Introducing the use of a stethoscope precedes learning how to listen to heart and

lung sounds. To be effective in using the stethoscope, a clinician needs to know

when to use the bell and when to use the diaphragm. In the same way, it is
imperative to have some understanding of how and when to use the tool of
informatics, the computer.

A complete computer system is the integration of human input and information

resources using hardware and software. In computer terms, hardware refers to
objects such as disks, disk drives, monitors, keyboards, speakers, printers, mice,
boards, chips, and the computer itself. Software includes programs that give
instructions to the computer that make the machine useful. Information resources
are data that the computer manipulates. Human input refers to the entire spectrum
of human involvement, including deciding what is to be input and how it is to be
processed as well as evaluating output and deciding how it should be used. In this
chapter, we look at the computer, and in the next, at software.

COMPUTER MISCONCEPTIONS

When computers were new, there were

many fears and misconceptions about
using them. Some of these were
computers can think, computers
require a mathematical genius to use,
and computers make mistakes (Perry,
1982). Today there are other
misconceptions, perhaps born of
familiarity, which can be dangerous to
users. It is important to understand that
computers cannot think, and they are
not smart. Incidents like the one in
which Deep Blue (the nickname given
to an IBM computer specially designed
to play chess) won a chess game
against world champion Garry
Kasparov led to such misperceptions.
Consider the game of chess. Although
there are many possible combinations,
there are a given set of moves, rules,
and goals that make it a perfect stage
to display the potential of computers.
Deep Blue is a very powerful computer,
capable of quickly analyzing hundreds
of millions of possible moves and
responding according to rules (known
as algorithms) that were part of the
software that beat Kasparov. It made
use of these qualities to beat Kasparov.
It did not use thinking in the human
sense.

The thought that only mathematical

geniuses can use computers, although
just as false, continues to flourish. This
belief is linked to the development of
the first computers as a means to
"crunch numbers," or process
mathematical equations. Hence, in
colleges and universities, many
computer departments are still housed
in, or closely related to, the
departments of mathematics. It did not
take experts long to translate the
mathematical concepts into everyday
language, an accomplishment that
made the computer available to
everyone, regardless of level of
proficiency in math.
The last myth, that computers make
mistakes, makes it a wonderful excuse
for human error. This was well
illustrated by a cartoon in the early
1990s that showed a man saying, "It's
wonderful to be able to blame my
mistakes at the office on the computer,
I think I'll get a personal computer."
Computers act on the information they
are given. As one humorist said,
"Computers are designed to DWIS, or
Do What I Say" As many a user will tell
you, they resist with great
determination any inclination to DWIM,
or "Do What I Mean!" Unlike a
colleague to whom you only need to
give partial instructions because the
person is able to fill in the rest, a
computer requires complete, definitive,
black-and-white directions. Unlike
humans, computers cannot perceive
that a colon and semicolon are closely
related, and in many cases, a
computer believes that an uppercase
letter and a lower case letter are as
different as the letter A from the letter
X. This is known as case sensitivity.
There are no "almosts" with a
computer.

COMPUTER CHARACTERISTICS
A computer accomplishes many
things that are impossible without it.
When programmed properly, it is
superb in remembering and
processing details, calculating
accurately, printing reports,
facilitating editing documents, and
sparing users many repetitive,
tedious tasks, which frees time for
more productive endeavors.
Remember, however, that computers
are not infallible. Being electronic,
they are subject to electrical
problems. Humans build computers,
program them, and enter data into
them. For these reasons, many
situations can cause error and
frustration. Two of the most common
challenges with computers are
"glitches" and the "garbage in,
garbage out" (GIGO) principle . That
is, if data input has errors, then the
output will be erroneous.

Anyone, who had been using a

computer when it crashed or "went
down" may have experienced a guilty
feeling that she or he did something
wrong. If the person actually did
create the crash, unless she or he
were purposely engaged in
something destructive, that person
did not cause the crash; she or he
just found a flaw in the system that
was inadvertently created by the
programmer(s).There are times,
however, when crashes occur for
seemingly no reason. Computers,
regardless of their manufacturer, will
at some time, for unknown reasons,
perform in a totally unexpected
manner (Perry, 1982). This is as true
today as when computers were new.
The good news is that this is much
less apt to happen despite the
complexity of today's computers.

OVERCOMING COMPUTER
ANXIETY

The attitudes people have toward

computers range from complete
dislike and frustration to curiosity
and excitement. Although the mass
media and personal acquaintances
convey both perceptions, people
seem to remember the negative
points more clearly. As with all new
experiences, becoming acquainted
with a computer or learning a new
computer application can produce
anxiety. When computers in
healthcare were fairly new, many
studies were done that looked at
the attitude of nurses toward
computers (Focus, 1995; McBride
& Nagle, 1996; Simpson & Kenrick,
1997). Today, these studies look at
the attitudes and anxiety toward
the electronic health record (Chan,
2007; Dillon, Blankenship, &
Crews, 2005). It is highly likely that
the same type of anxieties were
present when the general
population found it necessary to
learn to drive. There are, however,
no known studies of this
phenomena dating from that time
(Box 2-1).

Addressing these fears takes time

for both a trainer and the individual
experiencing the fears.
One-on-one sessions for the
person affected may be necessary
and save time in the long run by
preventing frantic calls to the help
center. Studies show that the
learning patterns of those afraid of
computers can be improved by
treating the bodily symptoms of
anxiety and providing distracting
thought patterns (Bloom, 1985).
Techniques, such as teaching
relaxation methods before starting
any hands-on training, often helps,
as does giving the anxious trainee
something to repeat internally such
as, "You're in control, not the
computer."

Other helpful techniques include

recognizing and accepting fear.
One method is to have trainees
check off from a list of possible
feelings (e.g. panicky, lost, curious)
those that they are feeling, a
practice that can help them face
their fears. Inherent in all these
terrors is the fear of failure and of
looking incompetent in front of their
peers. This may be especially
evident in people who see
themselves as having a high
degree of competence in their
profession and to whom people
look for answers. Therefore,
placing themselves in a learning
situation can be very threatening to
their self-image.
 TYPES OF COMPUTERS

The progress in computers is

measured by generations, each of
which grew out of a new
innovation. Computer sizes vary
from supercomputers intended to
process large amounts of data for
one user at a time to small palmtop
computers. Each type has its niche
in healthcare. However, it is
becoming increasingly difficult to
classify the different types of
computers, because smaller ones
take on the characteristics of their
bigger brothers as the amount of
space needed for processing
lessens.

Supercomputers
Technically, supercomputers are
the most powerful type of
computer, if power is judged by the
ability to do numerical calculations.
Supercomputers can process
hundreds of millions of instructions
per second. They are used in
applications that require extensive
mathematical calculations, such as
weather forecasts, fluid dynamic
calculations, and nuclear energy
research. Supercomputers are
designed to execute only one task
at a time; hence, they devote all
their resources to this one
situation. This gives them the
speed they need for their tasks.
Mainframes
The first computers were large,
often taking up an entire room.
They were known as mainframes
and were designed to serve many
users and run many programs at
the same time. These computers
formed the backbone of many
hospital information systems.
Users used what were technically
called videotext terminals, but
often referred to as "dumb
terminals." A videotext terminal
consisted of a display screen,
keyboard, and modem or device
that connected it to the mainframe.
Information was entered on the
keyboard and transmitted to the
mainframe, which was located
somewhere else, often in the
basement in a secure,
temperature-controlled room. Any
processing done to the information
was done by the mainframe, which
returns the results to the screen of
the videotext terminal. This is why
you still find the IS departments in
the basement of hospitals.

Minicomputers
As computers became more
powerful, their size was reduced.
The same work done by a
mainframe became amenable to
being accomplished on what was
termed a minicomputer.
Minicomputers were like
mainframes (i.e., they were
multiuser machines that originally
served videotext terminals), but
they were smaller and less costly
unlike larger mainframes, they did
not require a special
temperature-controlled room and
were useful in situations with fewer
users. As computers started to be
built in many sizes, it became
impossible to classify one as a
mainframe or another as a
minicomputer; these terms are
seldom used today.

Servers
The functions served by
mainframes and minicomputers
today are performed by computers
of varying sizes, which are referred
to as servers. The functions
performed by servers and their
powers are as varied as the needs
of the users. These functions vary
from servers that operate in the
mainframe/video text format
especially in hospital information
systems to those that are just a
repository for files (a user-created
item) that are "served" to users
who have software that does the
processing on their personal
computer (PC). Some servers in
the middle of this continuum may
also store the programs that a user
needs and provide them as
needed by the user.

Thin Clients
Thin clients are today's version of
the video-text terminal. These are
computers without a hard drive and
with limited, if any, processing
power. Besides costing much less,
thin clients do not need to be
upgraded when new software is
made available because they do
not contain any applications.
Because they do no processing,
older PCs can function in this
capacity instead of being retired.

Personal or Single-User
Computers
PCs are designed for one
individual to use at a time. PCs are
based on microprocessor
technology that enables
manufacturers to put an entire
processing (controlling) unit on one
chip, thus permitting the small size.
When PCs were adopted in
business, they freed users from the
resource limitations of the
mainframe computer and allowed
data processing staff to
concentrate on tasks that needed a
large system. Today, although
capable of functioning without
being connected to a network, in
businesses including healthcare,
PCs are usually connected or
networked to either other PCs or
servers. They still process
information, but when networked,
they can also share data. In
information systems, PCs often
replace the old videotext terminal
and handle the tasks of entering
and retrieving information from the
central computer or server,
although thin clients may be used
for this purpose instead. When a
full PC is available on the unit,
personnel can use application
programs such as word
processing. PCs are available in
many different formats such as a
desktop or tower model, laptops,
and tablet computers.

Desktop and Towers. The original

PC was a desktop model. You are
probably familiar with these. They
were placed horizontally on a desk
and a monitor was placed on top of
them. As the use of computers
became more common, users
were reluctant to give up desk
space to their computer, and
computers that stood upright,
known as towers, were developed.
With these, only the monitor
needed was on the desk, while the
computer itself stood on the floor,
often under the desk.

