This document discusses the history and development of nursing informatics in Canada from the 1990s onwards. It highlights several key initiatives and milestones: 1) The Canadian Nurses' Association recognized the need for nursing data to be included in the national health information system in the early 1990s. 2) In 1998, a national steering committee was formed to address nursing informatics issues and develop strategies to ensure nurses have the necessary competencies. 3) The National Nursing Informatics Project worked to develop a national consensus on definitions, competencies, and education priorities in nursing informatics.

1. "Registered nurses need to be able to demonstrate
their unique contribution
to the health of Canadians within Canada's rapidly
evolving health care system.
Basic, essential nursing information is required by
nurses, employers, researchers, educators, policy
makers, and clients so that informed decisions can be
made about nursing's role in the changing health care
system,”.

2. Canadian Nurses'
Association, 1993: Policy
Statement on Health
Information
The Canadian Nurses’ Association wrote this policy statement
to highlight the importance of developing the nursing data
components that will be included in their emerging national
health information system. The CNA has also spearheaded an
initiative, the National Nursing Informatics Project, to begin
to develop a national consensus on definition, competencies,
and educational strategies and priorities.

3. “Nurses in Canada have made an enormous
contribution to all aspects of Canadian society.
Their involvements have influenced the wider
social, economic and political history of Canada,
as well as the history and politics of health care.
Nursing history provides the public with valuable
perspectives on emerging technologies, health
care reform and gender issues in Canadian
history” (Canadian Nurses Association, 2004, p.
2).

4. Jeanne Mance (1606-
1673) founded the first
hospital in
Montreal, Canada in
1642. Various forms of
machinery such as
ventilators and
physiological monitors
were first used in
intensive and critical care
settings.
By the late 1980s, most
hospitals had at least a
rudimentary information
system that required nurses
to enter common data such
as admission profiles and
basic care requirements like
diet, medications, and
treatments into a computer
as part of their routine
duties.

5. It begins to develop a national consensus
on definition, competencies, and
educational strategies and priorities in
nursing informatics develop.
"In 1998 a national steering committee
was formed to address Nursing
Informatics issues and develop strategies
to ensure that Registered Nurses have the
competencies required to successfully
carry out the responsibilities of their
practice.

6. Develop
consensus on a
definition of
Nursing
Informatics for
Canada;
Recommend
Nursing Informatics
competencies for
entry level nurses
and specialists,
managers,
educators, and
researchers
Identify curriculum
implications and
strategies for both
basic and
continuing nursing
education
Determine
priorities for
implementing
national nursing
informatics
education
strategies.

7. The Nursing Minimum Data Set was the first
major Canadian Nurses Association
informatics initiative beginning in 1990.
This was in response to the strong
conviction that nursing data must be
included in the centralized national health
data system being planned by the Canadian
Institute of Health Information (CIHI)

8. This publication was a critical
overview of the essential
characteristics of the emerging
field of nursing informatics in
Canada. It also introduced a
definition of nursing informatics,
formulated by the National Nursing
Informatics Project working group
A key one was
published in the
September Nursing
Bulletin, entitled:
“What is Nursing
Informatics and
why is it so
important?”.
. “Nursing Informatics (NI) is the application of computer science and
information science to nursing. NI promotes the generation,
management and processing of relevant data in order to use
information and develop knowledge that supports nursing in all
practice domains” (Canadian Nurses Association, 2001, p.1).

9. Setting National
standards for
financial, statistical,
and clinical data
Setting National
standards for health
information
technology,
Collecting,
processing, and
maintaining
health related
databases and
registries

11. The intent of the study was to describe
the current state of:
Informatics education opportunities
currently available to students of nursing
across the country.
The level of preparedness of nursing
faculty to deliver these offerings.
Information and communication
technology infrastructure and support
for faculty in delivering these offerings.
Opportunities to enhance nursing curricula,
faculty preparedness, and ICT infrastructure
and support in schools of nursing across
Canada.

12. June Kaminski
launched in 2006,
which invites papers,
multimedia, and other
electronic media
focused on the diverse
arena of nursing
informatics.
Mission
Provide a peer - reviewed
venue for Canadian nurses and
researchers who work with
Nursing Informatics to
disseminate their research,
essays, reviews, presentations,
multimedia and other digital
publishable materials on a
global scale. They have decided
to offer this journal free of
charge in order to make
informatics research and theory
openly available to all Canadian
nurses.

