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Submitted to

Submitted by


1st Year MSc Nursing

Asst. Professor
Govt. College of nursing

Govt. College of Nursing



Submitted to

Submitted by



Asst. Professor

1st Year MSc Nursing

Govt. College of nursing

Govt. College of Nursing



































Page no:

Central objective:
On completion of the class, the students acquire knowledge regarding use of
computers in nursing, appreciates its importance and use of his knowledge in the
areas of profession
Specific objective:
At the end of the class, the students are able to:

Describe use of computers in nursing practice

Discuss use of computers in hospitals
Explain the use of computers in nursing education.
Describe the use of computers in nursing research.
Discuss the use of computers in nursing practice
Explain nursing informatics
Explain hospital management information system
Enlist advantages of computers in nursing
List down the disadvantages of computers in hospitals

Science has bestowed health care delivery system with
excellent technological innovations. One such innovation is the computerization of
the entire health care delivery system. Computerization has contributed
enormously towards the reduction of medical errors and the problems associated
with such errors. Computerization of health care delivery includes computerization
of the medical records popularly known as the Electronic Medical Record System
(EMR), Electronic Prescriptions, Personal Digital Assistants, Computer Automated
Cancer Detection and Computerized Theatre Management Applications. The
implementation of voice recognition technology in mobile healthcare settings is yet
another recent innovation.


Nursing has always been a very technically advanced field.
The medical arena is often the host for emerging technologies. While this has not
always included the use of computers, today computers are an integral part of
hospital and private practice culture, and thus of the nursing profession (in
educational side and clinical side). In some hospitals, specialists are hired who
bridge the nursing and information technology world, with specialties in both
How Are Computers Used in the Nursing Profession?
Nursing Administration
Computers are used in the administrative areas of nursing for basic tasks that once
were done on paper. Staffing and scheduling systems are used to construct daily,
weekly or monthly schedules. Many scheduling systems also collect data on
individual employees such as the amount of sick time used or vacation hours
accumulated. Staffing and scheduling systems often provide a variety of reports to
the administrative nurse. Budgeting and financial tracking are another way in
which computers are used in nursing administration.
Computers are valuable for patient and nursing education. Hospitals often use
computer programs to teach patients about chronic disease management or to
provide educational handouts. Preprinted documents such as discharge or
preoperative instructions can also be stored in the computer and printed as
necessary. Nurses use computers for a variety of continuing education programs as
part of the relicensure process and can also complete educational programs on the
computer to obtain advanced degrees.
Clinical Use
Clinical applications of computers in nursing are numerous. Physicians prescribe
medications and treatments on the computer, and the nurse can either transcribe
those orders onto paper tools or print the paper documents for use in patient care.
Staff nurses can order medications or supplies on the computer, look up drug
interactions or research medical condition. Many nurses use hand-held computers
such as personal digital assistants to communicate with physicians about the
patients in their care.
Electronic Medical Records
Nurses use computers for documentation with an electronic health record or
electronic medical record. When an organization uses an EMR, all documentation
related to patient care, diagnostic testing, specialty referrals or any other aspect of

patient 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 portable
electronic tablet that the nurse carries in lieu of a clipboard with paper documents
Microsoft windows is a series of operating systems produced by Microsoft.
The programs include Microsoft word, excel, PowerPoint etc.
"Nursing Informatics is defined as combining nursing science, information
management science, and computer science to manage and process nursing data,
information, and knowledge to deliver quality care to the public." (HRSA, 2008).
To improve the health of the population, communities, families and individuals
by optimizing information management and communication
To use technology in:
a. The direct provision of care
b. Establishing effective administrative systems
c. Managing and delivering education experiences
d. Supporting lifelong learning
e. Supporting nursing research
Distinct specialty practice and body of knowledge
Comprises both clinical and non-clinical
Supports nurses to improve quality of care and welfare of health care
Focus is delivering right information to right person at the right time
Human factors concepts are interwoven in practice
Ensure confidentiality and security of data and information and advocates
Promotes innovative, emerging and established information technology
Collaborates with and closely linked with other health related information
Problem identification
Solution identification
Development of solution


1. Turleys model
According to Turleys model [1996] nursing informatics is the intersection
between the discipline specific science and the area of informatics
There are 3 core components of informatics
Cognitive science
Information science
Computer science
2. Staggers and parks described framework for nurse computer interaction
research in which nurses and computers interact with information as the
common basis for interaction. The model includes:
A developmental trajectory
An assumed goal
An interaction
Differentiation of nurse behavior.
It promote and facilitate access to resources and references for nurses and the
entire interdisciplinary team in both clinical and administrative settings
Provide high quality evidence based care
Promotes improvement in relationships with physicians, peers, team members,
patients and families
Cost effective
Increased time to spend with patients.
Communicate and coordinates care with all other clinical disciplines
Coordinate discharge planning, education and transition of care
Manage all information related to nursing process and patients
Recording of patients data in an electronic health record
Distance learning via internet
Shared data
Centralized control
Improved data integrity
Improved data security and database system
Flexible conceptual design

Less chance of error
Standardized and customized reporting
A complex conceptual design process
Need for multiple external database
Need to hire database related employees
Longer running time for individual application
Computer literacy required-fear of computers
Admission, discharge and transfer
Patient access record
Financial parameters
Physician order entry
Pharmacy preparation
Using the steps of nursing process and theory to support nursing practice,
management, education and research.
Establishment of personal health records.
Electronic health record system
Health informatics education
Emergency preparedness
Defense against bioterrorism
Evidence based nursing knowledge
Nursing information management system
i. In Nursing Practice
Computer generated nursing care plans
Clinical decision-making alerts/prompts
Electronic monitoring devices that record and trend vital signs and show
patients conditions
Patient specific discharge instructions
Information about medication administration


