Nursing Medical Information Technology Program Course Description

Published Date: 02 Nov 2017

This Certificate course in Nursing Medical Informatics program is developed to suit the nursing personnel who have no background of Information Technology. It is mainly used in healthcare environment. Nursing informatics can be defined as the integration of nursing, computer and Information Sciences to manage and distribute information, data and knowledge in the practice of nursing. This integration helps to better serve patients while assisting nurses and other health care providers in making effective, timely decisions regarding patient care.

The main objective of this program is to train students to become technologically competent nurses who assist those who are responsible for maintaining of health, the improvement of health status, the prevention of illness, and the alleviation of suffering.

Theoretical lectures will cover the computer and human interface components, the ethics involved in nursing Informatics, confidentiality and privacy. Students will learn which technologies to use under various situations and how to apply best technologies to manage and communicate various types of information and data. Students will also learn to apply data principles and to document information appropriately within various computer applications designed specifically for nursing and health care administration.

The practical and field work "hands-on-the job" will enlighten how to operate and implement the competency that will facilitate in daily carrying out the responsibilities. The practical experience and skills with theoretical knowledge will help the nursing staff meeting the day to day work and in achieving swift, safe, improved quality care.

OBJECTIVE OF THE COURSE

Upon successful completion of the course, the students with IT knowledge will be able to:

Provide professional care for patients’ recovery and physical and mental health.

To perform administrative duties, such as safe-custody of drugs and maintenance

of equipment and materials in satisfactory condition

Maintaining comprehensive patient records for the services rendered

Provide continuing education to professional nurses and nursing assistants.

Communicate with investigation departments to send and receive orders investigations

Coordinate with the allied departments for the services required for effective patient care

To assist in the medical education and research programs

Teach the use of technology used to new staff and students.

Work within the environment where the technology has become part of the healthcare delivery system

Utilize for routine jobs such as admissions, discharges, transfers, sending orders and receiving reports

Understand the care team orders and requests to carry out the responsibility.

Get acquainted with the physician order entry (CPOE) and able to be entered at the point of care (POC)

Understand the different standards used for providing alert to possible contradictions to eliminate errors.

Track the status of patient care through computerized programs.

To take electronically; blood pressure, temperature, and other vital signs

Utilize the technology for staff development and continuing education

Utilize informatics applications to assist with staffing, managing, budgeting and disseminating information

Acquainted with the Hand-held, PDA units, mobile communication technology and other wireless local networks used in the facility

SYLLABUS FOR FOUR WEEKS MEDICAL INFORMATION TECHNOLOGY PROGRAM

(Syllabus with teaching hours and teaching faculty & department)

Introduction: Nursing is the field in which the health of a particular individual or group of people is taken care until they restore or regain their normal health condition. Nursing is well-recognized disciplined profession, and an area of practice. As a profession, nursing has a social mandate to be responsible and accountable to the public it serves. It is the duty of the nurses to take care of patients who suffer from illness, diseases or injury. Nurses act as bridge between the doctor and the patients.

S. No

TOPICS

Hrs

Hrs

Hrs

Taught by

Department

Nursing Medical Information Technology

32

1.

Introduction to Nursing

1/2

Nurse

Hospital

2.

Nursing Objectives

1/2

Nurse

Hospital

3.

Nursing Standards, Policies and Procedures

2

Nurse

Hospital

a. Nursing Standards

1/2

b. Nursing Policies

1/2

c. Nursing Procedures

1

4.

Nursing Functions

8

Nurse

Hospital

a. Nursing Professional Practice

1

b. Nursing Ward Management

1

c.Nursing Operation Theater Management:

1

d. Labor Room Management:

1

e.Post operative/ICU/Burns unit management

1

f. Public Health Nursing - functions

1

g. Documentation of: Records

1

i)Direct patient care related documents

1/2

ii)Indirect patient care related documents/registers and records

1/2

h. Staff Development and Educational

1

5.

Nursing Staff and Operational Organization

2

Nurse

Hospital

a. Staff Organization

1

i) Nursing Director

ii) Assistant Director

iii) Nursing Supervisor

iv) Night Supervisor

v) Nursing Sister

vi) Sr. Staff Nurse or Head Nurse

vii) Staff Nurse

b. Nursing Operational Fields

1/2

c. Nursing Profession

1/2

6.

Introduction of Basic Computers

8

IT

Networking

a) Introduction

1

b) Computers

c) Input

d) Output

e) Hardware

f) Software, Basics of Computers

g) Different types of computers

1

i) Desktop computers

ii) Laptop computers

iii) Hand held computers

iv) Tablet PC's

h) Data Management

1

i) Networking

i) Scale

ii) Connection Method

iii) Functional Relationships

iv) Network Topology

j) Engineering computer Hardware

1

k) Hardware Architecture

1

l) Database Software Design

1

m) Software Design

1

n) Management and Administration of entire Systems-related

1/2

o) Structure

1/2

7.

Healthcare Information Regulations, Laws and Standards

2

IT Standard specialist

Information Technology

a) ISO standards

b) JACHO standard

c) HIPAA standards

d) Evidence Based Medicine (EBM)

e) Health Record as a Legal Document

f) Security, Privacy and Confidentiality

8.

Healthcare Information Management System

5

Doctor

Hospital

a) Introduction to Healthcare Information

2

i) Hospital Information System

ii) Nursing Information System

b) Clinical Information System

3

i) Laboratory

ii) Radiology

iii) Pharmacy

iv)Computerized Physician Order Entry (CPOE)

v) Computerized Decision Support System (CDSS)

9.

Implementation of EHRR and Other System

4

Doctor

Hospital

a) Paper based Medical Records

1/2

b) Hybrid of Medical Records

1/2

c) EHR Implementation Process

1/2

d) Other System Implementation

1/2

e) PHR

1/2

f) Telemedicine &Tele-health

1/2

g) Mobile Technology

1/2

h) Introduction to ICD

1/2

10.

