
-​ Defined as all of the physical components of information from the outside world.
computer Output Devices
-​ A computer is a machine that uses electronic -​ These devices allow the computer to report its
components and instructions to the results to the external world. Output devices are
components to perform calculations, repetitive defined as any equipment that translates the
and complex procedures, process text, and computer information into something readable
manipulate data and signals. by people or other machines.
RAM
-​ is a temporary storage area for program Major Types of Computers:
instructions and data that is being processed. It • Supercomputers
is only active when. computer is on • Mainframes
ROM • Microcomputers (Personal Computers or PCs)
-​ is permanent; it remains when power is off. • Handheld Computers/Personal Digital Assistants
Example? start up instructions for the computer. -​ Handheld computers are small, special
CPU function computers, although a few "full
-​ brain of the computer function" handheld computers were introduced
Motherboard in the late 1990s. Even though of smaller size
-​ main printed circuit board (PCB) found in than the laptop and notebook microcomputers,
computers and other expandable systems. It some have claimed to have almost the same
holds many of the crucial electronic functionality and processing capabilities.
components of the system, such as the central
processing unit (CPU) and memory, and Categories of Software:
provides connectors for other peripherals • There are three basic types of software: system
Graphics Card software, utility programs, and applications software:
-​ A video card (also called a graphics card, System software "bots up" (starts up and initializes) the
display card, graphics adapter, or display computer system; controls input, output, and storage,
adapter) is an expansion card which generates and controls the operations of the application software.
a feed of output images to a display device • Utility software consists of programs designed to
(such as a computer monitor). support and optimize the functioning of the computer
Sound Card system. itself.
-​ An internal expansion card that provides input
and [Link] audio signals to and from a System Software
computer under control of computer programs. -​ System software consists of a variety of
Modem/Router programs that control the individual computer
-​ Modem is a box that connects your home and make the user's application programs work
network to the wider Internet. A router is a box well with the hardware
that lets all of your wired and wireless devices
use that Internet connection at once and also Basic Input/Output System (BIOS)
allows them to talk to one another without -​ The first level of system control is handled by
having to do so over the Internet. the basic input/output system (BiOS) stored on
Monitor a ROM chip on the motherboard.
-​ A computer monitor is an output device that
displays information in pictorial form. Operating System (OS)
Impact Printer -​ An OS is the overall controller of the work of the
-​ Early impact printers worked something like an computer.
automatic typewriter, with a key striking an
inked impression on paper for each printed Utility Software
character. The dot-matrix printer was a popular -​ Utility programs include programs designed to
low-cost personal computer printer. It's an keep the computer system operating efficiently.
impact printer that strikes the paper a line at a
time. Common Software Useful to Nurses:
• In most hospitals, most software systems used by
nurses are based in a Hospital Information System (HIS)
Free Software 02/26/26

-​ Free software is defined by the FSF in terms of Information Technology System

four freedoms for software users to have the Applicable in Nursing Practice
freedom to use, study, redistribute, and improve
the software in any way they wish. A program is INTRODUCTION
only free software, in terms of the FSF definition, ​ This unit discusses the information technology
if users have all of these freedoms applicable in nursing practice which includes hospital
and critical care applications such as different
Open Source Software monitoring devices needed to care for patients, The
-​ Open source software is any software satisfying community health applications focus on the health
the open software initiative's definition information system of the community it is centered on
the majority part of the public which also emphasizes
OSS/FS Applications: the prevention of the disease, medical intervention, and
• Operating system public awareness.
-​ Linux
• Web browser PURPOSE & OBJECTIVES
-​ Chrome, Firefox At the end of this unit, students will be able to:
• E-mail client 1.​ Describe the informationtechnologyapplicable
-​ Thunderbird in nursing practice.
• Word processing or integrated office 2.​ Explain the application of nursing informatics in
suite/Presentation tools. the community health practice.

OSS/FS Healthcare Applications: HOSPITAL AND CRITICAL CARE APPLICATIONS

1.​ GNUMed ​ There are a lot of information technology
2.​ OpenEHR applications applicable in the hospital. It can be
3.​ OpenEMR branched out based on the major functional
4.​ OpenMRS departments in the hospital such as in the
Administration, Clinical, and Nursing. In the
administration department, let us say for instance, the
admission of the patient and retrieval of clinical records
uses computer applications to make the work effective
and efficient. In this discussion, we focus on the critical
care aspects and how the nursing division benefits
from the information technology.

