COLEGIO DE SAN ANTONIO DE PADUA

Supervised by the Lasallian School Supervision Office

Ramon M. Durano Foundation Compound
Guinsay, Danao City
Tel. No. (032)344-4709

NURSING INFORMATICS
This course introduces nursing informatics as an integration of nursing, computer, and
information sciences for the support of nursing practice. It will acquaint practicing
nurses with the effective utilization of technology and its applications throughout all
aspects of health delivery.

MODULE 1

Learning Outcomes: After completion of this topic, the student should be able to:
 Describe the historical perspective of nursing informatics.
 Explore lessons learned from the pioneers in nursing informatics.
 Describe the types of nursing standards initiatives.
 Review the historical perspectives of electronic health records.
 List the major landmark events and milestones of nursing informatics.
 Identify the essential hardware components of a computer.
 List key peripherals attached to most computers.
 Describe the four basic operations of the central processing unit (CPU).
 Explain how power is measured for computers.
 Describe common computer input, output, and storage devices.
 List the names for six types of computers and describe how they are different.
 Describe computer network hardware devices and their functions.

Prepared by:

NURSE FAITH I. MANINGO

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CHAPTER 1
Historical Perspective of Nursing Informatics

 Nursing Informatics
1. Evolved from the French word “informatics”
2. Referred to the field of applied computer science
3. Concerned with the processing of information such as nursing
information
 Computers
1. First introduced into healthcare facilities in the 1960s
2. For the processing of basic administrative tasks
3. The computer is an essential tool in HIT systems
 Health Information Technology (HIT)
1. HIT is an all-encompassing term
2. Refers to technology that
a. Captures health information
b. Processes health information
c. Generates health information
3. Computerization affects all aspects of healthcare delivery
including
a. Provision and documentation of patient care
b. Education of healthcare providers
c. Scientific research for advancing healthcare delivery
d. Administration of healthcare delivery services
e. Reimbursement for patient care
f. Legal and ethical implications
g. Safety and quality issues
4. A shift toward
a. Integrating multiple technologies and telecommunication devices
b. Invisible storage devices such as cloud storage
c. User-friendly, menu-driven, touchscreen manipulation methods
5. Computers in nursing are used for
a. Managing patient care information
b. Monitoring quality
c. Evaluating outcomes
d. Communicating data and messaged via the Internet
e. Accessing resources
f. Interacting with patients on the Web
g. Documenting and processing real-time plans of care
h. Supporting nursing research
i. Testing new systems
j. Designing new knowledge databases
k. Developing data warehouses
l. Advancing the role of nursing in the healthcare industry and
nursing science

 Major Historical Perspectives of Nursing and Computers

Seven Time Periods
1. Prior to the 1960s
a. Developed in the late 1930s and early 1940s
b. Use in healthcare did not begin until the 1950s and 1960s
c. A few experts formed a cadre to adapt computers to healthcare and
nursing
d. Computers in healthcare were used for administrative and
accounting functions
2. 1960s
a. Use of computer technology began to be explored
b. Studies were conducted to determine how computer technology could be utilized
c. The nurses’ station was viewed as the most appropriate center for the development of computer applications
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d. The mid-1960s presented nurses with new opportunities for computer use
e. Increased time devoted to documentation and a rise in medication errors prompted the investigation of
emerging computer-based information systems
3. 1970s
a. During the late 1960s through the 1970s, hospitals began developing computer-based information systems
which initially focused on
(1) Physician order entry
(2) Results reporting
(3) Pharmacy
(4) Laboratory
(5) Radiology reports
(6) Information for financial and managerial purposes
(7) Physiologic monitoring systems in the intensive care units
b. A few systems started to include
(1) Care planning
(2) Decision support
(3) Interdisciplinary problem lists
c. Nurses were often involved in implementing systems
d. In the 1970s, conferences helped public and home health nurses
(1) Understand the importance of nursing data and their relationship to new Medicare and Medicaid legislation
(2) Provide information on the usefulness of computers for capturing and aggregating home health and public
health information
f. Hospitals and public health agencies embarked on investigating computers and nursing
g. The opportunity to improve education using computer technology also began
h. Early nursing networks helped to expand nursing awareness of computers and the impact HIT could have on
practice
i. The Clinical Center at the National Institutes of Health implemented the Technicon Medical Information
System (TDS) computer system
j. TDS one of the earliest clinical information systems (called Eclipsys & Allscripts)
k. TDS was the first system to include nursing practice protocols
4. 1980s
a. The field of nursing informatics exploded and became visible in the healthcare and nursing
b. The nursing profession needed to update its practice standards and determine its data standards, vocabularies,
and classification schemes that could be used for the computer-based patient record systems
c. Many mainframe healthcare information systems (HISs) emerged with nursing subsystems
d. These systems documented several aspects of the patient record
e. The microcomputer or personal computer (PC) emerged during this period
f. The first Nursing Special Interest Group on Computers met for the first time during SCAMC (Symposium on
Computer Applications in Medical Care) in 1981
g. In 1985, the ANA approved the formation of the Council on Computer Applications in Nursing (CCAN)
h. CCAN became a very powerful force in integrating computer applications into the nursing profession
i. The first edition of this book published in 1986
5. 1990s
a. Advances in relational databases, client-server
architectures, and new programming methods
b. Better application development at lower costs
c. Legislative activity in the mid-1990s paved the way for
electronic health records through the Health Insurance
Portability and Accountability Act (HIPAA) of 1996
(public-law 104-19)
d. The complexity of technology, workflow analysis, and
regulations shaped new roles in nursing
e. In 1992, the ANA recognized nursing informatics as a new nursing specialty separate Scope of Nursing
Informatics Practice Standards, and also established a specific credentialing examination for it
f. The demand for nursing informatics (NI) expertise increased
g. The ANA developed the Nursing Information and Data Set Evaluation Standards (NIDSEC) to evaluate and
recognize nursing technology rapidly changed in the 1990s
(1) PCs became smaller
(2) Computer notebooks became affordable
(3) Computers were linked through networks
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(4) The Internet became mainstream
(5) The World Wide Web (WWW) increased access to information
h. The purpose of Information systems was to guide the development and selection of nursing systems that
included standardized nursing terminologies integrated throughout the system
6. 2000s
a. More healthcare information became digitalized and newer technologies emerged
b. In 2004 an Executive Order 13335
(1) Established the Office of the National Coordinator (ONC) for Healthcare Information Technology (HIT)
(2) Issued a recommendation calling for all healthcare providers to adopt interoperable electronic health records
(EHRs) by 2014/2015
c. Wireless, point of care, regional database projects, and increased IT solutions proliferated
d. The use of bar coding and radio-frequency identification (RFID) emerged as a useful technology
e. Smaller mobile devices with wireless or Internet access increased access to information for nurses within
hospitals and in the community
f. The development and refinement of voice over Internet protocol (VoIP) provided voice cost-effective
communication
g. The Internet provided a means for development of clinical applications
h. The nursing informatics research agenda promoted the integration of nursing care data in HIT systems that
would also generate data for analysis, reuse, and aggregation
7. 2010s
a. The impact of the Nursing Minimum Data Set (NMDS) demonstrated that continued consensus and effort
was needed to bring to fruition the vision and implementation of minimum nursing data into clinical practice
b. A new nursing informatics research agenda for 2008–2018 emerged as critical for this specialty
c. The new agenda is built on one originally developed and published by the National Institute for Nursing
Research (NINR) in 1993
d. During 2010, the ONC convened two national committees:
(1) National Committee on Health Policy
(2) National Committee on Health Standards which outlined and designed the focus for the “Meaningful
Use” (MU) legislation. Interest in computers and nursing began to emerge in public and home health and
education
e. Meaningful Use was designed to be implemented in at least three stages
f. Consists of the regulations which built onto each other with the ultimate goal of implementing a complete an
interoperable EHR and/or HIT system in all US hospitals
g. In 2011/2012 MU Stage 1 was initiated focusing primarily on the Computerized Physician Order Entry
(CPOE) initiative for physicians
h. In 2012/2013 MU Stage 2 was introduced focusing primarily on the implementation of Quality Indicators
i. The Quality Indicators are used to guide hospitals in patient safety and if not implemented used as indicators
subject to financial penalties
j. It is anticipated that MU Stage 3 will be implemented in 2014/2015
k. The Center for Medicare and Medicaid Services (CMS) plans to increase reimbursement for the
implementation of “MU” regulations in their HIT and/or EHR systems through 2015
l. CMS may even penalize eligible providers and facilities who do not meet the proposed MU criteria
m. As the MU requirements increase they will impact on the role of the NI experts in hospitals
n. MU requirements ultimately on the roles of all nurses in the inpatient facilities, making NI an integral
component of all professional nursing services
Consumer-centric Healthcare System
1. There is a shift to a consumer-centric healthcare system due to escalating costs
2. Consumers are encouraged to be active partners in their care
3. A variety of technologies have evolved to enable consumers to have access to their health information
4. Consumers can choose whether to share this across healthcare providers and settings
5. Personal health records multiplied as either stand-alone systems or those tethered to EHRs
6. Consumers are more literate regarding healthcare information literacy and expect to become more involved in
managing their own health