Preparations and Assessment

8

11.

Practical or Fieldwork

20

FOUR WEEKS NURSING MEDICAL INFORMATION TECHNOLOGY PROGRAMME

1. INTRODUCTION TO NURSING

Nursing is the field in which the health of a particular individual or group of people is taken care until they restore or regain their normal health condition. Nursing is well-recognized disciplined profession, and an area of practice. As a profession, nursing has a social mandate to be responsible and accountable to the public it serves. It is the duty of the nurses to take care of patients who suffer from illness, diseases or injury. Nurses act as bridge between the doctor and the patients.

Nursing is the integral part of the health care system, and as such encompasses the promotion of health, prevention of illness, and care physically ill, mentally ill, and disabled people of all ages, in all health care and other community settings. Within this broad spectrum of health care, the particular concern to nurses is individual, family and group "responses" to actual or potential health problems"

Nursing is " both an art and science involving the total patients, as promoting spiritual, mental and physical health; stressing health education and health preservation, ministering to the sick, caring for the patient environment and giving health service to the family, the community and the individual"

2. NURSING OBJECTIVES

The different Nursing Objectives are as follows

To provide professional care for patients’ recovery and physical and mental health.

To provide non-professional care for patients’ comfort and safety such as bed making.

To perform administrative duties such as safe-custody of drugs and maintenance of equipment and materials in satisfactory condition.

To maintain comprehensive patient records for the services rendered.

To provide continuing education for professional nurses and nursing assistants.

To undertake understanding, or assist with, research for improved nursing care.

To provide, where necessary, clinical experience for student nurses.

To provide professional care for patients’ recovery and physical and mental health.

Providing professional care refers to nurses performing their duties timely. Like for certain types of injuries or diseases or infections it is very essential for the nurses to give the patients the medicines prescribed by the doctors at specific time. At times there may be a need to provide the patients with their prescribed medication in a given order, or their might arise complication for example it is essential that an anti-acid medicine is given on an empty stomach and a painkiller or an antibiotic is to be given only after taking food.

To provide non-professional care for patients’ comfort and safety such as bed making.

It is important for the nurses to maintain professionalism but is it also important for them to be personal towards the patient at times especially when the patient requires special care and attention. This personal care would enhance the recovery of the patient in many cases, especially for the patients who suffer with agony and mental illness.

To perform administrative duties such as safe-custody of drugs and maintenance of equipment and materials in satisfactory condition.

It is the responsibility of the nurses to pay special attention to the day to day equipment that is being used to treat the patient. Care should be taken that the sterility, hygiene, neatness and the working condition of each and every equipment is ensured. This special attention is required so that the patient does not develop further infections or complications.

To maintain comprehensive patient records for the services rendered.

The nurses tend to keep a track of time, accuracy and completeness of the patient record. Authentication is also necessary in order to know who has done the work.

To provide continuing education for professional nurses and nursing assistants.

Every profession requires constant leaning practice. Learning and education is mainly essential to keep a track of the changing revolution and technology. New learning concepts and technology can be implemented, which may or may not be known to all the nurses on a day to day basis.

To undertake understanding, or assist with, research for improved nursing care.

It is very important to keep a track or all the information and patient records to help in research work. This research work would help in finding out new drugs and discoveries.

To provide, where necessary, clinical experience for student nurses.

In some cases where a nurse is completely new to profession it is necessary to provide such nurses to take care of patients in clinics so that her hands on work would help her perform her duties more confidently when she approaches the wards in hospitals where utmost care is to be taken.

3. NURSING STANDARDS, POLICIES AND PROCEDURES

The different nursing standards, policies and procedures can be explained as

Nursing Standards

Nursing Standard is a practice that enjoys general recognition and conformity among professionals or an authoritative statement by which the quality of practice, service or education can be judged. Standard is an established rule or basis of comparison in measuring or judging capacity, quantity and quality, value of other products in the same category.

Nursing Policies

Nursing policy can be defined as a the set of rules and regulations that are prepared by the policy making authorities and duly approved by the professional higher authorities that are required to be followed by an institution, business, or even by the government in order to acquire the required result or outcome.

To restore patients to the highest level of health individually possible.

To get patient’s families to participate where appropriate, in tasks such as patient’s feeding, washing, and dressing.

To group patients in large wards by degree of illness with groups needing most care located nearest the Nurses’ Station.

To change locations in ward periodically for long stay patients’ psychological benefit.

Nursing Procedures

Nursing procedures can be defined as step by step procedures to be carried out on a particular action that is to be taken at that point of time or the main activity itself.

Receiving admitted patients

Administration of medication.

Assisting physicians.

Performing simple diagnostic procedures.

Collecting and sending specimens to laboratory.

Recording and maintaining medical records

Recording of vital signs

Performing gastric lavage and giving enema

Pre-operative preparations

Delivering bed-side nursing

Coordinating patient care with other team members

Maintaining clean and safe environment

Bed making and providing privacy to patients

Receiving admitted patients

Certain procedures need to be followed while admitting the different types of patients into wards. Like for example in case of those patients who need to undergo operations, certain diet plans need to be ensured like liquid diet etc. the hygienic conditions of the beds and the bed sheets need to be maintained.

Administration of medication.

Based on the type of illness, injury or post operative care the chart or a medical record consisting of the different types of medicines that are to be administered to the patients and their time of intake are to be noted by the nurses.

Assisting physicians.

Whenever the doctor/s or the physician/s come/s on rounds it is important for the nurse to assist them, to know understand in detail the condition of the patient and also the different types of medicines that are to be given to the patient for further treatment.

Performing simple diagnostic procedures.