In Nursing Administration
Workload measurement system
Online computer policy and procedure manuals
Staff scheduling system
Improved communication
Cost analysis
Patient tracking system
Staff attendance
iii. In Nursing Education
Online registration, attendance, test
Online grade management
Computer based tutorials
Online libraries
Online journals, publications
Distance education technologies
iv. In Nursing Research
Computerized literature review
Collaboration with nurse researchers
Data analysis
Online publication of findings
o Project manager
o Educator
o System analyst
o Entrepreneur
o Advocate
o Consultant
o Programmer
o Product developer
o Researcher
o Coordinator
The use of computers can be explained in the following headings: In hospitals
In nursing education

In nursing practice
In research

In Hospitals
In hospital practice the computers are mainly used as a mean for teleconferencing,

A teleconference or teleseminar is the live exchange and mass articulation
of information among several persons and machines remote from one another but
linked by a telecommunications system. Terms such as audio conferencing,
telephone conferencing and phone conferencing are also sometimes used to refer to
The telecommunications system may support the teleconference by providing one
or more of the following: audio, video, and/or data services by one or more means,
such as telephone, computer, telegraph, teletypewriter, radio, and television.
Internet teleconferencing
Internet teleconferencing includes internet telephone conferencing, video
conferencing, web conferencing, and Augmented Reality conferencing.
Internet telephony involves conducting a teleconference over the Internet or a Wide
Area Network. One key technology in this area is Voice over Internet Protocol
(VOIP). Popular software for personal use includes Skype, Google Talk, Windows
Live Messenger and Yahoo! Messenger.
A working example of an Augmented Reality conferencing was demonstrated at
the Salone di Mobile in Milano by AR+RFID Lab is another AR teleconferencing
Software and service providers
ACT Conferencing
Adobe Acrobat Connect
AT Conference
Life Size
Microsoft Office Live Meeting
Premiere Global Services

The 2 most popular types of teleconferencing are

{ Audio based teleconferencing
{ Video based teleconferencing
Teleconferencing is where a number of phone lines are bridged together so
that people can talk to each other across all the lines and the same time.
If people are asked to take part in a teleconference, they will typically get a:

Phone number to dial

Date and time to make the call

Security code to enter

While there are many teleconferencing providers, a popular option for
small businesses is Skype. The internet phone service allows you to connect to a
number of other Skype users at the same time, free of charge, by using your
internet connection and a microphone and headset. You can even call people on
landlines or mobiles to join in the conversation for a fee.
Some of the advantages of teleconferencing include:
Easy way to bring a number of people together quickly to discuss a topic
Most teleconferences can be recorded for a record or to send copies to
people who could not make the meeting
One of the downsides of teleconferencing is that you cannot see the facial
expressions or body language of other people in the meeting. This means some
conversations can be misinterpreted from time to time because body language is a
big part of human communication.
Video conferencing is where at least one person uses a video camera and
microphone to be part of a meeting in another place. Everyone involved in a video
conference needs to be able to see a video screen and be in front of a camera and
The most common setup in larger firms is for the boardroom to have large
monitors in place for board members to see remote guests and use microphones set
along the boardroom table to communicate with them.
Some smaller firms, use video conferencing companies to hold video conferences
(people travel to the conferencing providers office to use their system), while
others use freely available tools like Skype or Google, as examples.

People in the meeting can see each others facial expressions and body
language, making meetings almost as effective as meeting face to face
Most set ups offer some ability for viewing online documents or video
during the meeting
One of the downsides of video conferencing is the extra bandwidth
needed to send ones picture out and bring the picture of other attendees into ones

Advantages of Teleconferencing
Teleconferencing among multiple participants in two or more locations is a
strategic communication tool deployed by many companies with multiple locations
and dispersed employees. Business cyclical shifts and economic downturns tend to
see a rise in the use of teleconferencing facilities. Used judiciously and
strategically, teleconferencing can enhance organizational productivity, engage
employees at all levels and reduce travel budgets.
Reduces Travel
One of the most-apparent benefits of teleconferencing is reduced travel.
Businesses with multiple offices and federal governmental agencies with state
offices can hold discussions, share critical information and conduct other

meetings with employees through teleconferencing.

Saves Time
Teleconferencing frees up time for company executives to finish tasks and
execute assigned roles in their own locations or home bases. Time saved from
reduced travel can be used more productively.
Streamlines Costs
During economic downturns, teleconferencing sees a resurgence in
popularity as an effective communication and interaction tool. Companies report
significant savings in travel and human resource budgets.
Enhances Productivity
Teleconferencing allows dispersed employees to communicate with
coworkers at headquarters, conduct long-distance meetings and strategic
discussions, and share grievances and other human resource issues. Better

employee engagement, understanding of roles and effective use of time lead to

enhanced productivity.
Short-Notice Scheduling
Teleconferencing systems and toll-free, dial-in access facilities make it
possible for companies to schedule short-notice or ad-hoc employee
teleconferencing meetings or discussions

Disadvantages of a Teleconference
Lack of Body Language
Teleconferencing doesnt let to read other participants body language,
which can give clues as to whether you need to change your direction during a
meeting. For example, if the person youre meeting with crosses his arms, it might
be a sign of defensiveness and that you are not connecting. Seeing this, you would
be able to soften your message. Someone slouching or tapping their fingers can
signal they are losing interest, letting you know to change the subject or finish your
point. In a teleconferencing situation, you do not get these cues to make changes in
your presentation.
Lack of Eye Contact
Eye contact is another key benefit you lose when teleconferencing.
Someone who looks down at the floor might be lying, giving you a clue not to take
him at his word if you are interviewing him for a job or involved in a sales call. If
someones eyes dart around the room, they might be bored. If you or your meeting
partners absolutely cant make an in-person meeting, ask about videoconferencing
capabilities. Using the video cameras on our computers and the availability of lowcost and free video services such as Skype, it might be just as easy to organize a
video meeting.
People who teleconference do so using landlines, cell phones and voiceover
Internet protocol, or VOIP, phones. Plan on interruptions during telephone
meetings when calls are dropped and Internet connections go dead. Many people
attend teleconferences while driving, talking on cell phones that can create static or
other noise as the user moves in and out of dead zones. Some people take
advantage of teleconferences to stay at home that day, leading to crying babies,
barking dogs or people at the door disrupting your call.
No Visual Presentation

