WESTERN HILLS SCHOOL OF NURSING

NURSING INFORMATICS NOTE

INTRODUCTION

Since the days of Florence Nightingale, nursing has placed a priority on patient-centered care.
Kindness and compassion were the cornerstones of that care. Increasingly, informatics also
plays a fundamental role.

Healthcare delivery largely depends on information for effective decision making. Every
nursing action relies on knowledge based on information. The nursing process begins with
obtaining and communicating information in the initial and ongoing assessment. Nursing
informatics (NI) is therefore the management of data, information, knowledge, and wisdom
relevant to nursing (ANA, 2008).

Advances in information technology (i.e., computers and software) over the last two decades
has created significant opportunities for nurses to be aware of current information when
making decisions. Now we have faster computers to process data, more sophisticated
software to assist in the transformation of data into useful information, and powerful
communication technologies such as the internet to enable the secure transmission of
information among health service organizations and professionals.

As we enter the era of the electronic health record (EHR), NI has become an indispensable
element in the practice of nursing. It therefore becomes necessary for trainee nurses to be
equipped with requisite knowledge to enable them utilize informatics skills in their practice.

History of Nursing/Midwifery informatics

Florence Nightingale has been recognized as an early informatics nurse because of her use of
data to inform knowledge and changed nursing practices. Her report on health of British
soldiers in Crimea was based on her ability to gather, organize, process and analyze data
(Ozbolt & Saba, 2008).

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In the 1970s nurses became instrumental in the development of nursing application for
hospital information system. By early 1980s, nursing informatics was broadly defined as the
use of computer technology to support all aspects of nursing practice. However, the term
“nursing informatics” was first used by Scholes and Barber in their address to the
MEDINFO (Medical Information) Conference held in Tokyo, Japan, in 1980. In the same
year, medical and nursing informatics specialty emerged. Personal computer was introduced
which allows for flexibility in how these clinical systems were used.

In 1990 and beyond, the internet became the tool for web-based clinical applications,
communication and access to evidence-based resources and application at the point of care.
Telemedicine became possible and was recognized as a specialty in the late 1990s.

Post-2000 era saw an unprecedented explosion in the number and sophistication of both
computer hardware and software. Electronic patient record became an integral part of clinical
information systems.

Now nursing informatics is a field of study which is still developing and is based on the
concept that health care data and information can be effectively managed and communicated
using computer systems, networks, modems and telecommunications.

In Ghana, the national policy on e-Health came into force in 2010 (Acheampong, 2012). By
2015, Nursing and Midwifery Ghana had introduced Nursing informatics as a subject of study
in Nursing Training Institutions.

INFORMATICS

What is Informatics?

The word “Informatics” comes from the French word, “Informatique”, which means
computer science.

Informatics is therefore defined as;

1. computer science and information science.

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 2. the science of how to use data, information and knowledge to improve human health
and the delivery of health care services.
3. refers to processing, storing, and retrieving data to optimize healthcare delivery and
improve patient outcomes.

Computer science: refers to the study of computers (both hardware and software design) and
their uses.

Information science: is the study of information and how it is used by people within
organizations.

Note

To be an Informaticist, one needs to be a computer literate and information literate. This is

because informatics deals with computer science and information science.

What is Computer Literacy?

Computer literacy is defined as;

- The knowledge and ability to use computers and related technology efficiently.

- The familiarity with computers and how they work, especially a non-technical
understanding of computers and the role they play.

- The knowledge of non-technical aspects of capabilities and limitations of computers.

The individuals who have the knowledge and skills to use a computer and other related
technology is known as computer literate.

What is Information Literacy?

Information literacy refers to the ability of individuals to "recognize when information is

needed, how and where to locate the information, evaluate the information, and how to use
the information effectively.

The person who possesses these abilities is known as an information literate.

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Qualities of Information Literate

An information literate should be able to;

• Determine the extent of information needed.

• Access the needed information effectively and efficiently.

• Evaluate information and its sources critically.

• Incorporate selected information into one’s knowledge base.

• Use information effectively to accomplish a specific purpose.

• Understand the economic, legal, and social issues surrounding the use of information, and
access and use information ethically and legally. The focus here is the patient and the process
of care (Imhoff et al, 2001).

Health Informatics

Health informatics is defined as the development and assessment of methods and systems for
the acquisition, processing and interpretation of patient data with the help of knowledge from
scientific research. This implies that health informatics is not tied to the application of
computers but more generally to the entire management of information in healthcare. The
focus here is the patient and the process of care (Imhoff et al, 2001).

Branches of Health Informatics

The branches of health informatics are;

• Bio-Informatics

• Dental Informatics

• Clinical Informatics

• Public Health Informatics

• Nursing & Midwifery Informatics

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• Medical Informatics

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Nursing informatics is defined as, a specialty that integrates nursing science, computer
science and information science to manage and communicate data, information, knowledge
and wisdom in nursing practice (ANA, 2008).

It is also defined as the combination of computer science, information science and nursing
science designed to assist in the management and processing of nursing data, information and
knowledge to support the nursing practice and delivery of care.

Building Blocks of Nursing Informatics

The building blocks of Nursing Informatics (NI) are;

1. Computer Science
2. Information Science
3. Nursing Science
4. Cognitive Science

Computer Science

Computer science: refers to the study of computers (both hardware and software design) and
their uses.

COMPUTER

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Figure 7. Computer

What is Computer?

Computer can be defined as;

• An electronic device that processes data into information that is useful to people.
• An electronic device that can be programmed to perform the following major
functions:
• gathers data (or allows users to input data).
• processes that data into information.
• outputs data or information.
• stores data and information.

The easiest way to understand computers is to consider as an input–output systems. These

unique machines accept data input via a variety of devices, process data through logical and
arithmetic rendering, store the data in memory components, and output data and information
to the user.

Computer literacy is defined as;

- The knowledge and ability to use computers and related technology efficiently.

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 - The familiarity with computers and how they work, especially a non-technical
understanding of computers and the role they play.
- The knowledge of non-technical aspects of capabilities and limitations of computers.

The individuals who have the knowledge and skills to use a computer and other related
technology is known as computer literate.

Classification of Computers

Computers are classified into;

• Embedded systems/Microcontrollers
• Mobile/handheld devices
• Personal computers
• Servers
• Mainframe
• Supercomputer

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Embedded systems/ Microcontrollers;

Figure 8. Embedded systems

These are the tiny, specialized microprocessor (chip) installed in “smart” appliances and
automobiles.

Mobile/ Handheld devices or computers

Examples of these devices are smartphones, PDA and Palmtop

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Figure 9. Smartphones

Figure 10. Personal digital assistant (PDA)

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Figure 11. Palmtop

Personal Computers

These are Desktops or Towers, laptops, tablets, notebooks and netbooks.

Figure 12. Personal computers

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Servers

These are computers that control networks.

Figure 13. Sever

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Mainframe Computers

These computers are designed to handle many users.