The nurses would assist the doctor and perform simple tests under the supervision of the doctor.

Collecting and sending specimens to laboratory.

By performing simple diagnostic procedures the nurses should also ensure that the blood samples or urine samples are sent for further investigation in proper time, else the time delay may in most cases give rise to wrong results.

Recording and maintaining medical records

Services rendered must be recorded and placed properly according to their own placement.

Recording of vital signs

The vital signs of the patients should be noted from time to time in order to keep a track of the condition of the patient. These main symptoms which show whether the patient is recovering or developing more complications. The vital signs mainly include blood pressure, body temperature etc.

Performing gastric lavage and giving enema

The above treatments are mainly required by those patients who need to undergo operation or deliveries. They mainly include the preoperative care procedures.

Preoperative preparations

Preoperative preparations refer to the preoperative check list or procedures that need to be ensured by the nurses before taking the patients into the operation theater.

Delivering bed-side nursing

Certain patients who have are suffering from bed ridden illness or have underwent surgery may require some extra care. Such patients may even need bed-side assistance. In those cases it is the duty of the nurses to be by their side and perform the duties required.

Coordinating patient care with other team members

The nurse's duty is to coordinate with different departments for providing better patient care.

Maintaining clean and safe environment

Though the nurse may not be directly responsible for cleaning or maintaining hygiene, it is her duty to ensure that the house keeping do their duty regularly.

Bed making and providing privacy to patients

Nurses ensure that the bed sheets of the beds the patients use are regularly changed in order to avoid complications such as bedsores to the patients. It is the nurse’s duty to ensure that the patient’s privacy and their health care information are confidentially secured.

4. NURSING FUNCTIONS

The different Nursing functions can be explained as follows

a. Nursing Ward Management

Nurses perform innumerable number of functions in healthcare, not limited to the following.

Admission, transfer and discharge management

Supervising, directing and controlling staff

Diet ordering

Maintaining poisonous and narcotic drug controls and registers

Communicating

Maintaining records pertaining to patient care, investigation reports,

Inventory, medico-legal cases etc.,

Nursing education

Safe custody of patients’ valuables

Visitors control

Follow-up scheduling

Discharge and bill settlement

Admission, transfer and discharge management

Every ward would have certain important formalities that are to be taken care of by nurses during the time of admission. If a particular patient requires a change of ward like for example if his diagnosis reveals that he or she is suffering from a viral disease which might spread to the other patients in the ward then in such cases a change of ward may be required.

Another such similar condition may tend to arise when the patient is suffering from a mental agony or mental illness then it is important to provide the patient with a soothing atmosphere as per his requirement or as advised by the doctor.

Similarly the discharge of a particular patient also requires specific formalities that are to be completed, which need to be specially taken care by the nurses. Care should be taken by the nurse in charge that a detailed discharge sheet is prepared.

Supervising, directing and controlling staff

The head nurse supervises and trains the other nurses in performing their duties in a ward. The presence of more number of nurses in a particular ward should help in benefiting the patients present there instead of becoming a noisy place. Hence it would be the duty of the head nurse to take care of maintaining and controlling the staff in an orderly manner.

Diet ordering.

Every patient in a given ward would be prescribed with a different diet as per the physicians orders. It is the duty of the nurse to take special care of the nutrition required by the patient. One more essential reason for this is that, even the medication that is being given to the patient is given as per the food timings, like some medication needs to be given before food intake while certain after taking food.

Maintaining poisonous and narcotic drug controls and registers

In every ward there would be an availability of large number of drugs. It is important to maintain a record of what drug is used when and for what and the dosage of every drug is to be noted as per the requirement. Some dangerous drugs need to be kept aside and used carefully.

Communicating

Every nurse in that particular ward needs to communicate with the patient or with the family member of the patient to know the constant development or progress of the patient. The nurse acts a bridge between the doctor and the patient hence it is very essential for the nurse to keep a track of the patients conditions.

Maintaining records pertaining to patient care, investigation reports,

inventory, medico-legal cases etc.,

In medico legal cases it becomes very essential to maintain records which would carry out as proofs. In such circumstances the records maintained by nurses would play a very important role.

Nursing education

For those nurses who are new or have less awareness it is important for the head nurse to train the other nurses about their duties and responsibilities.

Safe custody of patients’ valuables

Every patient may or may not be accompanied by his friends or relatives to take care of his or her due to their own reasons. In such cases the nurses need to take the responsibility of taking care of the patients valuables and belongings and hand over them to the patient at the time of their discharge.

Visitors control

All hospitals would have fixed visiting hours. In case of some patients the visitors may be too many and may not follow the trimming then the ward nurse has to control the visitors and also see to that the other patients in the wards are not getting distracted.

Follow-up scheduling

Scheduling in this context refers to the scheduling of the next doctors visit, noting of time of the medicine given to the patient and the time at which the next medication is to be given.

Discharge and bill settlement

Some patients may be able to complete the discharge formalities or the bill settlements to the hospital or the doctors. It is the duty of the ward nurse to see to that all the bills are settled before the patient is discharged from the ward.

b. Nursing Operation Theater Management:

The important duties of the nurses in Operation Theater Management are

Aseptic environment maintenance

Autoclaving

Receiving patients from wards

Coordinating trolley traffic

Assisting surgeon and anesthetist

Indenting and procuring surgical instruments and surgical sundries

Maintaining records and reports

Safe maintenance of theater equipment and apparatus

Aseptic environment maintenance

Maintaining of aseptic environment mainly refers to nurses to be able to take care of duties such as ensuring the cleaning up of the operation theater after every surgery. Though the nurses may not participate directly in the cleaning up procedures, it is their duty to cross checks the neatness of the environment inside the operation theater.

