Computer application for patient care delivery system and nursing

practice
INTRODUCTION OF COMPUTER :-
INTRODUCTION :-
Being a modern-day kid you must have used, seen, or read about computers. This is
because they are an integral part of our everyday existence. Be it school, banks, shops,
railway stations, hospital or your own home, computers are present everywhere, making
our work easier and faster for us. As they are such integral parts of our lives, we must
know what they are and how they function. Let us start with defining the term computer
formally.
The literal meaning of computer is a device that can calculate. However, modern
computers can do a lot more than calculate. Computer is an electronic device that
receives input, stores or processes the input as per user instructions and provides output
in desired format.
DEFINITION :-
Acording to Navdeep kaur Brar :-
An electronic device that stores, retrieves and process data, and can be programmed with
instructions. A computer is composed for hardware and software, and can exist in a
variety of sizes and configurations.

INPUT-PROCESS-OUTPUT MODEL :-
Computer input is called data and the output obtained after processing it, based on user’s
instructions is called information. Raw facts and figures which can be processed using
arithmetic and logical operations to obtain information are called data.

The processes that can be applied to data are of two types −

 Arithmetic operations − Examples include calculations like addition, subtraction, differentials,
square root, etc.
 Logical operations − Examples include comparison operations like greater than, less than,
equal to, opposite, etc.
The corresponding figure for an actual computer looks something like this −

The basic parts of a computer are as follows −

 Input Unit − Devices like keyboard and mouse that are used to input data and instructions to
the computer are called input unit.
 Output Unit − Devices like printer and visual display unit that are used to provide information
to the user in desired format are called output unit.
 Control Unit − As the name suggests, this unit controls all the functions of the computer. All
devices or parts of computer interact through the control unit.
 Arithmetic Logic Unit − This is the brain of the computer where all arithmetic operations and
logical operations take place.
 Memory − All input data, instructions and data interim to the processes are stored in the
memory. Memory is of two types – primary memory and secondary memory. Primary
memory resides within the CPU whereas secondary memory is external to it.
Control unit, arithmetic logic unit and memory are together called the central processing
unit or CPU. Computer devices like keyboard, mouse, printer, etc. that we can see and
touch are the hardware components of a computer. The set of instructions or programs
that make the computer function using these hardware parts are called software. We
cannot see or touch software. Both hardware and software are necessary for working of a
computer.

CHARACTERISTICS OF COMPUTER
To understand why computers are such an important part of our lives, let us look at some
of its characteristics −
 Speed − Typically, a computer can carry out 3-4 million instructions per second.
 Accuracy − Computers exhibit a very high degree of accuracy. Errors that may occur are usually
due to inaccurate data, wrong instructions or bug in chips – all human errors.
 Reliability − Computers can carry out same type of work repeatedly without throwing up
errors due to tiredness or boredom, which are very common among humans.
  Versatility − Computers can carry out a wide range of work from data entry and ticket booking
to complex mathematical calculations and continuous astronomical observations. If you can
input the necessary data with correct instructions, computer will do the processing.
 Storage Capacity − Computers can store a very large amount of data at a fraction of cost of
traditional storage of files. Also, data is safe from normal wear and tear associated with paper.

ADVANTAGES OF USING COMPUTER

Now that we know the characteristics of computers, we can see the advantages that
computers offer−
 Computers can do the same task repetitively with same accuracy.
 Computers do not get tired or bored.
 Computers can take up routine tasks while releasing human resource for more intelligent
functions.

DISADVANTAGES OF USING COMPUTER

Despite so many advantages, computers have some disadvantages of their own −
 Computers have no intelligence; they follow the instructions blindly without considering the
outcome.
 Regular electric supply is necessary to make computers work, which could prove difficult
everywhere especially in developing nations.