The ability to share graphs, charts, photos, reports, drawings, videos,

product samples and other visual messages is important to make a sale, whether
youre trying to get a customer to buy, co-workers to understand a new procedure
or your boss to agree with a pitch youre making. When organizing or attending a
teleconference that would benefit from visuals, upload documents or videos to a
company or personal website or email information to attendees before the meeting
According to WHO, telemedicine is defined as the delivery of health
care services, where distance is a critical factor, by all health care professionals
using information and communication technologies to the exchange of valid
information for diagnosis, treatment and prevention of diseases and injuries,
research and education and for the continuing education of health care provides, all
in the interest of advancing the health of individuals and their communities.



The primary aim to reach the unreached through:

Information management
Patient information
Medical data (signs, symptoms, investigations, report etc)
Appointment scheduling
Archival and retrieval of patient records
Low cost solutions
Using ordinary telephone line, satellite etc.
Service to large population
through public health care delivery system
Development of knowledge based system
For decision support
For training and education
3 types
1. Store and forward ( asynchronous)
This is used to transfer digital images from one location to another by a
computer. This is typically used for non-emergent situations as in teleradiology,
telepathology and teledermatology.
2. Remote monitoring


It is also known as self-monitoring. It enables medical professional to monitor

the patient remotely using various technological devices.it manages chronic
3. Two way interactive televisions or real time or synchronous
This is used when face to face consultation is necessary. The patient and often
their provider are at the originating site. The specialist is at the referral site.
Telehealth care
It is the use of information and communication technology for prevention,
promotion and to provide health care facilities across distances. It can be divided
into following activities:
Tele follow up

Tele education
It should be understood as the development of the process of distance
education based on the use of information and telecommunication technologies
that make interactive, flexible and accessible learning possible for any potential
Disaster management
To provide health care facilities to the victim of natural disaster such as
earthquake, tsunami, tornado etc. and manmade disasters such as war, riots etc
Telehome healthcare
It can be applied to provide home health care for elderly or underserved home
bound patient with chronic illness.
Telenursing refers to the use of telecommunications and information
technology in order to provide nursing service in health care whenever a large
physical distance exist between patient and nurse or between any number of
Tele rehabilitation
It is the delivery of rehabilitation services over telecommunication network
and the internet.Telerehabilitation can deliver therapy to people who cannot travel
to a clinic because the patient has a disability. Some fields of rehabilitation practice
that have explored tele rehabilitation are neuropsychology, speech-language
pathology, audiology, occupational therapy and physical therapy.


In telecardiology, cardiology consultation can conduct via

vedioconferencing.ECG or electrocardiographs can be transmitted using telephone
and wireless.
It is a subspecialty in the medical field of dermatology and one of the more
common applications of telemedicine and e-health. Teledermatology involves an
individual with a skin condition contacting a dermatologist via telecommunication
to request diagnosis and treatment.
It is the use of information technology and telecommunication for dental
cares, consultation, education and public awareness in the same manner as
telehealth and telemedicine.
It is another aspect of telemedicine also utilizes video conferencing for
patients residing in underserved areas to access psychiatric services. Psychiatric
treatment of patients who are at home or in another private setting is called home
based telepsychiatry.
It is the ability to send radiographic images from one location to another.it
improves patient care by allowing radiologist to provide services without actually
having to be at the location of patients.
Benefits to patient
Access to specialized health care services to underserved rural, semi urban and
remote areas.
Access to expertise of medical specialists to a larger population without
physician referral
Reduced visits to specialty hospital to long term follow-up care for the aged and
terminally ill patient
Benefits to physician
Improved diagnosis and better treatment management
Access to computerized comprehensive data (text,voice,image etc.) of patients
offline as well as real time
Quick and timely follow-up of patients discharge after palliative care
Continuing education or training through video conferencing periodically
Hospital and insurance benefits
Significant reduction in unnecessary visits and hospitalization for specialized
care at tertiary hospitals.
Earlier discharge of patient leading to shorter length of stay in hospitals.

Increase in the scope of services without creating physical infrastructure in

remote hospitals
The cost of telecommunication and data management equipment and of
technical training for medical personnel that will employ it.
Virtual medical treatment also entails potentially decreased human interaction
between medical professionals and patient.
There is an increased risk of error when medical services are delivered in the
absence of a registered professional
Telemedicine may actually decrease time efficiency due to the difficulties of
assessing and treating patient through virtual interactions.
Inability to start treatment.
Acceptance of physicians
Lack of appropriate telecommunication technology.
Lack of funding for developing state of the art telemedicine infrastructure.
Some healthcare professionals have doubt about the quality of images
transmitted for teleconsultation and telediagnosis.

In Education
The use of computers in education started in the 1960s. With the advent of
convenient microcomputers in the 1970s, computer use in schools has become
widespread from primary education through the university level and even in some
preschool programs. Instructional computers are basically used in one of two ways:
either they provide a straightforward presentation of data or they fill a tutorial role
in which the student is tested on comprehension
Computer based tools and applications are used to assist the teacher or school
administrator in the management of the learner and instructional process.
A self-learning technique, usually offline/online, involving interaction of the
student with programmed instructional materials.
Computer-assisted instruction (CAI) is an interactive instructional technique
whereby a computer is used to present the instructional material and monitor the
learning that takes place.
CAI uses a combination of text, graphics, sound and video in enhancing the
learning process. The computer has many purposes in the classroom, and it can be
utilized to help a student in all areas of the curriculum.

