Requirement for Nursing Informatics

1. The Internet
Apalin, Ruth Rendell
BSN 3A1-3
Batang, Jonalyn
Muliloda, Fatima
Nacua, Hannah
Nicolas, Michelle
Pino, Alysa

2. Internet
 Worldwide network of
interconnected computer
networks that operates using a
standard set of
communications

3.  Any communications network that
can carry two-way digital data can
also carry Internet traffic; thus,
Internet traffic flows through
networks that use conventional
copper wire, coaxial cable, optical
fiber and radio waves.

4.  The internet is named after the
Internet Protocol, the standard
communications protocol used
by every computer on the
Internet.

5. Brief History of the Internet

6. Vannevar Bush
 Wrote the first visionary
description of the
potential uses for
information technology
with his description of
the “memex” automated
library system.

7. Norbert Weiner
 Invented the Field
of Cybernetics,
inspiring future
researchers to
focus on the use
of technology to
extend human
capabilities.

8. 1956 Dartmouth Artificial Intelligence
Conference
 Crystallized the concept that
technology was improving at an
exponential rate, and provided the
first serious consideration of the
consequences.

9. Marshall McLuhan
 Made the idea of a
global village
interconnected by
an electronic
nervous system
part of our popular
culture.

10.  I nternet vs. i nternet
 An internet (small “i”) refers to any
network of computers
 The Internet (large “I”) is a specific
name
 Given to the communication
network comprised of hundreds of
thousands of inter-connected

11.  On October 4
,1957 the Soviet
Union launched
the first satellite
called Sputnik

12.  This prompted then
United States President
Dwight Eisenhower to
create the Advanced
Research Project
Agency (ARPA).
ARPA was tasked with
the job to regain the
technological lead in the

13.  ARPA formed the Information Processing
Techniques Office (IPTO) to do research on
a Semi Automatic Ground Environment
(SAGE) program to help protect the US
against a space-based nuclear attack.
IPTO pushed the benefits of a country-wide
communications network .

14.  The Department of Defense got
together with the Massachusetts
Institute of Technology (MIT)
and created…
 ARPAnet (Advanced Research
Projects Agency) to develop an
alternative communication system
that could enable the military to
function in the event of a nuclear
strike.

15.  1970’s brought about Stanford
University’s testing and
development of early internet
protocols
 Vinton Cerf -- Father of the Interne
 1980’s & National Science
Foundation
 NSF obtained control of network fo
government and educational use

16. Technologies Behind
the Internet

17. Standard protocols enable the Internet to
function. It can be treated as the standard
language for the Internet.
Protocols determine the following:
Data transmission between 2 devices
The type of error checking that will be
performed.
Data compression
Signals and notifications

18. The main protocols on which the functioning of the Internet is
dependent are listed below:
 Transmission Control Protocol (TCP) –
allows computers to connect to a network
and exchange data; carries the task of
breaking messages into small packets
(datagrams)
 Internet Protocol (IP) – considered a
lower level protocol which is responsible
for making decision on the packets and
routing them.

19. Other protocols used on the Internet are the
following:
 Hypertext Transmission Protocol
(HTTP) – which supports the World
Wide Web (WWW)
 File Transmission Protocol (FTP) –
permit users to send all types of
electronic files over the Internet

20. Anatomy of a Web
Address

21.  Web addresses are also referred to as URLs. It can
identify a specific machine, directory and file of that
machine
 Example:
 https://www.facebook.com/
 HTTP – short for Hypertext Transfer Protocol
described as the transmission protocol, introduces a
web document or directory
 WWW – Short for World Wide Web
 Directory – The directory or folder(s) in the web
server that contains a group of related web pages

22.  Domain Name – identifies the computer name,
web server name, web name or host name. The
Internet Domain Name System (DNS) permit
users to give globally unique names to
networks.
 Top level domains:
 .edu – educational site (for a university or
college)
 .com – commercial business site/computer
 .gov – government/non military site
 .mil – military sites or agencies

23. Web Navigation and
Search Engines

24. There are 4 domains and 5 basic techniques
in web navigations
 Directions:
 Back – go back to the previous page (alt+left arrow
key)
 Forward – go forward to a new page after going
back (alt+right arrow key)
 Link – click a link and jump to a new page
 Jump – select a new page from external source such
as bookmarked sites

25.  Techniques:
 Surfing – Jumping ahead of the browser if the link
is already loaded but the rest of the page is lagging
behind
 Chains – After clicking several websites, a chain of
internet pages are created and explored backward or
forward.
 Reload – refreshing the page to ensure that the latest
copy is loaded
 Stopping – Stopping the loading process of a site
anytime the user wants.
 Restarting – Stopping the connection and clicking
the same link again