Autoclaving

Autoclaving is an important sterilization technique that is used to clean the equipment used in the operation theaters. The equipment consists of scissors, knife, needles and other essential apparatus required for performing the surgery. During autoclaving this equipment is mainly subjected to very high temperature, and is treated with steam for a certain period of time mainly in order to kill the unwanted virus and microorganisms.

Receiving patients from wards

The patients who need to undergo a surgery, would be asked to be admitted in the hospital wards on the prior day as per the the doctors advice. It is the duty of the nurse to receive the patients from these wards, see to that the required formalities are completed before taking them for the surgery.

Coordinating trolley traffic

Assisting surgeon and anesthetist

Most doctors and anesthetists may need the help of the nurse while performing their duties, especially in those which involve operations. The doctors duty is to conduct the surgery, it is the responsibility of the nurse to hand over the equipment in an orderly manner one after an other without any confusion of waste of time. In many such cases it is essential for the nurses to prepare themselves with the sequence of equipment required in order to avoid confusion.

Other nursing operation theater management procedures also include

Indenting and procuring surgical instruments and surgical sundries

Maintaining records and reports

Safe maintenance of theater equipment and apparatus

c. Labor Room Management

The labor room management involves

Preparation of expectant mother for aseptic safe delivery.

Conducting normal deliveries

Assisting doctors in obstetrical emergencies

Assisting difficult and abnormal deliveries.

Taking care of newborn and premature babies

Indenting and procuring drugs, linen etc.

Maintaining records and reports pertaining to labor room

d. Post operative/ICU/Burns unit management

Certain important procedures tat need to be essentially taken care of during the time of post operative care/ ICU/ Burns unit management are

Indenting and procuring drugs, equipment and oxygen cylinders.

Operating ECG, EEG, Cardiac resuscitation

Assisting physicians in operating other high-tech equipment and apparatus

Observing and documenting the progress of the patient monitor

e. Duties of out-patient nurse

The different duties of an outpatient nurse can mainly be classified into three important categories

a) Initial Care

b) Primary duties

c) Additional duties

Inertial care

In initial care the outpatient nurse takes care of duties such as observing the patients symptoms and progress on a regular basis and report them as well as the patients concerns to the doctor.

Primary care

The primary duties consist of monitoring vital signs like blood pressure, temperature, and pulse.

In some cases its the duty of the out patient nurse to even assist the doctor with tools used for surgery.

Additional duties

The additional duties are the ones which deal with the patients who leave the hospital on the same day.

In most cases the out patients tend to leave the hospital on the same day it self. In such cases it is the duty of the outpatient nurse to check the patients condition like his blood pressure and other such vital signs and ensure weather the patient has recovered and and in a condition to leave the hospital. It is also essential for the nurse to let the patients relatives or care takers know about the medication that needs to be given to the patient once they are discharged from the hospital.

Emergency

The emergency nurse mainly deals with the immediate action of assessment and treatment to the patients suffering with trauma.

Since most of the patients coming to the emergency ward come suffering with some trauma and pain it is the duty of the emergency nurse to prioritize the patient requiring treatment, based on his physical and mental conditions

e. Public Health Nursing – functions

The important functions of Public Health Management can be listed as follows

To promote Maternal and Child Health (MCH) program

To promote health and nutrition education activities

To coordinate the activities of health visitors in MCH,

Family Planning and Health and Nutrition Education.

To coordinate and conduct Immunization program.

To help in school health program in the district.

To ensure regular supply of equipment, records, registers drugs,

vaccines and other sundries for MCH program.

To ensure the maintenance of prescribed records and submission of periodical progress of MCH/Family Planning/Nutrition program

To help the Statistical Officer in compiling periodical progress reports of program

To review the progress of public health program.

To supervise and give technical guidance and support to ANMs and Health Visitors.

To investigate complaints against public health workers.

To provide continuing education for public health workers.

To work with other functionaries of Social Welfare, Rural Development and voluntary organizations

f. Documentation of Records

There are mainly two types of Documentation records

i) Direct patient care related documents

ii) Indirect patient care related documents/registers and records

i) Direct patient care related documents

Temperature, Pulse, Respiration form

Nursing Progress Record form

Operation / Special procedures consent form

Fluid Balance sheet

Medication sheet

Laboratory mount sheet

Pre-operative check list

Intake Output record

Nursing information sheet

Nursing Care Plan

24 hours Bed Turning

24 hours ward returns

Diet orders

Report form – Absconded patient

Incident Report Form

ii) Indirect patient care related documents/registers and records

Day and night report book

Treatment book / injection book

Instructions book – the head nurse carries with her when she accompanies the medical officer during ward rounds

Dangerous drugs register

Dispatch book

Inventory book

Breakages account book

Standing orders for patients

Telephone message book (specially maintained for receiving laboratory results of serious patients when required urgently)

Demand / indent book

Maintenance / repairs request book

g. Staff Development and Educational

The staff development and education procedures can be listed as follows

Introduction to new staff and students

In-service education and training

Continuing education

Assisting in research programs

Utilization of nursing services

Professional issues

Negligence

Do it absolutely right and safe

Right patient

Right Documentation

Right Medication

Right Dose

Right Route

Right Authentication

Right Date and Time

5. NURSING STAFF AND OPERATIONAL ORGANIZATION

The following are Nursing Professionals of different categories with varied educational background and their responsibilities.

Job, responsibilities, qualification and training and experience of nursing staff:

Job

Responsibilities

Education, Training and experience

Director of Nursing

Directs and supervises all nursing staff and activities

Determines and implements nursing policies and procedures

Plans and directs nurses’ introduction and in-service training

Evaluates quality of care

PhD / M. Sc in Nursing with 5 years nursing administration

Assistant Director of Nursing

Assists Director of nursing and assumes most of the duties and authority during absence

Analyses and evaluates nursing care quality and corrective measures

PhD. / M. Sc. Degree in Nursing with 3years nursing administration

Nursing Supervisor

Oversees administration and nursing care for a group of Wards or a Special Care Unit and coordinates them with other departments

B.Sc. degree in Nursing with 5 years experience as a Head Nurse.