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  Nursing Informatics Pioneers
History Project
1. In 1995, Saba initiated a history of NI at the National Library of Medicine, which consisted of the collection
of archival documents from the NI pioneers
2. The history project was initiated based on a recommendation by Dr. Morris Collen
3. In 2001, that the Nursing Informatics Working Group (NIWG) of the American Medical Informatics
Association (AMIA) became involved
4. The NI History Committee was established to take on this project
5. The committee solicited archival material from the known NI pioneers for a History of Nursing Informatics
to be housed in the NLM as part of its History Collection
6. In 2004, the rich stories of pioneers in nursing informatics were captured through a project sponsored by the
AMIA-NIWG
7. Pioneers were defined as those who “opened up” a new area in nursing informatics and provided a sustained
contribution to the specialty
8. Through multiple contacts and review of the literature, 145 pioneers and contributors were identified as
having shaped nursing informatics since the 1950s
9. Each identified pioneer was contacted to submit their nonpublished documents and/or historical materials to
the NLM to be indexed and archived for the Nursing Informatics History Collection
10. The catalogued document descriptions can be searched online:
www.nlm.nih.gov/hmd/manuscripts/accessions.html
11. A convenience sample of pioneers was interviewed over a 4-year period at various nursing informatics
meetings
12. Videotaped stories from 33 pioneers were recorded
13. The 33 videotaped stories are available on the AMIA website: www.amia.org/niwg-history-page
14. The website also provides “use cases” for ideas about how to use the information for teaching and learning
more about the pioneers
15. These resources are particularly useful for courses in informatics, leadership, and research
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16. They also are useful for nurses in the workforce who want to learn more about nursing informatics history
17. The early pioneers came from a variety of backgrounds as nursing education in nursing informatics didn’t
exist in the 1960s
18. Almost all of the pioneers were educated as nurses, though a few were not
19. The pioneers had a vision that technology could make nursing practice better
20. The nursing pioneers influenced the evolution of informatics as a specialty from granular-level data through
health policy and funding

 Nursing Standards Initiatives

Nursing Practice Standards
1. Nursing practice standards have been developed and recommended by the ANA
2. Nursing Scope and Standards of Practice that focused
a. On the organizing principles of clinical nursing practice
b. The standards of professional performance
3. Nursing Informatics Scope and Standards of Practice builds on
a. Clinical practice standards
b. Outlines further the importance for implementing standardized content to support nursing practice by
specialists in nursing informatics
Nursing Education Standards
1. Since the NLN’s Nursing Forum on Computers in Healthcare and Nursing was formed in 1985, it has
supported the integration of computer technology in the nursing curriculum
2. The American Association of Colleges of Nursing (AACN), revised The Essentials for Doctoral Education
for Advanced Nursing Practice and The Essentials of Baccalaureate Education for Professional Nursing Practice
to require the use of computers and informatics for both baccalaureate and graduate education
Nursing Content Standards
1. The nursing process data elements in EHRs are essential for the exchange of nursing information across
information systems and settings
2. Standardization of healthcare data began in 1893 with the List of International Causes of Death for the
reporting of morbidity cases worldwide
3. The standardization of nursing began with Florence Nightingale’s six cannons in her “Notes on Nursing”
4. In 1955, Virginia Henderson published her 14 Daily Patterns of Living as the list of activities and conditions
that became the beginning of nursing practice standards in the United States
5. In 1970, the ANA accepted the Nursing Process as the professional standards for nursing practice and which
was followed by the standardization of nursing content-data elements in 1973
6. Currently, the ANA has recognized 12 nursing terminologies
7. The ANA selected six of the ANA recognized nursing languages for inclusion in the NLM’s Metathesaurus
of the Unified Medical Language System (UMLS) and for inclusion in the Systematized Nomenclature of
Medicine—Clinical Terms (SNOMED-CT)
8. There are a large number of standards organizations that impact healthcare data content as well as healthcare
technology systems

Confidentiality and Security Standards

1. Increasing access through the electronic capture and exchange of information raised concerns about the
privacy and security of personal healthcare information (PHI)
2. Provisions for strengthening the original HIPAA legislation were included in the 2009 HITECH Act

 Electronic Health Records from a Historical Perspective

The Institute of Medicine (IOM)
1. In 1989, the Institute of Medicine (IOM) convened a
committee and asked the question, “Why is healthcare still
predominantly using paper-based records when so many
new computer-based information technologies are
emerging?”
2. Two major conclusions resulted from the committee’s
deliberations.
a. First, computerized patient record (CPR) is an essential
technology for healthcare and is an integral tool for all
professionals

