The Internet • The 1956 Dartmouth Artificial Intelligence Conference -

- is a worldwide network of interconnected computer crystallized the concept that technology was improving at an
networks that operates using a standard set of exponential rate, and provided the first serious consideration of the
communications. In contrast to older communications consequences.
systems, the Internet was purposely designed to be highly
• Marshall McLuhan - made the idea of a global village
decentralized (both with regard to physical infrastructure
interconnected by an electronic nervous system part of our popular
and management) and independent of the underlying physical
culture.
media.
- Any communications network that can carry two-way digital
In 1957, the Soviet Union launched the first satellite, Sputnik I,
data can also carry Internet traffic; thus, Internet traffic
triggering US President Dwight Eisenhower to create the ARPA
flows through networks that use conventional copper wire,
agency to regain the technological lead in the arms race. ARPA
coaxial cable, optical fiber and radio waves.
appointed J.C.R. Licklider to head the new IPTO organization with a
- The Internet is named after the Internet Protocol, the
mandate to further the research of the SAGE program and help
standard communications protocol used by every computer
protect the US against a space-based nuclear attack. Licklider
on the Internet.
evangelized within the IPTO about the potential benefits of a
- The Internet can powerfully leverage the nurses’ ability to find,
country-wide communications network, influencing his successors
manage, and share information. Never before in human history
to hire Lawrence Roberts to implement his vision.
has such a valuable resource been available to many people at
such little cost.
Roerts led the development of the network, based on the new
idea of packet switching discovered by Paul Baran at RAND, and a
Brief History of the Internet
few years later by Donald Davies at the UK National Physical
The conceptual foundation for the creation of the Internet was Laboratory.
significantly developed by three individuals and a research
A special computer called an Interface Message Processor was
conference, each of which changed the way we thought about
developed to realize the design, and the ARPANET went live in early
technology by accurately predicting its future.
October, 1969.
• Vannevar Bush - wrote the first visionary description of the
potential uses for information technology with his description of the The first communications were between Leonard Kleinrock's
"memex" automated library system. research center at the University of California at Los Angeles, and
Douglas Engelbart's center at the Stanford Research Institute.
• Norbert Wiener - Invented the field of Cybernetics, inspiring
future researchers to focus on the use of technology to extend The first networking protocol used on the ARPANET was the
human capabilities. Network Control Program. In 1983, it was replaced with the TCP/IP
protocol developed by Robert Kahn, Vinton Cerf, and others, which
quickly became the most widely used network protocol in the
world. http://www.mugglenet.com/books/quotes/index.shtml
Standardized protocols enable the internet to function. It can be • HTTP - short for Hypertext Transfer Protocol described as the
treated as the standard language for the internet. Protocols transmission protocol, introduces a web document or directory
determine the following: • WWW – short for World Wide Web
 Data transmission between two devices • Directory – the directory or folder(s) in the web server that
 The type of error checking that will be performed contains a group of related web pages within a website
 Data compression •Domain Name–identifies the computer name, web server name,
 Signals and notifications web name or host name. The Internet Domain Name System (DNS)
permits users to give globally unique names to networks.
The main protocols on which the function of the internet is
dependent: The top-level domains are tabulated below:
•Transmission Control Protocol (TCP) – allows computers to connect DOMAIN NAMES DESCRIPTION
to a network and exchange data; carries the task of breaking .edu Educational site (usually a University or a
messages into small packets (datagrams). college)
•Internet Protocol (IP) – considered a lower level protocol, which is .com Commercial business site/computer
responsible for making decision on the packets and routing them. .gov Government/non-military site
.mil Military sites or agencies
Other protocols used on the internet are the following:
.net Networks, internet service providers,
•Hypertext Transmission Protocol (HTTP) – which supports the organizations
World Wide Web (WWW) .org Non-profit organizations and others
•File Transmission Protocol (FTP) – permit users to send all types of
electronic files over the Internet. Web Navigation and Search Engines
There are four directions and five basic techniques in web
Since the internet is composed of a vast network of computers, navigation. Nurses must be aware of these functions to ensure
proper identification of computers and information sites must be convenience in exploring the web.
made. 1. Directions
Anatomy of a Web Address a. Back – go back to the previous page; press the back
- Web addresses are also referred to as URLs (Universal button, right click window and select back or use
Resource Locators). It can identify a specific machine, directory keyboard hotkey [alt+left arrow key]
and file of that machine. b. Forward – go forward to a new page after going back;
- The professor will consider the following example: press the forward button, right click window and select
forward or use keyboard hotkey [alt+right arrow key]
 c. Link – click a link and jump to a new page rapidly. Common providers are Yahoo Mail®, Gmail® and
d. Jump – select a new page from external source such as Hotmail®.
bookmarked sites
2. Techniques
a. Surfing - Jumping ahead of the browser if the link is already Anatomy of an E-mail Address
loaded but the rest of the page is lagging behind. Internet works by connecting computers using the same protocol.
b. Chains – After clicking several websites, a chain of internet Therefore, all e-mail addresses are using the same format.
pages are created and explored backward of forward
c. Reload – refreshing the page to ensure that the latest copy
is loaded (e.g. tracking bid on sites such as eBay) hyper_yke@yahoo.com