Night Supervisor

Represents the Administrator at nights.

Visits nursing areas, some patients and other departments.

Admits and transfers patients when postponement to day time would be inadvisable

Senior staff- nurse with previous experience as a Head Nurse.

Ward Sister

Supervises and manages ward independently in teaching hospitals. Teaches nursing students in GNM &B. Sc. level

B.Sc. degree in nursing with 3 years experience

Senior staff-nurse

Functions as ward in charge, supervises junior staff nurses, auxiliary nurses/midwives and nursing aides

General Nursing and Midwifery trained with 5 years experience as staff nurse in a reputed hospital

Staff nurses

Provide nursing services in wards, OPD, A&E, Operation theaters, Labor room CSSD, Radiology etc., under the supervision of Senior staff nurse/ ward sister/ nursing supervisor

General nursing and Midwifery trained

Auxiliary nurses &Midwives

Assist staff nurses in wards, OPD, A&E, CSSD, Labor room, Radiology etc., under the supervision of senior staff nurse/ ward sister.

Auxiliary nursing and Midwifery (ANM) trained

Ward Aides / Medical Orderlies

Assist nurses, provides patient transportation / messenger services

Secondary School Certificate with formal training in a reputed hospital

Ward clerks

Inventory control, collection of patient records, laboratory results, responding admitting office queries, laundry, CSSD affairs etc.

Secondary school Certificate with good handwriting.

b. Nursing Operational Fields

The nursing operational field mainly include

Accident and Emergency

Outpatient Clinics

Wards including Special care Units

Delivery Suites

CSSD

Operating Rooms

Radiology

Public Health

Nursing Education

Nursing Professional Practice:

Nursing profession mainly takes care of dealing with patients who are sick, injured of diseased. It is the responsibility of the nurses to carry out the doctor’s instructions and take good care of the patients. It is essential for these nurses to keep the patients records confidential. Another responsibility is to provide the patients with a neat and clean environment such that they do not catch any other infections. Nurses also tend to take care of certain duties which include maintaining a record of the patient’s health history. Nursing is a profession in transition. The trends and issues that underline this phenomenon hold important implications for the management of hospitals and other healthcare institutions and agencies. Nursing service is a critical component in fulfilling hospital, long-term care, and other health service organization objectives for patient care. The nursing profession exists in response to a need of a society and holds ideals related to man’s health throughout his lifespan.

Nursing profession also includes the following

Assessment, planning, intervention and evaluation of human responses to health and illness.

Provision of nursing care to individuals to restore optimum health.

Procurement, coordination and management of essential patient resources.

Provision of health counseling and education.

Establishment of standards of practice for nursing care.

Development of policies, procedures and protocols.

Supervision of those assist in the practice of nursing.

Administration of medications and treatment as prescribed by qualified medical professionals.

6. INTRODUCTION TO BASIC COMPUTERS

INTRODUCTION

The following is some of the basic information for candidates who do not have any knowledge about computers.

Computers

Computers are machines which perform tasks or different calculations according to the set of instructions or data given to it. The set of such instruction designed for a computer is called a program.

Input

the set of instructions or program that is instructed to the computer in known as input.

Output

After the computer executes the set of instruction given to it, the end result that is obtained is known as output

Hardware

Hardware with respect to the computer include every part of the computer that can be seen and even touched. The different parts which include the hardware of a computer are, keyboard, mouse, printer, monitor, microprocessor. CPU or the Central Processing Unit or the microprocessor of a computer in the most important part of it. CPU can also be known as the brain of the computer. The main role of CPU is to translate the commands and calculations into computer language it is basically a small rectangular chip that is present inside the system

Software

Software can be defined as the set of instructions that are designed to be given to the computer or the hardware of the computer to perform a given task. The Operating System is one of such software that is used to perform various tasks using a computer.

BASICS OF COMPUTERS

What is a Microcomputer?

A micro computer (also a personal computer or desk-top computer) is a computer small enough to fit on a desktop. The microcomputer is a single device; it consists of a number of separate components that work to gather as a microcomputer system. The system components, which are inter connected by cables, includes the following:

CPU

I/O UNITS

ALU UNIT

CONTROL UNIT

OUTPUT

INPUTBasic Structure of the Computer:

Key Board: Resembling a typewriter, this component allows the user to communicate information to the system. Nowadays, remote keyboard is also available without cable connections.

Monitor This component resembles a television set and is used to display information

Central Processing Unit

This is the central unit for the system. It contains electronic circuit for performing data manipulated and memory for holding data that is being manipulated.

Data storage: This devices store information on a long term basis. There are two types of data storage devices devices they are internal and external data storage devices. The internal data storage

device is called hard disk which built-in part of the computer. The external data storage devices are floppy disks, data cartridges, tape drive, CD-ROM etc. The most common external data storage devices are floopy diskettes.

Printer This component produces printed copies of data. There are various types printers, but commonly used are Dot Matrix, Ink Jet, Desk jet, Laser Printers, Plotters etc.

Hardware: The physical components of a micro computer system are collectively called hardware

Software: Refers to the medium containing the sets of instructions that instructs the hardware how to perform particular tasks.

Program: A set of instructions written in various computer languages or application program for performing a task is called a program.