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b. Second, the committee after hearing from numerous stakeholders recognized that there was no national
coordination or champion for CPRs
The Computer-Based Patient Record Institute
1. Created in 1992
2. Given the mission to initiate and coordinate the urgently needed activities to develop, deploy, and routinely
use CPRs to achieve improved outcomes in healthcare quality, cost, and access
3. Developed the CPR Project Evaluation Criteria in 1993 modeled after the Baldridge Award
a. These criteria formed the basis of a self-assessment that could be used by organizations and outside reviewers
to measure and evaluate the accomplishments of CPR projects
b. The four major areas of the initial criteria
(1) Management
(2) Functionality
(3) Technology
(4) Impact
c. Provided a framework through which to view an
implementation of computerized records
d. The criteria which provided the foundation for the
Nicholas E. Davies Award of Excellence Program
4. The Davies Program evolved through multiple
revisions
5. Under HIMSS management, the Davies Award of
Excellence is offered in four categories
a. Enterprise (formerly Organizational or Acute Care), first offered in 1995
b. Ambulatory Care, started in 2003
c. Public Health, initiated in 2004
d. Community Health Organizations (CHO), first presented in 2008
 Landmark Events in Nursing and Computers
Major Milestones
1. Computers were introduced into the nursing profession over 40 years ago
2. Major milestones of nursing are interwoven with the advancement of computer and information technologies
3. The increased need for nursing data, development of nursing applications, and changes, making the nursing
profession an autonomous discipline
4. There are currently several key events in which the NI community participates
a. Conferences
b. Symposia
c. Institutes
d. Workshops
5. Key events provide
a. An opportunity for nursing informatics novices and
experts to network and share their experiences
b. Key events provide the latest information, newest
exhibits, and demonstrations

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CHAPTER 1 MODULE 1 LEARNING ACTIVITIES
Multiple Choice: Read and analyze each item below. Encircle the letter of the correct answer. (2 points each)
1. Which event was considered to be the first major computerized system(s) used for nursing practice in
the 1970s?
a. Physiological Monitoring Systems in Hospital ICUs
b. Metathesaurus of the National Library of Medicine
c. PLATO designed to teach classes in off-campus sites
d. Army Nurse Corp conducted Educational Workshops
2. Which event was a critical milestone for nursing and computers in the 1980s?
a. The Internet emerged for public use
b. Nursing Computer Conference at NIH
c. ANA approved the formation of the Council on Computer Applications in Nursing (CCAN)
d. Faye Abdellah’s published 21 Problems for nursing practice
3. Which event was a critical historical nursing and computer milestone in the 1990s?
a. Nurses presented papers at the first SCMC
b. ARRA legislation passed
c. ANA recognized Nursing Informatics as a new nursing specialty
d. Office of National Coordinator established
4. Which event in the 2000s became a significant milestone for the promotion of HIT systems in the
United States?
a. Bar Coding Technology emerged
b. RFID Technology emerged
c. ONC was established in 2004 and first ONC Coordinator named
d. MU Stage 1was initiated
5. Which event is the most significant for the History Project of Nursing Informatics Pioneers?
a. They video-taped interviews of nurse practitioners
b. Archival material from NI Pioneers was submitted to the NLM for the NI History Collection
c. Developed Use Cases on how to teach NI
d. Developed rules for NI mentorship
6. What are the themes from the interviews of the NI Pioneers?
a. They had a vision that technology could make nursing practice better. True ___ False ___
b. They highlighted what nurses brought to the HIS table. True ___ False ___
c. They indicated that they selected a career of NI. True ___ False ___
d. They knew that they were NI experts. True ___ False ___
e. They learned NI through hands-on experiences. True ___ False ___
7. What Nursing Standards have impacted on the nursing profession?
a. Education, Administration, Content, and Practice
b. Practice, Content, Confidentiality and Security, and Education
c. Confidentiality and Security, Research, Practice, and Education
d. Research, Administration, Education, and Practice
8. What Nursing content and/or other technological materials are needed in EHRs?
a. SNOMED CT, Abdellah’s 21 Problems, and Nursing Terminologies
b. Nursing Terminologies, Nursing Cannons, and NLM
c. Nursing Process Model, SNOMED CT, and a Coded Nursing Terminology
d. SNOMED CT, Nursing Cannons, Nursing Process
9. What historical event initiated the need for computer-based health records?
a. IOM proposed that CPRs were critical and necessary as a new healthcare technology
b. CPRI was formed to develop technology standards
c. NCVHS proposed technology standards
d. Criteria for Davies Award of Excellence established
10. What were the initial criteria for the Nicholas E. Davies Award of Excellence Program?
a. Impact, Quality Indicators, Management, and HER
b. Management, Technology, Functionality, and Impact
c. Technology, Impact, Quality Indicators and Management
d. Functionality, Acute Care, Impact, and Quality Indicators

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CHAPTER 2
Computer Hardware

 Introduction
1. Computer hardware is defined as all of the physical components of a computer
2. A computer is a machine that uses electronic components and instructions to the components to perform
a. Calculations
b. Repetitive and complex procedures
c. Process text
d. Manipulate data and signals
3. Computer technology has evolved from huge, room-sized electronic calculators developed with military
funding during World War II to palm-sized machines
4. The basic hardware of a computer composes the computer’s architecture, and includes
a. Electronic circuits
b. Microchips, processors
c. Random Access Memory (RAM)
d. Read-Only Memory (ROM)
e. Graphic and sound cards
5. These are attached to a component called a motherboard
6. The motherboard is a square or rectangular board with circuits into which are plugged the main electronics of
the computer
7. Devices that may be inside the computer case but are not part of the architecture include
a. Main storage device which is usually an internal hard drive
b. Cooling system
c. Modem
d. Ethernet connectors
e. Optical drives
f. Universal Serial Bus (USB) connectors
g. Multi-format media card readers
8. Devices attached or linked to a computer that are peripheral to the main computer box are part of the
system’s hardware
9. These include
a. Input and output devices, including the keyboard, touch
screen, mouse, printer, and fax
b. Storage components such as external hard drives, thumb drives, floppy drives, tape drives, sound systems
(earphones, microphones, speakers, subwoofers)
c. Computer monitor