Laptops/Notebooks. As computer
usage became popular, people
found that they needed the files
and software on their computer to
accomplish tasks away from their
desks. The first computer that
made this practical was really more
transportable than portable.
Developed in the 1980s, it was
about the size of a desktop and
had a built-in monitor. Toward the
end of the 1980s, the
transportables were replaced by
true portables: laptops, or
computers small enough to fit on
one's lap. As technology continued
to place more information on a
chip, laptops became smaller.
They are now referred to as
notebook computers. Some
healthcare organizations use
notebook computers for
point-of-care (POC) data entry at
the bedside or anyplace where
care is delivered.

Notebook computers do have

some drawbacks. The screen is
usually smaller than the one in a
desktop, and the resolution may
not be as crisp. Keyboards are
also smaller. The mouse, or
pointing and selecting device, can
be a button the size of a pencil
eraser in the middle of the
keyboard, or a small square on the
user end of the keyboard, or a
small ball embedded in the
keyboard. Some users purchase
docking stations for their notebook
computers. The computer can be
placed in the docking station (may
be called a port replicator, or
notebook extender), which is
connected to hardware such as a
larger monitor, keyboard, and
regular mouse. This enables the
user to have access to these
devices when at their desk, but
makes it easy to remove the
computer and enjoy its portability,
albeit, without the hardware
connected to the docking station.

Other Mobile Computers. Again,

as the processing power and
storage capacity of computers
increased, there was a demand for
mobile computers that were more
versatile than laptops. The
subnotebook and tablet computer
are some of these as are personal
digital assistants (PDAs).
Basic Computer Ideas

For most people the inner workings of a

television are a mystery, but that does
not stop them from using and enjoying
television. In the same way, it is not
necessary to understand all the details
of computer technology before it can be
used to great advantage. This lesson is
intended to give an adequate but not
exhaustive understanding of computers,
thus enabling the student to take
confident advantage of whatever
computer technology is available. There
are generally two main parts to any
computer system.

Hardware is the term that describes the physical pieces of the computer,
commonly grouped into five categories.

1. Input - Data must be placed into the computer before the computer can be useful.
2.
Memory - All data processing takes place in memory.
3.
Central processing unit (CPU) - This is the "brain" of the computer, which
coordinates all the activities and does the actual data processing.
4.
Storage - The data and programs can be saved for future use.
5.
Output - Processed data are of little value to people unless they can see the data
in some form.

Hardware can be considered the anatomy of a computer, its physical, mechanical

portion.
 Input devices CPU Storage device (Hard
Drive)

Output devices Memory (RAM)

Software is the term that describes the nonphysical pieces. It can be grouped into
two categories.

1. Operating system - This is the collection of standard computer activities that need
to be done consistently and reliably. These processes are the building blocks for
computer functions and programs. Well known examples include Microsoft
Windows, Apple OS X, and the open source Linux flavors.
2.
Application programs - These are packages of instructions that com­bine logic
and mathematical processing using the building blocks of the computer. Programs
are what make computers valuable to people by transforming raw data into
information. Examples of applications include spreadsheets, word processing,
games, photo managers, etc.
 Operating Systems Application Programs

Software can be considered the physiology of a computer, the instructions that

make its anatomy function properly. These pieces of a computer are described
later in more detail, but it is important to have a mental picture of a "computer"
before we proceed. It is also helpful to understand some computer terminology (or
jargon) that often overwhelms or confuses.

Common Computer Terms

• Chip refers to a small piece of silicon that has electronic logic circuits built into it.
A chip can hold thousands of circuits in something that is about one-quarter of an
inch on each side. The chip is the fundamental physical piece used for computer
memory and central processing units.

• RAM and ROM are the two types of memory that a computer uses. ROM stands
for Read-Only Memory. This memory has information already stored in it by the
computer manufacturer, and nothing is allowed to change that information. RAM
stands for Random-Access Memory. This memory has no information in it but is
available for any program to store information.

• Bit is the smallest part of computer memory. It can hold exactly one piece of
information that has only two possible values, either a one (1) or a zero (0). This
"two-value" system is called a binary system.

• Byte is the fundamental grouping of bits used to make up computer mem­ory. By

grouping bits together and setting these bits to either 0 or 1 in different
combinations, a coding scheme can be built to represent informa­tion. The byte is
the basic measuring unit for memory capacity or storage capacity.

• Kilo, mega, and giga are prefixes that represent certain multipliers. Al­though
"kilo" in scientific notation means “1000" (103), its value is changed to "1024" (210)
when talking about computer memory or storage. Numbers that are powers of 2
(e.g., 4 is a power of 2, being 22) are chosen because the computer uses a binary
system. Thus, one kilobyte of computer memory represents 1024 (1 x 1024) bytes,
two kilobytes represent 2048 (2 x 1024) bytes, and so on. One megabyte
represents 1,048,576 (1024 x 1024) bytes, and one gigabyte represents
1,073,741,824 bytes (1024 x 1024 x 1024). Although it is not accurate, most
people tend to still give kilo, mega, and giga their normal values of 103,106, and
109 when referring to computers.

• Megahertz (MHz) and gigahertz (GHz) describe the frequency that the central
processing unit's internal clock uses for its timing control.

Computer technology has had an explosive growth during the past several
decades. The large computers that used to fill their own special purpose rooms
have in many cases been replaced by computers small enough to fit on a desk
("desktop" model), on one's lap ("laptop" model), or in the palm of one's hand
("palmtop" computers). This trend is expected to continue.
Keyboard

The keyboard is the primary data entry

tool for every computer. Commonly,
keyboards consist of an alpha,
typewriter formatted layout. Most have
an accounting/calculator type of
numeric pad to the right of the alpha
layout for easy financial information
entry. Additionally, there is a
numeric/symbols row across the top of
the alpha layout, very similar to a
typewriter.

Between the alpha and the

calculator/numeric pad on a keyboard is
a set of page command keys. These
usually control the page, such as Insert,
Delete, Home, End, Page Up and Page
Down. In this general area of the
keyboard, also reside directional arrow
keys that help you to navigate around
the page of your document or website.

Across the very top of the keyboard is a

row of Function Keys, usually
designated as such with labels such as
F1, F2, F3, etc. These keys are used to
accomplish specific functions within the
context of each software program.
When using a new software package, it
is best to read the Commands &
Function Keys pages of the manual to
learn how the F Keys work inside of the
particular program. And finally, there are
keys along either side of the alpha
layout which, similar to a typewriter,
help to navigate around the document.
The Tab key helps to insert indents; the
Caps Lock will put you into an all bold
mode; the Backspace key will
simultaneously back up your cursor and
erase the text you just typed; the Shift
key is a temporary capitalization or
upper case character of the key; and
the Enter key is also known as a hard
return and designates a deliberate line
space.
Mouse

The Mouse or clicker as it is known in

some places, is the small, palm sized
device created by the industry to help
the user short cut command keys on the
keyboard, and to navigate around
computer software, an internet page, or
a document.

Click is the primary function of the

mouse. The user simply points and
clicks onto whatever they desire to see.
On the internet and in software
documents, a double click is required to
open the page or document. Most
mouse designs have a left button, right
button, and a roll button on the top
center of the mouse. The left button is
for the click and the double click
functions, and the right button is for
Reveal or Copy codes in internet pages
and software screens.

The roll button on the top and center of

your mouse is for quick scrolling
through a page. This saves the operator
grief when using the scroll bar on the
right side of the monitor. Some scroll
bars can be awkward. It is also helpful
when copying large amounts of text that
require rolling the page down, since it
makes it easier to copy and scroll
without having to use the side scroll bar.
Central Processing Unit

The CPU of a computer is often referred to as the brains or the brain center.
Technically, the term CPU is an abbreviation for Central Processing Unit. Also
known among computer geeks as the box, the CPU is housed inside of metal
housing which usually includes floppy drives, hard drives and other peripheral.

The CPU itself includes what is known as the motherboard of the computer – the
central board which holds all of the computer's RAM [random access memory] and
all of the related components such as cooling fans, resistors and other electronic
parts which cause the computer to function properly. The computer's RAM size
determines the size of programs the computer can use. Generally, a software
package will have a RAM quote on it – that is, the amount of RAM necessary to
operate the program. A computer operator must check the software requirements
for RAM against the system's known size. Most programs today require no more
than 512MB [mega bytes] of RAM to operate.

Also contained in the CPU and the motherboard, is the computer's ROM [read only
memory], another essential component of the computer's brains. The ROM
functions in the motherboard to contain or store the program or programs which
boot-up [or start up] the computer. Anytime the ROM in a computer is damaged on
the motherboard, then the computer will not start up correctly and possibly not at
all
Processors