d. Stopping – Stopping the loading process of a site anytime
e. the user wants
f. Restarting – Stopping the connection and clicking the same
link again •Name – the name of the owner of the address. Users can devise
their own name based on the availability. Nurses must refer to their
With billions of web pages online, nurses could spend a lifetime organizational policies on how to make an email address in an
surfing the Web, following links from one page to another. Amusing organization.
perhaps, but not very efficient if one is seeking some specific •Email Provider / Organizational Code –denotes the email providers
information. Searching the internet requires part skill, part luck and (Yahoo Mail®, Gmail®, Hotmail® etc.) or Organizational Code in
a little bit of art. Fortunately, a number of free online resources help conjunction with the organizational website (@mugglenet,
with the hunt. These are the search engines such as Yahoo!, Google, @microsoft, etc).
and Ask.com. Search engines are of two types: •Domain –corresponds to the high-level domain names
a. Directories – good at identifying general information. A
Evaluating Quality Health Information on the Internet
good example is the Yahoo® Directory
b. Indexes – identify text on the given criteria by searching The health summit working group has identified the major criteria
contents of websites through the use of software and to evaluate an internet site. Not all information in the internet is
programs called robots and spiders that analyze millions of reliable so nurses must be very particular on the type of addresses
webpages. Examples are Google® and Yahoo Search®. they are acquiring health information from. The criteria identified
include the following:
Electronic Mail (E-mail) •Credibility – source of information and timeliness of the content
- One of the most popular uses for the internet remains the •Content – to help judge accuracy, examine the hierarchy of events
ability to send and receive electronic mail or e-mail. The and presence of original sources
number of healthcare providers with email address is growing •Disclosure – the purpose and moderator of the site
•Links – the quality of links provided by the site
•Design – site accessibility and convenience of use Communication through wireless devices is known as wireless
•Interactivities – presence of feedback and communication communication.
•Caveats – achievement of site goals - Science has invented many electronic devices that are helping
nurses a lot in their daily lives, one of which is computer by
One of the major issues in internet use is the availability of the which not a single company in this world is workable but how
connection. Nowadays, wireless fidelity (WiFi) hotspots and internet great it will be if this invention is wireless.
LAN stations are sprouting that enables mobile computing and - The wireless computer is known as Laptop which has become
communication. part of a normal human being now and any one can take it
with him or her with all their data stored in it. There are many
Mobile Computing other wireless devices like USB, cell phones, PDAs and radio
- in Nursing Mobile Computing in Nursing provides valuable etc. With the help of USB one can transfer the data from one
insights into how nurses are using mobile computing solutions place to another by taking that stick in his or her pocket.
at the bedside and how these solutions can best be used to - Cell phones have also become the most used wireless device
solve existing workflow inefficiencies. by people in which the communication is done by using radio
- Mobile computing makes it easy to stay connected no matter frequencies through different service provider stations.
where you are. It's more than that: Gamers enjoy peer-to-peer
interaction; photographers can send immediate downloads TERMINOLOGIES
and employees can telecommute from different time zones.
- Tablet PCs are wireless devices that provide the most Internet - a worldwide network of interconnected computer
promising trend in mobile computing. networks that operates using a standard set of communications. In
- The slightest of them is the size and weight of a spiral bound contrast to older communications systems, the Internet was
notebook. purposely designed to be highly decentralized (both with regard to
physical infrastructure and management) and independent of the
Wireless Devices underlying physical media.
- Wireless devices and devices with wires almost perform the
same functions but wireless devices have many advantages
over other devices with wires.
- It facilitates people to work in different places where they
cannot take the devices with wires attached to them. We are
using many electronic devices but the use of wireless devices is
making our life a bit easy.
- In wireless devices the data is transferred in the form of
electromagnetic waves, which are the main part of
electromagnetic spectrum present in the atmosphere.
Decision Support Systems (DSS)
Components of Clinical Decision Support System (CDSS)
- are automated tools designed to support decision-making
The following five elements are necessary, but not significant for a
activities and improve the decision-making process and
real-time clinical decision support system:
decision outcomes similar to Artificial Intelligence (AI).
- Such systems are intended to use on enormous amounts of  Integrated real-time patient database
data that exist in information systems to facilitate decision - combines patient data from multiple sources (e.g. lab,
process. radiology, pharmacy data etc.). This is needed to provide
- A clinical decision support system (CDSS) is designed to context for results interpretation.
support healthcare providers in making decisions about the  Data-driven mechanism
delivery and management of patient care. - allows event triggers to go into effect and activate alerts
- A CDSS program’s goals may include patient safety and and reminders automatically.
improved outcomes for specific patient populations as well  Knowledge engineer
as compliance with clinical guidelines, standards of - translate the knowledge representation scheme used in
practice, and regulatory requirements. the system so clinical knowledge in the system can be
- Within the complexity of today’s healthcare environment there extracted and translated into machine executable logic.
is an increasing need for accessible information that  Time-driven mechanism
supports and improves the effectiveness of decision-making - permit automatic execution of programs at a specific