CAI refers to the use of the computer as a tool to facilitate and improve instruction.
CAI programs use tutorials, drill and practice, simulation, and problem solving
approaches to present topics, and they test the student's understanding.
Typical CAI provides:1. Text or multimedia content
2. Multiple-choice questions
3. Problems
4. Immediate feedback
5. Notes on incorrect responses
6. summarizes students' performance
7. Exercises for practice
8. Worksheets and tests
1. Drill-and-practice: Drill and practice provide opportunities or students to
repeatedly practice the skills that have previously been presented and that further
practice is necessary for mastery.
2. Tutorial: Tutorial activity includes both the presentation of information and its
extension into different forms of work, including drill and practice, games and
3. Games: Game software often creates a contest to achieve the highest score and
either beat others or beat the computer.
4. Simulation: Simulation software can provide an approximation of reality that
does not require the expense of real life or its risks.
5. Discovery: Discovery approach provides a large database of information
specific to a course or content area and challenges the learner to analyze, compare,
infer and evaluate based on their explorations of the data.
6. Problem Solving: This approach helps children develop specific problem
solving skills and strategies.
One-to-one interaction
Great motivator
Freedom to experiment with different options
Instantaneous response/immediate feedback to the answers elicited
Self-pacing - allow students to proceed at their own pace
Helps teacher can devote more time to individual students
Privacy helps the shy and slow learner to learns
Individual attention
learn more and more rapidly

Multimedia helps to understand difficult concepts through multi-sensory

Self-directed learning students can decide when, where, and what to learn
may feel overwhelmed by the information and resources available
Over use of multimedia may divert the attention from the content
Learning becomes too mechanical
Non availability of good CAI packages
Lack of infrastructure
lack of computer skills of many students
Physical problems such as carpal-tunnel syndrome and eye disorders (caused by
sitting in front of the computer screen for long periods of time without blinking)
Programmed instruction is a method of teaching autocratic and
individualized strategy.It is based on psychological principles of operant condition.
Programmed instruction is a method of presenting new subject matters to
students in a graded sequence of controlled steps. Students work through the
programmed material by themselves at their own speed and after each step test
their comprehension by answering an examination question or filling in a diagram.
They are then immediately shown the correct answer or given additional
information. Computers and other types of teaching machines are often used to
present the material, although books may also be used.
Programmed instruction consists of a network of statements and tests,
which direct the student to new statements depending on his pattern of errors. It is
based on a particular tool which is called teaching machine.
There are 3 types:1. Linear programming-it is being used for teaching all subjects. In
programmed teaching strategy progressive chain elements are presented.
Last step is at the mastery level.it is based on 5 fundamental principles:
Small steps
Active responding
Immediate confirmations
Student testing
2. Branched programming-it is generally used in mechanical fields.
3. Mathematics-retrogressive chain of elements is presented. First step is the
master level while the last step is simplest element.

Programmed instruction has the following core elements:
Contents are broken down into pieces of instructions called frames. A frame
contains statements and questions.
Learners then read the frame and immediately answer a question about the frame
There is an immediate feedback about the correctness of the frame (usually in a
different place)
Instruction is self-paced and learners are active (in the sense of reactive)
The main emphasis is on individual differences and students involvements
There is not fixed time interval for learning. Students may learn at their own
Learning by doing maxims of teaching is followed to involve learners in the
learning process.
Students are exposed only to correct responses, therefore possibility to commit
errors is reduced.
Immediate confirmation of the results provides reinforcement to the learners to
proceed further. Feedback is provided to wrong answers, so that learner is able
to develop mastery over the content.
It is very difficult to develop an instructional programme.
Only cognitive objectives can be achieved.
Due to tight schedule of time table, students cannot be left to learn at their own
pace. It would be very difficult to learn the content the subject matter in a
limited period of time.
There is no chance for the students creativity, their responses are highly
Development of programme is not economical in terms of cost and time.
In absence of the teacher, students may spoil the disciplinary tone of the class,
or they will be helpless when any problem arises.
It cannot be applied at primary level of education or at higher education.
A programmer should have thorough knowledge of the content and technique
of content analysis.
This strategy should be used as a supplementary device for remedial teaching
in the classroom.
It should be used in distance education or continuing education programmes
where no rigid time table is applied.

If no at a primary level or higher level of education, this strategy may be useful

at secondary level of education.
Computer Based Learning, sometimes abbreviated CBL, refers to the use
of computers as a key component of the educational environment. While this can
refer to the use of computers in a classroom, the term more broadly refers to a
structured environment in which computers are used for teaching purposes.
E-learning (or eLearning) is the use of electronic educational technology in
learning and teaching.
Computer-based training (CBT) is any course of instruction whose primary means
of delivery is a computer. A CBT course (sometimes called courseware) may be
delivered via a software product installed on a single computer, through a corporate
or educational intranet, or over the Internet as Web-based training. CBT can be
used to teach almost any conceivable subject, but it is especially popular for
computer-related studies.
Class work can be scheduled around work and family
Reduces travel time and travel costs for off-campus students
Students may have the option to select learning materials that meets their level
of knowledge and interest
Students can study anywhere they have access to a computer and Internet
Self-paced learning modules allow students to work at their own pace
Flexibility to join discussions in the bulletin board threaded discussion areas at
any hour, or visit with classmates and instructors remotely in chat rooms
Instructors and students both report eLearning fosters more interaction among
students and instructors than in large lecture courses
eLearning can accommodate different learning styles and facilitate learning
through a variety of activities
Develops knowledge of the Internet and computers skills that will help learners
throughout their lives and careers
Successfully completing online or computer-based courses builds self-knowledge
and self-confidence and encourages students to take responsibility for their
Learners can test out of or skim over materials already mastered and concentrate
efforts in mastering areas containing new information and/or skills