Micro Computer: The microcomputer is versatile problem-solving tool. The micro computers were Revolution built in mid 1970s. They can be used to :

Write business letters

Develop a financial analysis of a project

Prepare graphs for a report

Schedule for Jobs and monitor progress at a construction site;

Transmit a report electronically to another office

Design an automobile on a screen

Use reference material stored in another computer to research a legal opinion

Assist in making a medical diagnosis etc

Speed: Micro computers process data with amazing speed. They can perform hundreds of thousands of operations per second and can retrieve a piece of data from memory in less than one millions of a second. The speed in measured in Mega Hertz. Specified as MHz. The computer speed various from 350 MHz to 600 MHz.

History of Micro Computer

The first electronic computers were built in the 1940s. By the early 1970s they were in common use in large business, government and the military agencies.

The largest computers like the ENIAC, were called main frame computer, which cost more than a million dollars. Designed for use by major company or government installation, they were housed in a large room, and required special electrical cabling and air conditioning.

In the 1970s small computers, called micro computers, were introduced.

The Micro computers was born in the late 1960s, and early 1970s, engineers made great strides in reducing the size of electronic components. They developed the semiconductor for chip, which was about the size of a fingernail and could contain hundreds of transmitters. The semiconductor chips enabled engineers to miniaturize the circuitry contained in all electronic devices. Most importantly it produced a new generation of main frames and microcomputers with increased capabilities, greater speed and smaller size.

In the early 1970s semiconductor technology progressed to the point where the circuitry for the "brain" of a computer (the Central Processing Unit or CPU) could be manufactured on a single semiconductor chip. These miniaturized computers were called micro computers and were manufactured by corporations such as Intel and Motorola.

These micro processors made it possible for the first time to build a computer that was small enough to fit on a desk top and inexpensive enough for an individual to afford. By the mid 1970s, several such microcomputers were available to consumers. The first microcomputers were sold in the forms of kits, designed for electronic hobbyists.

As the micro computers have become problem-solving tools, a number of hurdles needed to be overcome. The first was to simplify the programs for the machines. One step in the direction was taken by a young Harvard drop-out named Bill Gates, who wrote a version of the programming language BASIC (Beginners All Purpose Symbolic Instruction Code) for one of the earliest micro computers. BASIC had been introduced at Dartmouth College in the mid 1960s by John Kenery and Kenneth Kurtz. By the mid 1970s it was a popular programming language automatically included with most micro computers. Gates founded a computer company called Microsoft Inc. which has become one of the major producers of software for micro computers.

In 1977, Stephon Jobs and Stephon Wozniak, two micro computer enthusiasts, working in a garage, designated their own micro computer. This was named as Apple and their fledgling business was to became the Apple Computer Corporation. Business grew at an unprecedented rate. In no time, apple was selling hundreds and thousands of machines per month. One reason behind apples’ success was the availability of number of useful application programs. The most of important of these was the spreadsheet.

International Business Machines (IBM). At first major corporations viewed micro computers as toys and compared with the power available in their main frame computers. However, most corporations underestimated the significance of bringing computing power down to the level of the individual worker. This view abruptly changed in 1981 when IBM the largest computer company in the world, introduced its own micro computer, dubbed the IBM PC within a short time, the micro computer was recognized as a productivity tool to be used by workers at all levels to process, store, retrieve, and analyze information. Some companies have concentrated on building add-on circuits boards for add memory, communications facilities, and other hardware feature to the IBM PC. Others have concentrated on hardware development. Yet others have built machines that are functionally identical to IBM’s machine in the sense that they can use the same hardware and software as the IBM, such computers are said to be IBM compatible.

Operating System:

There are three types of operating systems, they are Microsoft Disk Operation System ( MS-DOS), Microsoft Windows (MS-Windows) and the Unix Operating System. The MS-DOS is almost in the end stage and outdated. The Unix Operating system is widely used in the scientific application and the networking. The Microsoft -Windows is commonly used operating system in the personal computer and the network version is also used in the Local Area Network computers. The Microsoft –Corporation had released the Windows operating system in late 1980s and early 1990s, later the modifications are being made regularly to suit the day to day needs. The latest version of the Microsoft Windows operating system Windows 2000 is expected to be introduced shortly.

Application Programs:

A program that performs tasks is called an application program. Micro computers are useful to millions of people because they can be made to run programs that perform tasks. For example a word processing program is an application program that inputs, edits and prints and documents such as letters, memos and reports. An Excel is an application program that manipulates numeric data, related to inventory or financial analyses, for example inventory of a store, hospital statistical analysis. A Harward Graphics (HG) is graphic package is an application program that displays graphs and charts on a screen and then prints them out.

Application Programs for Business:

Application programs for business fall into one of the following categories:

Word Processors (Microsoft Word)

Spread Sheets (Microsoft Excel)

Data Base Management system( Microsoft Access)

Graphics (Harward Graphics)

Communications ( Microsoft Explorer, Netscape Navigator etc. )

Integrated Software

Word Processor (Microsoft Word)

A word process is a program for manipulating text. Such a program allows you to type a document e.g. alter a document on the screen as you type. You can move directly to any point within the document to add or delete to copy or to move section of text, incorporate pictures and import information from other application programs. The Microsoft Word is much useful for publishing in the World Wide Web. The document can be saved for later retrieval or print. The typed text can be aligned in a required manner, spellings and grammar can be checked.

Spread Sheet (Microsoft Excel)

An excel program turns the micro computer into an accountant’ worksheet. It can be used to plan budgets, to do accounting tasks, and to analyze investments. This program allows to define relation ships between numbers with the definitions and formulae the hundreds of numbers entered on the Excel can be manipulated to required data. It is also flexible to import or export data from other applications programs. With help of macro, the user can create standard query language to retrieve data from other application programs.

Data base management ( Microsoft Access)

Data base is very important for any organization. For example, the patient information has a data sheet for each patient, and laboratory generates an investigation reports for every order placed. These information data can be easily maintained in the diskette for storage. When necessary, such data can be analyzed or updated by using data base management programs ( Microsoft Access). The technology used in the Microsoft Access application program is semi client server technology.