● Memory
The two basic types of memory, ROM and RAM, were defined earlier.
Generally, a computer has a sufficient amount of ROM built in by the
manufacturer. ROM is preloaded with the low-level logic and processes
needed to start the computer when its power is turned on (a process called
"booting up"). Most computers also have a starting amount of RAM
preinstalled. RAM can be purchased separately, though, and installed as
needed. Application programs are loaded, when called for, into RAM. The
program executes there and stores information in other parts of RAM as is
needed. Today, application programs have growing RAM requirements as
more logic and functions are packed in them.
● Central Processing Unit
The CPU of a computer is often referred to as the brains or the brain center.
Technically, the term CPU is an abbreviation for Central Processing Unit. Also
known among computer geeks as the box, the CPU is housed inside of metal
housing which usually includes floppy drives, hard drives and other peripheral.
The CPU itself includes what is known as the motherboard of the computer –
the central board which holds all of the computer's RAM [random access
memory] and all of the related components such as cooling fans, resistors and
other electronic parts which cause the computer to function properly. The
computer's RAM size determines the size of programs the computer can use.
Generally, a software package will have a RAM quote on it – that is, the
amount of RAM necessary to operate the program. A computer operator must
check the software requirements for RAM against the system's known size.
Most programs today require no more than 512MB [mega bytes] of RAM to
operate.
Also contained in the CPU and the motherboard, is the computer's ROM [read
only memory], another essential component of the computer's brains. The
ROM functions in the motherboard to contain or store the program or
programs which boot-up [or start up] the computer. Anytime the ROM in a
computer is damaged on the motherboard, then the computer will not start up
correctly and possibly not at all.
There are several types of CPU chips. In the personal computer world, the
Intel Corporation is probably the most recognized manufacturer with, first, its
80 x 86 series of CPU chips (i.e., 80386,80486,...) and then its Pentium chip
(i.e., Pentium 4 or P4) series. In the large computer world, IBM (International
Business Machines) is probably the most recognized name.
 ●
● One measure of CPU processing capacity is called MIPS ("millions of
instructions per second.") Although not a totally accurate measure, it is useful
to see the growth of processing capacity over time. Intel's 80386 chip,
produced in 1985, was rated at 5 MIPS. Intel's Pentium chip, introduced 8
years later in 1993, was rated at 100 MIPS—about 20 times faster. Intel's
Pentium 4 chip, made 7 years later in 2000, was rated at 1700 MIPS.
All CPUs have three basic elements: a control unit, an arithmetic logic unit
(ALU), and an internal memory unit. The ALU performs all the mathematical
operations, the control unit determines where and when to send information
being used by the ALU, and the internal memory is used to hold and store
information for those operations. The CPU has an internal system clock that it
uses to keep everything in synchronized order. The clock's speed is described
in terms of frequency, using megahertz (MHz) or gigahertz (GHz), so a CPU
might be described as having a clock speed of 450 MHz or 2.4 GHz.
Generally, the faster the clock, the faster the CPU can process information.
Storage

The memory of a computer is not the place to store information and programs for a
long time. ROM is read-only (unwritable) and therefore not of any use. RAM holds
programs and information but only so long as the computer is turned on; once
turned off; all information in RAM is gone. Therefore other means are used for
long-term storage, the most common technologies being magnetic, optical, and
special nonvolatile memory.

Hard Drive Flash Drive CD Drives

Floppy Disk Removable Disk Drive Tape

●
Hard Drive is the computer's primary data storage unit. The hard drive
generally holds all of your programs and all of your created, downloaded
and saved data.
● A flash drive is a small, portable drive that can hold as much as small hard
drives [internal drive]. Most flash drives are the size of a small cigarette
lighter and fit in the palm of your hand. They come in several popular sizes,
most commonly: 512MB; 1GB; and 2GB. They range on average from
$19.95 to $99.95 and are popular among the jet set, executive crowd.
Memorex gives theirs a standard dog-tag styled neck rope similar to
company security passes that makes it easy to carry and access.
Flash drives have replaced the older floppy drives, they are easier to use
and they hold a lot more information on them. They are quickly inserted,
accessed, and removed from most small and personal computers. Older
computers have their USB ports in the rear of the CPU [where the power
cord plugs in], while the newer computers have the USB port in the front,
 next to the CD drive. The USB port is what the flash drive plugs into directly.
The cool thing about the flash drive, other than its portability, is that when
you plug it in you do not have to go searching to find it in the computer. The
USB port on any computer will automatically prompt the computer to pull up
the flash drive for the user. From that point, you simply click and select your
file to use or save.
● CD drives read documents saved on CDs [compact disk]. A CD will hold up
to 700MB of information on it. Most CDs are not erasable, so they do not yet
have the flexibility of the earlier floppy drive. However, the CD is a more
reliable storage tool because it is sealed into a digital format. Unless you
break your CD, the information is relatively safe.
Most computer programs and teaching programs are sold on CD. When you
buy a new computer program, you download it from a CD and the CD
serves as your backup information. If your computer has a CD burner in it,
then you can also make CDs of anything you create. You create the file,
save it, and burn it into a new CD. Then it is available to share with others
on their computers.
● Floppy Drive is an older type of information saving device that is still
peripherally in use. Generally, a floppy disk is a 3.5 inch disk encased in
plastic with a sliding access panel for the computer to read the information
from. Users insert a floppy disk into the floppy drive, usually located on the
front panel of your CPU, and save data onto the floppy for use at their
convenience and in other locations.
Today, the CD drive and the flash drive are replacing the floppy drive.
However, there are still quite a number of small businesses and personal
computer users which rely on floppy drives to save their creations and
company information.
● Removable Disk Drive is the same kind of device as a hard disk drive with
similar storage capabilities. The difference is that the magnetic storage
media can be removed and replaced, just as with a floppy disk.
● Tape describes a medium that can magnetically encode a lot of information.
In many ways, tape in a computer system is used like audio tape. Computer
tape is typically used to store a copy of important information, to be
recovered in case of a major problem with the computer. Tape is packaged
in various ways, from large reels to small cartridges. Tape is reusable.
Output

Printer
Plotter
Monitor

●
Monitor is the visual display screen for the contents of the computer and
the data being worked on or viewed. It is similar to a television screen and it
displays the computer's content at a comfortable brightness and resolution.
The older monitors are large and bulky like a small office machine. Jokingly
referred to by geeks as "boat anchors", the older, large monitors are on their
way out of popular use. The newer monitors are similar to the newer
televisions in that they are light weight and slim. Generally, the newer
monitors weight under 3 pounds, are 4 inches or less in thickness, and are
referred to as flat screens. The most common sized monitors used in small
business and home computer operations are 15", 17" and 19" screens.
Monitors can be adjusted internally to accommodate the operator's comfort
level for viewing. The lower the resolution selected, the larger the lettering is
on the screen. Most monitors can be adjusted for a resolution level between
600 X 800 pixels [micro dots per inch] to 1280 X 1024 pixels. There are two
reasons to adjust the resolution:
○ Size and/or use of the monitor – larger screens require smaller resolution,
and gaming programs require smaller resolution for the best experience.
○ To make the user more visually comfortable – smaller resolution will cause
the letters in any screen to appear larger.

● To find the adjustment page screen for a Windows XP computer, go to the

Start button on the bottom left of the Task Bar, click onto the Start button
and go to Settings, and then to Control Panel and click. You will open the
Control Panel's selection of options. Double click onto Display, and you will
open the Display Properties. From this point, you want to select the Settings
tab. On the left side of this screen, about midway down, you will see a slide
bar which will allow you to adjust the resolution. Slide to smaller or larger,
according to your need, and then click onto Apply. From here you can close
out of the entire Control Panel and your computer will automatically update
according to your changes.
 Visually impaired individuals now have options not available 10 years ago
for their computer use. Included in these options are:
○ Screen readers – which will read the information displayed on the screen to
the visually impaired user.
○ Text readers – which will read text out loud that is typed into the user's
keyboard, a text reader also reads out loud emails and common word
processed documents, and
○ Screen magnifiers – which magnify the content of the screen from 2X to
16X its original size.
● Monitor is the most common way a person sees the information and
instructions on a computer. Historically, on desktop computers the monitor
looks like a television screen and uses the same display technology as a
television. On laptop computers ("small enough to fit in your lap"), the
monitor is a flat screen that uses liquid crystal display (LCD) technology.
This LCD technology is increasingly being used in desktop monitors as well.
Some other names for the monitor are VDT (video display terminal), CRT
(cathode ray tube), screen, and display.
● Printers and plotters are two ways by which the computer can put the
processed information, such as a report or a chart, onto paper for people. The
most common output device in offices is the laser printer, capable of putting either
text (e.g., a report) or graphics (e.g., a chart) onto standard-size paper.
Operating Systems

There are (5) five basic types of operating systems (OS) used in small office and
home computer systems today. They are:

1. DOS – Disk Operating System. This is the system of most home computers.
2. MS DOS – Microsoft's version of DOS. If the home computer is made by Microsoft,
or if it operates on a Microsoft based system such as Windows XP or any of the
Windows series, then it operates on MS DOS.
3. UNIX – A widespread operating system used primarily in businesses. Originally
developed by engineers at Bell South in the late 1960's.
4. Linux – A derivative of the UNIX system, developed into a more flexible system in
the early 1990's. This is an up and coming OS that is starting to take hold in the
marketplace.
5. The Mac OS series – Used by owners of Apple's Macintosh series of computers
a.k.a. Apple or Mac.

Although operating systems experienced growth, transitions and transformations

since the early days of the 1960's when they began to develop in competitive
avenues of the marketplace, those listed above dominate the marketplace today.
Microsoft Windows Operating System

Because GUIs are easy to use, most healthcare information systems use a GUI
operating system, usually a version of Microsoft Windows. For this reason, as well
as the computer fluency demanded of healthcare professionals, it is appropriate to
review some basics of using Windows. When a PC is turned on and finishes
booting (often a three- to five-minute process!), the screen that appears is called
the desktop. The desktop has icons representing many of the application programs
that are installed on the computer. Below these icons is the name of the
application that the icon represents. When "clicked" (putting the mouse pointer on
the icon and left clicking), the program the icon represents will open.

OPENING A PROGRAM IN A PC

As with all things with Microsoft Windows, there are several ways to start a
program when using a PC. Clicking the icon on the desktop, mentioned earlier, is
often used when the computer is first turned on. If an icon for the desired program
is not on the desktop, the user should click the Start button, then click All Programs
and click the name of the program on that list. The Start button, so called because
it "starts" processes, is located in the lower left corner of the screen. In Windows
Vista, the start button is the Windows logo surrounded by a blue circle. Some
programs that are together in a suite such as Corel Office, Lotus SmartSuite, or
Microsoft Office may require that the folder containing all of them be opened, then
the program selected from the secondary menu contained in the folder. In XP, this
will be indicated by a black triangle mark pointing to the right. In Windows 7, a
container or more programs will be the folder icon as seen in Figure 3-1. In either
case, clicking the container will show the programs with that folder, and you can
make your selection from there.
 WORKING WITH A PROGRAM IN A PC

Once a program is opened, you will see the work screen, which may look like any
of those in Figure 3-2. The choices on the menu bar can be clicked for a menu of
features classified by that choice. If you are using Microsoft Word 2007, the menu
bar is replaced with tabs, which when clicked have icons for the features classified
under that tab. When first starting to use a new application program, or a major
update, using Help to find the feature you want is often necessary.