Below is the list to sum up the various applications of

information technology in this setting particularly
focusing on patient care:
​ Process store and integrate physiological and
diagnostic information from various sources.
​ Present deviations from pre-set ranges by an
alarm or an alert.
​ Accept and store patient care documentation
in a lifetimes clinical repository.
​ Trend data in graphical presentetion.
​ Provide clinical decision support through alerts
alarms and protocols.
​ Provide access to vital patient information from
any location both inside and outside of the
critical care setting.
​ Comparatively evaluate patients from
outcomes analysis. Present clinical data based
on concept-oriented views.
PHYSIOLOGIC MONITORING SYSTEMS - Computer must have the appropriate computation.
Physiological monitors were developed oversee the Constant bolus must be injected at the appropriate
vital signs of the astronauts. By the 1970's these time in the respiratory cycle. saline = 10mL
monitors found their way into the hospital setting.
Physiologic systems consist of 5 basic parts: The Process of Thermodilution
1. Sensors ​ The influence of these user-related issues is
2. Signal conditioners negated by using heat of a thermal filament
3. File - rank and order information. embedded in the catheter to replace the injectate. An
4. Compurer processor - analyze data and direct alternative means of measuring cardiac output
reports. noninvasively, if provided by thoracic electrical
5. Evaluation or controlling component - regulate the biompedance. Four sensors are positioned on the sides
equipment analert the nurse. of the neck and thorax. Monitoring these changes
permits measurement of stroke volume: indices of
Microprocessors. Physiologic signals are typically of contractility such as velocity and acceleration of blood
very small amplitude and must be amplified flow, supraventricular rhythm, and index.
conditioned, and digitized by the device in preparation Using bioimpedance as factor integrated with analysis
for processing by its embedded microprocessors. It of the finger blood pressure waveform has also been
analyzes information, store pertinent information in demonstrated as a method of cardiac output
specific places and controls the direction in reporting. It measurement.
also alerts nursing personnel through a report, an nasal cannula = 7L; more kapag mask
alarm, or a visual notice. pulse deficit = differejce ng apical & radial pulse
​ Monitoring systems also store various data
elements with a time stamp derived from the Pulse Oximeter
monitoring system s internal clock. Pulse Oximetry
​ Physiologic monitoring systems typically have ​ A critical piece of hemodynamic information
modern platform allowing the selection of various involves the availability of oxygen to bodily tissues. The
monitoring capabilities to match the needs of a variety standard for measurement of blood’s oxygen
of clinical settings, More specialized monitoring saturation is co-oximetry. Pulse oximetry is a
capabilities such as intracranial pressure or bispectral non-invasive method of measuring oxygen saturation
index monitoring are also in modular format, that also uses spectrophotometry. Light is emitted
Physiologle monitors are usually built to incorporate through a pulsatile arteriolar bed and then detected by
both arrhythmic hemodynamic monitoring capabilities. photosensor.