26. Few examples of Search Engines:
 Yahoo!
 Google
 Ask.com

27. Two types of Search Engines:
 Directories
 good at identifying general information
 Ex.: Yahoo Directory
 Indexes
 Identify text on the given criteria by searching contents
of websites through the use of software and programs
called robots and spiders that analyze millions of
webpages
 Ex.: Google & Yahoo Search

28. Electronic Mail (E-mail)
 Program was developed by Ray
Tomlinson in 1972
 He introduced the @ symbol
 In 1973, 75% of the traffic was
E-mail
 One of the most popular uses for
the Internet remains the ability to
send & receive electronic mail
 Ex.: Yahoo Mail, Gmail &

29. Anatomy of an Email
Address

30. Internet works by connecting computers using the same
protocol. Therefore, all email addresses are using the same
format.
 Example: hyper_yke@yahoo.com
 Name (Username) – the name of the owner of the
address. Users can devise their own name based on
their availability.
 Email Provider/Organizational Code – denotes the
email providers or Organizational Code in
conjunction with the organizational website
 Domain – corresponds to the high level domain
names

31. Evaluating Quality
Health Information on
the Internet
The health summit working group
has identified the major criteria to
evaluate an internet site.

32. The criteria identified include the following:
 Credibility – source of information &
timeliness of the content
 Content – to help judge accuracy, examine the
hierarchy of events and presence of original
sources
 Disclosure – the purpose & moderator of the
site
 Links – the quality of links provided by the site
 Design – site accessibility & convenience of
use

33. Mobile Computing
in Nursing

34.  Mobile Computing in Nursing provides valuable insights into
how nurses are using computing solutions at the bedside &
how these solutions can best be used to solve existing
workflow inefficiencies.
 Mobile computing makes it easy to stay connected no matter
where you are; or gamers enjoy peer-to-peer interaction;
photographers can send immediate downloads; and employees
can telecommute from different time zones
 Tablet PCs are wireless devices that provide the most
promising trend in mobile computing. The slightest of them is

35. Wireless Devices

36.  Wireless devices and devices with
wires almost perform the same
functions but wireless devices have
many advantages over the other
devices with wires.
 It facilitates people to work in different
places where they cannot take the
devices with wires attached to them.

37.  In wireless devices, the data is
transferred in the form of
electromagnetic waves (which are
the main part of electromagnetic
spectrum present in the atmosphere)
 Communication through wireless
devices is known as Wireless
Communication.

38. Other electronic devices:
 Laptop – a wireless computer that anyone can take it
with him or her with all the data stored in it.
 USB – with the help of USB, one can transfer the
date from one place to another by taking that stick in
his or her pocket
 Cell phones – Cell phones have become the most
used wireless device by people in which the
communication is done by using radio frequencies
through different service provider stations
 PDAs
 Radio, etc.

39. Nurses and the
Internet

40.  Contemporary nursing practice has changed
tremendously over the last decade.
 Professional competencies for new nurses now
include informatics, case management, health
care policy, cultural sensitivity and disaster
preparedness.
 The study of nursing involves life sciences,
psychology, social services, patient education,
and ethics, in addition to the traditional medical
knowledge base.

41.  The ability to use the internet is an
essential skill for both nursing students
and nurses, both to support their studies,
especially as nursing students spend a lot
of their time in placement away from the
university campus and to support their
development of skills in using what is
becoming an increasingly essential tools
for professionals.

42. US Government Medical
& Health Informatics
Resources
• The US federal
government
provides some
of the most
important
sources of
online
information for
medical
professionals
as well as
health
consumers.

43. NLM Gateway
 A handy entry point for searching the resource
at the National Library of Medicine.
 Provides a global search function for PubMed
PubMed Central, and MedlinePlus.
 Search results include consumer health
information.
 An excellent place to begin a search of health
related government information.
 Access: http://gateway.nlm.nih.gov/gw/Cmd

45. Resource for Medical
Professional and
Researchers

46. Agency for Healthcare Research and Quality
(AHRQ)
• This federal agency
both conducts and
sponsors research on
healthcare quality,
safety and cost
effectiveness.
• It’s “Consumers &
Patients” links
provide information
on specific
conditions, health
insurance plans,
Access:
http://www.ahrq.gov/

47. National Institute of Nursing Research
• One of the National
Institutes of Health,
this organization’s
mission is to support
research in nursing in
clinical and community
settings through grants
and other funding
programs.
• It provides information on its
own funding initiatives,
including diversity programs
and resources, links to
nursing organizations for
various specialties, and
publications from national
Access:
http://ninr.nih.gov/nindr/index.html

48. PubMed Central
• A free digital archive
of life sciences
journal literature.
• The site offers
access to the full
text of more than
160 high-quality,
open access life
sciences journals
Access:
http://www.pubmedcentral.nih.gov/