Figure 14. Mainframe computers

Supercomputers

These are large, fast computers which are designed to concentrate on specific scientific tasks.

Figure 15. Supercomputers

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Components of a Computer

The components of a computer are;

• Hardware
• Software

Computer Hardware

Hardware is the physical component of the computer. It consists of System Unit and
Peripheral devices.

Figure 16. Computer hardware

System Unit is the cabinet that houses motherboard, CPU and Memory modules. Peripheral
devices are auxiliary devices that input and output information. Eg. Mouse; Keyboard;
Webcam; Microphone; Monitor; Speakers; Projector; Printer; USB Flash Drive; External
Hard; etc.

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 - Central Processing Unit (CPU)/Processor; Known as the brain of the computer,
directs and controls the actions of all other components of the computer. Some of the
best processors include;

1. AMDFX-9590,
2. AMD FX-8320,
3. AMD FX-6300,
4. Intel Core i7-5820K,
5. Intel Core i7- 4930K,
6. Intel Core i75960X, I
7. ntel Core i5-6600K, and
8. Intel Xeon processor (Futuremark, 2016).

- Motherboard : Known as “central nervous system” of the computer, facilitates

communication among all of the different computer components.

Hardware System

1. Device Driver - a program that determines how a computer will communicate with a
peripheral device.
2. Plug-n-play - The ability to add a new component to a system and have it work
automatically without technical configuration.

Input Devices: Enter data to be processed. They include;

• Keyboard
• Scanners
• Microphone
• Mouse
• Digital camera
• Trackball
• Touch screen
• Game Controller

Output Devices: Enable us to see or hear processed information. Eg.

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 • Monitor
• Speakers
• Printers

Storage device and Storage Medium

Storage devices: Are apparatus for recording computer data. Eg. Flash drive, floppy disk
drive, hard disk drive, zip drive, etc.

Figure 17. Storage devices

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Storage Medium: Is the material on which data is and stored. Eg. Hard disc, floppy disc,
compact disc, memory card, etc.

Figure 18. Storage medium

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 COMPUTER SOFTWARE

Software is a set of instructions that tells the computer what to do. Or programs that enable
the hardware to perform different tasks.

Types of software

There are two main types of software; application software and system software.

System software is designed to provide platform for other software. It is essential for
platform operation and support. Eg. Windows10, MacOS, MacBook, android, iOS, etc.

Application software is a tool for getting things done. Eg. Excel, PowerPoint, Chrome, MS
Word, Music player, Skype, etc.

Productivity software and Communication Software

Productivity software are programs that enable you to perform tasks required in home,
school, and business. Programs like Office Suite, is the most commonly used both in the
workplace and on personal computers. Examples include;

- Word processing : to create and edit written documents. Eg. MS Word, Open Office
Writer, KOffice KWord, Apple Pages, Corel Word Perfect or Corel Write.
- Spreadsheet : used to perform calculations and numerical analyses. Eg. MS Excel,
Open Office Calc, KOffice KSpread, Corel Quattro Pro, Apple Numbers.
- Presentation : usually use for business or classroom presentation using text, images,
graphs,. Eg. MS Power Point, Open Office Impress, KOffice KPresenter, Corel Show,
Apple Keynote.
- Email: integrates email programs to send and receive electronic mail.
- Database : database creation for text and numbers

Quantitative data analytical tools

These are;

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 • SPSS (Statistical Package for Social Science)
• Epi Info
• STATA
• SAS (Statistical Analysis System)
• Minitab
• MatLab

SPSS (Statistical Package for Social Science)

With SPSS you can;

• enter your data into the computer.

• calculate new variables.
• manage the SPSS files.
• select or weight cases in your data.
• describe the data (frequencies, graphics, statistics).
• make statistical tests (t-test, chi-square test, correlation test, ...).
• make the statistical analysis (anova, regression, factor, discriminant, ...).
• select our results in the output window and move them to the text editor.

Communication Software

Communication software enable users to dialogue, share, and network with other users via
the exchange of email or instant message(IM), by accessing the World Wide Web ,or by
engaging in virtual meetings using conferencing software. The features include;

- Email client: Allows a user to read, edit, forward, and send email messages to other
users via an Internet connection. Eg. Resident programsMicrosoft Outlook and Outlook
Express, Eudora, Pegasus, Mozilla Thunderbird, Lotus Notes Web-based programs
Gmail, Yahoo Mail, Hotmail
- Internet browsers: Allows users to access, browse, download, upload, interact with
text, video, and other web-based documents. Eg. Mozilla Firefox, Microsoft Internet
Explorer, Google Chrome, Apple Safari, Opera, Microbrowser (for mobile access).
- Instant Messaging (IM): It facilitates real-time text messaging and allows users to attach
images, videos and other documents via personal computer, cell phone and handheld

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 devices. Eg. MSN Instant Messenger, Microsoft Live Messenger, Yahoo Messenger,
Apple iChat
- Conferencing: Enables users to communicate in a virtual meeting room setting to share
work, discussions, planning, using an intranet or Internet environment; can exhibit files,
video, and screen shots of content. Eg. Adobe Acrobat Connect, Microsoft Live Meeting
or Meeting Space, Go To Meeting, Meeting Bridge, Free Conference, Rain Dance,
WebEx

The Positive Impact of Computer Science On Nursing Knowledge and Practice

1. Development of nursing Knowledge through the use of productivity, creativity, and

communication software.
2. Easy dissemination of knowledge with other users.
3. Computer science principles can facilitate optimal usage of technology in nursing
profession
4. The knowledge enables doctors and nurses communicate more efficiently, thus
eliminating most misinterpretations of written and verbal orders.
5. Using computers, smartphones and tablets, nurses can create and manage electronic
health records and update them, as needed.
6. Enables nurses to access essential nursing tools and key medical references online,
reducing diagnosis time and errors.

OPERATION SYSTEM (OS)

An operating system is a program that acts as an interface between the user and the
computer hardware and controls the execution of all kinds of programs.

Types of OS

Server OS

Desktop OS

Mobile OS

Server OS include Mac OS X server, Windows server, Red Hat (Linux/Unix), Solaris
(Linux/Unix), FreeBSD, etc.

Desktop OS are Microsoft Windows, Mac OS, Linux, Unix, etc.

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Mobile OS include Apple iOS, BlackBerry OS, Windows⁰ mobile and Android.

Functions of OS

The operation system;

• Provides user interface

• Manages the CPU

• Manages memory

• Manages hardware

• Coordinates application software with the CPU

Categories of Software

• Open source software – free software available for general public to use.

• Customized or Bespoke software – Is a software design to the needs of an individual

or organization.

• Off-the-shelf software – Is commercial software that are available in the market that
can be purchased for use.