Graphics:

Graphic programs help in creating images on a screen and to print such images with a printer or plotter. The most common graphics are bar charts, line graphs, pie charts, Histograms etc.

Integrated software:

Generally, data by one program is used as input to another program. There are integrated software packages, which include several applications within a single program. Such single package may include a Word, Excel, Power point etc. allow for easy manipulation of data in several applications. Nowadays, like ERP ( Enterprises Resource Product) will take of the complete requirement of any organization which contains software for payroll processing, inventory, material management, financial accounting etc.

Communications:

Communication and computers have become so easy and fast. With online system and internet facilities the computer users all over the globe have come closer and communicate each other with Electronic mail easily with minimal cost. Computer talk each other, provide database and provide innumerable services. The computer used in Airlines, Defense and Banks are well known. The hospitals of different parts of the world want to share their medical technology through the Internet facilities or tele-medicine facility. This has facilitated to store the research work information on world wide web and which is used by all over the world through the internet facilities.

Electronic Mail:

Electronic mail is one of the communication programs. By electronic mail, one can receive memos, reports, and sales information from anywhere in the world. The sender can deposit the mail at any time, and you can view your mail by using communication program to transmit the mail box to your computer or you can down load and print.

Programming a Micro computer.

Programs to perform a wide range of tasks are available in the market. For example, such programs can be a tutor for you for Scholastic Aptitude Test (SAT), manage your stock portfolio, calculate your share interests, taxes and preparation of reports.

Each program comprises of a sequence of steps that tells the computer what to do. The following are various functions to perform the tasks.

Display data on screen (Video Display Unit)

Obtain data -answer to the question from the user

Respond to the data. The user provided the right or wrong answer.

Save data for later retrieval.

Print data, reports, returns, statement etc.

Programming Language: Programs are written in a programming language, which is in a form resembling written English. The instructions in the programming language are the translated into machine language instructions that the computer can execute directly.

Problems Solving with Computer (PCs)

Problem Solving Tools: Micro Computer (PCs) are problem solving tools which has four basic components:

Hardware: the physical components of a computer systems, consisting of CPU, monitor, Keyboard, Printer and so forth. The hardware must be capable to solve the particular problem for which the amount of memory, the sizes of data storage devices, the speed of the computer, and the speed and quality of printer are all factors that determine.

Processing Unit

Random Access Memory (RAM)

Read Only Memory (ROM)

Secondary Storage

Input Devices

Output Devices

Option Cards

Random Access Memory (RAM)

One type of memory in the computer is called RAM also known as primary memory, short-term memory, or high speed memory. RAM holds the program currently being executed by the user, as well as the data being manipulated.

In planning the microcomputer system, an important step is to survey the application programs you are likely to want to use and the amounts of Ram they require and equip or accordingly or equip enough RAM to accommodate the largest of these programs.

RAM can be accessed very quickly. It takes only about one millionth of a second to read (or write) a character form (or to) primary memory. Primary memory is erased as soon as electrical power is turned off. RAM is constructed from semiconductor chips. Some of these chips are located on the circuit board of the processing unit. Memory capacity can be increased by adding RAM chips as optional circuit cards. Nowadays minimum requirement of RAM for a computer with the Pentium processors is 64 MB.

Read Only Memory (ROM)

The second type of computer memory is ROM, which contains important programs for operating the micro computer’s system devices. These programs are recorded in ROM at the factory and cannot be altered by the system used. Application programs use ROM to access the various system devices.

Software: programs that instruct a computer system how to carry out a particular task is called software. There are innumerable application programs to perform different types of tasks. However, for any particular task, there are specialized limited programs from which the most appropriate application program to be selected to carry out the task.

Data: The data which you would like to have should be fed into computer and this will be manipulated by the program into a letter, report, account statement, etc. the data stored in the computer or diskette that molded as per the required application program. This can allow feeding data into your computer, transmitting data from computer to another and rearranging the data into form of your application program.

User: The user is the appropriate person to determine the amount of time available to solve the problem, choose the best application programs, supply any necessary data, and direct the activities of the program.

Problem Solution: the interaction between the four e.g. hardware, software, data and user is the solution to the problem. Simple equation = Hardware + Software + Data + the user

The organization of a Personal Computer System:

The organization of a personal computer system is assembled from components in much the some way that stores system is. The parts of a micro computer system fall into seven categories.

Secondary Storage: is a third type of memory used for permanent storage of programs and data items. Secondary memory must be loaded into RAM before the computer can use them. The most common secondary memory devices are hard disk drivers and floppy diskette. A floppy disk drive reads and writes information as flexible diskettes, which can hold anywhere from 160,000 to 1,200,000 characters. A Hard disk drive reads and writes information on a hard disk, which is permanently sealed within a character in which it rotates at very high speed. A hard disk can store from 10 million to 100 million characters or more of data and provide much quicker access times than can a floppy disk drive.

Accessing Data from Memory: Access of data from secondary storage devices is much slower than access from primary memory. However, the slow speed is compensated by the ability to use secondary storage for long-term storage and to store large qualities of data RAM size and secondary memory requirements are key elements to consider in the hardware segment of the problem-solving equation.

User Communication with a Micro Computer:

There are many input devices that you can use to transmit information to the computer. The most common device used in applications is the keyboard. The other include mouse, light pen digitizing pad, scanner and voice recognition software. The choice of device will depend on the particular problem you are solving, the amount of data, its form and the amount of time available for input.

The computer communicates information to the user via an output device, such as a monitor (V.D..U or screen). In addition to monitor, a printer to supply output information on paper. Selection of output devices are very important and it should be appropriate to the problems you are going to solve. This depends the quality of output its volume and the speed with which it must be produced. Collectively In-put and Out-put devices are called input-output devices (I/O devices). They are also called peripheral devices or just peripherals.