All programs will have a symbol, which represents the mouse pointer, the shape of
which may vary according to the task and the program. In some cases it can be
changed by the user. In word processing software it is often a vertical "I" bar; in
spreadsheets it may be a large plus sign; and in a presentation or graphics
program, an arrow. Although many choices on the top of the screen may be
represented by icons, if you rest the mouse pointer on an icon, after a few seconds
words describing what the icon is will appear.

MULTIPLE WINDOWS

One of the advances of GUIs over DOS included the ability to have multiple
programs open at the same time and to easily move data between them. This
makes it possible to copy a graph from a spreadsheet into a word processor.

Closing Files and Programs

In the context of a PC, the term "windows" may refer to the operating system or to
the various content boxes that appear on the screen. Each program that is open
creates its own window and places a tab on the task bar on the bottom of the
screen. If a word processor and a spreadsheet program are open simultaneously,
two program windows are open; both may or may not be visible on the screen at
the same time. Closing the window in any program involves clicking on an X in the
upper right corner of the screen. In some programs you will see two Xs, one on top
of the other (see Figure 3-3). In these cases clicking the top one, which is usually
red, will close the program itself and all the files that are open in that program,
while clicking the lower one will close only the file that is open, leaving the
application itself open. If there is only one X, clicking it will close that file and
instance of the program.

Looking at the task bar at the bottom of the screen tells you how many instances of
each Microsoft program are open, and any other programs that are open. When so
many programs are open that there is no room on the task bar, multiple instances
of the same program will be grouped under one icon meaning that you will have to
click that tab and select which file you wish to use for that program.
 Navigating Between Programs and Files

One of the hardest things to grasp for new users of GUIs is that not only is it possible to
have many different windows open at one time, but using this option is an aid to
productivity. As mentioned earlier, when you have more than one program or file open, the
program name will be on the task bar, which is at the bottom of the screen. If this line is
not visible, place your mouse pointer on the bottom of the screen, and it will appear.
Part of the left side of the task bar is the Quick Launch bar to which you can drag
icons either from the desktop or the program list for programs that you frequently
use. Then instead of using the desktop or All Programs from the Start button to
open a program you can click the icon in the Quick Launch bar that represents the
program you wish to open. If you can't remember what the icons represent, rest
your mouse pointer a second or two on it and the name of the program will appear.

MAXIMIZING AND MINIMIZING A WINDOW

Not only does Windows allow you to have more than one window open at a time,
it lets you see multiple windows at the same time. Often when you open a
program, you will see that it does not take up the entire screen. You may even
see another program, or the desktop behind it. In this format, the window is said
to be "minimized." This holds true whether it takes up almost the entire screen or
is reduced to just the title bar (see Figure 3-4). You can maximize it by clicking
the square in the upper right corner of the screen and minimize it by clicking the
3D square that replaces the original square when the window is maximized.

In a minimized format, you can place your mouse pointer on the sides of the
window until it becomes a double-edged arrow, then drag the side to change the
size of the window. To move a window, place the mouse pointer in the title bar, or
the top line of the window that has the name of the program and often of the file
itself, and drag the window wherever you want it. If the windows overlap, the
window that is the active window, or the window in which you are working, will be
on top. Clicking in a window makes it the active window. If the windows are side
by side, the active window is the one where the mouse pointer is, although
sometimes the title bar will be a little darker in color in the active window. Placing
windows side by side or one on top of the other can be very useful when working
on two files in the same program, or needing to synchronize files from different
programs.

ACCESSORIES AND UTILITIES

Operating systems usually come with some utilities and built-in software.
Certain utilities are helpful with disk maintenance, such as the disk utilities
ScanDisk and Disk Defragmenter. Additional accessories such as Paint, a
simple drawing program, allow a user to create drawings or various shapes,
such as circles, squares, or triangles, in any of the colors available in the
program. Also available are writing accessories such as Notepad, a product
that is useful in creating files in ASCII (American Standard Code for
Information Interchange), which is a format that can be read by many different
programs.
 EXITING WINDOWS

In the earlier sections we have discussed how to close a file on which you are
working, and how to close a program. Before shutting down a computer, it is
necessary to exit Windows. Although invisible to users, Microsoft Windows,
like all operating systems, actually works very hard behind the scenes to
provide its many functions, as do many of the application programs. To do this,
application programs and Microsoft Windows have to have easy access to
specific information. Often, this is accomplished by creating files on the hard
disk of the information that the application needs to use. These files are
temporary and unknown to the users. They are created, changed, and deleted
as users change what they are doing. Before quitting Windows, the application
programs need to be able to shut these files down. If users do not exit all
programs and close Microsoft Windows properly, these temporary files are left
on the disk and can cause problems as well as fill up your hard disk. To exit
Windows and shut down your computer, click the Start button in the lower left
corner of the screen, select Shut Down from the menu and let the computer go
through the shutdown process, which may take a minute or more. If during the
time you have used the computer, a program or the operating system has
downloaded some updates, you may see a message that files are being
updated, please don't turn off the computer. This message may or may not add
that the computer will be turned off by the program, when the installation is
complete, but in most cases this will occur.
Types of Software

● Application Programs - are packages of instructions and operations that

take raw data and process them into information. Applications focus on working
with people to produce information that is important to them. Some examples of
applications are word processing, spreadsheets, and desktop publishing.

OpenOffice Calc OpenOffice Writer OpenOffice Impress

●
Graphical User Interface (GUI) Software - is a special type of software in
common use today. It can be part of the operating system software, or it can
be a complete application program on its own; at times, a GUI (pronounced
"gooey") seems to straddle the line between operating and application
software. The basic design of any GUI is that it stands between the operator
of the computer and the computer itself and acts as the go between. Any
GUI has two primary goals: (1) to shield the operator from needing a great
amount of technical knowledge to use the computer effectively and
correctly; and (2) to give a consistent “look-and-feel" to application
programs (if they are designed for it).
Accomplishing the first goal means that an operator can perform all
necessary technical tasks (e.g., copying data files between disks, backing
up information) by pointing at icons (small pictures) on the screen. These
icons represent tasks that can be done. For example, by pointing to an icon
that represents a desired data file and then dragging that icon over onto
another icon that represents a printer, a person can print the file.
Note that because of the GUI's capabilities, the person did not have to know
the correct operating system commands to print the file. Accomplishing the
second goal means that any application program can be designed so it is
less difficult for a person to learn how to use it. Basically, the GUI defines a
standard set of functions that it can provide (e.g., open a data file, save a
data file, print a data file) and gives standard ways for application programs
to use these functions. If application programs are designed and built to use
these functions, a person has to learn only once how to open a data file.
Any other program that uses the GUI functions has the same "look-and-feel”
that is, a person can open a data file in the same manner. Doing things in a
 consistent, predictable way not only reduces a person's learning time but
increases a person's comfort level and productivity.
● Databases and Relational Database Management Systems - A database
is a data file whose information is stored and organized so it can be easily
searched and retrieved. A simple analogy is a filing cabinet drawer.

●
● The difference between a file and a database is the same difference between a file
drawer that has reports dumped into it in any old way and a drawer that has neatly
labeled file folders, arranged in meaningful order, with an index that shows where
to store a report. In both cases, we know the information we need is in the file
drawer—only in the second case (i.e., the database) we are confident that we can
find that information quickly and easily.
A database management system (DBMS) is a set of functions that
application programs use to store and retrieve information in an organized
way. Over the years, various ways to organize information have been used
(e.g., hierarchical, network, indexed). The way it is used most frequently
now is called relational. A relational DBMS stores information in tables (i.e.,
rows and columns of information). This approach allows powerful searches
to be done quite easily.
● Operating systems - are the basic control programs for a computer. All the
basic logic required for using a computer's hardware, such as the monitor, the
printer, and the hard drive, is contained in the operating system. Because the
operating system handles those computer parts, it is unnecessary for application
programs to do so. An example in the personal computer world is Microsoft
Corporation's Windows operating system.

Linux – Ubuntu Windows 7 OS X

●
There are (5) five basic types of operating systems (OS) used in small office
and home computer systems today. They are:
1. DOS – Disk Operating System. This is the system of most home
computers;
2. MS DOS – Microsoft's version of DOS. If the home computer is made by
Microsoft, or if it operates on a Microsoft based system such as Windows
XP or any of the Windows series, then it operates on MS DOS;
3. UNIX – A widespread operating system used primarily in businesses.
Originally developed by engineers at Bell South in the late 1960's;
4. Linux – A derivative of the UNIX system, developed into a more flexible
system in the early 1990's. This is an up and coming OS that is starting to
take hold in the marketplace; to learn more, go to: http://www.linux.org/,
and;
5. The Mac OS series – Used by owners of Apple's Macintosh series of
computers a.k.a. Apple or Mac.
 Most Commonly Used Computer Terms

The terms listed in this lesson are meant to be beginner's terms only. Reference
for more advanced studies of terms and computer jargon are listed at the end of
the lesson. Included in some of the term's definitions are helpful information and
tips, particularly for those terms which require more details.

Backup

A saved copy of your computer hard drive, temporary files or current project.
Generally, a backup is a digitally saved copy [on CD] of everything on your hard
drive. Programs such as Ghost will also handle this task automatically although
most home operators perform the task manually themselves. It is essential to
anyone who seriously works on computers to backup their work. Computers crash,
accidents happen, files get erased by the unsuspecting, and work can be forever
lost without a backup.

Boot up

To start up your computer is to boot up your computer. If your computer crashes

you may need to use your boot disk, the one that came with your computer
system, in order to restore your system.