13. Initial goals of this e-nursing strategy include:
supporting the
development and
implementation of nursing
informatics competencies
among the competencies
required for entry-to-
practice and continuing
competence;
“The purpose of the e-
nursing strategy is to
guide the development of
ICT initiatives in nursing
to improve nursing
practice and client
outcomes” (Canadian
Nurses Association, 2006,
p. 7).

15. Learning activities which include:
1.a Cognitive, ("to
know" or
epistemological),
2.an Interactiv
e, ("to do" or
ontological) as
well as
3.a Reflective,
("to be" or
phenomenolo
gical)
The curriculum
designed to prepare
caring nurses as
"knowledge workers"
for the changing
economy of this new
millennium.
The assumption is that
as students use
computers to manage
information in their
student role, they will
more readily use their
critical thinking skills
to learn related
applications in their
work as nurses.
Nursing Informatics at Kwantlen
Polytechnic University

16. The main rational for
implementing a greater
use of information
technology (IT) in the
healthcare sector is to
improve safety and
quality, improve patient
outcomes, and at the
same time try to reduce
costs of healthcare. care.
The main mission in
Europe is to establish
stable infrastructure
that improves
healthcare quality
facilitates the reduction
of errors and the
delivery of evidence
based and cost effective
care.

17. Confidence
in IT and
competence
to use IT
Information
about society
services available
to all citizens
Continuity
of Care and
Availability
of Informati
on.
 Three Objectives of
National IT Strategy:

18. The common factors that may
have contributed are the
increasing cost constraints in the
mostly publicity financed
healthcare systems, which have
raised demands for cost-effective
care and quality improvement.

20. The method of concept
and information
modeling has been
carried out in many
countries during the last
decennium. The model
was divided into three
parts:
Core Process- which
is the clinical process
in healthcare.
Management
Process- which
monitors and
evaluates the clinical
process based on the
mandate to provide
healthcare.
Communication
Process- dealing with
information and
interaction with the
surrounding world as
documents or
messages.

22. Organizational Implementation
Project Management
The organizational
implementation is more about
how the application supports
planed and wanted changes in
work flow and organizational
structure
Project teams are mostly
selected to be
representatives of different
categories of clinicians and
organizational parts of the
healthcare enterprise.

23. Variety of views on
data- appears to be
a very attractive
advantage.
Structures
of data- is
important if data
are to be reused
and presented in
several different
ways.
Decision support-
is advantageous if
the clinician enters
the data
Supports of other
data analysis- may
prove an important
feature or quality
control, quality
improvement, and
resource
management.
Electronic data
exchange and
sharing care
support- assumes
reused of data.

25. The evolution of NI has varied in
each the pacific rim countries.
The adoption of informatics
usually began as a vision of one
or more individuals. Events
external to the nursing
profession frequently became
the catalysts stimulating some
type of activity by nurses toward
the adoption of informatics

26. New Zealand's total population is just over 4
million. These people are predominantly found in
the urban areas, with the greater Auckland area
having over the third of the total population. The
hub labeled " Informatics Influences" represents
information collection, since this is seen as
central to nursing, informatics and healthcare.
The other and entities identified are significant
layers in new zealands healthcare system, which
influences NI and its development.

27. There are a number of informatics interest
groups in New Zealand, each with a slightly
different focus. Health Informatics New
Zealand (HINZ) is a national, not-for-profit
organization who's focus is to facilitate
improvement in business processes and
patient care in the health sector through
the application of the appropriate
information technologies. HINZ, a new
organization, emerge in September 2000
from two health informatics organizations.

28. Australia is the federation of
eight state and territories. It has
a population of just fewer than
20 million. As a consequence of
the globalization of the
profession, Australia's
contribution to international
education, the resultant work
force mobility, economic growth,
and changes in healthcare
industry resulting from
technology and informatics
advances, changes or being
witness in the nursing work
force.

29. Australia has had a
representative to
IMIA's working group
8(WG8) (now NISIG)
since 1984. Nurses
were the second group
of health professionals
to organize
themselves to promote
health informatics in
Australia.

30. Computers were first
introduced into the
healthcare sectors of Asian
counties in the 1970s. The
first applications of
information technology in
healthcare in Asian
countries were in
administration, billing, and
insurance. Now these
countries are moving
toward implementing
paperless electronic health
records.