Computer Specifications

The following are the things you need to consider if you want to purchase a computer;

• System

• USB Port

• Hard disk

• Size of the monitor

• Networking

• Operation system

• Backup devices

• Brand

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 • Processor

• Memory

• Battery type

Tips to extend Laptop’s Battery Life

• Decrease the screen brightness.

• Avoid using screensavers.
• Remove external USB devices when not in use.
• Switch off wireless.
• Don’t run it down to empty.
• Give it rest

Uses of computers in healthcare

• For telemedicine - use of computers and telecommunications technology to deliver

healthcare.
• Computers are used to maintain and access patient records.
• Research tool for healthcare professionals.
• Monitoring of patients’ vital signs.

Computer Applications for Diagnostics

• Computer-based diagnostic test.

• Electrocardiogram (ECG).
• Computerized Tomography (CT) scanner.
• Magnetic Resonance Imaging (MRI)
• Positron Emission Tomography (PET)
• Ultrasonography
• Oncology
• Stimulation

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 CT SCAN

Figure 19. CT Scan

MRI

Figure 20. MRI

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 ECG

Figure 21. ECG

ULTRASOUND

Figure 22. Ultrasound

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 HARVEY STIMULATOR

Figure 23. Harvey Stimulator

Harvey Stimulator

Harvey simulator is a proven simulation system used to teach bedside cardiac assessment
skills that transfer to real patients

Scanner and reading Devices

• Data input without key-punching or typing.

• Optical mark recognition
• Bar code
• Radio Frequency Identification (RFID)
• Biometrics
• Smart cards

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Optical Mark Recognition is a technology that reads hand-drawn marks such as small
circles or rectangles.

Figure24. Optical Mark Recognition

Figure 25. Barcode & Barcode reader

Barcode is an optical machine-readable representation of data

Biometrics refers to technologies that measure and analyse human body characteristics such
as:

• DNA
• Fingerprints
• eye retinas and irises
• voice patterns
• facial patterns
• and hand measurements,

for authentication purposes.

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Smart card is any pocket-sized card with embedded integrated circuits.

Figure 26. Smart cards & Card Reader

Radio Frequency Identification (RFID)

This is a technology whereby digital data encoded in RFID tags are captured by RFID reader
via radio waves.

Figure 27. RFID Tags & RFID Reader

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Figure 28. RFID IMPLANT

Figure 29. RFID IN HEATHCARE

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Figure 30. ANTI THEFT SYSTEM

Figure 31. FACIAL RECOGNITION AND FACIAL RECOGNITION READER

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Disadvantages of using computers

• Health Risks
• Violation of Privacy
• Public Safety
• Impact on Labour Force
• Impact on Environment

Ergonomics refers to minimizing injury or discomfort while using the computer.

INTERNET

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Internet (simply called “Net”) is

- the wider network that allows computer networks around the world run by companies,
governments, universities and other organisations to talk to one another.

- Internet is a worldwide collection of networks that links millions of businesses,

government agencies, educational institutions and individuals.

- a worldwide system of computer networks

Physical Components Internet

- Computer

- Network

- Services

Computer Network

- Two or more computers connected together for sharing of resources and or

transferring of files.

Types of Network

• Local Area Network (LAN): is a computer network that interconnects computers

within a limited area such as a residence, school, laboratory, university campus or
office building.

• Wide Area Network (WAN): is a large computer network that connects groups of
computers over large distances. It uses telecommunication lines.

Uses of Internet

Some specific examples of how the Internet is used include:

• Social media and content sharing;

• E-mail and other forms of communication, such as Internet Relay Chat
(IRC), Internet telephony, instant messaging, video conferencing;
• education and self-improvement through access to online degree programs,
courses and workshops and

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 • searching for jobs - both the employer and applicant use the Internet to post open
positions, apply for jobs and recruit individuals found on social networking sites
like LinkedIn.
• Online discussion groups and forums
• Research
• Reading electronic newspapers and magazines
• Online shopping, or e-commerce.

Web or World Wide Web (WWW)

- Collection of information that can be accessed using the internet.

- Is a service on top of internet (is the infrastructure).

- Set of protocols and tools that allow us to share information with each other.

World Browser (Browser)

Web browser is software that allows you to locate, view, and navigate the Web.

Examples:

- Google Chrome
- Safari
- Mozilla Firefox
- Opera
- Internet explorer, etc.

Search Engine

- is a web based tool that is used by people to locate information on the internet.
- It allow users to search the internet for content using keywords.

Examples:

- Google
- You Tube
- Facebook
- Twitter
- Amazon
- Yahoo!
- Bing, etc.

How we Communicate through the Internet

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 - E-mail
- Instant messaging (IM)
- Voice/Video calls or conferencing (VoIP)
- Social media

E-commerce

• Buying and selling on the Internet.

• Types

– C2C (Consumer to Consumer)

– B2C (Business to Consumer)

– B2B (Business to Business)

• Major payment methods and shipping.

• Payment option:

– Mobile money

– VISA

• Debit cards

• Credit cards

• Master card

– paypal – shop all over the world.

Benefits of Internet

Benefits of the Internet include:

• Access to endless information, knowledge and education.

• An increased ability to communicate, connect and share.
• The ability to work from home, collaborate and access a global workforce.
• The chance to sell and make money as a business or individual.
• Access to an unlimited supply of entertainment sources, such as movies, music,
videos and games.
• The ability to amplify the impact of a message, allowing charities and other
organizations to reach a wider audience and increase the total amount of donations.

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 • Access to the internet of things (IoT), which allows home appliances and devices to
connect and be controlled from a computer or smartphone.
• The ability to save data and easily share files with cloud storage.
• The ability to monitor and control personal accounts instantly, such as bank accounts
or credit card bills.

Some IT Vocabularies and Meaning

Big Data: This refers to the phenomenal growth, use, and accessibility of information. The
sources include social media updates, search data, multimedia content, and even climate
information, among others. Big data could also mean the rise of new tools to analyse all the
data available to you.

BYOD (Bring Your Own Device): The refers to institutional policy that allows employees to
use their personal devices such as smartphones, laptops and tablets to access work related
information, software and applications. This also involves getting IT support.

Cloud Computing: refers to products, services, and platforms that allow businesses and other
users to access computing resources that are delivered to them over the Internet or other
networks.

Content Management: ls a collection of tools, software, and processes that allow you to
collect, manage, and publish information on any medium.

Cross-platform (agnostic, agnostic application, or agnostic platform): ls focused on software

that can run on any operating system and on any processor architecture.

Data Centre: ls a facility that houses your computer systems, components, servers and storage
systems.

Green Technology: ls environmental friendly and innovative technology that relate to safety,
health, energy efficiency, renewable resources, and recycling, among other things.

Artificial Intelligence (Machine Intelligence): Is a machine created or programmed to work,

react and respond like a human being. Simple put, it is an intelligence created in a machine to
function. This includes speech recognition, learning, planning, and problem-solving.

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Virtualization: is the development of a virtual version of an IT resource, such as a server,
storage, device and operating system. This gives rise to virtual machines where you can run
programs very much like on a physical machine.