Bug

A bug is an error in programming that was overlooked. Bugs are the primary
reason for updates that have to be downloaded from the internet to keep your
system up to date and running smoothly.
Burn

To copy your file or information onto a CD is to burn a CD. This requires a CD

burner since not all CD drives have burners in them.

Bytes

Eight bits is a byte. Each bit is designated by a 1 or zero; this is the basis of all
written computer code. Technically, there are differences, but to the novice, the
easy way to think of it is that a byte is most commonly a letter, punctuation or
space.

CD

Compact disk; a small, plastic disk which retains information in a digital format
[there are a variety of digital formats which can be recorded on a CD]. The CD
superceded the floppy disk because it encases the saved information in a hard
plastic that is impenetrable without excessive force. It is virtually weatherproof and
cannot be easily destroyed.

Chat Room

An online forum in which people [usually adults although some young adult forums
exist] can talk to one another instantly via a login and password system. Most chat
rooms cover specific topics: consumer advice or advocacy; dating; politics;
religion; technical information; and others.

Crash

For the computer to crash is to have it suddenly stop working and refuse to restart.
Indications of this are that you cannot get it to boot up, you cannot get it to reboot,
you cannot access your files, or it will not give you a prompt in DOS. Usually, if
your system crashes, the information on your hard drive is gone forever unless it is
backed up somewhere.

Doc File
A doc file is usually a reference to the Microsoft Word program in which a
document is saved with a file extension of .doc. Doc files are some of the most
common files sent in emails and used to transfer information from person to
person in the internet.

Download

A download is a program, a program update, a file, or anything transferred via

email. Some of the big search engines like Google and Yahoo have downloads for
their customers on a regular basis to update the customer's version of the search
engine program. A file sent from one person to another in the internet is generally
called a download. A download can also be a file that you paid for such as an MP3
music file. If you go out to the internet, capture a file, and save it on your computer,
then it is a download.

DOS

The abbreviation for "Disk Operating System"; also known as THE Microsoft
language. Every product produced by Microsoft is written in DOS.

DVD

An abbreviation for "Digital Versatile Disk". It is currently the most high powered
portable storage disk available on the market. The current maximum storage for a
DVD is 4.7GB which is more than 5 times the storage space on a CD.

e-Book

A book made available online in a digital format; also known as an "electronic

book". The e-Book is the most progressive format for the book publishing industry,
yet it suffers certain obstacles such as appeal to those over 30, portability, and the
comfort factor to name a few.

Email
Online electronic communication between people in different locations. Most
commonly email is provided for and supported by large search engines, individual
websites and public library accounts. Some of the best places to look for free
email providers are:

● Google – http://mail.google.com
● Yahoo – http://www.yahoo.com
● Free Email Provider's Guide -
http://www.fepg.net/providers.html
● EmailAddresses.com -
http://www.emailaddresses.com

Flash Drive

A flash drive is a small, portable drive that can hold as much as small hard drives
[internal drive]. Most flash drives are the size of a small cigarette lighter and fit in
the palm of your hand. They come in several popular sizes, most commonly:
512MB; 1GB; and 2GB.

Folder

A file; a place to store your documents. Located in the directory of your hard drive
[a.k.a. C drive].

Format a drive

To prepare a disk for use.

Gigabytes

1024 megabytes or approximately 1 billion bytes [characters].

Hard Drive
The hard drive is the computer's primary data storage unit. The hard drive
generally holds all of your programs and all of your created, downloaded and
saved data.

Hardware
Hardware is all of the physical, tangible elements of your computer.

ISP
Information Services Provider; the company that brings your computer services to
your house or business. ISPs are very similar to your phone or electric company in
that they provide a specific service. Most ISPs utilize your current phone cabling or
your satellite/television cabling to provide their services.

JPEG File
Joint Photographic Experts Group is the name of the committee that wrote the file
format that is now in widespread use for most online photos that are shared or
posted on public sites. This is a file type in which you will save most of the photos
that you use in your computer.

Laptop
A small, self-contained computer that can fit in your lap. Generally used for mobile
purposes such as business or travel.

Megabytes
1024 kilobytes; 1 kilobyte is 1024 bytes.

Modem
A communications medium between your computer and the ISP, most commonly
contained in a box that connects to your computer with Ethernet cables and phone
cables. The exception to this is the FIOS [fiber optic cable] services available from
Verizon.
Network
The computers in your home or business which are all connected together.

PDA
Also known as a personal digital assistant; the most popular ones are the Palm
Pilot and the Blackberry. You can send and receive email and other documents via
your PDA.

PDF File
Technically, it means portable document format. The .pdf format is used primarily
on Adobe's Acrobat programs. Adobe owns the market on this format, and
provides free readers to anyone online. Without the current Acrobat reader you
cannot see a .pdf file unless you purchase the Acrobat program for about $450.
The .pdf file is a common and popular file type for business forms, e-Books and
general mainstream documents.

Phish
Hackers and others bait email users to try to attain the user's personal identity and
credit card information for the purposes of perpetrating fraud and/or identity theft.
Phishers also post fake websites that look identical to the real ones so they can
trick users into giving their credit card information.

Program
Also known as software, a program is a set of commands, written in a computer
language, which instructs the computer to function in certain ways. Examples of
common programs include the Windows collection of popularly used products such
as, MS Word for everyday document production, MS Excel for everyday
accounting calculations and spreadsheets, and MS Access for everyday database
creations for small offices.

Reboot
Reboot is what a computer operator does when his or her computer crashes or
suddenly shuts down and stops working.
Snail Mail
Snail mail is opposed to email which is fast, almost instantly and electronically.
Snail mail is your regular paper delivery mail service in your country.

Surfing
Surfing is what computer operators do when they go online via the internet and do
searches for various needs or topics. Surfing is what you are doing when you are
looking for what you need; similar to shopping, except it is the web version.

Text File
A text file [.txt ] is the most common file used. It is also the most adaptable for
anything you want to use the contents for in the future .

Trojan
A Trojan is a hidden program inside of another program, usually serving a good
purpose. However, in reference to email and the internet, a Trojan is commonly a
particularly nasty type of virus that comes in via a hidden method.

Virus

In computer usage, a virus is computer code [as a

computer user, your concern is for the harmful ones] that is transferred from one
computer to another without your knowledge or permission. Most commonly, the
harmful viruses that circulate on the internet come into your computer [to destroy it
or take personal information from it, etc.] via your email
Your Data

● Backup Systems
The most traditional method of backing up your data is the disk system. For
home computers and small home offices a floppy disk, CD disk, or flash
drive is the best method for saving a backup copy of your created data.
Innumerable computer operators, authors, artists, creators of original works,
and others have lost their work due to the simple oversight of a basic
backup system. Any creation of yours, in which you take time to build it and
store it, is worth saving to a recoverable file.
● Preserving Your Data

The method of backup and storage that you decide to use will determine the
quality of preservation for your data. How well your data is preserved
determines its use in the future. Therefore, it is worth the effort to keep your
data backed up and preserved in systems that have longevity and can be
accessed easily for many years.
To the average home computer operator, I would suggest that you preserve
your files in CD backups at least once every 3 months or in a flash drive
every month. Be sure to store your backup copies in a location off of the
premises of your computer, preferably a safe deposit box or a relative's safe
in their home. If your home or office were severely vandalized or caught on
fire, you want your data in an off-site location so that you can recover your
work.
The same is true for small business operations, except that the backups
should be weekly and definitely stored in a safe deposit box in your bank or
similar financial institution.
● Protecting Your Data
Data is best protected by a number of factors such as passwords,
encryption, storage location and method. Passwords protect accessibility to
your data, encryption protects your data from being used by unscrupulous
or unauthorized individuals, storage method will determine your data's
ability to survive natural disasters and weather fluctuations, and location will
help to secure your data in dire emergency situations and other similar
instances.
Small businesses are usually more concerned than individuals about these
factors, although freelancers, independent contractors and others who earn
their living in a more independent way than normal employment will also
find protection a central concern for them.
Terminals, Workstations, Stand-alone

● Terminals

●
● In the early days of computer technology, an organization usually required only a
single large-capacity computer to handle its information needs. These computers
were called "mainframes." They required a trained staff to maintain and run them and
were quite expensive to purchase and upgrade (e.g., add more memory, more disk
storage). People gave information and commands to the mainframe through a
"terminal," essentially just a keyboard and monitor; the terminal had no processing
capability of its own. The number of terminals a mainframe could handle was limited,
which created lineups of people waiting their turn to submit computer requests.
● Workstations
Advances in computer technology, such as IBM's personal computer
introduced in 1981, dramatically changed this situation. Now it was possible to
have a powerful computer right in the office and for far less money. What is
more, all its resources and power were under the control of, and totally
available to, its user. As people began to move toward personal computing,
computer manufacturers built more powerful workstations. Soon, these
powerful workstations became small enough to be easily moved, promoting
the idea of "mobile computing." Today, laptop computers easily allow
computer technology to be available at the point of care.
● Stand-alone

●
● By "stand-alone" we mean that all the pieces of a computer that are needed to
gather, process, display, possibly store, and provide an output of the information are
physically connected; moreover, if needed, they can be moved as a complete unit to
another location. This is the usual setup for most home and small business computer
systems. Such a setup is inexpensive and quite simple to manage. Although it makes
sense to use a "stand-alone" computer, it is often better for a computer to be part of a
network.
 Peripherals

A peripheral is any external device such as a keyboard, monitor, or mouse, which is

connected to the computer. Because they are external in desktops, it is easy to see
that these are peripherals. On laptops, however, the connection of keyboards and
monitors is internal. In general, peripherals are the devices that allow inputting of
data to a computer and outputting of information from a computer. Besides these
obvious peripherals, there are many others such as printers (output) and scanners
(input) that allow humans to use computers. Although the CPU would happily
complete any instructions it received without any visible output, users generally want
some type of output, such as what is seen on a monitor or video screen. There are
also devices that both input and output information to a computer such as the port to
which a printer is connected.

