For over a decade, Working Group 8 (Nursing) of the International Medical Informatics Association has sponsored, in conjunction with a host country, a triennial international symposium on nursing informatics. Each conference consists of a main conference and an invitational working conference following the main event. In 1991, the symposium was held in Melbourne, Australia and hosted by the Nursing Computer Group, Victoria and the Royal College of Nursing, Australia. Nine Pre-Conference workshops offered participants indepth exploration of a variety of information technology topics. The main conference attracted 700 participants from 19 countries and over 150 peer-reviewed papers. The invitational working conference was held at Whitehall in Sorrento, Victoria and involved the individual and collective work of 40 experts in nursing informatics from around the world. This group addressed the theme HEALTH CARE INFORMATION TECHNOLOGY: IMPLICATIONS FOR CHANGE. Health care organizations are faced with growing demand for information technology and must cope effectively with the processes and outcomes of its introduction. As the impact of information technology is felt both on the local and the global level, the conference selected for its theme a three tiered approach to information technology and organisational change - through the lens of society, the organization, and the individual. The conference was organized around three forms of contribution: plenary talks, working groups, and individual contributions by the participants. Part one of this book contains the papers of the plenary speakers for the conference.