Biometrics: refers to the physical characteristics that are unique to the user. They are used as
account or user verification, typically in line with This can include facial recognition,
fingerprints, and voice recognition.

IT Governance: Is corporate governance that is focused on information technology systems. Its

focus is to review the performance and security risks of IT systems.

COMPUTING ETHICS AND SECURITY

Ethic is the standards that determine whether an action is good or bad. Ethics includes
standards of professional practices, code of conducts etc.

Computer ethics is the moral guidelines that govern the use of computers.

Areas of Computer Ethics

• Software theft (piracy).

• Intellectual property right
• Code of conduct
• Information privacy

Software Piracy/theft – Is the unauthorized copying of a copyrighted software. Some

common types of software piracy include:

• counterfeit software,
• hard disk loading,
• corporate software piracy,
• Internet software piracy.

A software licenses

It is a legal instrument governing the use or redistribution of software.

Intellectual Property

An intellectual is someone who can use the mind creatively.

An Intellectual property refers to unique and original works such as ideas, inventions,
writings, art, product names and logos etc, sually results from creativity.

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Intellectual Property Rights

Intellectual property rights are the rights to which the creator is entitled for their work.
Intellectual property right includes:

• Copyright
• Trademark
• Patent

Copyright is a set of exclusive rights granted to an author or creator of an original work.

Simply put – the right to copy an original creation. These rights include the right to;

• copy
• distribute
• adapt etc.

Copyright symbol is (c) or ©

Plagiarism

Means taking someone else’s work and passing it off as your own.

Fair use - permits students to make use of copyrighted works for limited purposes including;

• Criticism,
• News reporting,
• Educational and references.

Trademark

Trade marks are signs which allow a business to distinguish its products or services from
those of other suppliers.

Trade marks can include words, letters, numerals or designs and even the shape of goods or
their packaging.

Computer Security

Cyber crime encompasses any criminal act dealing with computers and networks. It also
includes traditional crimes conducted through the Internet.

Cybercriminals are individuals who use computers, networks, and the Internet to
perpetrate/commit crime.

Hackers and Crackers

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A hacker is Anyone who unlawfully accesses a computer system.

A Cracker is any one who gain unauthorized access to a computer system with a criminal
intent.

Techniques to prevent unauthorized access

• Install Firewall.
• Install Intrusion detection software.
• Provide access control mechanism (set a password or use biometric devices etc.).

How to choose a good/strong password

1. Use a mix of alphabetical and numeric characters.

2. Use a mixture of upper- and lowercase; passwords are case sensitive.
3. Use symbols if the system allows (spaces shouldn’t be used as some applications may
trim them away).
4. Use a combination of letters and numbers, or a phrase.

Note

Do Not Choose;

1. Your name in any form — first, middle, last, maiden, spelled backwards, nickname or
initials.
2. Any ID number or user ID in any form, even spelled backwards.
3. Part of your user id or name.
4. Any common name, e.g., Sam, Jane.
5. Words or phrases with all the vowels or white spaces deleted.
6. Words or phrases that do not mix upper and lower case, or do not mix letters or
numbers, or do not mix letters and punctuation.
7. Any word that exactly matches a word in a dictionary, forward, reversed, or
pluralized, with some or all of the letters capitalized.
8. Passwords of fewer than six characters.
9. The name of a close relative, friend, or pet.
10. Your phone or office number, address, birthday, or anniversary.
11. Acronyms, geographical or product names, and technical terms.
12. Any all-numeral passwords, e.g., your license-plate number, social-security number.
13. Names from popular culture, e.g., Harry Potter, Sleepy.
14. A single word either preceded or followed by a digit, a punctuation mark, up arrow, or
space.

Virus and Malware

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Virus – Is a program that attaches itself to another program and spreads itself to other
computers. Viruses are hidden within the code of a host program.

Malware – Is a software designed to disrupt or damage computer system.

Types of Malware

1. Viruses
2. Worms
3. Trojans
4. Rootkits
5. Spyware
6. Crimeware
7. Adware

How to Protect Your Computer Against Viruses or Malware

1. Install Anti-virus
2. Install Firewall
3. Do not download e-mail attachments when not sure of the source.

Issues with the social media

1. Sending sexually explicit photograph, messages and video in a text message or email.
2. The smartphones and the social media apps/websites have become a dangerous tool
causing more harm.
3. It has become a very common practice to send nude pictures or videos to loved ones.
4. A lot of people have very sensitive data on their phone and this can be very
dangerous.

How people’s Private Data Get into Public Domain (Leaked)

1. Revenge – jilted lover

2. Phones could get missing
3. Repairs
4. Connect to friend’s PC to charge or share or exchange files.
5. Others (technical)
6. Under no circumstance should you keep any sensitive data on your phone.

How to Prevent Private Data from Getting into Public Domain

1. Don’t ever send any sensitive data to anyone.

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 2. Don’t ever allow yourself to be captured by anyone.
3. You can’t trust anyone to keep your data safe – it might genuinely not be their fault.
4. Never forward any leaked data.
5. Be guided by common sense.

General Security Tips

1. Do not reveal personal information inadvertently.

2. Realize you may be monitored at work, avoid sending highly personal e-mail to
mailing lists, and keep sensitive files on your home computer.
3. Do not reply to spammers, for any reason.
4. Use multiple usernames and passwords.
5. Keep your usernames and passwords for social networks, online banking, e-mail, and
online shopping all separate.
6. Be really cautious about geo-location services.
7. Smart phones, apps, and Web services are frequently tagging your location as you
move through life.

Information Science

Information science: is the study of information and how it is used by people within
organizations.

Basic Concept of Nursing Informatics

Blum (1986) introduced a framework that explains clinical information system and its impact
on health care. This framework is based on the following concepts;

1. Data
2. Information
3. Knowledge

In reference to the concept of data, information, and knowledge, Blum explained that the
health informatics could not be defined by information technology that is used in the practice
on medical informatics, but rather the discipline of informatics is defined by how the provider
uses technology to meet human needs. The emphasis here is on the medical use of the
information technology and not on the application of technology to medicine.

Data

1. Is a representation of a fact or idea;

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 • Number
• Word
• Picture
• Sound
2. Is defined as facts or figures that can be analysed or used in an effort to gain
knowledge or make decisions.
3. A discrete observations that are not interpreted, organized or structured
4. An uninterpreted item.

For example is a patient/ client’s weight of 65kg. Without additional data of height, age, etc.,
it would be impossible to interpret the significance of an individual number.

Types of Nursing Data

In Nursing, client's data is organized into;

1. Subjective data
2. Objective data

Subjective data: These are information from the client or the patient. It represents patient’s
feelings, perceptions and thoughts and can only be obtained or discovered by asking
questions (interview). This cannot be directly observed. For example, if a patient in an
interview tells a nurse that he has been coughing, vomiting, having headache, abdominal
pain, feeling nauseous, loss appetite for food, etc for the past three days, the patient’s
experiences here are referred to as subjective data. Subjective data are therefore symptoms
of conditions that can only be obtained from a client/patient through assessment.