Learners with low motivation or bad study habits may fall behind
Without the routine structures of a traditional class, students may get lost or
confused about course activities and deadlines
Students may feel isolated from the instructor and classmates
Instructor may not always be available when students are studying or need help
Slow Internet connections or older computers may make accessing course
materials frustrating
Managing computer files and online learning software can sometimes seem
complex for students with beginner-level computer skills
Hands-on or lab work is difficult to simulate in a virtual classroom
Using a computer really helps speed up your research. Computers have
revolutionized how people gather information. The ability to store organized, neat
notes on a safe computer hard drive coupled with access to the World Wide Web
and its millions on websites makes using a computer for research.
A clinical data management system or CDMS is a tool used in clinical research to
manage the data of a clinical trial. The clinical trial data gathered at the
investigator site in the case are stored in the CDMS.
Paper-based systems
Electronic data capturing systems
1. Internet
There is a wealth of information online about everything you could
possibly imagine. Search engines such as Google, Bing and Yahoo can direct you
to relevant information in seconds. Some websites can provide detailed statistics
and facts about your research subject, providing you with hard evidence. Other
sources on the web can provide expert opinions on subjects that can give your
piece a different critical viewpoint and form new arguments that you might not
have thought of. Take care to confirm what you are reading is accurate before
trusting it as fact.
2. Quick Communication


It is now easier than ever to communicate. Email is available to everyone,

with those who are serious about an online presence usually advertising their own
personal contact somewhere on the web.
3. Security
With computers we can keep our work secure and digital, meaning there is
no paper to lose or get damaged. It also means that we can back up our work,
giving an extra copy just in case. Using a password can protect the computer so
that only researcher can access private documents.
4. Easy to Record
Word processors are fantastic when it comes to logging the findings. As
well as being quicker, easier and neater to edit than fumbling around with pen and
paper, it is easier to archive. We can store our work in specified, organized folders
on the hard drive. Other relevant documents and resources can be kept in the same
place to keep all of the information together.
5. Computational Tools
Computers began as powerful calculators, and that service is important to
research today. Regardless of the amount of data you have, you can do more with it
with a computer's help. Statistical programs, modeling programs and spatial
mapping tools are all possible because of computers. Researchers can use
information in new ways, such as layering different types of maps on one another
to discover new patterns in how people use their environment.
6. Mobility
Researchers can take computers anywhere, making it easier to conduct field
research and collect data. New areas of research in remote areas or at a community
level are opened up by the mobility of computers. Social media sites have become
a new medium for interaction and information.
Uses of Computers in Scientific Research
Complex Data Analysis
Computers used in scientific research have the ability to analyze data in ways and
at speeds not possible with the human eye. They are able to analyze percentages of
materials present in a variety of compounds from soil samples to chemicals and
even the air you breathe. Additionally, computers used in this manner can
determine trends in data samples. For example, computer analysis of data in
research could determine the temperature at which certain chemical compounds
break down or the percentages of improvement patients show when administered a
certain medication.
Solving Mathematical Equations


Scientific research often requires that complex mathematical equations be solved

in order to determine if data is valid or if a certain structure of molecules will
remain stable. Computers are integral to this calculation process since scientists
can write software programs specifically to provide answers to such questions.
This removes the element of human error, which can cost research institutions
millions of dollars in fixing a product that was created with even the smallest
amount of flawed data.
Prediction Modeling
Scientists and researchers are able to use computer programs to model how data
might manifest itself in the future. This ability is useful in predicting climate
patterns, simulating how engineered products might perform in the field, predicting
the erosion rate of beaches and anticipating the absorption rate of medications in
the body. Scientists and engineers are then able to adjust building strategies or
chemical compositions of products to ensure safe operation and consumption.
Distraction Is Inevitable
You may sit at your computer with research as your primary goal, but the
Internet contains a long list of materials to divert your attention. Even if you do
head to a database like LexisNexis to look for sources, you're still only a click
away from social media, online games and YouTube videos. A 2009 Stanford
University study revealed that too much multitasking on your computer can impair
brain and cognitive functions. Apps like Anti-Social and Self-control are designed
to block websites you're tempted to visit while researching.
Gateway to Plagiarism
Computers can make it easier to research and write papers, but they can also
make it easier to plagiarize. The copy and paste function enables students to insert
portions of a source into their papers, committing deliberate or accidental offenses.
A 2011 study by the Pew Research Internet Project revealed that 89 percent of
university presidents believe computers and the Internet have significantly affected
the incidence of plagiarism in the classroom.
All Sources Are Not Created Equal
While the Internet houses plenty of good information, separating what's
credible and what's not isn't as simple as it seems. Without carefully judging a
source's usefulness, it's easy to cite research that's not trustworthy or not
appropriate for scholarly work. Online information from personal websites,
political organizations or other potentially biased sources runs the risk of
presenting an incomplete or inaccurate view of the topic. To avoid using flawed
computer research in your essays, do background checks on your sources to ensure
they're reliable. Websites for reputable educational institutions, scholarly journals

and government agencies are examples of acceptable sources for computer-based

Not Everything's On the Internet

In Nursing Practice
{Patient Administration
Among the first uses for general computers in the medical field was basic
patient administration, and they are of course still used for this today. Computer
systems are used at patient check-in to store patient contact information, insurance
information and pertinent medical history. In larger office and hospital settings,
they also control patient flow, keeping track of who is in which room or bed, and
which rooms and practitioners are available for routing patients.
{ Electronic Medical Records
Electronic charting makes the chart more legible. Electronic charting is the wave
of the future. There will be a computer at every bedside, and every nurse will
type her notes. Electronic charting has some distinct advantages over paper
charting, but there are some disadvantages, too. A computer makes it very easy to
keep a chart readable and accessible, but it is very easy to become accustomed to
the ease of a computer.
As security standards have been put in place for protecting confidential
patient medical data, more and more hospitals and doctors' offices are keeping
medical records in electronic form. Not only is this good for the environment,
saving millions of reams of paper every year, but electronic records provide
information instantly as a patient moves through their care process. Different
offices and specialties have instant access to critical data, and nurses can check
allergies and other important information with the touch of a button as they make
their rounds.
Five levels of Electronic Health Care Record (EHCR) keeping has been
1. The Automated Medical Record, which is a paper-based record with some
computer-generated documents.
2. The Computerized Medical Record (CMR), which makes the documents of
level 1 electronically available.
3. The Electronic Medical Record (EMR) which restructures and optimizes the
documents of the previous levels ensuring inter-operability of all documentation
4. The Electronic Patient Record (EPR) which is a patient-centered record with
information from multiple institutions
5. The Electronic Health Record (EHR) that adds general health-related
information to the EPR that is not necessarily related to a disease (Walker, 2005).