and promotes clinical accountability and the use of best time to alert healthcare provider to carry out a specific
practices. function or ensure that action has been completed (e.g.
- The definition of CDSS is well explained by Wyatt and medication administration, time alerts)
Spiegelhalter. They regard Clinical Decision Support Systems  Long-term clinical data repository
as active knowledge systems which use two or more items - data collected over time from a variety of sources
of patient data to generate case-specific advice. allowing a longitudinal patient record.
- Clinical DSSs are typically designed to integrate a medical
knowledge base, patient data and an inference engine to Key Functions of CDSS
generate case specific advice. Perreault and Metzger identified four (4) key functions of CDSS in
the healthcare field:
•Administrative - Supporting clinical coding and documentation, first search of the rules base for relevant rules though with
authorization of procedures, and referrals. additional heuristic support to control the search for a
proposed solution).
• Managing Clinical Complexity and Details - Keeping patients on • CASNET
research and chemotherapy protocols; tracking orders, referrals - (Causal Associational Networks), developed in the 1960s,
follow-up and preventive care. was a general tool for building expert system for the
diagnosis and treatment of diseases.
• Cost Control - Monitoring medication orders; avoiding duplicate or
- The most significant Expert System application based on
unnecessary tests. CASNET was CASNET/Glaucoma for the diagnosis and
• Decision Support - Supporting clinical diagnosis and treatment treatment of glaucoma.
plan processes; and promoting use of best practices, condition-
• DxPlain
specific guidelines, and population-based management
- is a decision support system which uses a set of clinical
findings (signs, symptoms, laboratory data) to produce a
Early Clinical Decision Support Systems ranked list of diagnoses which might explain (or be
associated with) the clinical manifestations.
• Internist I
- DXplain provides justification for why each of these diseases
- was a rule-based expert system designed at the
might be considered, suggests what further clinical
University of Pittsburgh in 1974 for the diagnosis of
information would be useful to collect for each disease,
complex diagnosis of complex problems in general
and lists what clinical manifestations, if any, would be
internal medicine.
unusual or atypical for each of the specific diseases
- It uses patient observations to deduce a list of
compatible disease states (based ona tree-structured
Myths Affecting Development of CDSS
database that links diseases with symptoms).
The healthcare industry challenged three basic assumptions
• MYCIN which strongly influenced the development of decision support
- was a rule-based expert system designed to diagnose and systems:
recommend treatment for certain blood infections o“Diagnosis is the dominant decision-making issue in medicine”
(antimicrobial selection for patients with bacteremia or o"Clinicians will use knowledge-based systems if the programs can
meningitis). be shown to function at the level of experts"
- It was later extended to handle other infectious diseases. o"Clinicians will use stand-alone decision-support tools."
Clinical knowledge in MYCIN is represented as a set of IF-
THEN rules with certainty factors attached to diagnoses. By implication, these myths, which are gradually being
- It was a goal-directed system, using a basic backward overcome, partly contributed to the relative lack of success of DSS
chaining reasoning strategy (resulting in exhaustive depth- in clinical care.
 - At the same time, the aging of baby boomers will
cause increased demand for hospital services
- In 2002, the American Academy of Nursing (AAN)
Policy Issue #1: Commission on Workforce launched a multiphase
 Nursing Informatics as a Specialty In 1992, project to develop IT that will help support nurses
- the American Nurses Association (ANA) recognized intheir day-to-day work, thereby reducing demand on
nursing informatics (NI) as a specialty. their jobs.
- Attempts in 1989 to be recognized as a specialty - Given the average age of nurses are 45.2,
failed, but political forces within ANA supported the technology devices would enable some nurses to
request when it was repeated in 1992. stay in their careers longer.
- The term NI first appeared in the literature in - On the other hand, patient safety is also a
1980s. It has constantly evolved molded by the concern for nurse informaticist. Proposals to
maturation of the field and influenced by health increase patient safety with the use of IT have been
policy. made by a variety of groups.
- NI practice differentiates itself from other areas of - California law 1875, for example, passed in 2003,
nursing practice but emphasizes its interaction applies pressure to hospital to install IT to help
with informatics discipline such as mathematics, healthcare providers reduce errors.
statistics, linguistics, engineering, computer science - The Health Insurance Portability and Accountability
and health informatics. Act (HIPAA) was passed in 1996 and is intended to
- NI supports national efforts, such as those outlined by improve the public and private healthcare
the Pew Health professions and Institute of Medicine programs by establishing standards to facilitate
to increase interdisciplinary education. the efficient transmission of electronic health
- To become a specialty, it was necessary for NI to show information
that educational programs are available to prepare
nurses to practice in the field. Policy Issue #3:
- The field of NI has slowly expanded since 1992. It  TeleHealth and Nursing Informatics
will be interesting to see how the current focus on IT - Telehealth is defined as the use of electronic
impacts the growth of NI as a specialty communication networks to transmit data or
information that focuses on health promotion,
Policy Issue #2: disease prevention, diagnosis, consultation,
 Nursing Informatics Practice education, and/or therapy.
- Nursing has experienced a number of shortages in - In one of its many forms telehealth has been
recent history. The healthcare industry is headed for a practiced ever since the advent of the telephone.
major crisis in the nursing workforce.
- Telehealth in patient care covers many areas, but can
be divided into two distinct parts, the technology