Objective data: These are assessment information obtained through observations (signs of a
condition) using our five senses or are discovered through physical examination, laboratory
investigations and diagnostic testing. It is either a measurement or an observation. Examples
of objective data are;

1. Body temperature
2. Pulse (Heart rate)
3. Respiration
4. Blood pressure

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 5. Facial expression
6. Wound
7. Dry skin, etc.

Methods of Gathering Nursing Data

Nursing data can be obtained through;

1. Observation- focuses on client’s physical condition and functions that can be seen.
2. Physical examination- It is a hand-on-skill that focuses on body systems and it
involves inspection, palpation, percussion and auscultation.
3. Interview- purposeful interaction between the client and the expert (nurse) aimed at
gathering data.

Sources of data

There are two main sources of data. These are;

1. Primary
2. Secondary

Primary source – This refers to data (useful information) collected directly from the client or
patient. It includes both subjective and objective data. The aspect of data that may be
collected from a client include;

A. Physical data: Demographic data such as name, age, sex, marital status, no. of
children, education background, past and present medical history.
B. Psychological data: These include client’s emotional state, mental status,
attitudes, coping strategies and history of psychological problems, etc.
C. Developmental data: refers to information on the growth and development of
the client.
D. Socio-economic data: Involves occupation, social status, income, life style,
etc.
E. Spiritual data: Religious affiliation
F. Environmental data: These include safe drinking water, housing, sanitation,
etc.

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Secondary source – data collected from family and significant others, health team members,
and medical records.

Information

1. Information is processed data that has meaning.

2. Information is data that has been organized or presented in a meaningful fashion.
3. It is data that is interpreted, organized or structured.
4. Information is a group of data elements that have been organized and processed so
that one can interpret the significance of the data elements.

For example:

1. Suppose someone states the number 99.5. What does that mean? It could be a
radio station or a score on a test. Now suppose someone says that Mr.
Sampong’s temperature is 41°C —what does that convey? It is then known
that 99.5 is a person’s temperature. The data (99.5) were processed to the
information that 99.5° is a specific person’s temperature.

Height, weight, age, and gender are data elements that can be used to calculate the Body
Mass Index (BMI). BMI is a person’s weight in kilograms divided by the square of height in
meters.

BMI = Weight ÷ (Height)² or Kg/m²

= 75kg ÷ (1.6m) ²
= 29.3kg/m²
The BMI can be used to determine if the individual is underweight, overweight, have
normal weight or obese.

Types of information

We have two types of information. These are;

1. Static information

Static information is information that are concrete, constant and stay same. Once a static
information source has been created, it is unlikely to be changed or updated for a significant
amount of time. Think about an encyclopaedia which has been produced on a CD-ROM.

42
Once the encyclopaedia has been written and checked for accuracy, it probably will not be
updated again for at least a year. So once the CD-ROM has been made the data will not
change - it will be static. Examples of static sources of information include books and
newspapers. It takes months or even years to write a book, edit it and publish it. Once they
are printed and published the information remains unchanged for a long time.

Dynamic information

Dynamic information on the other hand means to ever changing information. A good
example of a dynamic information source would be a web site which is updated on a regular
basis. Think about the Citifm, Joynews or BBC news web site – it changes throughout the
day as news stories happen around the world. The growth of video phones and satellite
technology means that news can be reported on whilst it is still happening.

However, you need to be clear that not all websites are dynamic information sources, some
could be classified as static. Although we are constantly adding new worksheets and pages to
this web site, the theory mini-web that you are using right now probably won't be updated
again for at least another year. That would be classified as a static source of information.

One must also take note of the fact that although many websites are updated regularly, there
is nothing to guarantee that the information is correct or unbiased. No one polices the internet
and basically anyone with access to web creation software and hosting space can create a web
site about anything they like. Unless the content is illegal, then it will stay on the web for
anyone to view.

Valuable and Meaningful Information

A valuable and meaningful information must be of good quality. Its value relates directly to
how the information informs decision making.

Characteristics of Valuable and Quality Information

Features of valuable and quality information include;

1. Accessibility: - The right of user (authorized) to obtain the right information at the
right time and in the right format to meet his or her needs.

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 2. Security: - preventing information from getting to unauthorized user.

3. Timeliness: - making information available when it is needed for the right purpose
and at the right time.

4. Accuracy: - no errors in the data and information.

5. Relevancy: - availability of right information for a particular need.

6. Completeness: - information must contain all the essential details.

7. Flexibility: - means that the information can be used for a variety of purposes.

8. Reliability: - information must come from clean data or authoritative and credible
sources.

9. Objectivity: - factual or impartial information.

10. Utility: - refers to the ability to provide the right information at the right time to the right
person for the right purpose.

11. Transparency: - information must be clear as much as possible so that the user can apply
or use the information to accomplish a task.

12. Verifiability: - means that one can check to verify or prove that the information is
correct.

13. Reproducibility: - the ability to produce the same information again.

Knowledge

Knowledge is the awareness and understanding of a set of information and ways that
information can be made useful to support a specific task or arrive at a decision.

Types of Knowledge

Knowledge could exist in essentially two forms,

1. Explicit knowledge:

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 These are factual or documented knowledge. It can be acquired through formal
education. This knowledge is expressed in words, numbers, and symbols and stored in
books, computers, etc. Explicit knowledge can be articulated and easily
communicated between individuals and organizations.
2. Tacit (Implicit) knowledge (“Know how”): This knowledge is acquired through
personal experience. This knowledge is not taught from a book but it is rather
acquired through experience of working in an organization or with others.

Wisdom

Wisdom may be defined as the appropriate use of data, information, and knowledge in
making decisions and implementing nursing actions. It includes the ability to integrate data,
information, and knowledge with professional values when managing specific human
problems. Wisdom of nursing is demonstrated when the nursing data, information and
knowledge are managed and used in making appropriate decisions that meet the health needs
of individuals, families, groups and communities (ANA, 2015)

Information System

As healthcare organizations have come to appreciate the importance of communication,

tracking, and research, however, they have developed integrated information systems that can
handle the needs of the entire organization. Examples of information system includes;

• Clinical Information System (CIS): it manages the administrative, financial, and

clinical aspects of a clinical facility.
• Decision Support System (DSS): Organizes and analyzes information to help
decision makers formulate decisions when they are unsure of their decision’s possible
outcomes.
• Executive Support System: Collects, organizes, analyzes, and summarizes vital
information to help executives or senior management with strategic decision making.
Provides a quick view of all strategic business activities.
• Geographic Information System (GIS): Collects, manipulates, analyzes, and
generates information related to geographic locations or the surface of the earth;
provides output in the form of virtual models, maps, or lists.