Electronic charting is always legible because it is done on a computer screen.
All entries into the record are automatically time- and date-stamped so that an
accurate record of the patient's treatments can be followed.
Nurses can be prompted by the computer to ask certain questions for their
charting or to give certain medications. The computer serves as a guide to help
the nurse give proper and safe care. A computer can remind her to check an
important assessment and make all the difference to a patient's outcome.
Electronic charts are always available and easy to access. There is no need
to hunt down a chart from any of the myriad places it could be. It can simply
be pulled up on the computer screen and manipulated. The information on a
patient chart also does not take up as much room on a computer.
Expensive Start-up
One of the disadvantages of electronic charting is how expensive it is to start and
maintain. All of the computers cost money to purchase and keep running, and
this can be prohibitive to smaller hospitals. It also costs a lot to train employees
to use the new technology. These factors have kept many hospitals and nursing
homes from changing over to computer charting because the money is not
available for the conversion. The hardware, software and personnel are just not
in place for the transformation.
The other disadvantage of computer charting is the dreaded downtime.
If a computer system crashes, everyone has to go back to hand charting for a
while, and this may create some unrest and tension. Training is available in
downtime procedures, but few people like working without computers once they
are used to them.
The Push for EMRs
The Obama administration has been advocating electronic medical records
on the grounds that they can help improve the efficiency of health care delivery
by sharing information of a patient's history, treatment and outcomes. But among
the risks associated with switching to EMRs are doubts about their accuracy, the
risk of records being hacked and unauthorized access to records by insurers,
employers or others who could use that information against patients by denying
them insurance or jobs.
The HIPAA Factor

One of the reasons medical records haven't gone digital as they have in financial
services or other fields is HIPAA. The federal Health Insurance Portability and
Accountability Act, enacted in 1996, requires hospitals, clinics and others in
health care to guard the privacy of medical records. HIPAA includes penalties of
up to $250,000 in fines and 10 years in prison for violations. Given the harsh
penalties and the number of breaches of electronic records, many in the health
care industry consider it easier to secure paper records.
Medical Record Errors
Security Breaches
Although information security technology is available to block unauthorized
access to medical records, security breaches happen all the time.
Spying on Patient Records
Privacy advocates warn that unauthorized access could lead to patient
discrimination. An insurance company could deny coverage to someone based
on what it finds in the person's medical records or an employer could decline to
hire someone because of her health history.
{ Electronic Prescriptions
Nurse Practitioners have prescriptive authority in the United States and
prescription error is a problem in current nurse practice. Communication has
been cited as the single biggest block in such prescription errors leading to
wrong reading by the pharmacist. Errors seem to be more in the dose of the
medicines prescribed. Electronic prescription systems have been designed as a
total remedy to this problem
{ Personal Digital Assistants
Personal Digital Assistants popularly known as PDA are literally handheld
computers that help patient management. Using a PDA, a nurse can access a
patient's laboratory reports and refer the latest information on relevant therapies,
tests and treatments. The PDA can also be used for billing and updating patient
visits. The PDA can also provide map and directions to the patient's homes.
Using a PDA, a nurse can instantaneously transfer prescriptions to the patient's
pharmacy, answer patient e-mail, refer to medical textbooks, drug databases,
journals and updates.
{ Computer Automated Cancer Detection
A Thin Prep Processor Model 2000 has been recently approved by the FDA for
the automatic preparation of PAP slides making it easier for screening atypical
cells in female patients suspected with Cancer of the cervix. The Thin Prep
System has been found to be especially effective for detecting low-grade
squamous intraepithelial lesions known as SILs and severe lesions. The Thin
Prep System provides for better detection of Cancer cells. PAPNET is another

innovation that uses neural net computer technology, where, the computer
provides guidelines for identifying abnormal cells from a series of digital images
of PAP smears fed priori. Auto Pap 300 QC is another Pap test re-screening
system that uses image interpretation and pattern recognition techniques for
identifying abnormal cells
{ Computerized Theatre Management Application
Theatre Management Applications automatically record patient
information like demographic and financial data, visit history with dates,
procedures, performing and attending providers, care records with clinical
highlights and patient status, surgical data including proposed, type, actual,
severity and risks stored for reference in the event of future surgical procedures.
The most important aspect of such applications is that they facilitate the
management of patient supplies with associated refill lists. These systems help to
monitor and track the use of implant and surgical items utilized during operative
procedures. The applications allow the theatre nurses to create lists which give
full information on the necessary equipments and surgical instruments required
in the operating theatre for a surgery specific to a surgeon or specialty.