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10. Computer systems are composed of many different component parts that enable the user to communicate
with the computer, and with other computers to produce work
11. The group of required and optional hardware items that are linked together to make up a computer system is
called its configuration
12. When computers are sold, many of the key components are placed inside a rigid plastic housing or case,
which is called the box
13. What can typically be seen from the outside is the box containing the internal components, and the
peripherals such as a keyboard, mouse, speakers, monitor, and printer
14. Computers are now pervasive throughout the healthcare industry
15. Their applications are expected to continue to expand and thereby improve the quality of healthcare while at
the same time reducing some costs
16. The applications of computers to healthcare will greatly expand the diagnostic and therapeutic abilities of
practitioners and broaden the diagnostic and treatment options available to recipients of healthcare
17. Computers allow for distance visualization and communication with patients in remote areas
18. None of these changes could have happened without tremendous advances in the machinery, the hardware,
of computers
• Computer hardware advances during the late 1900s and into the 2000s have made possible many
changes to the healthcare industry
• The first work to be modified consisted of special administrative functions such as finance, payroll,
billing, and nurse staffing and scheduling support
• Later, the computer allowed fantastic changes in the practice of radiology and imaging, allowing
noninvasive visualization not only of internal structures, but even of metabolic and movement functioning
• Computer enhanced surgical instruments enabled surgeons to insert endoscopy tools that allow for both
visualization and precise removal of diseased tissues, leaving healthy tissues minimally damaged and the patient
unscarred
• Virtual reality programs in surgery have greatly enhanced the scope and complexity of surgeries that are
now amenable to much less invasive surgeries
• As a result, massive damage to skin, subcutaneous tissues, muscles, and organs have been eliminated
from many procedures
• Millions of patients who formerly would have needed weeks in the hospital for recovery are now able to
be released from the hospital the same day of their surgery or in a day or two at most
• Telemedicine is now being used to reduce the impact of distance and location on accessibility and
availability of healthcare
 Required Hardware Components of a Computer
1. The box of any computer contains a motherboard
a. The motherboard is a thin, flat sheet made of a firm, nonconducting material on which the internal
components— printed circuits, chips, slots, and so on—of the computer are mounted
b. The motherboard is made of a dielectric or nonconducting plastic material
c. Electric conducting lines are etched or soldered onto the bottom of the board
d. The motherboard has holes or perforations through which components can be affixed so they can transmit
data across the circuits on the motherboard
e. One side looks like a maze of soldered metal trails with sharp projections (which are the attachments for the
chips and other components affixed to the motherboard)
f. The motherboard contains the microchips (including the CPU), and the wiring, and slots for adding
components
g. The specific design of the components on the motherboard—especially the CPU and other microprocessors—
composes the foundation of the computer’s architecture
h. The motherboard’s storage media is called memory
 Memory
1. Read-Only memory
a. It is a form of permanent storage on the computer
b. It carries instructions that allow the computer to be booted (started), and other essential machine instructions
c. Its programming is stored by the manufacturer and cannot be changed by the user
d. Data and programs in ROM can only be read by the computer, and cannot be erased or altered by users
e. Theoretically, ROM can be changed by the factory
f. Effectively, the programs are permanently wired into the memory
g. ROM generally contains the programs, called firmware, used by the control unit of the CPU to oversee
computer functions
h. In microcomputers, this may also include the software programs used to translate the computer’s highlevel
programming languages into machine language (binary code)
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i. ROM storage is not erased when the computer is turned off
2. Random access memory (RAM)
a. Refers to working memory used for primary storage
b. It is used as temporary storage
c. Also known as main memory, RAM can be accessed, used, changed, and written on repeatedly
d. RAM is the work area available to the CPU for all processing applications
e. When a user clicks on a program icon, the computer loads all or part of the program into RAM where it can
be
accessed very quickly
f. It saves work done through the programs until the user formally saves the work on the hard drive or other
permanent storage
g. RAM is a permanent part of the computer
h. RAM is called volatile memory because everything in RAM unloads (is lost) when the computer is turned off
i. The computer programs that users install on their computers to do work or play games are stored on
media such as on the hard drive
j. They are not permanent parts of the computer itself
k. Running programs from the hard drive would be a very slow process, so parts of the programs are loaded and
unloaded from the much faster RAM as needed
l. They are unloaded when the user shuts the program down or turns off the computer
m. The contents of RAM are erased whenever the power to the computer is turned off
n. RAM is made ready for new programs when the computer is turned on again
3. Cache
a. A smaller form of RAM
b. Its purpose is to speed up processing by storing frequently called items in a small, rapid access memory
location
c. Prior to the development of cache, all information had to be fetched from the hard drive, and then stored in
RAM
d. To handle all the work, the processor had to move information into and out of RAM (and back to the hard
drive) in order to manage all the data from programs and their output
e. Given that RAM is large it takes a bit of searching to find just the pieces needed and is relatively slow
f. Fetching from cache takes much less time than from RAM
g. Keeping information that will be used frequently in cache greatly reduces the amount of time needed to move
data around among the memory locations
h. It is a relatively inexpensive way to increase the speed of the computer
• To understand how cache works, think of a surgical nursing unit
• Prior to the 1980s, many hospitals did not have many volumetric pumps, and all were kept in the
Central Supply (CS) department—usually far away in the basement
• Whenever a nurse needed a pump (which at that time were used only for especially dangerous IV
medication infusions), the nurse had to go to CS and fetch it
• When no longer needed for that patient, the pump was returned to CS
• This is analogous to a system with no cache
• This was a good system when pumps were seldom used on any unit as storage space is always limited
in nursing units
• Consider changes in practice which have led to the need for one or more volumetric pumps used for
every patient
• The new plan is to have a storage area in the nursing unit so when one is needed, the machines are
always nearby
• This system is much more efficient for the nurses. Having a space to store the pumps nearby greatly
reduces the time needed to access a pump
• Rarely used equipment is still often kept in the CS department, but frequently needed items have a
nearby storeroom so they can be retrieved more quickly and efficiently
• This is similar to cache
 Input and Output
1. Input devices
a. These devices allow the computer to receive information from the outside world
b. The most common input devices are the keyboard and mouse
c. Others commonly seen on nursing workstations include the touch screen, light pen, voice, and scanner
d. A touch screen is actually both an input and output device combined
e. Electronics allow the computer to “sense” when a particular part of the screen is pressed or touched
f. In this way, users input information into the computer
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g. The touchscreen displays information back to the user, just as does any computer monitor
h. A light pen is a device attached to the computer that has special software that allows the computer to sense
when the light pen is focused on a particular part of the screen
i. It allows smaller screen location discriminations than does a touchscreen
j. For both the touch screen and light pen, software interprets the meaning of the user identified screen location
to the program
k. Many other input devices exist
l. Some devices are used for security and can detect users’ fingerprints, retinal prints, voiceprints, or other
personally unique physical characteristics that identify users who have clearance to use the system