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 • Management Information System (MIS): Provides summaries of internal sources of
information, such as information from the transaction processing system, and
develops a series of routine reports for decision making.
• Office System: Facilitates communication and enhances the productivity of users
needing to process data and information.
• Transaction Processing System (TPS): Processes and records routine business
transactions, such as billing systems that create and send invoices to customers, and
payroll systems that generate employees’ paystubs and wage checks and calculate tax
payments.
• Hospital Information System (HIS): Manages the administrative, financial, and
clinical aspects of a hospital enterprise. It should help to link financial and clinical
outcomes.

Electronic Medical Record (EMR)/Electronic Health Record (EHR)

These two terms are almost used interchangeably. The electronic medical records replaced
paper records of a patient’s medical history. The electronic health record includes more
health data, test results, and treatments. It is also designed to share data with other electronic
health records so other healthcare providers can access a patient’s healthcare data. Examples
of EHR include;

Practice Management Software

It helps healthcare providers manage daily operations such as scheduling and billing.
Healthcare providers, from small practices to hospitals, use practice management systems to
automate many of the administrative tasks.

Master Patient Index (MPI)

It connects separate patient records across databases. The index has a record for each patient
that is registered at a healthcare organization and indexes all other records for that patient.
MPIs are used to reduce duplicate patient records and inaccurate patient information that can
lead to claim denials.

Patient Portals

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These allow patients to access their personal health data such as appointment information,
medications and lab results over an internet connection. Some patient portals allow active
communication with their physicians, prescription refill requests, and the ability to schedule
appointments.

Remote Patient Monitoring (RPM)

Also known as telehealth, it allows medical sensors (a device) to send patient data to
healthcare professionals. It frequently monitors blood glucose levels and blood pressure for
patients with chronic conditions. The data is used to detect medical events that require
intervention and can possibly become part of a larger population health study.

Benefits of Electronic Health Records (EHR)

1. It contribute to more effective communication.

2. It enhances the collection of patient information, resulting in more effective patient
care.
3. It maximizes the time nurses spend on direct patient care.
4. It improves accuracy of documentation.
5. It decrease medication errors.
6. It promotes patient safety.
7. It can store large amount of data that are accessible from remote sites by many people
at the same time.
8. It can provide clinical alert and reminders .
9. It can identify abnormal parameters of laboratory and assessment data and prompt
clinicians on important tasks.

Some Facilities Using EHR

2. Ridge Regional Hospital

3. Trust Hospital
4. UG Medical Centre
5. 37 Military Hospital
6. Accra Psychiatric Hospital

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 7. Korle-Bu Teaching Hospital
8. Kofo Anokye Teaching Hospital
9. Bank of Ghana Hospital
10. Tamale Teaching Hospital
11. International Maritime Hospital

Some Operating System Software use in some hospitals in Ghana

1. LHIMS – Lightwave Hospital Information Management System.

2. DHIMS – District Health Information Management System.
3. HEALTH PRO
4. HIMS – Hospital Information Management System.
5. HAMS - Hospital Availability Management System
6. HIS – Health Information System

What is Nursing science?

Nursing science is the development of theories and practical concepts for improving how
clinicians and patients administer care and manage conditions.

The American Nurses Association (2016) defines nursing as the protection, promotion, and
optimization of health and abilities, prevention of illness and injury, facilitation of healing,
alleviation of suffering through the diagnosis and treatment of human response, and advocacy
in the care of individuals, families, groups, communities, and populations.

The focus of nursing is on human responses to actual or potential health problems and
advocacy for various clients.

This definition of nursing science, therefore focuses on the ethical application of knowledge
acquired through education, research, and practice to provide services and interventions to
patients to maintain, enhance, or restore their health and to acquire, process, generate, and
disseminate nursing knowledge to advance the nursing profession.

Nursing is an information-intensive profession. The steps of using information, applying

knowledge to a problem, and acting with wisdom form the basis of nursing practice science.

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Consider this case scenario;

Kofi B. is a registered nurse who works in a very busy hospital emergency Unit. He has just
admitted a 69-year-old man whose children brought him to the hospital because he is having
difficulty in breathing. Kofi immediately clips a pulse oximeter to the patient’s finger and
performs a very quick assessment of the patient’s other vital signs. He discovers a rapid pulse
rate and a decreased oxygen saturation level in addition to the rapid and laboured breathing.
Kofi notices that the patient is not in immediate danger and that he does not require
intubation. Kofi focuses his initial attention on easing the patient’s laboured breathing by
elevating the head of the bed and put patient on oxygen ; he then hooks the patient up to a
heart monitor. Kofi continues to assess the patient’s breathing status as he performs a head-
to-toe assessment of the patient that leads to the nursing diagnoses and additional
interventions necessary to provide comprehensive care to this patient.

Cognitive Science

The term, “cognitive science” was coined by Prof. Hugh Christopher Longuet-Higgins (1923
– 2004). Cognitive Science therefore, refers to the study of the mind, intelligence, and
behaviour from an information-processing perspective.

In other words, cognitive science is simply the study of the mind and how information is
processed in the mind.

This type of the building block is an interdisciplinary field that explores the nature of the
mind, knowledge representation, language, problem solving, decision making, and the social
factors that influence the design and use of technology.

Connectionism

It is a component of cognitive science that uses computer modeling through artificial neural
networks to explain human intellectual abilities. Neural networks can be thought of as
interconnected simple processing devices or simplified models of the brain and nervous
system that consist of a considerable number of elements or units. The diagram below
represents artificial neural networks.

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 Dehydration

Dry mouth, muscle crumps, decreased urine production, dry skin, headaches & dizziness

Theoretical model of Nursing Informatics

The theoretical model that underpins Nursing informatics is called Novice to Expert Theory.
This theory was first proposed by Hubert and Stuart Dreyfus (siblings) in 1980 and was
called, “Dreyfus Model of Skill Acquisition”. This theory which is now called “Novice to
Expert theory” was modified and applied to Nursing informatics by Patricia Benner in 1984.

As presented by Benner, Novice to Expert theory involves five levels of development as

illustrated in the diagram below.

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Novice

A novice here is someone who does not know anything about the subject he/she is
approaching and has to memorize its context-free features. The novice needs guidelines to
help his or her studies. To improve, the novice needs monitoring, either by self-observation
or instructional feedback. For example, a nurse learning to use a new hospital information
system needs explicit instruction and rules to learn to use the computer interface and
manipulate the software.

Advanced Beginner

An advanced beginner is still dependent on rules, but as he/she gains more experience with
real-life situations, he/she begins to notice additional aspects that can be applied to related
conditions.

Competent

At this stage, the competent person grasps all the relevant rules and facts of the field and is,
for the first time, able to bring his/her own judgment to each case. This is the stage of
learning that is often characterized by the term problem-solving. A competent level nurse
would be able to use a hospital information system with ease and know how to solve
technical difficulties or interpret conflicting data.