and the provider/client relationship. On the
technology side are many different technologies TERMINOLOGIES
including advanced image and audio capabilities that
range from high resolution still images to Decision Support Systems (DSS) - automated tools designed to
sophisticated interactive teleconferencing systems. support decision-making activities and improve the decision-making
- Technology is now available that allows a virtual process and decision outcomes similar to Artificial Intelligence (AI).
simulation of tissues and blood flow.
- Use of the Internet to transmit the feel of a
lesion, or even muscles and bones, prior to surgery
will happen soon.
- Aspart of its participation in the national dialogue
on telemedicine/telehealth, ANA on August 29,
1996, submitted preliminary comments to a Joint
Working Group (JWG) convened by the Health
Resources and Services Administration (HRSA) of
the U.S. Department of Health and Human
Services.
- ANA continues to develop a more detailed and
comprehensive analysis of the broad range of issues
relevant to the continued growth and development of
telehealth. There have been various proposals made
to amend the current state-based system to adapt
to the increasing demands of telehealth.
- Of these, California State Senate Bill 1665 has
advanced the farthest. It addresses some of the issues
related to telehealth --for instance, by allowing for
consultation services from an out-of-state
practitioner --but leaves open many other issues
related to provision of care other than
consultation, including primary health services.
 descriptions in a paper chart or a transcription. Examples of
terminologies are LOINC for lab results; SNOMED for clinical terms;
and ICD for medical diagnoses
Healthcare Data Standards • Document Standards – these indicate what type of information is
included in a document and where it can be found. A common
The healthcare field has a long history of establishing data standard in paper medical records in the SOAP (Subjective,
standards. Data standards as applied to healthcare include Objective, Assessment, Plan) format. The CCR (Continuity of Care
methods, protocols, terminologies and specifications for the Record) provides a standard format for inter-provider
collection, exchange, storage and retrieval of information associated communication, including patient identifying information, medical
with the healthcare applications including medical records, history, current medications, allergies, and a care plan
medications, radiological images, payment and reimbursement, recommendation.
medical devices, monitoring systems and administrative process. It • Conceptual Standards – these allow data to be transported across
is important however for nurses to understand the basic of systems without losing meaning and context. For example, the HL7
standards. Key decisions must be made to about how and when RIM (Reference Information Model) provides a framework for
standards should be implemented to assure quality care. describing clinical data and the context surrounding it.
• Application Standards – these determine the way business rules
Categories of Standards are implemented and software systems interact. Examples including
Interoperability in healthcare depends on two important concepts: sign-on, which simultaneously logs a user into multiple applications
•Syntax - refers to structure of communication; the equivalent of within the same environment; and standards for providing a
rules in spelling and grammar comprehensive way of viewing information across multiple, non-
•Semantics – convey the meaning of communication; the equivalent integrated database.
of dictionary and thesaurus. The available healthcare standards • Architecture Standards – these define the process involving in
today address both types of interoperability. data storage and distribution. The Centers for Disease Control’s
Public Health Information Networks/ National Electronic Disease
Healthcare standards are categorized into six (6): Surveillance System is an example. An emerging functional
• Data Exchange / Messaging Standards – these allow transactions architecture is the national electronic health record proposed by the
to flow consistently between systems or organizations because they Institute of Medicine and HL7, commissioned by the HHS.
contain instructions for format, data, elements, and structure.
Common standards includes HL and for administrative data such as Impact of Clinical Data Standards
patient demographics or encounters; DICOM for radiology images
and NCPDP for electronic prescriptions. The comprehensive patient record accommodates the patients’
• Terminology Standards – these vocabularies provide specific codes movement among all locations where care is provided: inpatient,
for clinical concepts such as diseases, problem list, allergies, outpatient, and clinic settings. This allows the healthcare
medications, and diagnoses that might have varying textual organization to conduct outcome analysis with comparable data.
Instead of conducting manual chart reviews and relying on for student populations. Electronic records support the
individual interpretation of narrative notes, the system provides transformation of data into information and knowledge that can
semantically consistent data that can be analyzed. enhance the quality of nursing care. The use of a common
There are also unintended benefits. The improved charting has vocabulary to gather data will assist in validating the
led to better charge capture, since changes are a function of contributions of school nurses to student health and educational
documentation and not a separate activity. And, by bringing various outcomes.
regions together to plan and design the system, staff have come to
see each other as internal consultants who share best practices on The Nursing Minimum Data Set (NMDS) is a current
policies and procedures, patient education programs, and standardization effort. The American Nurses Association Steering
preparation for accreditation visits. A planned single medication list Committee on Databases to Support Clinical Practice (ANASCD) is
per patient will cover inpatient and outpatient environments; it is involved in developing the NMDS. This set is described as "the
expected to improve case management, prevent adverse drug minimum data elements necessary for defining the cost and quality
interactions, and enhance patient satisfaction of nursing care." Elements of the NMDS include the following