● DIGITAL CAMERAS are finding a place in healthcare for purposes such as

recording the healing progress of wounds. Text descriptions cannot compare
with a picture in letting clinicians and patients see healing progress.
● SCANNERS take a picture of a document and then allow users to save this
as a file. Unless there is character recognition software available, any text that
is scanned will be in a picture format and uneditable. Additionally some
healthcare agencies are inputting clinical records to electronic health records
by scanning free text. Even when character recognition software is used to
translate the words in the "picture" to text, the result needs to be checked for
accuracy. Further, unless the form that is scanned is especially designed for
scanning, this free text is unstructured and not easily used for reporting
information from data.
● CLINICAL MONITORS can be part of a network and monitored at a central
location. They can also be programmed to provide alarms, either at the
central station or to individual pagers, when the monitor shows something
beyond the norm. Clinical monitors whether attached to a network, or not, can
allow patient data such as that produced by cardiology or fetal monitors to be
directly input to a computer. The advantage of computerized clinical
monitoring is that it allows one person to monitor many patients at once as
well as provide notification of problems. It should never be allowed to reduce
nurse-patient interaction.

Connecting Peripherals
A peripheral is connected to a computer through a port. Although today the USB port
is the de facto standard for PCs, in the past there were other types of ports such as
serial and parallel. Computers manufactured in the last few years do not have serial
or parallel ports.

● USB PORT or universal serial bus is a standard that was originally created to
connect phones to PCs in the mid-1990s ("Everything USB ... We Mean
Everything!"). Lately, it has become the standard port for connecting
peripherals to PCs. These ports are a thin slot, about half inch by one fourth
of an inch, which are found on the sides of laptops and on the front of newer
desktops or towers. The port is designed with a solid piece in one part, usually
the top, so that USB device can only be inserted one way. The original USB
port was capable of transmitting data at only 12 megabits (Remember, it takes
8 bits to form a byte, which is required to transfer one letter) per second,
which made it useful for only mice and keyboards ("Everything USB . . . We
Mean Everything!"). This easy connection method, however, created a
revolution that resulted in devices such as flash drives, external hard drives,
and webcams, which needed faster transmission speeds. This need was met
by a new standard, the USB2.0 port, which transmits information at 480
megabits per second. The USB connection has largely replaced older serial
and parallel connectors.
● FIREWIRE originated in the mid-1980s as a high-speed data transfer method
for Macintosh internal hard drives (Nathanael, 2006). Apple presented this
technology to the Institute of Electrical and Electronics Engineers (IEEE) who
in December 1995 released IEEE 1394, which is an official Firewire standard.
It was often referred to as Firewire 400 and had transfer speeds of 100 to 400
megabits per second. In April 2002, the IEEE released a new standard for
Firewire 800, which can theoretically transfer data at up to 3.2 gigabits per
second. Although its speed is faster than USB ports, it is impractical for
low-bandwidth devices. This fact, together with the knowledge that only
Macintoshes include Firewire ports by default, has kept it out of the
mainstream. Because of its superior ability to transfer uncompressed video
from digital camcorders, it is now found in all modern digital camcorders. Most
digital cameras, however, still use USB to transfer images because USB ports
are today standard equipment on computers.
● INFRARED PORT is a connection on a computer that uses IR signals to
wirelessly transmit information between devices such as a PDA and a
computer. It has a range of about 5 to 10 feet. Most handheld devices have
the capability to communicate via IR ports that allow the device to directly
interface with another device to exchange data.
Ergonomics

Ergonomics is the science of designing a work environment so that it is convenient to

use and does not prove injurious to health. Although it is an important consideration
for preventive health, it is too often overlooked when setting up computer hardware.
This despite the fact that using a keyboard injures more workers in the United States
than any other workplace tool (Bailin, 1995) Even nurses who do not spend all day at
the computer are affected. One study from a Scandinavian journal, reported by
Nielsen and Trinkoff (Nielsen & Trinkoff, 2003) found that some nurses, even those
who use a computer less than four hours a day, had a 32% prevalence of upper arm
repetitive stress injury, 60% of which was carpal tunnel syndrome.

Healthcare agencies, which should be very concerned about preventing injuries

associated with any repetitive activity such as typing, could save money by focusing
more on ergonomics. Computers are supposed to facilitate data recording, not
impose additional burdens on healthcare personnel. Those planning a system should
walk a day in the shoes of a user or several days in the shoes of several users
before making firm decisions about computer placement. Asking staff nurses and
other clinical computer users to participate in determining computer workstation
design is another way of improving ergonomics (Nielsen & Trinkoff, 2003).

Unfortunately, few studies have been done on nursing use of computers with most
research concentrating on seated workstations (Nielsen & Trinkoff, 2003). Some
simple things could improve the work environment of nurses who document with or
otherwise use computers. For nurses who are on their feet all day, if they are to chart
at the point of care, they need a way to be able to sit while using the computer. If the
computer is also used by those standing, an adjustable computer stand could be
employed so that a user who is standing does not have to stoop. Additionally, if the
computer is fixed at a height for users who are standing, a stool should be provided
for the nurse who uses the computer extensively. Touch screens and light pens may
be ideal for quick entry, but for extended entries, they are very tiring to the arm.
Providing dual means of entry may solve this situation. Resolution of a screen is also
important. The higher the resolution, the easier the screen is on the eyes. It is also
important to prevent glare on the screen. In situations where this is impossible, it is
possible to purchase screen filters that will cut down the glare.

More thought also needs to be given to how a workstation is designed for those who
will use a computer for more than four hours a day. Consideration needs to be given
to the posture the user will be forced to adopt. The best chairs have adequate
support for the outward curve of the lumbar spine and the inward curve of the
thoracic spine. Studies have shown that a 100 to 110 reclined position is better than
an upright posture (Cornell University Ergonomics Web, 2007). The feet should be
flat on the floor, or a footrest should be provided (Figure 2-3). Wrists, knuckles, and
the top of the forearm should fall into a straight line while typing (Bailin, 1995). To
promote circulation to the lower arm and hand, the elbow angle should be open.
Both of these can be accomplished with a negative tilt keyboard (Cornell University
Ergonomics Web). The monitor should be placed directly in front of the user to avoid
neck twisting. Studies have found that the best position for the monitor is for the
center of the screen to be about 17.5 degrees below eye level and about an arm's
length away. The ideal placement of a mouse is on a flat, movable mouse platform
positioned one to two inches above the numeric keypad.

Laptops, under most use conditions, violate all ergonomic requirements for
computers (Cornell University Ergonomics Web, 2004). This is caused by the
connection between the keyboard, screen, and computer. If the computer rests on a
table, the keyboard will be too high for proper arm positioning. If the computer is
lower, the monitor placement may require that the head be tilted forward for use. For
these reasons, if a laptop is your primary computer, to provide more ergonomic
working conditions you should invest in a docking station. If you carry the laptop and
all the required accessories such as spare battery, power cord, or external drive
weighing 10 pounds or more, consider a wheeled carrying case.
 Computerese

Many computer-related terms are used in discussion, instruction, and advertising.

Although they are not strictly hardware terms, they can often be confusing. If one
watches a computer when it has just been turned on, one will see different types of
information flashing across the screen. This information is produced by what is called
the "booting" process. Booting refers to all the self-tests that a computer performs
and the process of retrieving, either from the BIOS or a disk, the instructions
necessary to allow the user to start using the computer. The term "reboot" means to
restart the computer. A warm boot is restarting the computer without turning it off, a
selection that is offered when one elects to start turning off the computer. A cold boot
is starting the computer when the power is completely off. Avoid cold boots if you
can, because the jolt of electricity received each time the computer is turned on may
shorten its life span. Warm boots are often used when a computer freezes or
crashes. It erases information in RAM, which often eliminates memory conflicts that
may have caused the problem. These conflicts can be caused by different programs
trying to store data in the same location. If a warm boot fails to notify the programs
that it is time to stop fighting for the same space and give control back to the user,
the machine must be turned off for a cold boot.
A bug is a defect in either the program or hardware that causes a malfunction. It may
be as simple as presenting the user with a blood pressure chart when a weight chart
was requested, to a more serious defect that causes the entire system to crash.

Compatibility refers to whether programs designed for one chip will work with an
older or newer chip, or whether files created with one version of a program will work
with another version of the same program. Most computer chips and software are
backward compatible, that is, they will work with older versions of a program or files
created with an older version of a program. Some are not, however, forward
compatible, or the situation in which an older program does not recognize files
created by a newer version of the same program. This is particularly true of
spreadsheets, databases and presentation programs.

A driver is a software program that allows data to be transmitted between the

computer and a device that is connected to the computer. Drivers are generally
specific to the brand and model of the device. They may come with a new peripheral,
or can often be downloaded from the vendor's Web site.

Although the term hacker originally meant a person who enjoyed learning about
computer systems and was often considered an expert on the subject, mass media
have turned it into a term to refer to individuals who gain unauthorized access to
computer systems for the purpose of stealing and corrupting data. The original term
for such a person was cracker. Today, differentiations may be made by using the
term white hat hacker for a person who uses his or her computer knowledge to
benefit others. Black hat hacker is the term used for those who use their computer
skills maliciously.

When used with a computer the terms logical and physical refer to where data are
located in the computer. The physical structure is the actual location, whereas a
logical structure is how users see the data. For example, when a user requests
information about laboratory tests, he or she may see the indications for the test, the
normal values, the cost of a test, and the patient's test results. Although this
information may be presented as one screen, which is a logical structure, different
pieces will have been retrieved from different files in different locations, which is the
physical structure of the information.

Another potentially confusing computer term is object. Although the more common
use of the term "object" is for a physical entity, or at least a picture on the screen, to
a computer, an object is anything the computer can manipulate. That is, an object
can be a letter, word, sentence, paragraph, piece of a document, or an entire
document. Objects can be nested, that is, a word is an object nested within a
sentence object. A paragraph is an object that is contained in a document. When an
object is selected, clicking the right mouse button presents a menu of properties of
that object that can be changed.
 Networks

A nurse encounters a patient with an unfamiliar disease. From an email message,

the nurse learns that a document on a computer in another country has information
about caring for patients with this disease. Within 60 seconds of logging on to the
Internet, the nurse prints out the document. This ability to exchange information on a
global scale is changing the world. No longer do healthcare professionals have to
wait for information to become available in a journal in the country in which they live.
Nurses and other healthcare professionals can and do use computers to network
with colleagues all over the world.