• In healthcare computing, many medical devices serve as input devices

• For example, the electrodes placed on a patient’s body provide input into the computerized physiologic
monitors
• The oximetry device placed on a patient’s finger uses light waves to detect impulses which are sent to a
computer and then interpreted as oxygen levels in the blood
• Voice systems allow the nurse to speak into a microphone (which is the input device) to record data,
submit laboratory orders, or request information from the computer
• In radiology, most machines today input images from the X-Ray machines to a computer rather than
storing them on film
• The most advanced imaging machines could not exist without computer technology
• Computerized Axial tomography (CAT)-scans, and Medical Resonance Imaging machines are the best
known computerized imaging devices, but most radiology today is computerized
2. Output devices
a. These devices allow the computer to report its results to the external world
b. Defined as any equipment that translates the computer information into something readable by people or
other
machines
c. Output can be in the form of text, data files, sound, graphics, or signals to other devices
d. The most obvious output devices are the monitor (display screen), and printer
e. Other commonly used output devices include storage devices such as the Universal Serial Bus (USB) drive
(also known as flash or thumb drives), and optical media
• In healthcare settings, a variety of medical devices serve as output devices
• Heart monitors are output devices recording and displaying heart rhythm patterns, and initiating alarms
when certain conditions are met
• Volumetric infusion pumps output include both images on a screen and fluids infused into the patient’s
body
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• The pump delivers a specific volume of IV fluids based on commands that the nurse inputs so the
ordered fluid volume will be infused in the correct time period
 Storage Media
1. Hard Drive
a. It is a peripheral that has very high
speed and high density
b. It is a very fast means of storing and
retrieving data as well as having a large
storage capacity in comparison with the
other types of storage
c. The hard drive is the main storage
device of a computer
d. For small computers, it is typically
inside the case or box that houses the
CPR and other internal hardware
e. Internal hard drives are not portable;
they are plugged directly into the
motherboard
f. The storage capacity of hard drives has increased and continues to increase exponentially every few years
g. In 2014, most personal computers are sold with about a terabyte of storage
h. In 1990 most personal computers came with about 500 megabytes
i. On the biggest computers, storage is measured in petabytes, which is an almost unimaginably huge number
2. USB Flash Drive
a. As demands for higher and higher density transportable storage rise, the popularity of the USB disk has also
risen
b. A USB flash drive is actually a form of a small, removable hard drive that is inserted into the USB port of the
computer
c. There are many names for it, including pen drive, jump drive, thistle drive, and pocket drive
d. This is a device that can store 4 gigabytes (GB) for about $10
e. Flash drives can be very tiny, only about ½ in by 1 in
f. They can also be much bigger and can home 128 GB or more
g. The flash drive is highly reliable
h. Small enough to fit comfortably in a pants pocket or on a lanyard as a necklace, or on one’s keychain
i. The device plugs into one of the computer box’s USB ports and instead of saving to hard drive or CD-ROM
or disk, the user simply saves to the flash drive
j. Can store so much data in a package so much smaller than a CD or DVD, the convenience makes it worth the
slightly higher price to many users
k. As its popularity increases, prices drop
• Flash drives are not really used in clinical settings, at least not for business or patient care purposes
• However, they are often carried by personnel who may plug them into the hospital’s computer to do
personal work
• There is a danger that they can end up used to compromise patient or company confidentiality
• Nurses should not save confidential patient information onto their personal flash drive (or any other
personal storage devices)
• It is too easy to lose the drive itself, and then confidential information could end up anywhere!
• With paper medical records, a person had to laboriously hand copy confidential information onto a
piece of paper to create such a risk to confidentiality
• With electronic media, it is perilously easy to copy confidential information, and since it then becomes
so accessible, there is little security for that information
• As nurses are responsible for protecting confidential information, as both a personal and company
policy, confidential patient or company information should not be downloaded onto personal storage devices
without a very good reason and legal permission to do so
3. Optical Media
a. Include Compact Disks (CDs), Digital Versatile Disks (DVDs), and Blu-Ray
b. CD-ROMs and DVDs are rigid disks that hold a higher density of information and have higher speed
c. Until the late 1990s, CD-ROMs were strictly input devices
d. CD-ROMs were designed to store sound and data, and held about 737 megabytes of information and large
laser writers were required to store data on them
e. CD-ROMs were read-only media

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f. Technology developed in the 1980s by Philips Corporation permitted the development of a new type of CD
that could be written on by the user
g. Those are called CD-RW for Compact Disc Read-Write
h. As technology advanced and people wanted to store motion pictures on computer readable media, DVDs
were developed and they held approximately 4.3 gigabytes of information, which will handle a regular 2 hour
movie
i. DVDs are too limited to handle high definition movies and movies longer than 2 hours
j. Media moved to the even higher storage capacity of BluRay discs which store approximately 27 gigabytes of
information or the equivalent of a 2 hour high definition movie
k. Double layer Blu-Ray discs can store 54 gigabytes or 4.5 hours of high definition motion picture media
l. Blu-Ray is derived from the blue color of the laser that writes on the media and ray for the optical ray that
reads
the media
4. Other Storage Devices
a. As computers became more standard in offices during the 1990s, more and more corporate and individual
information was stored solely on computers
b. Even when paper backup copies were kept, loss of information on the hard drive was usually inconvenient at
the least and a disaster at worst
c. Diskettes could not store large amounts of data, so people began to search for economical and speedy ways to
back up the information on their hard drive
d. Zip drives, which were mini magnetic tape devices, were a form of relatively fast (in their time) backup
storage for people’s data
e. Thumb (USB) and external hard drives were faster than tape media and replaced it as the backup media of
choice
f. Today, many people purchase services that allow them to back up their data online, which means it gets
stored
on commercial computers that they have backup facilities
5. Cloud Storage
a. An extension of the online storage service offered by individual vendors
b. Data stored in the “Cloud” is still stored on commercial computers called servers
c. The “Cloud” refers to a distributed system of many commercial, networked servers that communicate through
the Internet, and work together so closely that they can essentially function as one large system
d. Physically, enormous numbers of servers that store data are located in buildings, many warehouse sized
e. These data storage sites are called data centers
f. Multiple data centers are linked together to create cloud storage
g. The advantage to the customer is safety of the stored data
h. A key factor in cloud storage is redundancy
i. The storage vendors must maintain multiple copies of the data they store
j. If one server in a data center becomes inoperable, copies of the data on that server are stored elsewhere and
thus the data are not lost
k. They can be retrieved from another server
l. There are numerous vendors who offer individuals free cloud storage space for their personal files, such as
photos and music
m. They may also offer storage for a modest monthly or yearly fee
n. Some continuously back up data, others back up data at specified times, and typically the user can order files
to be backed up whenever he or she wishes
o. Cloud storage is far more secure and reliable than a personal hard drive or backup drives
p. Most users of smartphones, tablet computers, and other portable devices store their data in the Cloud, not
only
because of the security of the data, but because storage in small devices is somewhat limited
q. The Cloud allows more data storage than most individuals need for personal use
 Major Types of Computers
1. Supercomputers
a. The largest type of computer
b. First developed by Seymour Cray in 1972
c. The early supercomputer research, development, and production was done by Cray Corporation or one of its
affiliates (Cray, 2014)
d. A supercomputer is a computational-oriented computer specially designed for scientific applications
requiring a gigantic amount of calculations which, to be useful, must be processed at superfast speeds
e. The supercomputer is truly a world class “number cruncher”
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f. Designed primarily for analysis of scientific and engineering problems and for tasks requiring millions or
billions of computational operations and calculations
g. Are huge and expensive
h. Supercomputers are used primarily in such work as defense and weaponry, weather forecasting, advanced
engineering and physics, and other mathematically intensive scientific research applications
i. Provides computing power for the high-performance computing and communication (HPCC) environment
2. Mainframes
a. The most common fast, large, and expensive type of computer used in large businesses (including hospitals
and other large healthcare facilities) for processing, storing, and retrieving data
b. It is a large multiuser central computer that meets the computing needs large and medium sized public and
private organizations
• Virtually all large and medium sized hospitals (300 beds and up) have a mainframe computer to handle
their business office operations
• They may have the hospital’s electronic medical record (EMR) on that computer as well, or they may
subcontract mainframe computing from a professional computer system support vendor
c. Mainframes are used for processing the large amount of repetitive calculations involved in handling billing,
payroll, inventory control, and business operations computing
• For example, large volume sales businesses like grocery store chains and the “big box” stores have
mainframe computers tracking all sales transactions
d. The machines and software that process transactions in high volume businesses are known as transaction
processing systems (TPS)
• The information nurses chart on patients in inpatient care facilities can be viewed as transactions
• For example, every time a nurse charts a medication, that charting records use of one or more drugs
• That charting in turn is transmitted to the pharmacy so that one item of that drug in inventory can be
decreased
• Typically, when the count of remaining inventory drops to a certain level, the TPS automatically
initiates an order to a pharmacy supply house for more of the drug
• Operations like charting a patient’s vital signs goes into that person’s medical record, and might trigger
a warning to the nurse should any of the vital signs be out-of-range for that patient
• For example, if the blood pressure is too high or too low, the system might be programmed to signal a
warning so the nurse is advised to assess the patient and take appropriate action
• Given the number of these kinds of “transactions” in clinical facilities, a powerful computer is needed
to handle them all, and therefore, the hospital’s EMR and other clinical applications are often handled through a
mainframe computer
e. Mainframes always have very high processing speeds (calculated in millions of processes per second, or
MIPS,
or in floating point operations per second, or FLOPS)
f. Prior to the year 2000, mainframes were often defined almost entirely by their high processing speed
g. Today’s mainframes are more defined by the following characteristics than merely processing speed:
(1) Their extensive input and output capabilities to support their multiuser environment