HEMODYNAMIC MONITORS ANTICIPATED PROBLEMS

Machines under the human machine inter face used Largest contributor to alarms in the ICU caused by:
specifically for the following: 1.​ Blood pressure cuff
1.​ Measure hemodynamic parameters - closely 2.​ Tourniquet
examine cardiovascular function. 3.​ Air splint that may cause venous pulsations.
2.​ Evaluate cardiac pump output and volume 4.​ Limits the sensors' ability to distinguish between
status. arterial or venous blood pressure while pulse
3.​ Recognize patterns (arrhythmia analysis) and oximetry provides a measure of oxygen
extract features. delivered to the tissue, mixed venous oxygen
4.​ Assess vascular system integrity - evaluate the saturation provides a measure of the amount
patient's physiologic response to stimuli. of oxygen used by the patient.
5.​ Continuously assess respiratory gases
(capnography). ​ These problems usually cause nurses to spend
6.​ Continuously evaluate glucose levels. more time in troubleshooting and can lead to less
7.​ Store waveforms. hours doing the necessary bedside care. To prevent
8.​ Automatically transmit selected data to a these from happening, it is important for nurses to
computerized patient database. become familiar with the user guide of the respective
machines specifically on the trouble shooting part.
Thermodilution Technique Some pulse oximeters are more sensitive as compared
- The bolus must be injected within 4 seconds. Amount to the others, some need specific charging times, and
solution must be accurate temperature of the injective. some are more durable than the others.
Must be measured and accurately maintained.
Catheter must be properly placed.
Telemetry into the CCIS. Automatic calculation of physiologic
​ Hemodynamic monitoring can take place at indices can be performed.
the bedside or can be conducted from a remote
location via telemetry. Telemetry allows for the - DECISION SUPPORT
continuous monitoring of patients usually outside of the ​ The CCIS can provide alerts and reminders to
ICU. Telemetry monitoring is susceptible to signal loss. guide care in accordance with evidence-based
Remember that computer-based hemodynamic guidelines. Point of care access to knowledge bases
monitoring offers the critical care nurse a wealth of that contain information on evidence-based guidelines
information that does not replace clinical judgment. of care, drug information, procedures, and policies.
Data can be integrated with patient information.
ARRHYTHMIA MONITOR
​ Computerized monitoring and analysis of - MEDICATION MANAGEMENT
cardiac rhythm have proved reliable and effective In Can facilitate the medication,administration process.
detecting potentially lethal heart rhythms. A key Medication,administration of,flowsheets incorporate the
functional element is the system's ability to detect use of bar code technology.
ventricular fibrillation and respond with an alarm.
SYSTEM TYPES: Detection Surveillance Diagnostic or - PROVIDER ORDER ENTRY
Interpretive. ​ Electronic entry and communication of patient
orders can help clinicians improve communication,
WHAT IS THE DIFFERENCE? streamune processes, facilitate care, and can help
​ In the detection system, the criteria for a clinicians, all providers in managing quality.
normal ECG are programmed into the computer.
Interpretive systems search the ECG complex for five
parameters. Location for QRS complex; time from the
COMMUNITY HEALTH APPLICATIONS
beginning to the end of the QRS; comparison of
amplitude, duration, and rate of QRS complex with all ●​ Focuses on the health information system of
Limb leads P and T waves; comparison of P and T the community, it is centered on the majority
waves with all limb leads. part of the public.
●​ Emphasizes the prevention of the disease,
CRITICAL CARE INFORMATION SYSTEM (CCIS) medical intervention, and public awareness.
​ A system designed to collect, store, organize, ●​ Fulfills a unique role in the community,
retrieve, and manipulate all data related to care of the promoting and protec ing the health of the
critically ill patient. CCIS is the organization of a community at the same time maintaining
patient's current and historical data. CCIS allows the sustainability and integrity of health data and
free flow of data between the critical care unit and information.
other departments. Provides a rich repository of patient
information that can be integrated for use in outcomes GOAL OF COMMUNITY HEALTH INFORMATICS
management. Each patient's data can be accessed Effective and timely assessment that involves
from any terminal or workstation. This capability can monitoring and tracking the health status of
extend across units and departments or be restricted populations including identifying and controlling
to a single unit. CCIS include: Patient management disease outbreaks and epidemics.
service, length of stay, morality, readmission rates.
PRIMARY FOCUS OF COMMUNITY HEALTH INFORMATION
- VITAL SIGNS MONITORING SYSTEM
​ Vital signs and other physiologic data can be ●​ Preventing, identifying, investigating,
automatically acquired from bedside instruments and and eliminating
incorporated into the clinical database. Data can be communicable health problems.
incorporated into flow sheets with other data elements ●​ Accessibility of data and information, through
such as laboratory results body system assessment communication.
findings problem lists. ●​ Educating and empowering individuals to
adopt health lifestyle.
- CLINICAL DOCUMENTATION ●​ Facilitate the retrieval of data.
​ Support the process of physical assessment ●​ Effective transformation of data into
findings, As the critical care environment requires information.
frequent assessments, these flowsheets may be
configured to ease this extensive data collection.
Flowsheets may also be organized by body system. All
disciples can document patient assessment findings
COMPUTER BASED SURVEY SYSTEM 03/05/26

Health Statistical Surveys AMBULATORY CARE SYSTEMS

●​ Are used to collect quantitative information
about items in a population to establish certain ​ The ambulatory care nurse focuses on patient
information from the obtained data. safety and the quality of nursing care by applying
●​ Focused on opinions or actual information appropriate nursing interventions, such as identifying
depending on its purpose and many surveys and darifying patient needs, performing procedures,
involve administering question to individuals. conducting health education, promoting patient
advocacy, coordinating nursing and other health
ADVANTAGES services, assisting the patient to navigate the health
• Consistent exchange of response care system, and evaluating patient outcomes.
• Disease tracking ​ The ambulatory care covers a wide range of
• Data and information sharing. Building strategies. services that can be offered to patients that needs
• Early detection and monitoring of disease and medical [Link] integrating the ambulatory care
sickness - control of spread of disease. information system in the nursing practice will really
• National alertness and preparedness - building strong help in making the work easy like the processing of
communication. data and information and the billing and charges etc.

