Purpose:To explore the use of the Internet to obtain information for increasing the knowledge base of nurses.Objectives:
INTRODUCTIONBASIC TERMS, SERVICES AND NAVIGATION ON THE INTERNETTHE INTERNET AND THE NURSING PROCESSWEB PAGES OF SELECTED HEALTH CARE RESOURCESCONCLUSIONREFERENCES
INTRODUCTION Society has advanced on a continuum from the Agricultural Age to the Industrial Age and has now arrived at the threshold of the "Information Age." The product of the Information Age is knowledge and knowledge is composed of information, intelligence and expertise. A person is no longer guaranteed a job based on seniority but a growing reputation for making things happen based on knowledge (Bartlett and Ghoshal, 1995). Knowledge is the key to success in the "Information Age" and a person who has knowledge will be an asset to any organization.Historically people have been paid to do the job and let the managers do the thinking but with the onset of the "Information Age" this paradigm is no longer productive (Bridges, 1996). To ensure control and conformity, people were treated like machines and expected to be consistent, reliable and efficient but this type of paradigm inhibited creativity and initiative (Bartlett and Ghoshal, 1995). Today jobs are knowledge-based, not industrial-based, requiring the employee to be a change agent who can think critically and improve the job through problem-solving. The American Society for Quality defines a change agent as:
In the health-care environment, the needs of clients are rapidly and constantly changing and employability is dependent upon the knowledge and ability to manage those health-care needs. In uncertain times careful planning is necessary to survive the changes that will occur in the 21st century. By the time a textbook is published it is outdated. Current information is essential in a rapidly changing health care environment and obtaining that information is essential to employability. In addition to using the library to obtain information, information can now be obtained by surfing the Internet on the "Information Superhighway."BASIC TERMS, SERVICES AND NAVIGATION ON THE INTERNETBefore 1993 and the World Wide Web, only a few in privileged positions were able to use the Internet but according to the Pew Internet and American Life Project, the United States online population has grown to over 126 million. The China Internet Network Information Center has now estimated that there are over 79.5 million Internet users in China which still places them in the third position as Japan is in the second position with over 100 million users. Just like traveling to another country requires an understanding of the basics of a foreign language, navigating the "Information Superhighway" requires an understanding of the basic terms or computer jargon for a successful journey.To be able to access the Internet, a user needs a computer and an Internet provider. Anyone can obtain information from the Internet by obtaining an account from an INTERNET SERVICE PROVIDER (ISP) which provides you with a "gateway" to the Internet. The High Speed Internet Access Guide lists five types of providers:1. Dialup Service2. Digital Subscriber Line (DSL)3. Cable Providers 4. Satellite Service 5. Wireless Providers The INTERNET is a world-wide network of computer networks and the WORLD WIDE WEB (www) is a global HYPERMEDIA document containing electronic publications, photos and drawings on over countless millions of "pages" of information spread over too many computers to count. HYPERTEXT is the text on the Internet that is organized by using HYPERLINKS (Links) that jump from one source of information to another. All text on the Internet is written in a "markup language" called HTML (Hypertext Markup Language) that tells all computer networks how to display a piece of text or a graphic by using "tags" that show how and where the text, graphics and hyperlinks are positioned and formatted. (James, 1996; Gibbs, Sullivan-Fowler & Rowe, 1996).To be able to obtain information on the World Wide Web, a program called a BROWSER (Mosaic, Netscape or Microsoft Explorer) is necessary for retrieving and viewing HTML documents. A URL (Uniform Resource Locator) is an address that web browsers use to locate, retrieve and display a document. A special protocol called HTTP (HyperText Transfer Protocol) controls how documents that are requested are transferred from a host computer to the web browser. HTTP allows clients and servers to communicate with each other through use of an addressing scheme called DOMAINS (the site where the computer is located). There are six top-level domains:
Internet sites that are located outside the United States are identified with a two-letter, top-level domain name: Examples
(Edwards, 1995; Gibbs, Sullivan-Fowler & Rowe, 1996; James, 1996).Navigating the Web with requires a basic understanding of the "click on buttons." Microsoft Explorer provides an easy to understand tutorial entitled "Surfing, Browsing, and Finding Your Way" which provides a step-by-step instruction. Netscape also provides a similar tutorial for new users entitled "Netscape Communicator 4.5 Tutorial for New Users."BACK allows reloading of a Web Page that has been previously visited during a current session. If the button is "gray" there is no previous page to visit as when a session on the Internet first begins.FORWARD allows returning to a recent Web Page during a current session. Again, if the button is "gray" there is no previous page to visit as when a session on the Internet first begins.HOME is the default home page that the computer loads when each session begins. This is determined by selecting the Options pull-down menu, clicking on General Preferences and setting the Appearance to StartUp the Browser with the location that is typed into the HomePage Location box.RELOAD/REFRESH is used to upload the most current information from a news or weather Web Page or to reload a page if an error in transfer has occurred while loading.OPEN can be used to type in a URL (internet address) when you already know the URL of the Web Page.PRINT is used to print the page that is currently on the computer screen or the entire document.STOP is used to discontinue loading of a document. This can be used if a document is taking too much time to load and you suspect that a problem exists with loading the document.LOCATION displays the URL of the Web Page that is currently on the computer screen.NET SEARCH is used to locate a SEARCH ENGINE that will perform a comprehensive search for a keyword or concept.There are approximately 250 SEARCH ENGINES on the Internet to search through 600 million pages of information. SEARCH ENGINES are tools that assist with locating information on the WWW much like a card catalog assists in finding information in a library (Gibbs, Sullivan-Fowler & Rowe, 1996).There are basically two types of search engines to help find information on the Internet.The first type is called a