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(2) Complex engineering to support long term stability with high reliability, allowing these machines to run

uninterrupted for decades

(3) Their ability to process the massive throughput needed for high volume business transactions and business
office operations
• In hospitals, mainframe computers are often used to support the entire Hospital Information Technology
System (HIT), also known as the Hospital Information System (HIS), purchased from one of the 30 or so large
HIT vendors
• The HIT includes not only business and nursing operations, but supports many clinical systems
• As previously mentioned, the applications nurses use in hospitals and other large healthcare facilities to
document patient care, obtain laboratory and radiology results, record medication orders and administration
records, and perform many other nursing record-keeping and information retrieval tasks typically involve use of
a hospital mainframe computer
• Virtually all inpatient healthcare facility departments need large amounts of computer support
• A partial listing of departments that typically have their systems on the hospital’s mainframe computer
includes: the laboratory and radiology systems, the dietary department, the admissions department and its
patient location system, the pharmacy department, and the central supply department’s inventory control system
• Sometimes clinical monitoring systems such as cardiac and fetal monitors, and surgery information
systems may be housed on the mainframe, although these systems often reside on their own separate computer
hardware
• Today the average sized or large acute care hospital has a HIT implemented by one of the 30 or so large
HIT vendors
• It has a hardware configuration of a mainframe which may be located on-site (physically located at the
hospital) or it might be located somewhere else
• In some cases, the Mainframe is not owned by the hospital, but by a computer service vendor who
provides mainframe computing power to multiple customers
• In that case, the hospital’s information is processed and stored on the vendor’s computer systems
h. A mainframe is capable of processing and accessing billions (GB) of characters of data or mathematical
calculations per second
i. Mainframes can serve a large number (thousands) of users at the same time
j. In some settings, hundreds of workstations (input and output devices that may or may not have any processing
power of their own) are wired directly to the mainframe for processing and communication speeds faster than
can be achieved with wireless communications
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k. There are also wireless and telephone linkages into the computer so that remote users can gain access to the
mainframe
l. As compared with a desktop PC, a mainframe has an extremely large memory capacity, fast operating and
processing time, and it can process a large number of functions (multiprocessing) at one time
3. Microcomputers (Personal Computers or PCs)
a. While mainframe computers provide critical service to the healthcare industry, much smaller computers are
also an essential part of healthcare computing systems
b. Computers designed to support a single user are called microcomputers or personal computers (PCs)
c. Much smaller and less powerful than a mainframe, PCs were designed to be used by one person at a time
• In hospitals, they are used for an increasing number of independent applications as well as serving as an
intelligent link to the programs of the mainframe
• Hospital nursing departments use PCs to process specific applications such as patient classification,
nurse staffing and scheduling, and personnel management applications
d. Microcomputers are also found in educational and research settings, where they are used to conduct a
multitude of special educational and scientific functions
e. Desktops are replacing many of the mainframe attributes
f. Desktops can serve as stand-alone workstations and can be linked to a network system to increase their
capabilities
g. This is advantageous, since software multiuser licensing fees are usually less expensive per user than having
each user purchase his or her own copy
h. Computer size has steadily decreased since their invention while at the same time, power has grown
exponentially
i. The components of desktop computer are typically housed in a hard case
j. While the size of the case can vary considerably, one common size is 2 ft long by 6 to 10 in wide
k. The case is most typically connected via wire or wireless technology to a keyboard, monitor, mouse, and
printer
l. Microcomputers are also available as portable or laptop computers, and as notebook, tablet, and handheld
computers
m. Laptop computers are highly portable because they are much are smaller than the standard desktop
microcomputer
n. Many are less than 2 in deep
o. There is huge variation in the length and width, but if a 15 in viewing screen is used, the case is usually about
16 in by about 12 in
p. Notebook computers are even smaller; one size marketed in 2014 is 8.5 in × 11 in
q. Tablet computers are smaller with a width of about 7 in and length of about 9 in, but are super thin as
compared with the laptop and notebook computers
r. Less than an inch deep, they end up widened due to the addition of a protective case that usually also serves
as a stand
• Desktop and laptop computer systems with wireless connectivity to the hospital’s computer are often
placed on a rolling cart for use of the nursing staff in recording nursing notes, ordering tests and treatments,
looking up medications, and other computer work in inpatient settings
• These computers on carts are often referred to as “WOWs” for workstation on wheels, or “COWs” for
computer on wheels
• Many nurses find these rolling workstations to be much more useful than fixed computers at patient
bedsides for a variety of reasons
• Additionally, one workstation can be assigned to a nurse to use with his or her assigned patients, thus
eliminating the need for a separate computer for every bed
• This solution allows nurses to adjust screen height and location of the mouse on the COW for their
physical comfort that day rather than having to readjust a separate computer at every bedside