Healthcare depends on communication: communication between the nurse and the

patient, communication between healthcare professionals, communication about
organizational issues, and communication with the general public. As you can see
from the previous paragraph, the methods used to communicate in healthcare are
today being augmented with computer networking. Since the first computers talked
to each other in the late 1960s, networking has progressed to the point where not
only computers in an organization are connected to each other, but also institutions
are connected to a worldwide network known as the Internet.

A network can range in size from a connection between a palmtop and a personal
computer (PC) to the worldwide, multiuser computer connection - the Internet.
Variation in network size or the number and location of connected computers is often
seen in the name used to denote the network, such as a local area network (LAN) or
a wide area network (WAN). A LAN is a network in which the connected computers
are physically close to one another, such as in the same department or building. A
WAN is a network in which the connections are farther apart. Often, a WAN is an
internetwork of LANs. WANs are sometimes referred to as enterprise networks
because they connect all the computer networks throughout the entire organization
or enterprise.

NETWORK ARCHITECTURE
There are many different variations in how networks are constructed, or what is
referred to as their architecture, often depending on the purpose of the network. For
a home network, a peer-to-peer network in which each connected computer is a
workstation is a normal approach. In this scheme, each computer can have a shared
folder that is accessible by the other computers. Often, the network is primarily for
connecting to the Internet or for sharing hardware such as a printer.

Another type of architecture, often seen in healthcare agencies, is client/server

architecture. The principles behind this model vary, but for most healthcare
applications they are similar to the "dumb terminal" model. A client computer has
software that allows it to request and receive information from the server. The server
has software that can accept these requests, find the appropriate information, and
transmit it back to the client (Figure 5-1). The client views the information, enters
data, and sends it back to the server for processing. Under this model, the client
computer does no processing. Beyond making the initial request, rarely is any of this
process visible to the user. Users sometimes have the misperception that the
software and data reside on the computer/terminal that they are using, instead of the
server.

There are other variations for networks. A computer in a healthcare facility may
function as a client for the patient care information system, but may have application
software that allows users to do things like word processing, in which case it acts like
a regular computer. This computer may also be networked to another server that
stores the files created by the networked computer, or the files may be stored on the
computer that was used to create them. This computer may even be connected to
the Internet through another server. Printers are usually connected to a network so
that more than one computer/client can use them. Managing networks is an ongoing
maintenance task performed by the network administrator.

CONNECTIONS

Networks are connected physically with a variety of materials such as twisted-wire

cables, phone lines, fiber optic lines, or radio waves. Computers that are wired
together are said to be hard wired. When you see the term "hard" with another item,
this means that the item is permanent, or that it physically exists. Most healthcare
agency networks, even those that use wireless, are hard wired to some extent.

Wireless transmissions are limited in distance, so they do not compete with other
radio traffic. When a wireless system is installed, nodes are placed at strategic
locations throughout the institution, locations that are determined after a thorough
assessment of the building. A node in a wireless connection is a single point on the
network that consists of a tiny router with a few wireless cards and antennas. These
nodes pick up the signals sent by a user and transmit them to the central server, or
even to another node for rebreed-cast, and transmit signals back to the user's
computer. Successful wireless communication depends on an adequate number of
nodes or hardware that send or rebroadcast the signal and on their placement. The
distance of a device from the node will affect both the speed of transmission and
whether one can use the network.

Wireless transmission is less secure than hard-wired transmission because the

signal is available for use for anyone in range. Security depends on the network
administrators who follow procedures to secure the transmission. Many wireless
networks, including those at home, use wired equivalent privacy (WEP), the goal of
which is to prevent disclosure or modifications of messages in transit. When this is
employed, to connect to a network, a user must have the WEP key to enter before
being allowed to use the network. In many cases, once a WEP key is entered on a
computer, the computer remembers it and will automatically find it any time a user is
in range of that network. Another newer, more secure form of protection is WPA
(Wi-Fi Protected Access) (Webopedia, 2007). It features improved data encryption
and better user authentication.

PROTOCOLS

For networks to function correctly, it is necessary that there be agreements known as

protocols, which prescribe how data will be exchanged between participating
computers. These protocols include standards for tasks such as how the system will
check for transmission errors, whether to use data compression, and if so how, how
the sending machine will indicate that the message it has sent is complete, and how
the receiving machine will indicate that it has received the message.

● Internet Protocol and Transmission Control Protocol

To ensure interoperable data transmission on the Internet, the Internet
Protocol (IP) and the Transmission Control Protocol (TCP), sometimes
referred to as TCP/IP, were introduced in 1974 and are still in use, although
consideration is being given to moving beyond the capabilities of these two
protocols. The IP enables computers to find each other, and the TCP controls
the tasks associated with data transmission. Although invisible to the user,
messages sent on the Internet are not sent as a whole. Instead they are
broken up into what are called packets. Each packet may even take a
different route to its destination. For each packet, a device called a router
scans the routes available to the final destination, selects what is the shortest
and the least congested route at that moment, and then sends the packet to
another router that again makes a decision about the best route at that
moment. This process continues for each packet until all the packets in a
message reach their final destination. Under this process, it is not uncommon
for packets in a message to take different routes to their destination.
● File Transfer Protocol
Another process used on the Internet is the file transfer protocol (FTP). This is
the method used to download files (as opposed to retrieving a page from the
Web) from another computer. Until the early 1990s, this was a manual
process and users had to learn commands to do it. Today, Web browsers
have automated this process for files that are retrieved from the World Wide
Web (WWW/W3). People who create pages for the WWW on their own
computers use an FTP program to place their files on the server.
Local Area Networks

● Definition

●
● A network is a way to connect computers so several benefits can be realized. Local
Area Networks (LANs) connect computers that are physically close together (i.e., in
the same local area). This means not only in the same room but also in the same
building, or in several buildings that are close together. LANs use three things to
connect computers: a physical connection (e.g., wire), a network operating system,
and a communication scheme.
There are several ways to connect computers physically. The most common
method is to use category 5 cable and the latest way uses fiber optic cable
(light is used in place of electricity). The very latest methods are wireless; they
use either radio transmission or infrared light for the connection. Each method
is suited for different situations and is part of the consideration when a
network is built.
There are several network operating systems available today that provide the
necessary processes to allow computers to talk with each other and to share
information and programs. The communication schemes are properly called
protocols. This is a standard method by which the computers in a network to
talk with each other and pass information around. There are three main ways
to connect computers in a network: star, ring, and bus configurations. These
are called network topologies and represent different physical arrangements
of the computers. As with the physical connecting medium, each topology has
its strengths and weaknesses, which must be considered when a network is
built.
● Benefits of a Network
The important benefits of a network are shared information, shared programs,
shared equipment, and easier administration. It is technically possible for any
computer on a network to read and write information that another computer
has in its storage (i.e., its hard disk). Whether that computer is allowed to do
so is an administrative matter. This means, though, that information can be
shared among the computers on the network. Programs can also be used by
computers on the network, regardless of where those programs are physically
stored. It is also possible (and usually desirable) for computers on a network
to share equipment such as printers.
Technically, any computer on the network can print its information on a printer
that is physically connected to another computer somewhere else. By sharing
expensive office equipment, an organization reduces its expenses. Finally,
administration of computers on a network is simplified because all the other
computers can be examined, helped, and maintained from one computer.
Wide Area Networks

Wide Area Networks (WANs) are extensions of Local Area Networks. There are two kinds
of WAN. The first one attaches or connects a single computer to a preexisting LAN; this
kind is called "remote LAN attachment." The second one connects, or "bridges," two or
more preexisting LANs. Both WANs allow a computer to use information or equipment no
matter where they are located in the organization. An interesting point about WANs is the
options that can be used to connect the LANs. Instead of being limited by the length of
cable that can be placed between computers, WANs can communicate via satellite and
earth stations. This literally means that a person could be using a computer in Africa and
working with information that is on a computer in Iceland—without knowing or caring about
its origin. To that person, the information appears to be on his or her computer.
● Open Systems
"Open systems" is the idea that it should be possible to do two things: run a
particular program on any brand of computer and connect any collection of
computers together in a network. However, because of the development of
computer technology, this is difficult to accomplish.
Most computers were initially developed as "closed" systems; that is, a
manufacturer built the computer, wrote the operating system, and wrote the
application programs to run on the computer. Each computer manufacturer
saw tremendous sales advantage from this strategy. The result was several
computers that were similar in function but very different in how those
functions were executed. It was not easy to buy an application program
from a vendor and run it on two different brands of computers. It was a
torturous exercise to get any two computer brands to "talk" with each other.
For people who simply want to buy and use computer technology, "plug and
play" is the ideal mode. This means that a computer could be purchased
from vendor X, a second computer from vendor Y, a program from vendor Z,
and a printer from vendor A, and all these parts could be connected and
used with the same ease that people expect with stereo system
components. The way to achieve this ideal is through standards. Just as
stereo components are built to use a standard voltage, produce or use a
standard type of signal, and connect with standard plugs and cables,
computers and application programs need to use certain standards for
communication protocols and file access. This "plug and play" mode is
getting closer today because of vendors and manufacturers' support and
adoption of standards.
● Client/Server Computing
As we have seen, computers come in a variety of sizes and with various
processing capacities. Some computers are better suited than others for
different tasks. For example, personal computers, because of the physical
size of their hard drives, have a limit to their storage capacity. On the other
hand, the large, mainframe-type computer was designed to handle
 tremendous amounts of information and therefore has large storage
capacity. Where does it make more sense to store a large data set?
● This brings us to client/server computing. The essence of "client/server computing"
is to assign to each computer the tasks for which it is best qualified or, in other
words, to use the right tool for the job. Capitalize on the strengths of one computer
for task A and use a different computer more suited for task B. A personal
computer works well with people; it is fast and has color and good graphics display
capability. It could be the primary interface device for people and computer
systems. Mainframe computers have huge storage capacity, great speed, and
large processing power. This could be the place to store, process, and retrieve
information from the vast amount of data accumulated by a large organization. In a
network, client/server computing makes sense.
● Remote Access Computing
● Computers can be connected together in a network; but, increasingly, mobile
computing requires that computers be able to access and connect to other
computers from almost anywhere. This is possible through the use of telephone or
cable systems and special computer communication devices called modems.
"Modem" is short for "modulate-demodulate." The computer that, at the moment, is
sending information uses its modem to "modulate" its electronic signal into a form
that can be carried over the telephone or cable system; the computer receiving that
information uses its modem to "demodulate" the signal. Information can be
exchanged at speeds that allow effective long-distance computing.
 Short Cuts and Tips

This is a small section of miscellaneous short cuts and computer navigation tips.
They are in no particular order, but will help you as you go along in your computer
learning.