49. Center for Disease Control and Prevention
• It’s mission is
to monitor
public health,
put forth
prevention
initiatives,
investigate
health problems
& promote
Access:
http://www.cdc.gov/

50. Healthfinder
• This consumer
health information
site is maintained by
the National Health
Information Center
of the US
Department of
• It is a hand
selected directory
of the health
related web sites of
more than 1,500
organizations
(government ,
Access:
http://htalthfinder.gov

51. Medline Plus
• A consumer health
resource that brings
together
information from
various government
agencies including
the National
Library of
Medicine, the
National Institutes
for Health, and
Its medical encyclopedia, drug and
herbal supplement information,
current health news, and superior
interactive tutorials are excellent
Access:
www.rtlm.nih.gov/medlineplus/tutorial.html

52. National Institutes of Health
• Another directory of
consumer health
information, this site
has a simple design
and is organized by
conditions, body
systems, type of
patient, etc.
• It also provides links
to MedlinePlus and
to specific institutes
within NIH
Access: http://www.health.nih.gov/

53. Non – Governmental
Portals

54. BioMed Central
• This resource
publishes more than
140 open access
journals covering all
areas of biology and
medicine
• Included are
journals on
nutrition, public &
international health
& BMC nursing,
Access:
http://www.biomedcentral.com/home

55. Mayo Clinic: Tools for Healthier Lives
• Though aimed at the
layperson, nurses and
students will welcome the
plethora of information
and tools provided by the
Mayo Clinic• Users can choose
“Diseases &
Conditions”, “Drugs &
Supplements”,
“Treatment Decisions”,
“Healthy Living”, “Ask a
Specialist” and “Health
Tools.
Access: http://www.mayoclinic.com

56. Online Journal of Issues in Nursing
 OJIN is a free, peer reviewed, international
journal addressing topics affecting nursing
practice, research, education and the wider
health care sector.
 OJIN presents timely information required
by nurses and other health care
professionals to provide current and
informed patient care, to be socially
responsive healthcare professionals and to
meet professional development needs.Access: http://www.nursingworld.org/ojin

58. Public Library of Science
• PLoS is an initiative by
scientists & doctors to
publish quality, peer
reviewed literature and make
it freely available to the
public and other researchers.• It publishes journals in
biology, medicine, clinical
trials & genetics.
Access: http://www.plos.org/

59. World Health Organization
• An excellent
source of global
health
information,
including statistics
and country by
country health
overviews..
• This site is well
indexed & easy to
navigate.
Access: http://www.who.int/en/

60. Nursing Specialties &
Disease Specific Sites

61. Alzheimer's Association
• The Alzheimer’s
Association provides
information and support
to family members,
caregivers and health
professionals on
Alzheimer’s disease.
• It is updated daily and
includes news,
resources &
information.
Access: http://www.alz.org/

62. HIV InSite: Gateway to AIDS Knowledge
• San Francisco School of
Medicine gives
comprehensive, up-to-
date information on
HIV/AIDS treatment,
prevention, and policy at
this site.
Access:
http://hivinsite.ucsf.edu/

63. Oncolink
• University of
Pennsylvania cancer
specialists launched
this site in 1994 to
“help cancer
patients, families,
health care
professionals and
the general public
get accurate cancer-
related information
Access: http://www.oncolink.com

64. Public Health Nursing Section of the
American Public Health Association
• This site provides
current health related
news, links to
information about
public health
advocacy, articles of
concern to public
health nurses, ask an
expert sites, and a
discussion forum on
public health nursing.
• A good all-purpose resource for
nurses with an emphasis on
public health.
Access:
http://www.csuchico.edu/~horst/index.html

65. Study Aids for
Nursing Students

66. AMA Medical Ethics Web pages
 The American Medical
Association (AMA) offers
resources and information
about medical ethics.
 One especially helpful resource
for nursing students is their
“Virtual Mentor”, an
interactive, Web based forum
for analysis and discussion of
ethical & professional issues.Access:
http://www.amaassn.org/ama/pub/category/2416.html

67. Geriatric Assessment-Case Studies
 The Virtual Health Care Team Web
Site is sponsored by the School of
Health Professions and the School of
Medicine at University of Missouri.
 The approach, as explained authors, is
an integrated team approach in which
“team members actively coordinate
care and services across disciplines in
a process resembling problem-based
learning.”
Access: http://www.vhct.oirg/index.shtml

68. Gray’s Anatomy of the Human Body
 It features 1,247 pictures
from the classic 1918
publication, as well as a
subject index with 13,000
entries.
Access: http://www.bartleby.com/107/

69. Human Anatomy Online
 Easy to navigate, the user
begins by choosing among ten
systems: skeletal, digestive,
muscular, lymphatic, endocrine,
nervous, cardiovascular, male or
female reproductive and
urinary.
 Graphics are interactive and
users can view animations of
the system, tutorials and
descriptions.Access: http://www.innerbody.com/htm/body.html