PHILIPPINE INTEGRATED DISEASE SURVEILLANCE AND There are advantages of the ambulatory care
RESPONSE (PIDSR) information. Like:
​ A multi-faceted public health disease 1.​ the access of medical records of patients to
surveillance system that provides public health officials health care providers
the capabilities to monitor the occurrence and spread 2.​ the nurses will be able to give quality care and
of diseases. improve workflow, reduce medical errors
Goal: 3.​ the management and monitoring of the billing,
-​ Strengthen the surveillance and response doctor's fees, prescriptions and many more.
capabilities at each level of the health system ​ One of the most important responsibility of a
by building local capacities and leveraging nurse is to make sure that the patient receives the care
strengths and areas of expertise through that he/she needed and with the use of this system I
partnership and coordination. believe the quality of care can be glven.

FUNCTIONS EMERGENCY PREPAREDNESS AND RESPONSE

1. ​ Same with the objective in the application of
2. informatics in community health, the over-all objective
3. is public health. The only difference is the focus and
4. Provide detailed data to control programs to level of prevention. In Community Health, the focus of
facilitate the identification of specific disease the use of informatics is on the promotive and
trends. preventive side, while in emergency preparedness and
5. Work with cities and provinces and partners to response focus in the mitigation and control of
implement and assess prevention and control emergencies. The use of informatics here is much
programs. wider and critical. The need for information in real-time
is very crucial in saving the lives of many.