JPEG Files

If you scan a photo into a .jpg file or .jpeg file, many times you will find that it is too large
[too many pixels] to use on public sites [like MySpace, eHarmony and others] where you
would want to use it. The quick way to solve this issue is to resize the .jpeg file using one
of the online services such as Shrink Pictures. Simply go to:
http://www.shrinkpictures.com/ and follow their directions. When you finish shrinking and
saving your new .jpeg file, their page gives you an option to delete the file from their server
which makes the entire practice fairly safe as far as services on the internet.

Acrobat Reader

You will not be able to read an Adobe Acrobat file without the current reader. Since
Acrobat is one of the more popular files used on the internet, this will prove to be an
essential part of your computer system. Acrobat files are all the files you will ever see
which have a file name extension [the part of the file name on the other side of the period]
of .pdf . To download the current Acrobat reader, go to:
http://www.adobe.com/products/acrobat/readstep2.html

Reboot

If the computer is still on, the easy way to reboot is to quickly and sequentially press your
CTRL + ALT + Delete keys on your keyboard. This is the most common reboot command
to give a personal computer. If the computer is not on, then reboot will occur when you
turn it back on.

Text File
If you copy text from something on the internet because you intend to post it in another
place, the best file to save it to is a .txt file. In the Windows programs, the .txt files can be
created in Notepad usually under the Accessory panel under your Start button. The
reason .txt is the best file to save to is because when you go to copy and paste the
content to another site, document or format, all of the previous program's formatting will be
stripped out of it and will not confuse the new site or document. In other words, you will
transfer only content, not programming. You can then easier re-format the text to fit the
current program you choose to use.

Virus

When using email, use an email system that will first scan your incoming attachments for
viruses. If you open an email attachment and it contains a virus, then you will have to
clean your entire computer.

Secured internet pages – a.k.a. "Secured for financial transactions" pages

The quickest way to tell if you are on a "secured" page is to look at the top of your page for
an "s" in the internet address line. The "s" should appear behind the "http" and before
the colon. Example: The Pay Pal site is https://www.paypal.com. If there is no "s" in this
location on the address line, then you are not on a secured page regardless of what the
page states in its content. If you post your personal data to such a page, then you are a
sitting target for identity theft. This is another common way online thieves phish for your
credit card information and personal identity; they make an exact copy of the real website,
but they change the address by one or two characters leading you to believe it is just
another page of the real site so you will disclose your information. Look for the "s" in the
address line behind the http.
 Your Online Pseudonym

It may be best to establish a pseudonym for yourself, complete with an assumed date of
birth, mailing address and phone number. For many folks this can be accomplished with a
PO Box and a cell phone number. The point is that the fewer places you put your real
information, the more secure you are on the net and less likely someone could use your
information for gaining false credit or purchases.
 File Saving Tip

When you save any file in your hard drive, you want to be able to easily locate the file at a
later date. You will eventually have files in your drive that are older, outdated or have
limited current use for you. Over the years I have created shortcuts for myself in the file
name. Some of those short cuts include:
1. business acronym in file name;
2. addressee's initials in file name;
3. version of the document in the file name; and
4. date of the file's creation in the file name.

Example:

My business name is XYZ Corporation

Person I am writing the document to is named John Smith

This is the third version [or third edit] of the original document

Original document is saved/named as: Business Plan for John Smith

Today's date is March 31, 2008

For this example, I am saving a Word document

-----------------------------------------------------------------------------------

Here is how I would name/save the file:

XYZ.JS.v.3.Business Plan.033108.doc
At a glance in my file directory I can later tell the "who, what, when and document type" of
the file. This helps to later sort files according to timing and relevancy without having to
open lots of files to find the most recent or most appropriate file.

Common File Extensions

To help you quickly identify file types, this is a small list of the most common types of file
extensions used in file names, and which program they indicate has been used by the file
creator:

● .doc – MS Word
● .pdf – Adobe Acrobat
● .xls – MS Excel
● .rtf – [rich text file] – created most often in Word – keeps the document formatting
[such as fonts, sizes, layout, etc.]
● .jpg – [a.k.a. jpeg] – created in a JPEG supported program
● .txt – [text file] – created most often in Notepad or similar tool of Microsoft – strips
out the document formatting.
 ICE – In Case of Emergency

This lesson is a small run down of how to handle emergency issues which can
occur. The ones listed here are those that are most likely to create panic for new
users. Techniques to solve each problem are offered; if they do not work in your
situation, then you will need to seek a local geek to help you.

Computer doesn't start up

Every computer has an OS disk to use for reboot in cases where a crash happens.
Always insert your OS CD/DVD to reboot if your computer doesn't start up as
normal. If you are using a laptop or a PDA and are away from your disk source,
then you will need to take other measures to reboot in cases of emergency.

● Windows – When you turn your computer on, immediately begin pressing your F8
key repeatedly until a screen pops up. When the screen pops up it will give you
several options. You want to select Restart in Safe Mode. This will allow the
computer to reboot and start up [so you can find your document(s) on the spot].
You do not want to create documents in Safe Mode, and you do not want to
 perform any complex tasks while on the blink. When you return home, or wherever
you have your OS disk, then you can use it to reinstall your OS if necessary.
●
MAC – To reboot in Safe Mode on a Mac, hold down the Shift key as you reboot,
or hold down the "S" key to reboot in Single User Mode to look through your files
and find your problem. If you are away from home, it is best to wait until you have
access to your OS disk before digging through the files to find the problem.
 Computer takes too long to move/think

If your computer sounds like it is grinding or thinking and it takes too long to move
from one point to another, then you have system problems. The specific problem
referred to here will prevent you from opening a document, or it will take 15
minutes for the system to boot up, or some similarly extreme delay in achieving
your decided command to the computer.

● You have contracted through the internet, or through another person's file which
you have opened, a virus, Trojan, worm or some other destructive tool and it has
corrupted your computer's OS. In this instance, the virus or worm, etc. is achieving
its goal. You will have to immediately run a clean up program on your computer or
risk it freezing up completely. Programs such as Ghost or Norton 360 provide ways
to regularly backup your work, so you should already have your information
secured and available for emergency retrieval. If you haven't installed a program to
backup your data, then you may lose your documents. The first thing you should
do is reboot in Safe Mode, and then perform a virus scan in your system. Most of
the antivirus and firewall products now have a systematic way to isolate viruses in
your system. Use this program tool and you should get back to normal.
●
You have installed a program or tool that requires more RAM than your system
currently has on it. Large or complex programs use a lot of RAM when your system
is up and running, and even more when the particular program is open and being
used. Too little RAM will freeze up your system. For today's home computers and
small business computers, the very minimum RAM a system should have is
512MB. If you install between 2GB and 4GB of RAM on your system, then you
should be somewhat safe from RAM freezes. Keep in mind that the amount of
RAM your system can safely hold is determined by the computer's motherboard
and processor. If you are running on say an older Pentium III processor, then the
most your motherboard will operate with is 512MB of RAM. On the Windows
system, you can find your processor and RAM information by clicking through the
Start button, and then the following sequence of clicks: Settings/Control
Panel/Administrative Tools/My Computer/View System Information/General Tab. At
the bottom of the General Tab is the information on your processor and RAM.
Close out of these by clicking the X in the top right corner of each box. This
process is for viewing only. Do not make any changes to anything when you open
this up to find it.
The good news about RAM is that it is fairly inexpensive to purchase [about $60
per 512MB]. The bad news is that unless and until you become fairly experienced
with opening up your computer and making hardware changes to it, you will need
to pay a service center to install the RAM so that you do not inadvertently fry your
motherboard or the RAM. This is one area where it is good to heed the warning: If
you do not know anything about the insides of a computer, then do not attempt to
install the RAM.
 Other Emergency Cases

Display screen turns sideways

If your data or visual changes from vertical to horizontal, then you most likely have
given your computer conflicting commands. This can happen when trying to use
the CTRL + ALT + Delete sequence for rebooting. If you accidentally hit any other
buttons, you may mess up your display screen. If you find you are reading your
screen sideways, then use the command CTRL + ALT + Up Arrow, and your
visuals should return to normal.

None of my programs will start

The first thing to do is try to reboot. If after rebooting you still cannot get your
programs to come up, then you have most likely experienced a hard drive crash.
The drive will either need repair or replacement. Either way, you will need a tech to
help fix the problem and to extract or recover your files. This is a time to find your
backup CDs.

Exclamation sign in my internet signal/monitors

You are disconnected from your internet. Usually this will happen from traffic in
your computer area. People will tend to trip over and disconnect your Ethernet
connection. If you have kids, it is especially good to tack up your Ethernet wire out
of the main traffic area; be sure not to use a staple gun on the Ethernet cable as
you could short out your internet services. If you experience the no signal sign in
your window often, then it could be because you have a very long cable from your
box to your computer or it could be that you have a faulty Ethernet cable and it
needs replacing.