directory-based engine (Yahoo or Magellan) and is a manually created catalog of Internet sites useful for searching for general topics.1. Yahoo 2. Magellan The second type is an auto-indexed search engine (AltaVista, Excite, Infoseek, and Lycos) that have databases created by software programs useful for searching for obscure topics or proper nouns. These search engines send out agents called "spiders" to find and break down data into an on-line list of sites, documents, pictures, sound, or film clips.1. AltaVista 2. Excite 3. Infoseek 4. Lycos Each search engine has a HELP link to assist in searching but three simple words can get you started. AND (+) indicates that two keywords are necessary in the search. OR indicates that either keyword will do and are usually synonyms. And NOT (-) directs the search engine to be sure that the word following NOT is not included in the search (Matta, 1997). To run a basic search, select a search engine, and begin your search. The most outstanding and top ranking search engine is1. GOOGLEEach search engine provides additional instructions on how to perform a search. To run a complex search or for detailed information about each search engine, select the search engine and request additional assistance by clicking on the HELP button located on the web page of each search engine.THE INTERNET AND THE NURSING PROCESSThe Internet is a resource for sharing and gathering nursing information much in the same way that the nursing process has been used by nurses as a vehicle for providing quality patient care. This the nursing process vehicle has four components:
During assessment, the nurse gathers information necessary for making a nursing diagnosis. Once a nursing diagnosis has been identified, the nurse plans patient care through implementation of specific nursing interventions that are continuously evaluated for effectiveness (McFarland and McFarlane, 1983).A search for nursing interventions using Google as a search engine provided a wide array of resources. Google took 0.21 seconds to find 420,000 sites regarding nursing interventions. Three sites were chosen as examples of web sites available on the Internet that focused on the nursing process and specific nursing interventions.The first site is sponsored by Duke University School of Nursing and assists with providing information regarding:
These systems of classification assist nurses in developing plans of care for patients that are in a standardized and comprehensive language. NIC and NOC were developed by the nursing faculty from the University of Iowa. Although 91% of nursing schools still use NANDA, a new system is beginning to assist nurses with clinical decisions using the best available research evidence. This new process is called Evidence Based Nursing. The University of Minnesota hosts an impressive website that details information related to Evidence Based Nursing.A second site, Cancer and Chemotherapy by NurseWeek was an impressive web page that highlighted specific nursing interventions to implement for chemotherapy side-effects. This chemotherapy education site offered information regarding introduction to cancer, diagnosis, staging, and treatment of cancer, basis principles of chemotherapy administration, physiological impact of chemotherapy, and psychosocial impact of chemotherapy.For the patient with a nursing diagnosis of "Altered protection related to pancytopenia," nursing interventions were identified for:Links from MedlinePlus Medical EncyclopediaThe third website is an impressive web page created for the University of Cincinnati College of Nursing that provides a variety of virtual nursing resources for Physical Assessment. This web page contains excellent examples of the use of Computer Assisted Instruction (CAI) for self-directed learning.Provided by the Center for Academic Technologies and Educational ResourcesThe Information Highway is an excellent resource for nurses to utilize to increase their knowledge base and communicate their expertise with other nurses. The nursing process (the vehicle for providing quality patient care) can now travel the Information Highway. During the 21st century, nurses have the opportunity to be one collective voice that can be heard around the world as they travel the Information Highway sharing information on health promotion, restoration, and maintenance and disease prevention.WEB PAGES OF SELECTED HEALTH CARE RESOURCESNumerous health care resources are available on the Internet therefore only a sampling of sites have been identified for you to examine. Evaluate each site by looking at readability (text size and color), information availability (links to additional useful sites), and accuracy. The sites have been placed in categories to provide a wide variety of evaluation opportunities. Remember to use the BACK button to return to this page after each site evaluation.Health Care OrganizationsAmerican Diabetes AssociationAmerican Cancer AssociationAmerican Heart AssociationAmerican Lung AssociationHealth Care JournalsGovernment Health Care ResourcesNursing OrganizationsAmerican Association of Critical-Care NursesAmerican College of Nurse-MidwivesAmerican College of Nurse PractitionersAmerican Holistic Nurses AssociationAssociation of Womens Health, Obstetric and Neonatal NursesMiscellaneious Health Care ResourcesCONCLUSIONThe Internet will assist in breaking down the walls so that worldwide communication will be possible. The information available on the Internet is only a fraction of the information that will be available over the next five years. Futurists tell us that during the next five years, society will experience more change than it has experienced in the past 50 years. Although you may have received a quality nursing education, if you cease to learn you will be ineffective in a technological 21st century. New and more effective methods of providing patient care must be researched and implemented by critical thinking, problem-solving nurses who can provide safe and effective nursing care in a rapidly changing health care environment. The Information Highway provides the opportunity to access information, share information, and provide information using the vehicle of the Nursing Process.REFERENCESBartlett, C. & Ghoshal, S. (1995, May-June). Changing the role of top management. Harvard Business Review, 132-142.Bridges, W. (1996). Leading the de-jobbed organization. In F. Hesselbein, M. Goldsmith & R. Beckhard (Ed.). The Leader of the Future (pp.11-18). San Francisco: Jossey-Bass Publishers. Edwards, M. (1995). The Internet for Nurses and Allied Health Professionals. New York: Springer. Gates, B. (1995). The Road Ahead. New York: Viking Penguin. Gibbs, S., Sullivan-Fowler, M. & Rowe, N. (1996). Medical Surfari. St. Louis: Mosby. James, P. (1996). Official Netscape Navigator 2.0 Book. Netscape Press. McFarland, G. & McFarlane, E. (1983). Nursing diagnosis & intervention. St. Louis: Mosby.
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