70. McGill University Virtual Stethoscope
 It is a multimedia tutorial featuring a virtual stethoscope
to assess both respiratory and cardiovascular conditions.
 Also included is a review of selected cardiac and
pulmonary physiology and pathophysiology topics
 Some examples are Biomedical Ethics & Law in
Clinical Practice, Clinical Nutrition, Histology, EKG
Tutorial, Gastroenterology, Endoscopic Pathology,
Immunology, and Virtual CPR.
Access: http://www.sprojects.mmi.mcgill.ca/mvs/mvsteth.htm

72. Merck Manual of Diagnosis and Therapy
 The Merck Manual’s 17th,
Centennial Edition is available free,
searchable by keyword or the table
of contents.
 It also offers two other complete
manuals through this site:
 The Merck Manual of Geriatrics
 The Merck Manual of Health & Aging
Access:
http://www.merck.com/mrkshared/mmanual/sections.jsp

73. Physical Exam Study Guides
 Created by the University of Florida
Medical Program, these guides are
thorough and clear.
 The exams offered are:
 Vital Signs
 Back & Extremity
 Chest & Lung
 Cardiology
 Head and Neck
 Eye
 Abdominal
 Breast
 Pelvic
 Neurologic & Mental Status
Access:
http://www.medinfo.ufl.edu/y
ear1/bcs/clist/index.html

74. RN Central
 Created by nurses for nurses and
students, this site offers good resource
links, but the highlight is its “Care plan
Corner,” with predefined nursing care
plans under 3 categories:
 Altered/Alterations
 Impaired/Impairment
 General
 Users can copy, save or print and
modify any of the plans, and there is
also a blank plain template to print out
and fill in
Access:
http://www.rncentral.com

75. RxList
 Information provided for each drug
includes the description, clinical
pharmacology, indications and
dosage, side effects and drug
interactions, warnings and
precautions, drug over dosage
contraindications and patient
information.
 Words in the articles and
descriptions that may need to be
defined for the layperson or student
are hyperlinked to Taber’s online
Access: http://www.rxlist.com

76. Philippine Based
Nursing Resources

77. Philippine Nurses Association
Founded on September 2, 1922 as Filipino Nurses Association (FNA) in
a meeting of 150 nurses presided by then Anastacia Giron Tupas (Mrs.
Tupas), the FNA was incorporated in 1924. The International Council of
Nurses accepted the FNA as one of the member organizations during the
Congress held in Montreal, Canada on July 8-13, 1929. The FNA
became the PNA (Philippine Nurses Association) in 1966, which was
the same year that the office at 1663 F.T. Benitez Street, Malate, Manila
was inaugurated.
Today there is a total of 368,589 licensed nurses (February 2005) in the
Philippines and produces an average of 13,000 new nurses every year.
The PNA was awarded the Most Outstanding Accredited Professional
Organization by the Professional Regulation Commission in 2003
besting 40 other professional associations and was five-time nominee
for the same award.

79. Nurse Directory
 Contains information regarding
nursing industry including
Nurse Companies, Nursing
Review Centers, Nursing
Schools, Care Givers, and
Nursing Articles

80. Decision Support System
 DSS are automated tools designed to support
decision making activities and improve the
decision making process and decision
 Such systems are intended to use on enormous
amounts of data that exist in information
systems to facilitate decision process

81. Clinical Decision Support Systems
 As explained by Wyatt and Spiegelhater, they
regard CDSS as active knowledge systems that
use two or more items of patient data to
generate case specific advice
 Designed to integrate a medical knowledge
base, patient data and an inference engine to
generate case specific advice
 A CDSS is designed to support healthcare
providers in making decisions about the
delivery and management of patient care

82. A CDSS program’s goals include:
 Patient safety and improved outcomes for
specific populations
 Compliance with clinical guidelines,
standards of practice, and regulatory
requirements.

83. Components of
CDSS

84. 1. Integrated Real Time Patient Database
 Combines patient data from multiple
sources
 Ex.: Lab, Radiology, Pharmacy Data, etc.
 This is needed to provide context for
results interpretation

85. 2. Data-driven Mechanism
 Allows event triggers to go into
effect and activate alerts and
reminders automatically

86. 3. Knowledge Engineer
 Translate the knowledge
representation scheme used in the
system so clinical knowledge in the
system can be extracted and
translated into machine executable
logic

87. 4. Time driven mechanism
 Permit automatic execution of programs at a specific
time to alert healthcare provider to carry out a
specific function or ensure that action has been
completed
 Ex: Medication administration, Time Alerts

88. 5. Long Term Clinical Data Repository
 Data collected over time from a
variety of sources allowing a
longitudinal patient records.