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4. Handheld Computers
a. Small, special function computers, although a few “full function” handheld computers were introduced in the
late 1990s
b. Some have claimed to have almost the same functionality and processing capabilities as a laptop or notebook
c. Limited in their expansion possibilities, their ability to serve as full participants in the office network, and the
peripherals they can support
d. More popular are the palm-sized computers, including personal digital assistants (PDAs), which are the
smallest of the handheld computers
e. The PDA is a very small special function handheld computer which provides calendar, contacts, and note-
taking functions, and may provide word processing, spreadsheet, and a variety of other functions
f. Originally sold as isolated devices, today virtually all PDAs are combined with telephone functionality and
sold as smartphones
g. Smartphones are ubiquitous
h. Smartphones are owned by a huge number of people worldwide, from the slums of South Africa to business
people in the most developed countries
i. Smartphones have replaced wristwatches, pocket calendars, and other personal items people used to keep their
lives organized
j. Many people might be more comfortable leaving home without a coat in winter than without their
smartphone.
k. These devices provide constant connectivity and access to Internet and telephone functions
l. They are particularly useful in that they can synchronize with other technology and provide automatic support
for such things as the user’s calendar
m. The processors for most smartphones, tablet computers, and other small but powerful devices are made by
Advanced RISC Machines Ltd. (ARM)
n. A RISC processor is a “Reduced Instruction Set Computer,” which means it is a special purpose processor
o. As of 2014, these processors are 32 bit microprocessors that use the RISC architecture
p. There are a variety of hardware platforms and operating systems for smartphones and tablet computers
q. The three most common are the Apple Corporation’s
iPhone and iPad using the iOS operating system, smartphones, and tablets using the Android operating system
(owned by Google Corporation), and the Windows operating system for smartphones and tablets from
Microsoft
Corporation
r. The Android system is an open source operating system, the other two OS are closed and proprietary
s. There are thousands of software applications (called apps) developed for all these platforms, many of them
free or sold at a very low price
t. Typically, the apps work on only the platform for which they were developed
u. Quite a few will work on both smartphones and tablets using that platform
v. For example, many apps that work on the iPad tablet will also work on the iPhone
• Clinical applications can allow the nurse to obtain assessments such as electrocardiograms, heart and
respiratory rate, hearing acuity, oxygenation, and blood pressure using a smartphone
• There are calculators that can make drug dosage calculations safer
• There are programs that can help identify drug facts such as actions and dosages, drug interactions, and
remind the nurse of potential complications to watch for as well as special nursing actions to take with various
medications
• Reminders can help the nurse avoid forgetting to perform a treatment or give a medication on time
• Wisely used, tablet computers, smartphones and other PDA technology have the potential to support
patient care safety and quality in all settings of care
• As wonderful as these handheld devices can be, there are pitfalls for nurses in their use in clinical areas
• They come with both still photo and video capabilities
• It can be very easy to forget the legal requirement for permission to photograph anything on a patient,
much less make a photo of a patient’s face when the technology is so available
• It is quite a simple matter to upload information stored on a smartphone onto the Internet
• A few nurses have found themselves in serious trouble when they forgot that social media, such as
Facebook, Twitter, and LinkedIn are not private spaces and they uploaded photographs of patients or
confidential patient information on social media.
• Smartphones are incredibly easy media on which to store information
• Nurses must remember that most information in their workplace has confidentiality requirements that
can be protected only with sophisticated technical barriers to unauthorized access
• Those barriers are typically not available in an individual’s smartphone

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  Connectivity, Compatibility, and Incompatibility Issues
1. Communication among various hardware devices cannot be assumed.
a. Given that departments within a single organization have often bought small systems designed to support
their work, a single hospital may have literally hundreds of different computers and applications on those
computers
b. Simply wiring incompatible machines so that power can flow between them accomplishes nothing
c. Often, computers cannot transfer data meaningfully among themselves
d. This makes it difficult to create a comprehensive medical record for individual patients
e. Information stored somewhere in the facility may not be available when needed to the providers who need the
information to make good patient care decisions
f. As greater attention is placed on patient safety and quality improvement, and on analysis of performance data
for planning and evaluation, there is a need to acquire and combine data from multiple patient care operations
computers and systems
2. Different computers have different architectures, hardware configurations, and different storage schemes
a. Software must be specifically designed to communicate with another program for the two to communicate
b. Systems not designed specifically to work together cannot communicate information and processes to each
other without the addition of complex translation programs (that usually don’t exist); that is, they are not
interoperable
3. As a result of the interoperability problems, it can be economically infeasible to move data across different
computers and programs.
a. The interoperability problem limits the nurses’ ability to obtain, combine and analyze data they need to
provide high quality, safe patient care
b. Organization progress and performance is hampered when data and information are not available to perform
the analysis required to identify problems, opportunities for improvement, safety risks, and to make projections
about future needs
c. Interoperability is necessary to meet the requirements of the Medicare and Medicaid EHR Incentive Programs
(which provide financial incentives for the “meaningful use” of certified EHR technology) as part of the
HITECH
Act of 2009
d. Interoperability usually requires interoperable software
programs such as SNOMED CT and LOINC

 Computer Power
1. Bits and Bytes
a. A bit (binary digit) is a unit of data in the binary numbering
system
b. Binary means two, so a bit can assume one of two positions
c. A bit is an ON/OFF switch—ON equals the value of 1 and OFF
equals 0
d. Bits are grouped into collections of 8, which then function as a
unit
e. That unit describes a single character in the computer, such as
the letter A or the number 3, and is called a byte
f. There are 255 different combinations of 0 and 1 in an 8-
character (or 1-byte) unit
g. That forms the basic limit to the number of characters that can be directly expressed in the computer
h. The basic character set hardwired into most PCs contains 255 characters
i. In the early days of PCs, this was a problem because it severely limited the images that could be produced
j. With the advent of graphics cards and the additional character sets and graphics that graphics cards allow,
virtually any character can be produced on a computer screen or printed on a printer
k. Even without graphics cards, additional character sets can be created by means of programming techniques
l. The size of a variety of computer functions and components is measured by how many bytes they can handle
or store at one time
2. Main memory, which includes the ROM on the motherboard in today’s computers, is very large as compared
with that of just a few years ago, and continues to increase every year with new computers
a. The size of memory is an important factor in the amount of work a computer can handle
b. Large main memory is another key measure in the power of a computer
c. In the mid-1970s, the PCs on the market were typically sold with a main memory of between 48 and 64 K
d. By 2014, the size of main memory in computers sold to the public had risen exponentially