Proficient

The fourth stage is called fluency. At this level the learner is knowledgeable in the field of
study and would be able to do step-by-step analysis and be able to solve problem holistically.
The proficient hospital information system learner would know how to interpret data from all
departmental information and provide guidance to other disciplinary members as needed.

Expert

An expert is someone who is very knowledgeable and very experienced in how things are
done in his or field of specialty ( has the technical know-how). Specific situations normally
dictates their instinctual appropriate action. He or she sees what needs to be done, and
decides how to do it. The expert not only knows what needs to be achieved, but he/she knows
how to achieve his or her goal.

51
Note

Both Dreyfus and Benner estimated that it takes approximately five years to move through
the five stages from novice to expert. They also explained that not all novices become
experts. Some people get 'stuck' at the competent or proficient stages. According them the
successful graduation from Novice to Expert level depends on two personal characteristics.
These are;

1. Deliberate practice;
2. The willingness to take risk to go beyond the “norm”.

Application of Novice to Expert theory

Within the field of nursing informatics, this theory can be applied to:

1. The development of nursing informatics skills, competencies, knowledge and expertise in

nursing informatics specialists.

2. The development of technological system competencies in practising nurses working in an

institution.

3. The education of nursing students, from first year to graduation.

4. The transition from graduate nurse to expert nurse.

What is the Goal of Nursing Informatics?

The goal of nursing informatics (NI) is to improve the health of populations, communities,
families, and individuals by optimizing information management and communication (ANA,
2001, p. 17). Information management is integral to providing high-quality health care cost-
effectively. To provide this level of care, it is important to have accurate clinical information.

Purposes of Nursing Informatics

1. To enhance all aspects of patient care and health management.

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 2. To study the process and structure of nursing information to support clinical decision-
making.
3. To help nurses know how to retrieve evidence-based information and render standard
care.
4. To help nurses access relevant information and use it efficiently to render quality care.
5. To safeguard personal records of patients.
6. To enhance sharing of data within the co-workers and other health disciplines.
7. To develop information-sharing network and data handling standards locally and
nationally.

Competencies of Informatics

All nurses need competencies in informatics. Level of competencies vary from;

1. beginning nurse,
2. experienced nurse,
3. informatics specialist, to
4. informatics innovator

The Beginning Nurses

The entering requirements for beginning nurse should include computer literacy and basic
information management skills. Computer literacy skills include skills in use of;

1. word processing,
2. healthcare database and spreadsheet applications,
3. presentation software, and
4. email.

Information literacy skills enable a nurse to locate, access, and evaluate clinical data. Access
includes the ability to perform bibliographic retrievals using the Internet and library-based
resources (McNeil et al., 2003).

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The important technology skills of the entry-level nurse include knowing how to use nursing-
specific software such as;

1. computerized documentation;
2. use of patient care technologies such as monitors, pumps, and medication dispensing;
3. information management for patient safety

The Experienced nurses

The experienced nurses should be skilled in;

1. information management and

2. computer technology;

to sustain their specific area of practice. These skills include making judgments based on
trends of data in addition to collaboration with informatics nurses (IN) in the development of
nursing systems.

An informatics nurse specialist (INS)

Informatics Nurse Specialist is expected to have advanced informatics preparation at the

graduate level and assists the practicing nurse in meeting his or her needs for information
(ANA, 2008).

The informatics innovator

The nurse informatics innovator is expected to have advanced informatics preparation and
possesses skills for conducting informatics research along with theory development (Thede,
2003).

Importance of Nursing Informatics

1. It enables the appropriate flow of data collected by nurses.

2. It improves access to patient information at the point of care.
3. It helps in the collection, storage, processing, retrieval and timely communication of
data across health facilities.
4. Facilitates the integration of data, information and knowledge to support clients,
nurses and other health providers in their decision making.

54
 5. It allows for evaluation of nursing practice.
6. It affords nurses a useful knowledge in decision making at the operational and
strategic planning level of health care.
7. It allows articulation of organized information.

Application of Nursing Informatics

Clinical Practice

• It helps to display physiologic parameters

• It helps to store and retrieve standardized nursing care information
• It monitors client progress and variance from plan.
• Develop technologies that support clinical decision making.
• It creates an integrated clinical information system.
• It facilitates and supports data collection, data entry as well as data retrieval.

Nursing Administration

• It helps in the establishment of database on each employee.

• It facilitates and improves communication through the use of E-mail and other social
media platforms.
• It promotes efficient data usage for quality assurance and nursing audit.
• It facilitates billing and budgeting
• It helps in staffing and staff scheduling.

Nursing Education

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 Distance learning/teaching via the internet.

• Online courses.
• Literature access and retrieval
• Online examination
• Computerized record-keeping.
• Computerized-assisted instruction.
• Distance Learning-Web based courses and degree programs.
• Presentation software for preparing slides (MS PowerPoint), MS Excel and MS
Word.

Research

• Evaluation of nurse-sensitive outcome measures using a standard minimum data set.

• Use of knowledge bases via the internet.
• Computerized literature searching -CINAHL, ERIC, Health Source, Medline,
psycINFO and other Web sources.

CINAHL (Cumulative Index to Nursing and Allied Health Literature): This is the
definitive research tool for nursing and allied health professionals.

ERIC - Education Resources Information Center.

• The ability to find trends in aggregated data, that is data derived from large population
groups - Statistical Software, SPSS.
SPSS - Statistical Package for the Social Sciences.

• Recording of workload and interventions as a by-product of electronic charting.

Benefits of Nursing Informatics

1. It improves access to nursing records.

2. Reduces time spent on documentation.
3. It increases patient contact hours

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4. Facilitates data collection for research
5. Easy access to multiple information.
6. Improves communication and decreases error.
7. Provides historical and current data reports for effective data management and trend
finding.
8. Support software provides alert to any discrepancies in patient medications.
9. Support software helps to identify food allergies.
10. It reduces turnaround time.
11. It helps nurses and midwives work faster, smarter and makes them more competent.

Limitation of Nursing Informatics

1. It needs complex conceptual design process.

2. It is very expensive.
3. Highly dependent operations systems.
4. There can be system failures
5. Need for multiple external databases.

NURSE INFORMATICIST

A Nurse informatics Specialist (Informaticist) is a nurse who has formal education,

certification and practical experience in using computers in patient care setting.

Responsibilities and Duties of Nurse Informaticist

Nurse informaticists play a critical role in not only developing health care technology but
educating staff and evaluating the results of implementation. Other responsibilities and duties
include:

1. Assessing and analyzing health care technology needs.

2. Designing systems technology.
3. Testing systems technology
4. Implementing the technology which also includes:
a. Staff training

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 b. Troubleshooting
c. Escalating issues as needed
5. Assisting in the transition from one system's technology to another.
6. Evaluating the success of implementation; revising as needed.
7. Serving as project managers.
8. Assisting in ensuring organizations meet state health care laws and regulations.
9. Serving as a resource to staff.
10. Serving as a liaison between staff and information technology experts.
11. Assessing user requirements and developing solutions.
12. Serving as an educator to staff and new nurses.
13. Developing organizational policies and standards.
14. Researching different informatics topics that affect health care providers as well as
patients.