31. Nursing Informatics in Hongkong
Hongkong nurses established NURSINFO (HK) in 1991,
and this organization has enjoyed a consistent increased
in membership. They have as their motto " Nursing
Informatics for excellence in patient care." They organize
regular educational activities, use a communication
network, produce a regular news letter, and are actively
involve with the Hongkong society of medical informatics
and Hongkong computer society.

32. Hospital
27%
implemented
information
systems
9% were
developing
information
systems
40% were not
planning to
make any
investments in
nursing
information
systems
Long term care institutes:
• 50% were not planning to make any
investments in nursing information
systems
• 19% installed information systems

34. NI research is still at its infancy in Taiwan, with
only around 40 papers published in domestic
nursing journals in the period 1994-2003. The first
formal academic association on NI was set up in
2004, when NI working group was organized within
Taiwan association of Medical Informatics, which
had been established in 1991. Standardized
terminology such as existing diagnosis
classification systems and the ICNP have been
translated for clinical use, and test of their
reliability and validity have been proposed in
Taiwan.

35. Computerized
care plans are
now common in
clinical use
Decision support
systems to test
the integration of
medical
diagnoses and
nursing
diagnoses, and
expert systems
implemented on
PDAs for the
emergency triage
system have
been reported.
Patient
classification
systems have
also been applied
for patient
assessment,
nursing
interventions,
and staff
workload
assignments.
A national “e-
Taiwan” program
has been
promoted by the
Ministry of Health
to promote the
development of
health informatics
in Taiwan since
2002

36. The nursing Informatics Special Interest Group with
20 hospital nurses was founded as a branch of the
CMIA in 1991. The first article referring to the term
“nursing information science” appeared in China in
1999, and this led to the application of information
technology in the field of nursing science for
education and research. The term NI was first used
in the Chinese literature in 2002.

37. Nursing Informatics Research
NI research is at its fancy in
China, with only 30 research
articles published in domestic
nursing journals from 1994 to
2004
Nursing Informatics Practice
The use NI in clinical practice
in China includes nursing
quality management, nursing
information management, and
training clinical skills for staff
nurses. The major weakness
of nursing information
management systems in
China is the lack of national
standards and the low level of
computer literacy and
informatics skill exhibited by
nurses.

38. The healthcare delivery system in Japan provides
access to healthcare. Financial contribution to health
insurance is proportional to their income. Families pay
20-30%, respectively, of all health expenditures, and the
publicly funded health insurance pay the rest when a
patient receives medical treatment in a hospital.
The total health expenditure of Japan remains lower
than that in some other advances nations, partially
attributable to healthier dietary habits.The relatively
small number of healthcare professionals in the country
also help lower the expenditures.

39. 1970s- Japan began to pay
attention to the use of
computers in healthcare.
1980-the Japanese
association if medical
informatics (JAMI) was
founded at that time with
the aim of supporting
health informatics in Japan.
Initially research was focused on
computerized billing systems for
medical fees and the
development of the use of
personal computers at an
individual level.
The focus then shifted to
research and development of
systems at an organizational
level.

40. 1980- the third
international congress on
medical informatics
MEDINFO80, organizes by
IMIA, was held in Tokyo.
1990s- nursing
education in Japan
rapidly shifted to a
more academic
orientation
2000s -
The
nursing
division of
JAMI was
established
The Japanese Nurses
Association prepared a
course on nursing
information management
as a first step of a
continuing curriculum for
ward managers.

41. 3. The cost of
improving the
network and
computer
environment
is high.
2. There is
little
development
on
educational
tools.
1. There are
few
researchers
and
educators in
NI.

42. Use of Information
Technology in Clinical
Practice
Picture Archiving and
Communication
Systems (PACSs)
-enables physician to
communicate with other
departments for
practice-related
requisitions and the
retrieval of data.
-one of the most
common information
technology systems in
south Korean hospitals.
These systems
allowed physician
to enter medical
orders directly into
the computer, and
major ancillary
departments could
receive
requisitions and
enter test results.

43. Higher nursing education was introduced in 1983, at
least one computer course is required at level, and
nursing students can select other computer courses
as elective courses.
Health informatics in South Korea has grown
considerably in recent years, with the professional
outreach activities of the Korean Society of Medical
Informatics (KOSMI) as well as with the help of the
government, private business, academic institutions
and medical and nursing organization.

