MAJOR HISTORICAL PERSPECTIVES of NURSING

and COMPUTERS

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

SIX TIME PERIODS

The use of computers in the health care industry grew

Prior to the 1960s

Computers were initially used in health care facilities for basic business office functions

Use punch cards to store data and card readers to read computer programs, sort and prepare data for processing

1960s

Uses of computer technology in health care setting began to be questioned

The nurses’ station in the hospital was viewed as the hub of information exchange

The introduction of cathode ray tube (CRT), online data communication, and real-time processing added important dimensions to the computer system

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

1970S

Nurses began to recognize the value of the computer for their profession

Several mainframe HISs were designed and developed, a few of which eventually became forerunners of a number of today’s system

Several states and large community health agencies developed and/or contracted for their own computer-based management information system (MISs)

MISs provided statistical information required by local, state, and federal agencies for specific program funds

Home health agencies provided billing and other financial information required for reimbursement of patient services by Medicare, Medicaid, and other third-party payers

1980s

Many mainframe HISs emersion- Documents patient’s record- Kardex- vital signs - discharge plan- -online source- -nurse’s notes

NI became an accepted specialty and many nursing experts entered the field

Microcomputer or personal computer emerged

They were user-friendly and allowed nurses to create their own applications

1990s

Computer technology became an integral part of health care setting, nursing practice and the nursing profession

NI was approved by the American Nurses Association (ANA) as a new nursing specialty

Workstations and local area networks or (LANs) were developed for hospital nursing units

Smaller and faster computers laptops, and notebooks

Wide area networks were developed for linking care across health care facilities

Internet started to be used for linking across the different systems

Post 2000

-Development of wireless point-of-care-clinical information system became

individualizes in Electronic Patient Record (EPR)

-Electronic Health Record (EHR)- life longitudinal record

-Personal Digital Assistant (PDA)

-Use of Voice-over Internet Protocol (VoIP)-Health Insurance Portability and Accountability

Act (HIPAA) of 1996 was enacted-Critical Care Units are monitored remotely by

health care providers (eICU)

FOUR MAJOR NURSING AREAS

NURSING PRACTICE

-It has become an integral part of the EHR-used to assess problems, document care, track

the care process, and measure outcomes-electronic version of nursing practice has

revolutionized and transformed nursing practice

NURSING ADMINISTRATION

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

NURSING EDUCATION

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

NURSING RESEARCH

Nursing research provides the impetus to use the computer for analyzing data

Standard Initiatives

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

Nursing Practice Standards

- have been developed and recommended by the ANA

- Have also been set by the Joint Commission on Accreditation of Hospital Organizations (JCAHO)

- Included the contents of EHR, such as what data should be collected and how the data should be organized in the electronic database

Nursing Data Standards

- Emerged as a new requirement for the EHR- ANA is responsible for the recognition of the

terminologies and for determining if they have meet the criteria to be included in the National Library of Medicine

Health Care Data Standards Organizations

• American National Standards Institute (ANSI)• American Society for Testing and Materials

(ASTM)• SNOMED• National Committee on Vital and Health

Statistics (NCVHS)

Early Computer-Based Nursing Applications

• Developed before the mid-1970s as part of larger HISs

• Focused on documentation of nursing practice and management of patient care

• Designed for hospitals, ambulatory care settings, and community health agencies

Landmark Events in Nursing and Computers

• Introduced into the nursing profession over 35 years ago

• Major milestones of nursing are interwoven with the advancement of computer and information technologies, the increased need for nursing data, development of nursing applications, and changes making the nursing profession an autonomous discipline