Software and Data:

The second component in solving problems on a PC involves Software, and the third involves data. These two ingredients must work closely together to perform tasks on the PC. A computer program consists of a sequence of instructions for the computer to execute used can design a program for his use or to solve problem. There are many packages in the market that has the tools required to solve the problem. Many users prefer to use ready made packages. Each application package brings a finite set of capabilities choosing the right package depends on understanding how it works and what the options are. Some packages allow more sophisticated than other but more difficult to use. Finding the right package for the problem is thus a major consideration in solving the problem.

Finding the right Application Package:

There are many different application packages that can be used for most problems. Correct information on right application package can be had either from software directories or review in computer journals. It is very important to consider the following when choosing a program:

Will the program run on your computer system? All programs are designed with particular hardware configurations in mind. One must make sure that configuration of your machine is one on which the program can run.

What are the inputs and outputs of the program? Check whether the program can perform the data manipulation you require and that it can use the data that you provide.

Is the program easy to use ? How long will it take to learn the program?

Will this require major alterations?

Designing a PC system:

While designing a PC system or plan to purchase a PC, the following must be considered in order of priority. (If you have long term plans - consider that also).

Analyze the type of business or work involved

Determine the type of application software to solve the business problems

Choose appropriate software that suit your needs

Choose hardware that best functions with that application software

Plan for making for future potential uses

Should have the facility to upgrade the physical components such as memory

Running a Program:

Generally, the program which are in use are in hard disk of PC. When the programs are not used, they are stored in secondary storage, e.g. on a floppy diskette. When you want to run a program that is on a diskette insert the floppy diskette into PC and give a command that specifies the name of the program and where it is located. In response, the computer does the following:

The computer reads the program from secondary memory in to RAM

The computer executes the program’s instructions.

When the program ends, the RAM occupied by the program and data is released for use by the next program.

Data:

The third component in a problem solution is data. Without data a problem cannot be solved. Therefore, it is necessary to consider the following questions.

What data will the program need as input?

What is the source of the data?

How will the data be input into the computer?

Who will do the inputting?

What data manipulation must be performed?

What format will the output data be ?

Who will use the output data and the one produced will satisfy or not ?

Types of Data:

Alphabetic data: Data consisting of only of letter(s) are called alphabetic data (e.g. letter "ì" or "n").

Numeric Data: Numbers such as 7, 2,418, 6.002 or 78,311 are classified as numeric data

Alpha Numeric Data: Data consisting of normal text characters (letters, digits, punctuation marks, and common symbols such as $, %, # are called alphanumeric data (e.g. the text of a business letter)

Graphic Data: Data displayed by visual or symbols e.g. diagram, line chart or a logo of any organization are called graphic data.

Sound: the voice recognition sound data.

Data input and output:

Generally some programs provide data within the program instructions themselves. However a program can get its data from external sources. Such external data are called program input.

Program Output: the results of input data manipulation are usually provided as program output. The program output which either is given directly to the user (via Screen or Printer some other output device ) or is saved in a secondary memory device (for later output to the use or for later input to another program).

Caution: the data fed into computer must be accurate and complete. Computer can manipulate only the data that you fed. The output is only as good as input. There is no way for computer program to compensate for incorrect or mission data. The Garbage in is Garbage out.

The user:

The fourth component in a problem solution is the user. The user has complete control over when and how a problem is solved. The PC puts power in the hands of the user and performs tasks that would be impossible for one person to do, such as adding and computing ratios of large numbers of figures on continuous basis.

Problems description and analysis:

The user is responsible for problem description and analysis. Most problems require the user to describe them in clear terms, fill in missing information, and develop a method of solutions.

In developing a solution method that involves a PC you must decide the role that the PC is to play; the information that you have available to input to the computer and the information you wish the computer to derive for you. From the facts, the user decides which application package is suitable for solving the problem.

User interaction with the PC:

The user interacts with the computer in numerous ways and on a multitude of levels. First of all, the user gives the commands to initiate and interrupt programs and to perform system functions such as copying erasing etc.

Interactive Programs:

A program requiring user participation is called an interactive program. One of the significant features of micro computing is its emphasis on interactive programs. This is one of the reasons the application of micro computer is often called personal computing, and micro computers are called personal computers.

The User Interface:

The process whereby the user communicates with the computer is called the user interface or the human interface. The human interface of an interactive program can range from quite simple typed communication to very elaborate using a mouse, light pen and graphic presentation of commands.

Interactive computing stands in sharp contrast to batch processing, which is commonly used for data processing in mainframe and micro computer installations. In batch processing, a number of programs are input to the computer at the same time and the computer runs them in sequence without for the human interaction.

Hardware:

As a PC user, you should familiarize yourself with the basics of what goes an "under the blood" of a micro computer. This knowledge can help you understand how your application program works, what they can do and how to keep yourself and your PC out of trouble. In any event, when you are confronted with a task or problem, you must first analyze all the components of the problem-solving equations, which we introduced earlier.

The first component of the equation is hardware. This consists of

PROCESSING UNIT

RAM

THE KEY BOARD

THE MOUSE

THE MONITOR

SECONDARY STORAGE

THE PRINTER

The Processing Unit:

The Processing unit and RAM are the most fundamental components of a PC system. They are also most mysterious, since the exists of complex electronic circuits that are intelligible only to some with a technical background. However, understanding how these circuits operate is quite simple.

The processing Unit consists of the circuitry necessary to manipulate data and to control the various components of the system. The Processing unit, usually consists of a number of semi conductor chips mounted on a single circuit board (often called the mother board of the system board)

The central processing unit (CPU)

The bus

The system clock

The expansion slot (Ports)

The expansion boards

The read-only memory (ROM)

The r