A system which acquires,stores,processes and delivers patient related
information in a hospital with required details in response to a query or routinely or
periodically ads per predetermined format to those who need, it is called a hospital
information system (HIS).
In many implementations, a HIS is a comprehensive, integrated
information system designed to manage all the aspects of a hospital's operation,
such as medical, administrative, financial, and legal issues and the corresponding
processing of services.
Easy access to patient data
Helps in decision-making
Improve monitoring
Connects people, processes and data in real time across the hospital on a single
Enhance information integrity
Highly flexible and customizable
Fast and reliable information storage
Helps in improved health care delivery
It is a good managerial tool

Helps to educate patients about their disease

Non computerized HIS
computerized HIS
Non Computerized HIS
Manual non-computerized hospital information systems consists of:
{ Various documents
{ Reports
{ Returns
{ Transmission channels
{ Personnel
{ Documents
{ Medical records
{ Admission/discharge books
{ Records of laboratory test and X-ray
{ Account book
{ Store ledger
Computerized HIS
Elements in a computerized HIS are:
{ A host computer
{ Terminals/workstations/peripherals
{ Communication network
{ A database
{ Software
{ Skinware
Improved Workload Functionality
The need for high-quality healthcare implies that accurate and timely
information should be of primary importance. Staffing levels and appropriate skill
mix per shift can be determined easily by using the shift modules, which can later
be used in distribution of labor among the nurses. This leads to less time spent in
designing and altering duty rosters.
Enhanced Decision Making
According to HealthMad.com, information systems are computer-based
applications used for transforming raw data into information usable in a variety of
ways to improve operational efficiencies and the quality of service delivery. Right
clinical decisions need right information, such as accessing medical resources
online and identifying the right information that is critical in decision making.

Decision support modules also provide prompts and reminders, and guides to
disease linkages between signs or symptoms, etiologies or related factors and
patient populations.
Scheduling and Personnel Management
You can self-schedule your shifts using information systems. Patient care
becomes more effective and economical using shift modules designed to handle
absences, overtime, staffing levels and cost-effective staffing. This makes for more
complete patient-care plans and more comprehensive assessments and evaluations.
Improved Drug Administration
Information systems enable electronically prescribed drugs to become more
understandable, as it is less likely that you can administer wrong drugs to patients.
By using patient-charting modules, the patient's vital signs, admission and nursing
assessments, care plan and nursing notes can be entered into the system and then
stored in a central repository that you can retrieve when needed for drug
Clinical Data Integration
Patient records have become more readable and accurate with the application of
nursing information systems, which have ensured improvement of standards of
keeping records. Time spent on patient data classification is also reduced. Retrieval
of both local and regional statistics on patients becomes easy, duplication of data
entry is avoided, and there is less manual paperwork and fewer printouts.
1. Stock of Medicines
One of the major advantages of computers in nursing is that a basic system
permits the nurses to have an updated record of the pharmaceuticals the hospital
have in stock. Therefore, when making inventories, the process is much faster and
accurate in order to always have a full stock of all the medicines needed to treat
patients. Computers also allow making a description of each medicine, including
side effects, composition and uses.
2. Clinical Records
Computers allow nurses to get the patient's clinical records in a matter of
minutes. It's not necessary for nurses to wade through stacks of papers and files
anymore. Also, if the patient has ever been treated in a specific medical institution,
the hospital interconnected network allows nurses to ask online for their patient's
clinical records and receive an immediate response. This is very important when
treating a patient since knowing their pre-existing conditions is a matter of life or
3. Improving Patient Treatment and Follow-ups


Nurses often use computers to take full notes on how a treatment is progressing.
By placing notes on the patient dosage, with reminders about giving medicines,
nurses ensure the proper treatment of a patient. Statistics show that even when
there's human error involved when treating patients, these have been reduced to a
minimum. If a medication has not been released, the computer makes a notification
so that the nurses can address this issue in a timely manner.
4. Research
Computers in nursing today contain huge medical libraries open to research and
study. Nurses, during their college years and when working in a hospital, need to
keep updated constantly. Online data bases of medical cases from all around the
world, medicine researches, and treatment comparisons are essential to their
professional growth
One of the biggest drawbacks of adding computers to hospitals is the cost.
Computers cost money, and a large hospital needs many computers to keep the
system running smoothly. Creating a network to transfer medical records or keep
track of billing is an additional initial cost. Unlike paper records, which simply
require a few more copies, electronic record keeping requires constant upkeep of
computers, computer software and other electronic elements, which can cost even
Paper records are kept in a doctor's office or a warehouse, but once
computers are added to a hospital, electronic record keeping typically follows.
Once electronic record keeping is begun, medical information is usually added to
a closed computer network, but as long as an Internet connection comes into the
network, the system is vulnerable to outside sources, opening the debate to
questions about patient privacy and medical record security.
Lack of Standardization
From a hospital point of view, one of the biggest disadvantages of adding
computers and electronic records to a hospital is the lack of standardization
through the medical field. Different hospitals use different shorthand abbreviations
or symbols on medical records than others. Even the codes called out during
emergencies don't always mean the same thing in every hospital. If a medical
record is transferred from another hospital or the system becomes open so hospitals
can share information, the lack of standardization in hospital notes and records
could cause problems when it comes to a medical professional's understanding of
the medical record.


I. Using computer assisted learning for clinical skills education in nursing:

integrative review.
Bloomfield JG1, While AE, Roberts JD.
This paper is a report of an integrative review of research investigating computer
assisted learning for clinical skills education in nursing, the ways in which it has
been studied and the general findings.
Clinical skills are an essential aspect of nursing practice and there is international
debate about the most effective ways in which these can be taught. Computer
assisted learning has been used as an alternative to conventional teaching
methods, and robust research to evaluate its effectiveness is essential.
Twelve studies met the inclusion criteria. An integrative review was conducted
and each paper was explored in relation to: design, aims, sample, outcome
measures and findings. Many of the study samples were small and there were
weaknesses in designs. There is limited empirical evidence addressing the use of
computer assisted learning for clinical skills education in nursing. Computer
assisted learning has been used to teach a limited range of clinical skills in a
variety of settings.
The paucity of evaluative studies indicates the need for more rigorous research to
investigate the effect of computer assisted learning for this purpose. Areas that
need to be addressed in future studies include: sample size, range of skills,
longitudinal follow-up and control of confounding variables.
II. A meta-analysis of computer-based instruction in nursing education.
Cohen PA1, Dacanay LS.
Although dozens of studies regarding computer-based instruction (CBI) in nursing
education have been conducted over the last 25 years, little has been done to
summarize these studies quantitatively. In the current study, the authors used
Glass's techniques of meta-analysis (Glass, McGaw, & Smith, 1981) to integrate
statistically findings from 29 comparative studies concerning CBI. A clear
majority of these studies favored CBI over conventional methods of instruction.
The overall achievement effect size for 26 studies that quantified outcomes was
0.45, a medium-sized effect. Two study feature variables--type of CBI and
required versus elective course--related to effect size. Interactive video
applications of CBI produced larger effects than tutorial, computer-managed, and
simulation applications, and CBI implementations in elective courses showed