BOOTING
Starting a computer or a computer-embedded device is called booting. Booting takes
place in two steps −

 Switching on power supply

 Loading operating system into computer’s main memory
 Keeping all applications in a state of readiness in case needed by the user
The first program or set of instructions that run when the computer is switched on is
called BIOS or Basic Input Output System. BIOS is a firmware, i.e. a piece of software
permanently programmed into the hardware.
If a system is already running but needs to be restarted, it is called rebooting. Rebooting
may be required if a software or hardware has been installed or system is unusually slow.
There are two types of booting −
 Cold Booting − When the system is started by switching on the power supply it is called cold
booting. The next step in cold booting is loading of BIOS.
 Warm Booting − When the system is already running and needs to be restarted or rebooted, it
is called warm booting. Warm booting is faster than cold booting because BIOS is not reloaded.
COMPUTER IN NURSING EDUCATION :-

INTRODUCTION :-

TOFFLER (1990) described the 1990s as a new era for informatics, the process of
gaining power through the data information knowledge triad. This era continues as
we enter the new millennium. The need for nurses to feel comfortable working with
computerized data and information is escalating. Computerization can be absorbed
into virtually every area of nursing services, e.g. clinical nursing, nursing,
administration, nursing education and nursing research.

NURSING PRACTICE :-

Nursing practice has evolved and changed radically. It has become an integral part of the
(electronic health record )EHR. Computer systems with nursing and patient care data, nursing
care plans are no longer separate subsystems of the computerized HISs, but rather integrated
into one interdisciplinary patient health record in the EHR. The need for an interdisciplinary
EHR resulted because of many initiatives proposed and promoted by the nursing profession as
well as by other health care providers. They all require patient care data to track the care
process. Further nursing practice data emerged with the introduction of several nursing
terminologies that were recognized by the ANA as coded terminologies usable for the EHR.
They are used to assess problems, document care, and track the care process, and measure
outcomes. Thus, the electronic version nursing practice – the computer – has revolutionized
and transformed nursing practice.

List of the other task :-

A list of some other tasks is as under :

Admission, discharge and transfer (ADT) :- This system enables the nurses to obtain the
basis information of clients before they arrive to the ward. When the discharge or transfer is
entered into the computers, all the concerned departments like housekeeping, dietary,
pharmacy, etc. are automatically notified. It saves a lot of tome.

Health reporting / documentation :- Nursing assessments records, reports, medication,

discharge plans and care plans are documented in computers in the form of electric health
records. When an organization uses an electric health record, every documentation related to
patient care, diagnostic testing, specialty referrals or any other aspect of patients care or
management is done on the computer. The computers can be stationed at the bedside, used on
mobile carts or might be in the form of a portables electronic tablet that the nurse carries in
lieu of a clipboard with paper documents.

NURSING ADMINISTRATION

Nursing administration in hospitals has also changed with the introduction of the computer
that links nursing departments together. Most policy and procedure manuals are accessed and
retrieved by computer. Further, workload measures, acuity systems, and other nursing
department systems are online and integrated with the hospital or patient's EHR system or in
separate nursing department systems. The Internet is being used by nurses to access digital
libraries, online resources, and research protocols at the bedside.

NURSING EDUCATION

The computer has radically changed nursing education. Most universities and schools of
nursing offer computer enhanced courses, online courses, and/or distance education. They are
becoming universities without walls where students can attend a university anywhere in the
world without being present. Campus-wide computer systems are available for students to
communicate via e-mail, transfer data files, access the digital libraries, and retrieve online
resources of millions of Internet WWW sites (Saba, 1996). These new educational strategies
require different methods of teaching. Today, most faculty members use the Internet to teach
courses via the Web and communication with their students via e-mail. They require new tools,
techniques, and a full array of multimedia strategies to stimulate their students. The students
on the other hand, have to be more active and assume more responsibility for their education.
Time, distance, and cost are no longer barriers to educational programs (Joos and Nelson,
1992; Saba, 2000).