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e. Most computers in 2014 are advertised with between 5 and 16 GB of main memory and computers with 20
GB or more of main memory are available
f. Cache has also become an important variable in computer power and thus in advertising the power of
computers
3. Another important selling point of a computer is the size of the hard drive that is installed in the box
a. The first hard drives sold for microcomputers in the 1970s were external devices that stored about 1,500
kilobytes
b. At that time, home computers were not sold with internal hard drives
c. When the user turned on the computer, they had to be sure the operating system (OS) diskette was in the disk
drive, or the computer could not work
d. This architecture severely limited the size and functionality of programs
e. Consumer demand for hard drives was such that their size grew exponentially while at the same time the cost
of hard drive storage decreased exponentially.
f. By late 1999, home computers sold typically had between 6 and 20 GB of space on the hard drive
g. In 2010 the typical laptop computer was sold with a 300 to 500 GB hard drive
h. Desktops often came with hard drives that offered a terabyte or more of storage
i. By 2014, most home and laptop computers were advertised with 1 to 2 terabyte hard drives
j. Hard drive space will undoubtedly continue to increase
k. Applications programs have become so large that both the main memory and the hard drive storage space
have
had to increase exponentially
 Computer Speed
1. The basic operations of the CPU are called cycles
a. The four types of cycles, or operations of a CPU, include:
(1) Fetch
(2) Decode
(3) Execute
(4) Store
b. It takes time for the computer to perform each of these functions or cycles
c. The CPU speed is measured in cycles per second, which is called the clock speed of the computer
d. One million cycles per second is called 1 megahertz (MHz)
e. A billion cycles per second is called 1 gigahertz (GHz)
f. CPU speed is very fast because computers perform many billions of cycles per second
g. They can be slow if their processors have insufficient speed for the work they are required to process
2. Clock speeds, like most other components, have greatly improved over time
a. For example, the original IBM PC introduced in 1981 had a clock speed of 4.77 MHz (4.77 million cycles per
second)
b. In 2010, home computers commonly had speed of 1.8 to 3 GHz. In 2014, advertised computers in the $1000
range have clock speeds of 2.5 to 3 GHz
c. The higher the clock speed possessed by the CPU, the faster and (in one dimension) the more powerful the
computer
d. Clock rate can be misleading, since different kinds of processors may perform a different amount of work in
one cycle
e. General purpose computers are known as complex instruction set computers (CISCs) and their processors
are prepared to perform a large number of different instruction sets
f. A cycle in a CISC computer may take longer than that for a specialized type of computer called a reduced
instruction set computer (RISC)
g. Clock speed is one important measure of the power of a computer
 Network Hardware
1. A network is a set of cooperative interconnected computers for the purpose of information interchange
2. The networks of greatest interest include local area networks (LANs), wide area networks (WANs), and the
Internet, which is a network of networks
a. A LAN usually supports the interconnected computer needs of a single company or agency
b. The computers are physically located close to each other, and generally, only members of the company or
agency have legitimate access to the information on the network
c. WANs support geographically dispersed facilities, such as the individual grocery stores in a national chain
d. A subset of WANs includes the metropolitan area networks (MANs) that support and connect the many
buildings of local governmental agencies or university campuses
3. The most important components of network hardware are the adapter or interface card, cabling, and servers
4. The role of hardware in a network is to provide an interconnection between computers
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5. For a computer to participate on a network, it must have at least two pieces of hardware:
a. Network adapter or network interface card
(1) A network interface card (NIC) is a computer circuit board or card that is installed in a computer so that it
can be connected to a network
(2) PCs and workstations on LANs typically contain a NIC specifically designed for the LAN transmission
technology, such as Ethernet
(3) NICs provide a dedicated, full-time connection to a network
(4) Most home and portable computers connect to the Internet through modems on an as-needed dial-up
connection
(5) The modem provides the connection interface to the Internet service provider
(6) The oldest network interface (or “adapter card”) is an Ethernet card
(7) Wireless network modems are used more often today
(8) There exist other options such as arcnet and serial-port boards
(9) The choice of NIC depends on the communication medium
b. Communication medium (cabling)
(1) Distance. Relatively short distances are required for wireless, compressed video and coaxial cable systems.
For much longer distances, fiber-optics, telephone lines, and satellite transmission are used
(2) Amount of data transfer. Large amounts of data (especially video) are best handled with coaxial cables and
compressed video and through satellite communications (satellite and compressed video are very expensive).
Smaller amounts of data or serial (nonvideo) streams are best handled through the other wire types, such as
twisted pair copper wire and optical fiber, and are less expensive
(3) How often the transfer is needed. Coaxial works best for locally wired networks that are used constantly
by a very limited number of users. Telephone wires work well for the relatively high usage public networks
(like the Internet) but are more likely to get overloaded when many users try to use the system at the
same time. Consider, for example, the busy Internet or phone lines getting clogged up when a tornado or
hurricane has struck a community
(4) Availability. Availability depends on cost, transmission speed, number of users (who might clog up the
system), and weather conditions (satellites)

CHAPTER 2 MODULE 1 LEARNING ACTIVITIES

Multiple Choice: Read and analyze each item below. Encircle the letter of the correct answer. (2 points each)
1. What is the definition of Computer Hardware and what does it represent?
a. It is a Text Processor
b. It is a Set of Instructions that makes the Computer Work
c. It represents the Physical Components of a Computer
d. It represents an Electronic Calculator
2. What are the four basic components for a computer?
a. CPU, Input/Output, Storage, and Software
b. CPU, Input/Output, Storage, and Controllers
c. Hardware, Input/Output, Storage, and CPU
d. Storage, Controllers, Hardware, and CPU
3. What are the three key types of memory in a computer?
a. CPU, RAM, and Cache
b. CPU, Cache, and ROM
c. RAM, CPU, and Cache
d. Cache, ROM, and RAM
4. What are the major types of storage media?
a. Motherboard, Hard Drive, Optical Media, and USB Flash Drive
b. Optical Media, USB Flash Drive, Motherboard, and Hard Drive
c. USB Flash Drive, Cloud Storage, Disk Storage, and Hard Drive
d. Hard Drive, Optical Media, USB Flash Drive, and Cloud Storage
5. What best describes virtual storage?
a. Storage on a thumb drive
b. Storage in a computer hard drive
c. Storage on a CD
d. Cloud storage via the Internet
6. What are the five basic types of computers?
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a. Handheld, Microcomputer, PDAs, Mainframe, and Laptop
b. Laptop, Supercomputer, Mainframe, Microcomputer, and Personal Computer
c. Handheld, Supercomputer, Microcomputer, Mainframe, and PDAs
d. Mainframe, Personal Computer, Laptop, Microcomputer, and PDAs
7. How is a computer described in terms of characteristics?
a. Speed, Memory Size, Cache, and Hard Drive
b. Hard Drive, Software, Speed, and Memory Size
c. Cache, Hard Drive, Programming Language, and Speed
d. Memory Size, Software, Hard Drive, and Speed
8. What are the three types of networks or information exchange?
a. WWW, Internet, and LAN
b. LAN, Internet, and WAN
c. WAN, CPU, and LAN
d. Internet, WWW, and LAN
9. On what characteristics is the communication medium mostly based?
a. Availability, Distance, Number of Telephone Lines, and Amount of Data Transfer
b. Distance, How often Data Transfer is Needed, Availability, and Amount of Data Transfer
c. Amount of Data Transfer, Number of Telephone Lines, and How often Data Transfer is Needed
d. How often Data Transfer is Needed, Availability, Satellites, and Distance
10. What other components should a person have at home besides the basic computer hardware
components?
a. Monitor, Motherboard, Mouse, and Keyboard
b. Printer, Monitor, Keyboard, and Mouse
c. Mouse, Printer, RAM, and Keyboard
d. Keyboard, Mouse, ROM, and Motherboard

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