​ Based on Weiner and Slepsk (2012) the modern

movement toward HEl could go a long way to
expanding information outreach to victims of disasters
and humanitarian crises. Although not the primary
reason for the legislation that has provided such
sanctioned growth in electronic health care records, for
once an unintended consequence has a possible
positive effect. Other efforts to expand and upgrade
communications to all populations have benefits for
the disaster community as well. As an example, radio
frequency Identification (RFID) technology hold such
promise with early prototypes tagging victims with
treatment and other information. Longer range RFID
tags and readers will make it possible to continuously
track victims as they move through the system from
evacuation to treatment facilities (National Research Purpose of Emergency Preparedness and Response:
Council, Committee on using Information Technology 1.​ Minimize the risks of emergencies occuring.
to Enhance Disaster Management, 2007). 2.​ Identify the emergency situations.
3.​ Maintaining essential health and community
​ Improved decision support and resource services despite disruptions.
tracking/allocation tools brings added intelligence to
the disaster situation. For example, better available Radiofrequency Identification (RFID) is a wireless
collaboration software and file sharing have benefited technology that uses radio waves to identify, track, and
the recent business world and can serve to better store information about objects, people, or animals. It
reduce duplication of efforts during times of disaster. At works like a barcode, but instead of scanning with a
the same time, distributed emergency operation laser, RID uses small tags and a scanner to read data
centers provide resources in a less centralized manner without direct contact.
that aids in the distribution of planning, coordination,
and scheduling. Computer assisted decision-making Administrative Assistive Device
tools and intelligent adaptive planning provide It refer to tools and equipment that help with
alternatives to decisions that are typically made in a administrative tasks, improving efficiency, accuracy,
vacuum.​ and accessibility in workplaces like hospitals, offices,
and others. In a healthcare setting, these devices assist
​ Bio surveillance is a key capability of obtaining nurses, doctors, and administrative staff in managing
and maintaining situational awareness before and patient records, scheduling, communication, and
during a health emergency. Early recognition and documentation.
understanding of departures from human, animal,
plant, and environmental baselines, including detection Purpose of AAD:
of novel occurrences, is necessary to give early warning 1.​ Automating and simplifying routine tasks dor
and save lives, however, detecting deviations from the better efficiency
norm is complicated because of the complexities of 2.​ Minimizing manual efforts through ergonomic
systems and variables and the multiple stovepipes that and assistive technologies
exist. Many efforts are underway to improve data
collection, sharing, and analysis. Informatics and Electronic Health Records (EHRs) are digital versions of
technology solutions such as smartphones, tablets, and a patient's paper medical chart. They contain
other wireless devices may help to gather signals to comprehensive health information, including medical
detect potential incidents earlier, regardless of the history, diagnoses, medications, treatment plans. These
cause, and communicate early warning and critical devices assists the nurse with their day-to-day
updates and foster electronic information exchange handling of patients allowing them more time to
worldwide. Rapid detection is critical to save lives and efficiently manage care of patient,
improve incident outcomes, and the United States
serves in a key role as part of global surveillance Patient Monitoring Systems are medical devices and
network. software that track a patient's vital signs and health
status in real-time. These system allows for continuous
monitoring of patient health drastically reducing time
Emergency Preparedness & Response
for nurses in gathering vital signs and more time for
●​ Emergency Preparedness and Response treatment and health teaching plans.
focuses on action taken before an emergency
occurs. TELEHEALTH
●​ The modern movement towards Health ​ According to Mayo Clinic (2020), telehealth is
Emergency Informatics (HEI) enhances the use of digital information and communication
information access for disaster victims and technologies, such as computers and mobile devices,
humanitarian crises (Weiner & Slepski, 2012). to access health care services remotely and manage
Although electronic health records (EHRs) your health care. These may be technologies you use
were not originally intended for disaster from home or that your doctor uses to improve or
response, their expansion has had positive support health care services.
effects. Improved communication systems also
benefit disaster management. Consider for example the ways telehealth could help
you if you have diabetes. You could do some or all the
following:
• Use a mobile phone or other device to upload food
logs, medications, dosing, and blood sugar levels for
review for a nurse who responds electronically.
• Watch a video on carbohydrate counting and in tracking and forecasting the related impact data. Let
download an app for it to your phone. us look at some of the major ways informatics shines
• Use an app to estimate, based on your diet and during the critical time and some resources to aid in
exercise level, how much insulin you need. these processes.
• Use an online patient portal to see your test results,
schedule appointments, request, prescription refills or SUPPORTING THE DAY TO DAY
email your doctor. Information Technology (IT) and Informatics Specialists
• Order testing supplies and medications online. (S) are integral to all emergency actions taken by
• Get a mobile retinal photo screening at your doctor's health care organizations during a pandemic. This
office rather than scheduling an appointment with a includes addressing supply chain and labor shortages,
specialist. business partner considerations, telecommuting,
• Get email, text, or phone reminders when you need a enhanced physical and technological, security,
flu shot, foot exam, or other preventive care. continuity, and disaster recovery planning, and
monitoring supplies of personal protective equipment
TELEHEALTH GOALS (PPE) (AEHIS Incident Response Committee, 2020).
Also called e-health or m-health (mobile health),
include the following: Specific attention is also required from IT and IS to
●​ Make health care accessible to people who live organize the following:
in rural or isolated communities. 1. Mass Notifications - digital experts often spearhead
●​ Make services more readily available or innovations in mass notification to ensure staff are
convenient for people with limited mobility, updated immediately as the crisis evolves. "Healthcare
time, or transportation options. systems may want to ensure that they test their mass
●​ Provide access to medical specialists. communications systems and procedures to ensure
●​ Improve communication and coordination of that they can get critical information into the hands of
care among members of a health care team staff as quickly and efficiently as possible. (AEHIS
and a patient. Incident Response Committee, 2020).
●​ Provide support for self-management of health
care. 2. Client Information - IS experts have found innovative
ways to provide COVID-19 support to clients in some
​ In the Philippines, we have also adopted health organizations. For instance, Siwicki (2020)
telehealth and have become an increasing necessity described how the Montefiore Health System in New
with the emergence of the pandemic and York City harnessed chatbot Al technology to support
implementing the community quarantine measures. To client information. "Staff wanted to offer patients the
promote safety among the public, telehealth has been ability to be directed to Montefiore information, but also
adopted by private and government hospitals. The be in a position to get answers to key questions they
University of the Philipnes - Manila (UPM) is one of the had about COVID-19. Being in New York City, they were
earliest in the Philippines who adopted the telehealth in facing an increasing volume of calls coming into
1998. They established the UP National Telehealth doctor's offices, an increased demand for services, and
Center with the commitment is to engage people to worried patients coming into the emergency rooms
use available technologies to improve health care and hospitals. Chatbot technology was meant to be an
albeit distance barriers. Since its conception, it offering to provide value to patients and direct them to
continues to develop telehealth applications derived the care they needed.
from people's own problem-solving contributions.
Through research-cum-service activities, the center 3. Client Teaching - IS experts may also be involved
helps both patients and health care providers with the development of client health promotion and
maximize widely available and cost-effective ICT tools prevention teaching materials that target COVID-19,
to improve delivery of health care. such as brochures, infographics, handouts, videos,
games, and other interactive and engaging
INFORMATICS IN THE TIME OF COVID-19 productions. For instance, IS may work with
​ 2020 has proven to be an unprecedented year organizations such as the Public Health Agency of
in modern history, and it has barely begun! The Canada to produce infographics to educate the public
emergence of the COVID-19 pandemic has caused on Social Distancing.
major impacts on global society, including huge
challenges for health care. No one in this planet is 4. Privacy of Health Data - IS and IT also dedicate a lot
immune to these sweeping changes, as many joins in of energy to ensure staff and clients stay safe: this
the efforts to contain this virus. Informatics teams are a includes protecting their personal health information
critical part of these efforts, serving as support, (PHI) as well as employee data. It also entails securing
facilitating new methods of delivering care, and aiding organizational systems and educating staff about
potential COVID-19 inspired scam and malware 03/12/26

