Historical Aspects of Nursing Informatics

Kindly discuss on the following:

1. Describe the historical perspective of nursing informatics.

From the beginning of modern nursing, data from standardized patient records were seen as a
potentially powerful resource for assessing and improving the quality of care. As nursing
informatics began to evolve in the second half of the 20th century, the lack of standards for
language and data limited the functionality and usefulness of early applications. In response,
nurses developed standardized languages, but until the turn of the century, neither they nor
anyone else understood the attributes required to achieve computability and semantic
interoperability. Collaboration across disciplines and national boundaries has led to the
development of standards that meet these requirements, opening the way for powerful
information tools. Many challenges remain, however. Realizing the potential of nurses to
transform and improve health care and outcomes through informatics will require fundamental
changes in individuals, organizations, and systems. Nurses are developing and applying
informatics methods and tools to discover knowledge and improve health from the molecular to
the global level and are seeking the collective wisdom of interdisciplinary and interorganizational
collaboration to effect the necessary changes

2. Explore lessons learned from the pioneers in nursing informatics.

The advancement of Nursing Informatics (NI) in practice differs between regions and
there is a need to support the advancement of NI all over the world. Exemplifying
means that have been successful in supporting NI in practice could be used to guide the
development of NI in other places as well. To address this need, the IMIA-NI SIG
Student and Emerging Professionals (SEP) group proposes a panel of pioneers in the
field to discuss means of how to support NI in practice throughout the continuum - from
places where the field is just emerging to those where NI today is more advanced. The
discussion will cover issues such as NI roles, requirements, competencies and
education. Discussed ideas will be collected and reported in the future.

3. Describe the types of nursing standards initiatives.

The American Nurses Association (ANA) develops the general nursing scope and
standards that apply to all nurses. Specialty organizations align with those broad
parameters by developing and revising their own specific scope and standards of
practice. Standards of professional practice include a description of the standard
followed by multiple competency statements that serve as evidence for compliance with
the standard (Strong, 2016). The standards of professional practice are divided into two
categories, standards of practice and standards of professional performance. The
standards of practice align with the nursing process and define what NPD practitioners
do (Wilson, 2012). The standards of professional performance describe how NPD
practitioners comply with the standards of practice, apply the nursing process, and
attend to other practice concerns and issues (ANA, 2010). These specialty standards
drive NPD practice, and it is important that they not only reflect current practice but also
define future practice.

4. Review the historical perspectives of electronic health records.

 The concept of a patient’s medical information stored electronically instead of on paper
is not a new one. In the 1960s, as medical care became more complex, doctors realized
that in certain situations the patient’s complete health history would not be accessible to
them. The availability of comprehensive medical information when needed brought the
innovation of storing the patient’s information electronically. Improvement of patient
medical care was and is the catalyst for the electronic health record (EHR).

5. List the major landmark events and milestones of nursing informatics.

    Computer technology emerged in nursing in response to the changing and

developing technologies in the health care industry and in nursing practice. It is
analyzed according to:

(1) six time periods: prior to the 1960s, the 1960s, the 1970s, the 1980s, the 1990s
and post-2000; 

(2) four major nursing areas: nursing practice, administration, education, and

research; 

(3) standards initiatives: nursing practice, nursing data, and health care data
standards; 

(4) significant landmark events; 

(5) major landmark milestone chart listing those events that influenced the
introduction of computers into the nursing profession including the key
“computer/informatics” nurse that directed the activity.
SIX TIME PERIODS

PRIOR to the 1960s.

Starting in the 1950s, and as the computer industry grew, the use of computers in the
health care industry also grew. During this time, there were only a few experts who
formed a cadre of pioneers that attempted to adapt computers to health care and
nursing. During this time, the nursing profession was also undergoing major changes.
The image of nursing was improving, nursing practices and services were expanding in
scope and complexity, and the number of nurses was increasing. These events
provided the impetus for the profession to embrace computers. 

The 1960s. 

        During the 1960s the uses of computer technology in health care settings began
to be questioned. Questions such as “Why computers?” and “What should be
computerized?” were discussed. Nursing practice standards were reviewed, and
nursing resources were analyzed. Studies were conducted to determine how computer
technology could be utilized effectively in the health care industry and what areas of
nursing should be automated. The nurses’ station in the hospital was viewed as the
hub of information exchange, the most appropriate center for the development of the
computer applications.

        During this period, computer technology advanced, while the number of health
care facilities increased. The introduction of cathode ray tube (CRT) terminals, online
data communication, and real-time processing added important dimensions to the
computer systems providing more accessible and “user-friendly” machines.

 The 1970s.

In the 1970s, the inevitable continued integration of computers into nursing. Nurses
began to recognize the value of the computer for their profession. During this decade,
giant steps were taken in both dimensions: nursing and computer technology. Nurses
recognized the computer’s potential for improving the documentation of nursing
practice, the quality of patient care, and the repetitive aspects of managing patient care.
They assisted in the design and development of nursing applications for the HISs and
other environments where nurses functioned.

During this period, several states and large community health agencies developed
and/or contracted for their own computer-based management information systems.
Generally, public health MISs provided statistical information required by local, state,
and federal agencies for specific program funds, whereas home health agencies
provided billing and other financial information required for reimbursement of patient
services by Medicare, Medicaid, and other third-party payers.

 
The 1980s.

During the 1980s, the field of informatics emerged in the health care industry and
nursing. NI became an accepted specialty and many nursing experts entered the
field. Technology challenged creative professionals and the use of computers in
nursing became revolutionary. As computer systems were implemented, the needs of
nursing took on a cause-and-effect modality; that is, as new computer technologies
emerged and as computer architecture advanced, the need for nursing software
evolved.

During this period, many mainframe HISs emerged with nursing subsystems. These
systems documented several aspects of the patient record; namely, order entry
emulating the Kardex, results reporting, vital signs, and other systems that documented
narrative nursing notes via word-processing packages. Discharge planning systems
were developed and used as referrals to community health care facilities in the
continuum of care.

In the 1980s, the microcomputer or personal computer (PC) emerged. This

revolutionary technology made computers more accessible, affordable, and usable by
nurses and other health care providers. PCs brought computing power to the workplace
and, more importantly, to the point-of-care. PC s served not only as terminals linked to
the mainframe computers but also as stand-alone systems (workstations). They were
user-friendly and allowed nurses to create their own applications.

 The post-2000.

The early years of the new millennium continued the torrid pace of hardware and
software development and growth. This growth is reflected in healthcare and nursing,
with developments such as wireless point-of-care, serious consideration for open
source solutions, regional database projects, and increase IT solutions targeted at all
healthcare environments. Further, clinical information systems became individualized in
the electronic patient record (EPR) and patient specific systems considered for the
lifelong longitudinal record or the electronic health record (EHR).

Information technologies continued to advance with mobile technology such as with

wireless tablet computers, personal digital assistants (PDAs), and smart cellular
telephones. The development and subsequent refinement of voice over Internet
protocol (VolP) promises to provide cheap voice communication for health care
organizations. Post-2000 also witnessed the continued impact of legislation on the U.S
healthcare industry.
REFERENCES:

https://sites.google.com/site/nursingb1g/module-one/nursing-and-computers