Organizations on Standardizing Healthcare Data Nursing Care Elements

 Nursing Diagnosis
Standards have been created by variety of healthcare  Nursing Intervention
organizations including service delivery entities, regulators, vendors  Nursing Outcome
and consultants. Typically, the standards development involves  Intensity of Nursing Care
technical committee that defines methods, and groups organized
around the communities of interest. Representing stakeholders in Patient Demographic Elements
these development projects are clinicians, researchers,
bioinformaticist, chief information officers, database administrators,  Personal identification
information systems analyst, and project managers. In addition,  Date of Birth
special interest entities in public health, patient safety, and  Sex oRace and ethnicity
electronic health records work to ensure that the standards are  Residence
relevant to practice in those areas.
Service Elements
Nursing Minimum Data Set  Unique facility or agency number elements
 Unique patient health record number
Information technology can have a positive impact on the quality  Unique number of principle RN
and efficiency of today’s health care system. In addition, large  Episode encounter date
savings may be realized by moving from a paper-based system  Discharge or termination date
to electronic records. Data in electronic or digital form provides an  Disposition of patient
efficient method of storing, retrieving, analyzing, and archiving data
  Expected payer for this bill  UMLS Metathesaurus - The National Library of Medicine UMLS
Metathesaurus includes terms from NANDA, NIC, NOC, HHCC,
and others.
In 1991 the American Nurses Association (ANA) created a
committee to review nursing languages and to recognize those that
had met the committee’s own criteria as potentially useful to  Clinical Care Classification - The Clinical Care Classification (CCC)
support nursing practice. Since that time, the ANA criteria have System is a standardized, coded nursing terminology that
evolved with the growing knowledge of terminology standards in identifies the discrete elements of nursing practice. CCC
health informatics. Standardized terminologies are bulleted below: provides a unique framework and coding structure for capturing
the essence of patient care in all health care settings.
 NANDA (diagnoses from the North American Nursing Diagnosis
Association). While ICD-9-CM codes describe a disease or injury,  Perioperative Nursing Data Set (PNDS) - Describes
NANDA nursing diagnoses describe a patient's reactions to the perioperative nursing practice with a sub-set of terms that
disease and to treatment. specifically describe perioperative nursing diagnoses, nursing
interventions, and patient outcomes in surgical settings from
 NIC (Nursing Interventions Classification) is a standardized pre-admission until discharge.
language for treatments that nurses perform. NIC was
developed at the University of Iowa and information is  SNOMED CT - (Systematized Nomenclature of Medicine-Clinical
published by Mosby, There is a section of that University's Terms) is considered to be the most comprehensive,
Nursing Web site devoted to NIC and NOC. multilingual clinical healthcare terminology in the world.
 NOC (Nursing Outcomes Classification). Also developed at the  PCDS - The Patient Care Data Set (version 4.0, 1998) contains a
University of Iowa. It goes beyond the work of NIC toward data dictionary and sets of terms and codes representing
classification of outcomes useful in clinical nursing. specific values of Patient Problems (363 terms), Patient Care
Goals (311 terms), and Patient Care Orders (1357 terms). It was
 Omaha System – the Omaha System of nursing classifications
recognized in 1998 by the American Nurses Association (ANA) as
was developed by the Omaha Visiting Nurse Association. It
one of the vocabularies to be considered for use by nurses, and
covers some of the same ground as the NANDA nursing
is included in the National Library of Medicine's Metathesaurus.
diagnoses, and incorporates the Nursing Minimum Data Set
(NMDS).  International Classification for Nursing Practice – The ICNP is a
 Saba’s Home Healthcare–the Home Health Care Classification combinatorial terminology for nursing practice developed by
of Nursing Diagnoses and Interventions (HHCC), developed at the international nursing community under the sponsorship of
Georgetown University, focuses on community health. the International Council of Nurses (ICN).