attempts, as well, policies related to PIH in the time of a INFORMATICS APPLICATION IN EVIDENCED-BASED
pandemic should be reviewed and revise, as NURSING PRACTICE
necessary. One example of potential policy tips is
available through the US system, as a bulletin: HIPAA
Privacy and Novel Coronavirus. Evidence-based practice (EBP) is the process of
collecting, processing, and implementing research
5. Equipment Disinfection - all equipment used within findings to improve clinical practice, the work
health organizations must be protected and disinfected environment, or patient outcomes.
if used more than once, including electronics.
"Particular attention is needed to address sanitation of 5 A's in Evidence- Based Practice
mobile devices that are handed off by workers between 1. Ask
shifts or handed from patient to patient." (AEHIS -​ identify problem
Incident Response Committee 2020). P: patient
I: intervention
6. System Interoperability - EHR based rapid screening C: comparison
processes, laboratory testing, clinical decision support, O: outcome
2. Acquire
reporting tools, and patient-facing technology related
to COVID-19 are all supported by system -​ searches for best available research evidence
interoperability. A great paper addressing these 3. Appraise
functions is available from Reeves et al., 2020). -​ critically evaluate the research; reliabiloty,
validity, applicability
4. Apply
-​ integrate the best evidence with clinical
expertise and patient preferences
5. Asses
-​ evaluates if the intervention improved patient
outcome

COMPUTERIZED NURSING CARE PLAN

KEY FEATURES:
> Automated Care Plan Generation: CNCPs utilize
patient assessment data to automatically generate
tailored care plans, reducing the time nurses spend
documentation.
> Standardization: By employing standardized nursing
terminologies and classifications, CNCPs ensure
consistency in care planning across different
healthcare settings.
> Integration with Electronic Health Records (EHRs):
These systems seamless integrate with EHRs, allowing
for real-time updates and access to compreh patient
information.

CRITICAL PATHWAYS
- also known as clinical pathways are structured
pathways multidisciplinary care plans that outline
essential steps in the care of patients with specific
clinical problems. They aim to standardize care,
improve outcomes, and optimize resource utilization.

EXAMPLE:
●​ Day 1 (Emergency Phase)
-​ Immediate brain imaging (CT scan) to confirm
the type of stroke.
-​ Administration of thrombolytic therapy (if
eligible) to dissolve blood clots.
 -​ Close monitoring of vital signs and neurological
status.

●​ Day 2-5 (Acute Care & Rehabilitation Phase)

-​ Start physical, speech, and occupational
therapy to improve movement and speech
-​ Monitor for complications like infections, blood
pressure spikes, or secondary strokes.

KEY COMPONENTS:
> Timeline: Specifies the expected progression of care
activities and patient milestones over time.
> Interventions: Details the specific medical, nursing,
and allied healt actions required at each stage.
> Expected Outcomes: Defines measurable goals that
the patient shou achieve as they progress through the
pathway.
> Variance Tracking: Monitors deviations from the
pathway to identif areas for improvement.

Features Computerized Critical

Nursing Care Pathway
Plan (CNCP)

Purpose Helps nurses Provides a

create and structured
update guideline for
personalized managing a
care plans for specific
individual condition
patients. efficiently.

Focus Nursing-specifi Multidisciplinary

c interventions approach
tailored to covering all
patient needs. healthcare
professionals.

Flexibility Highly Follows a fixed

adaptable sequence of
based on a interventions
patient's unique and outcomes.
condition.

CLINICAL GUIDELINES