larger effects than implementations in required courses. Few studies reported on

outcomes of retention, attitudes, and time to learn. The results demonstrate a need
for more and better reported research to identify instructional qualities that lead to
positive student outcomes.
III. Effectiveness of a computer-based educational program on nurses'
knowledge, attitude, and skill level related to evidence-based practice.
Hart P1, Eaton L, Buckner M, Morrow BN, Barrett DT, Fraser DD, Hooks D,
Sharrer RL.
To conduct a baseline assessment of nurses' perceptions of knowledge, attitude,
and skill level related to evidence-based practice (EBP) and research utilization;
determine the level of organizational readiness for implementing EBP and
research; and examine the effectiveness of a computer-based educational program
on nurses' perceptions of knowledge, attitude, and skill level related to EBP and
research utilization.
A descriptive, quasi-experimental design with a one-group, pre-intervention
survey, intervention, and post-intervention survey method was used. A
convenience sample of 744 nurses working in an integrated health care system
was recruited. The study was conducted from May 2006 through November 2006.
Data collection instruments were a demographic data questionnaire and the
Evidence-Based Nursing Questionnaire. An education intervention on principles
of EBP and research utilization was conducted via three computer-based learning
Statistically significant differences in perceptions of knowledge, attitude, and skill
level, as well as beliefs about organizational readiness were found after nurses
participated in the computer-based education intervention. Although nurses
indicated having positive attitudes about using research to support best nursing
practice, gaps in knowledge and skills in retrieving research publications,
evaluating the evidence, and incorporating the evidence into practice remain.
Nurses rated their managers, senior nursing administrators, and staff nurses on
their unit higher than hospital managers in supporting changes to practice based
on research.
Nurses in clinical settings need to be able to use research findings and incorporate
EBP into their nursing practice to promote positive patient outcomes. Appropriate
organizational infrastructures are essential for promoting EBP and research


utilization in clinical settings. Diverse and effective methods are essential in

educating and engaging nurses in EBP and research utilization. Computer-based
education is an effective approach that can be used by nursing leaders in health
care organizations to educate and engage nurses in EBP initiatives and research
IV. Effect of information and communication technology on nursing
Fujino Y, Kawamoto R
The aim of this study was to investigate the influence of information and
communication technology use and skills on nursing performance. Questionnaires
were prepared relating to using the technology, practical skills in utilizing
information, the Six-Dimension Scale of Nursing Performance, and
demographics. In all, 556 nurses took part (response rate, 72.6%). A two-way
analysis of variance was used to determine the influence of years of nursing
experience on the relationship between nursing performance and information and
communication technology use. The results showed that the group possessing high
technological skills had greater nursing ability than the group with low skills; the
level of nursing performance improved with years of experience in the former
group, but not in the latter group. Regarding information and communication
technology use, the results showed that nursing performance improved among
participants who used computers for sending and receiving e-mails, but it
decreased for those who used cell phones for e-mail. The results suggest that
nursing performance may be negatively affected if information and
communication technology are inappropriately used. Informatics education should
therefore be provided for all nurses, and it should include information use relating
to cell phones and computers.
A systematic review evaluating the impact of online or blended learning vs.
face-to-face learning of clinical skills in undergraduate nurse education
Karen McCutcheon, Maria Lohan, Marian Traynor, Daphne Martin
To determine whether the use of an online or blended learning paradigm has the
potential to enhance the teaching of clinical skills in undergraduate nursing.
The need to adequately support and develop students in clinical skills is now
arguably more important than previously considered due to reductions in practice
opportunities. Online and blended teaching methods are being developed to try and
meet this requirement, but knowledge about their effectiveness in teaching clinical
skills is limited.

Mixed methods systematic review, which follows the Joanna Briggs Institute User
guide version
Data sources
Computerized searches of five databases were undertaken for the period 1995
August 2013.Review methods Critical appraisal and data extraction were
undertaken using Joanna Briggs Institute tools for experimental/observational
studies and interpretative and critical research. A narrative synthesis was used to
report results.
Nineteen published papers were identified. Seventeen papers reported on online
approaches and only two papers reported on a blended approach. The synthesis of
findings focused on the following four areas: performance/clinical skill,
knowledge, self-efficacy/clinical confidence and user experience/satisfaction. The
e-learning interventions used varied throughout all the studies.
The available evidence suggests that online learning for teaching clinical skills is
no less effective than traditional means. Highlighted by this review is the lack of
available evidence on the implementation of a blended learning approach to
teaching clinical skills in undergraduate nurse education. Further research is
required to assess the effectiveness of this teaching methodology.

Computerization has contributed enormously towards the reduction of
medical errors and the problems associated with such errors by providing timely
access to client information and by assisting nurses with client monitoring,
decision making and bedside documentation. But, the real challenge lies in
utilization of features, functions, input and output modalities that nurse would find
most useful.

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foundation of knowledge, Jones and Bartlett Pvt limited; PP: - 6-28, 68-100.
2. Shabeer .P. Basheer (2013), A CONCISE TEXTBOOK OF ADVANCED
NURSING PRACTICE, EMMESS medical publishers, PP:-779-810.
3. Samta Soni (2009), textbook of advance nursing practice, jaypee publication,
4. http://www.ehow.com/list_6815401_disadvantages-using-computerresearch_.html
5. http://www.ehow.com/info_8050652_importance-computers-research.html

6. http://www.ehow.com/list_7184064_uses-computers-scientific-research.html
7. www.wikipedia.com
8. www.pubmed.com