NURSING RESEARCH

Nursing research provides the impetus to use the computer for analyzing nursing data.
Software programs are available for processing both quantitative and qualitative research
data. With the advancement of computer technology databases supporting nursing research
emerged, principally for online searching and retrieving information from the electronic
bibliographic literature systems or other databases that contain relevant health care content,
such as drug data. The Internet also provides online access to the millions of Web resources
around the world which have increased the capabilities and expanded the field of nursing
research.

STANDARD INITIATIVES 
NURSING PRACTICE STANDARDS

 Nursing practice standards have been developed and recommended by the ANA, the
official professional nursing organization. The ANA published The Standards of
Clinical Nursing Practice (ANA, 1998) which focused not only on the organizing
principles of clinical nursing practice but also the standards of professional
performance.  They recommended that the nursing process serve as the conceptual
framework for the documentation of nursing practice. 

 Nursing practice standards have also been set by the Joint Commission on
Accreditation of Hospital Organization (JCAHO) which stressed the need for
adequate records on patients in hospitals and practice standards for the
documentation of care by nurses (Namdi and Hutelmyer, 1970). They also
recommended acuity systems to determine resource use as well as required care
plans for documenting nursing care (JCAHO, 1994). Further, they have included in
their recent manual the required contents of an EHR, such as what data should be
collected and how the data should be organized on the electronic database (Corum,
1993). These standards have evolved and continue to increase as the federal
requirements evolve and/or are implemented. 

NURSING DATA STANDARDS

 Nursing data standards have emerged as a new requirement for the EHR. The
original data elements and historical details are described in the third edition;
however, for this fourth edition is it important to understand that currently there
are 13 nursing terminologies that have been recognized by the ANA and which are
described in other sections of this book. The ANA is responsible for the recognition
of the terminologies and for determining if they have met the criteria to be included
in the National Library of Medicine (NLM) Unified Medical Language Systems
(UMLS) (Humphreys and Lindberg, 1992; Saba, 1998). 

HEALTH CARE DATA STANDARDS ORGANIZATIONS

 It is critical to review the standards organizations that have emerged to either develop or
recommend health care data standards that should be recommnded to the federal government
as required health care data standards. The major ones are listed below but also described
elsewhere in this book. The American National Standards Institute (ANSI) is a private
nonprofit membership organization. It was instituted to coordinate and approve voluntary
standards efforts in the United States. ANSI was combined with the Health Care Informatics
Standards Board (HISB) to form ANSI-HISB to fulfill a request by the European standards
coordinating organization (CEN TC/251) to represent the U.S. standards effort. 

        American Society for Testing and Materials (ASTM): The ASTM E-31 Committee on
Healthcare Informatics is an accredited commitee that develops standards for health
information and health information systems designed to assist vendors, users, and anyone
interested in systematizing health information (Cendrowska et al., 1999; Hammond, 1994).

SIGNIFICANT LANDMARK EVENTS

 Computers were introduced into the nursing profession over 35 years ago. Major milestones
of nursing are interwoven with the advancement of computer and information technologies,
the increased need for nursing data, development of nursing applications, and changes making
the nursing profession an autonomous discipline. The major developments in the use of
information technologies and nursing, and in the introduction of NI, were chronologically
described by program effort, or by organizational initiative. The landmark events were
described by the following categories: (a) early conferences, meetings, (b) early academic
initiatives, (c) initial ANA initiatives, (d) initial National League for Nursing (NLN) initiatives,
(e) early international initiatives, (f) initial educational resources, and (g) significant
collaborative events. 

HOSPITAL MANAGEMENT INFORMATION SYSTEM :-

WEBOGRAPHY :-

1. http://www.asrn.org/journal-advanced-practice-nursing/346-computers-in-
nursing practice.html#sthash.8EaYX9hg.dpuf
2. https://si.wsj.net/public/resources/images/OG-
AC049_INFORM_G_20140721213025.jpg
3. https://www.rubbermaidhealthcare.com/SiteAssets/img/product-segments/RHC-
Products-Standard-CC-Inuse.png?Redirect=1