 Nursing Management Minimum Data Set - Data variables

categorized into environment, nurse resources, and financial
 resources that are needed to inform the decision making
process of nurse executives related to leading and managing
nursing services delivery and care coordination.
The primary motivation for standardized terms in nursing is the The following terminologies may be helpful to define
need for valid, comparable data that can be used across information relationships:
system applications to support clinical decision making and the • Concept –thought or reference; unit of knowledge created by a
evaluation of process and outcomes of care. unique combination of characteristics (an abstraction of a property
of an object or of a set of objects.)
Concept-Oriented Terminology in Nursing Informatics • Objects –the referent; anything perceivable or conceivable.
• Term –the symbol; verbal designation of a general concept
The health informatics literature provides an evolving framework corresponds to two or more objects which form a group by reason
that enumerates the criteria that render healthcare terminologies of common properties.
suitable for implementation in computer-based systems. The
relationship will be best described by the professor using the Components of Advanced Terminology Systems
semiotic triangle:
Within the context of the high-level information model, there has
been extensive development and refinement of terminologies for
describing patient problems, nursing interventions and nursing
sensitive patient outcomes. The main component of more advanced
terminology systems is a concept-oriented terminology model for
ontology representing a set of concepts and their inter-
relationships. The components of advanced terminology systems for
the nursing practice are as follows:

 Terminology Mode l– concept-based representation of domain-

specific terms that is optimized for the management of
A single concept may be associated with multiple terms (synonymy); terminology definitions. It encompasses
however, a term should represent only one concept.  Schemata – incorporate domain-specific knowledge
about the typical constellation of entities, attributes and
In order to appreciate the significance of concept-oriented events in the real world and reflect plausible
approaches, it is important for nurses to understand the definitions combinations of concepts. Example: “pain” can be
of and relationship among things in the world (objects), his thoughts combined with “acute” to make “acute pain”.
about things in the world (concepts) and the labels nurses use to  Type Definitions – are obligatory conditions that state
represent and communicate thoughts about things in the world only the essential properties of the concept. Example: a
(terms).
 nursing activity must have a recipient, an action and a
target.

 Representation Language - terminology models may be

formulated and elucidated in an ontology language. Ontology
language represents classes and their properties. In this way,
ontology languages are able to support, though explicit
semantics, the formal definition of concepts in terms of their
relationships with another concept.

 Computer-Based Tools – a representation language may be

implemented using description logic within a software system
or by a suite of software tools.

TERMINOLOGIES

Nursing Minimum Data Set(NMDS) - a classification system which

allows for the standardized collection of essential nursing data. The
collected data are meant to provide an accurate description of the
nursing process used when providing nursing care.