Ethical Application of Nursing Informatics

TELEMEDICINE (TELEHEALTH)

The term “Telemedicine” was coined in the 1970s, which literally means “healing at a
distance” (Strehle & Shabde, 2006). This signifies the use of ICT to improve patient
outcomes by increasing access to care and medical information.

Definition of Telemedicine

Telemedicine can be defined as the use of technology (computers, video, phone, messaging)
by a medical professional to diagnose and treat patients in a remote locations.

According to WHO, Telemedicine is the delivery of health care services, where distance is a
critical factor, by all health care professionals using information and communication

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technologies for the exchange of valid information for diagnosis, treatment and prevention of
disease and injuries, research and evaluation, and for the continuing education of health care
providers, all in the interests of advancing the health of individuals and their communities
(WHO, 1998).

Branches of Telemedicine

Telenursing: refers to the use of telecommunications and information technology in order to

provide nursing services in health care whenever a large physical distance exists between
patient and nurse, or between any number of nurses.

Telepharmacy: is the delivery of pharmaceutical care via telecommunications to patients in

locations where they may not have direct contact with a pharmacist.

Telepsychiatry:, another aspect of telemedicine, also utilizes videoconferencing for patients

residing in underserved areas to access psychiatric services.

Teledermatology: allows dermatology consultations over a distance using audio, visual and
data communication, and has been found to improve efficiency

Teledentistry: is the use of information technology and telecommunications for dental care,
consultation, education, and public awareness in the same manner as telehealth and
telemedicine.

Teleophthalmology: is a branch of telemedicine that delivers eye care through digital

medical equipment and telecommunications technology.

Purpose of Telemedicine

1. It is to provide clinical support.

2. It is intended to overcome geographical barriers, connecting users who are not in the
same physical location.
3. Its goal is to improve health outcomes.

Benefits of Telemedicine

1. Easy access to specialists

2. Lower cost of health care.
3. It gives medical access for people without health insurance
4. Medical access for people in rural areas.
5. Medical access for people in underserved urban areas.
6. Reduced exposure to pathogens.
7. Middle-of-the-night care for babies and children.

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 8. Doctors get to stay home and operate from home during a pandemic.
9. Reduced medical overhead costs.
10. Support for people with chronic conditions.
11. Access to online psychiatric support.

Limitation of Telemedicine

1. Telemedicine does not allow doctors to take blood or urine samples.

2. Doctors can not use a stethoscope to listen to your heart or breathing, take your blood
pressure, or take other vitals.
3. Doctors also rely on visual assessments, which may be harder to perform virtually.
4. Other tests, such as mammograms, Pap smears, sonograms, and eye pressure exams
for glaucoma, cannot be done virtually.
5. Children who receive services such as speech therapy may have trouble concentrating
or working with their therapists remotely.
6. Lack of internet connectivity.
7. Poor internet service.
8. It may be expensive to use.

System Integration

System integration can be defined as;

• The process of linking together different computing systems and software applications
both physically and functional to act as a coordinated whole.
• The process of connecting different sub-systems (components) into a single larger
system that functions as one.

The main reason for system integration is to;

a. improve productivity
b. improve quality of operations

Integrated Healthcare System (IHS)

IHS is the organization and management of health services so that people get the care they
need, when they need it, in ways that are user-friendly, achieve the desired results and
provide value for money (WHO, 2017). It is characterized by the sharing of information
among team members related to patient care.

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The primary focus of IHS is to provide a coordinated health care to patients and their
families.

Types of Integrated Healthcare System

Integrated healthcare system can be classified into;

• Horizontal Healthcare System

• Vertical healthcare system

Importance of Integrated Health System

• It allows the establishment of a comprehensive treatment plan.

• Integrated healthcare management plans deal with the patient’s biological,
psychological, and social needs.
• It converts the EHR into an accessible source of integrated health information systems.
• It creates dynamic clinical integration and effective communication.
• System integration works best for patients having complex behavioural health needs.
• Many complex conditions can be handled through online practice management at a
lower cost using integrated models.
• It improves medical records management and reduce costs by automated healthcare
solutions.

Benefits of Integrated healthcare system

• Easy data access

• Remote patients monitoring
• Management of chronic diseases

Interoperability and Intra-operability

Interoperability – refers to the ability of different information technology systems and

software applications to communicate, exchange data and use the information that has been
exchanged. This facilitates the exchange of data between clinicians, labs, hospitals,
pharmacies, etc.

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Or it is the ability to communicate, collect data, and use information for patient care by many
users who need access to patient information.

Intra-operability- describes the exchange of data between systems used in the same
organization or developed by the same vendor. This strictly focuses on operations within
certain parameters.

Change Process in Nursing

Change is the process of altering or replacing existing knowledge, skills, attitudes, systems,
policies, or procedures.

Though change is a dynamic process that necessitates alterations in behaviour and usually
causes some conflict and resistance, it also can stimulate positive behaviours and attitudes and
improve organizational outcomes and employee performance.

Change can be the result of;

1. identified problems in existing knowledge,

2. skills,
3. systems,
4. the need to change established ways of conducting business because of
alterations in knowledge, technology, management, or leadership.

Change may be necessary due to change in;

1. organizational structure or goals

2. accreditation criteria,
3. advances in diagnosis, treatments and patient outcomes.

It is important to note that change at any level requires different behaviour from the people
involved. Skills needed to effect change include;

1. leadership,
2. management,
3. political savvy (know-how),
4. analytical,
5. interpersonal,

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 6. system,
7. business, and
8. communication skills (Nickols, 2007; O’Shea, 2002).

Key things to remember in change process

1. Employees will react differently to change, no matter how important or advantageous

the change is purported to be.
2. Basic needs will influence reaction to change (such as the need to be part of the
change process, the need to be able to express oneself openly and honestly, and the
need to feel that one has some control over the impact of change).
3. Change often results in loss (e.g., downsizing, changes in established routines) and
employees may react with shock, anger, and resistance, and, hopefully, ultimate
acceptance.
4. Change must be managed realistically, without false hopes and expectations, yet with
enthusiasm for the future.
5. It is important that management deal with the fears and concerns triggered by change
in an honest manner (Monaghan, 2009; Team Technology, 2014).

Group Presentation

- Change Theories in Nursing;

1. Kurt Lewin’s change Theory
2. William Bridges change theory
3. Lippit's Change theory
4. Roger’s change theory

- Management and Change Process in Nursing

- System implementation and maintenance

THANK YOU

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Bibliography

American Nurses Association. (2001). Scope and Standards for Nursing Informatics
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