44. The rapid growth of mobile
telephone users and the advances in
wireless local area network
(LAN)technology have lead to mobile
computing in healthcare becoming a
popular issue in Korea.
Teleconsultation - allow a
generalists doctor at a health center
in a remote area to have a
telepathology or a teleradiology
consultation with the specialist of a
tertiary hospital.

45. In Thailand, they have the Universal Healthcare
Covery Policy to improve the quality and access
to services. They want services to be available
to all so they established computer systems in
different places for better communication of
services. This is supported by the Nurses
Association of Thailand, World Health
Organization, and the Ministry of Health.

47. Nursing Informatics in
South America has
been based more on
ACTIVITIES of
INDIVIDUALS than on a
policy established by
governments or
national efforts.
Each country in South
America has varied levels
of development and
deployment of
technological resources.

48. The use of
Technology has
visible tendency in:
Health
Nursing
Education
Nursing
Practice
Nursing
Research
Administration

49. COMPUTERS NURSING
Are considered an important
tool to help nurses take care
of patients and to recognize
nursing service and nursing
education.The growth of
information technology in
Latin America and the
Caribbean has been
consistently the world’s
highest for 20 years.
Has been identified around the
world as an emerging profession
for over 100 years.
Nurses were considered as the
primary users of technology in
healthcare (Safran, Slack and Bleich
1989).
Historically nurses are used to
facing challenges, adapting new
tools in to the practice to improve
their performance. Creating new
models to enhance patient care.

50. Is the key element for
decision making process in
the healthcare area. The
more specific information
in place to support clinical
decisions, the better care
can be delivered to the
patient.
Plays an important role
in facilitating access to
the information because
for the information to be
useful and meaningful, it
has to be timely. There
is a clear trend in the
direction of the
computerization of
health records.
INFORMATION
TECHNOLOGY

51. The initial motivation to develop
computer systems in the healthcare
area was driven by financial and
administration concerns.The hospital
sector can be considered the area better
served by information systems. Brazil,
Mexico, Argentina, Colombia, Chile and
Paraguay have clinical information
systems in hospitals or health
institutes.
Patient data that
are also used for
nursing
administration are
integrated in the
systems or nurses
have to collect and
analyze nursing
data separately

52. Hospitals have been working
to design their own systems in
order to attend to specific
needs and policies.
National and International
software become more
represented in South America
health care workers.
They provide a broader range
solutions with systems that
address patient care
documentation.

53. Technology is
transferring not
only nursing
practice but also
nursing training
and education
models.
Nurses became
the primary
users,
responsible for
data input.
Nurses become
“Computer-
Literate” in
ordere to use
computer
technology in a
efficient manner.
To meet
education and
training need,
nursing schools
and hospitals
initiated programs
to prepare nurses
to use hospital
initiated programs
to prepare nurses
to use computers.

54. Nucleo de Informatica em
Enfermagem at the
Universidade Federal De
Sao Paulo was the first
center to offer the
specialization degree
certificate in South America.
Provides since
1989, the
nursing
informatics
discipline in its
graduate and
undergraduate
nursing
programs.

55. Sharing and
communicating
information is
essential to make
decisions and
deliver care.
The language includes an
alphabets, words, phrases
and symbols that express
and assign meaning,
understood by all users
(PAN America Health
Association/World Health
Organization, 1997).

56. CLARK (1995)
Pointed out that communicating among ourselves
has always been important but communicating with
other people about nursing has acquired a new
urgency since we are forced to recognize that the
value of nursing is no longer apparent to those who
have the power to influence our practice.

57. containm
ent
Policies
Reimburs
ement
Technolo
gical
Develop
ment

58. In 1990, the International Council of Nurses
(ICN) initiated a long term project to develop
an international classification for Nursing
Practice with the objective to establish a
common language about nursing practice to be
used for describing nursing care for people in
variety of setting (Mortensen, 1996)

59. In Brazil, the dissemination of the International
Classification for Nursing Practice (ICNP)
started around 1996 when NIEn/UNIFESP
became a sponsoring partner in the Telenurse
Consortium, led by Randi Mortensen – director
of the Danish Institute for Health and Nursing
research.
Home Health Care
Classification (HHCC)
developed by Saba
1992 is available on
the internet in
Brazilian Portuguese
version.

60. The recommendations from the experts
that are merged into this text book
edited by the Division of Systems at
PAHO.
Was published in English and Spanish
and distributed to universities,
professional organization and technical
cooperation agencies.