Information literacy
Defined as the ability to recognize when information is needed as well as the skills to find, evaluate and use needed information effectively
Information
Term used to describe data that has been interpreted
Information science
Focus on how to gather, process and transform information into knowledge. It also incorporates features from 5 other sciences
-communication science
-computer science
-social science
-library science
-cognitive science
Information systems
Using the EHR to document care of a patient with a fractured femur is an example of using the EHR in which way
Simulation Technology Improving patient outcomes.
Allowing them hands-on practice and immediate feedback of the skill being learned
Knowledge worker
Nurses in this type of role
-are continuous learners
-use technology to support and inform nursing practice
-generate knowledge as a product
Expert/Experienced Nurse
Expected to fully integrate informatics throughout the course of his/her practice, not just for basic data entry and retrieval. They also know how to pull trends out of data
Nursing informatics
Nursing informatics as a specialty does have its own National certification exam
Clinical practice guidelines
Clinical practice guidelines can allow for the creation of nursing policies. True rooted in evidenced based research
Information technologies, not systems but functions within a system
CPOE, bar code medication administration, and clinical decision support are all examples of what
Computerized Physician Order Entry (CPOE)
The name used to describe the process by which the physician or provider enters orders electronically into the EHR
RFID
A radio frequency identifier (RFID) is a type of (information) technology that is used to identify and track supplies and medications within a healthcare environment
Informatics affecting Nursing Practice
Clinical pathways and computer generated care plans are examples of how informatics can affect nursing practice True, examples of clinical decision support
Nursing informatics
The use of technology and information to help support all aspects of nursing practice
The foundation of knowledge model
The basis for which knowledge is used to meet the needs of the healthcare delivery system
It is derived from its 3 key elements of knowledge acquisition, knowledge processing and knowledge dissemination
Data (not information until it has been analyzed)
A patients height, weight, code status, and date of birth are all examples of what
Less consumer accountability
Not an emerging trend in healthcare
Mission
The purpose or reason for an organizations existence
Strategic planning, long-range
The development of a comprehensive long range plan for guiding the activities and operations of an organization
They will need to be trained on the system
Why is it not important that selection committee board members understand software and electronic processes
Strategic Planning
Strategic planning is not driven by short term goals as Strategic Planning is a LONG TERM GOAL
Blogging
Not a national trend related to nursing informatics
Needs assessment
During which phase of the information life cycle should the “musts” and “wants” be determined
Information Life Cycle Phases
- Needs assessment phase
- System selection phase
- System implementation phase
- Maintenance phase
Project scope
Term that defines the size and details of a collaborative effort
Nurses active participation in Electronic Information Importance
To ensure the information is current and accessible to the healthcare team
Project Implementation Team Responsibilities
Execution of system changes, active involvement in user participation, knowledge of current workflows
Company history
A common request contained in a request for information (RFI) document includes what
System Implementation Role
Go-live planning, applying system changes as needed, end-user training
Continuous
Term that best describes the life cycle of an information system
EHR Essential Components
Evidence-based decision support, assessment findings, vital signs, demographic data
EHR Function
Bar-code medication administration
EHR Benefits
Reduces medication errors, improves provider documentation
Patient Support Example
Providing education material
EHR Primary Benefit
One primary benefit of the EHR is a decreased wait time for diagnostic testing…FALSE
EHR Main Goal
Primary goal of EHR functionality in contrast to that of a health information system is promoting patient safety
HIS Health Information System
Broad term used to describe administrative and clinical systems to streamline work flow processes efficiency
Barrier to patient centered care
Is waiting until the end of the shift to chart patient assessments a barrier to patient centered care…Yes, chart in real time.
Computer position can be a barrier if it is placed between the provider and the patient…pay attention to your patient.
Standardization of Data and Different data needs of each clinic
What potential challenge can occur when implementing an EHR in a medical center with various outpatient clinics
Local Area Network (LAN) access
What is the type of connection is needed to access the EHR when an internet connection is lost
EHR Information Includes
Immunization history, CT scan results, date of birth
EHR Quality Care Between Facilities
By providing continuity of care, interoperability
EHR
The EHR is a longitudinal electronic patient record of all health care encounters…carries with the patient (longitudinal)
Medication Administration System (Pyxis) Access
Barcode ID badge, fingerprint
Order entry system
Type of health information system that ensures the accuracy of physician orders
ADT System (Admission, discharge, transfer)
A registration system is also commonly refereed to as
Health information systems
A group of systems used within the hospital to support and enhance healthcare
HIS Implementation Nursing
It is important to secure staff nurses active participation when implementing a health information system b/c the nurses knowledge of current patient care workflow may improve implementation decisions
Standardized Terminologies important to nursing
They improve communication within the interdisciplinary team
HIS Examples
Laboratory system, pharmacy system, registration system
Perioperative nursing data set (PNDS)
Which nursing terminology contains a nursing diagnosis, interventions and outcomes specific to the perioperative experience
Standardized Terminologies in Nursing Informatics Development is Driven by what Principles
Accessibility, ubiquity, longevity, reusability
Collaboration when selecting a Health Care System
Collaboration leads to knowledge sharing
Administrative Information System Examples
Scheduling system, financial system, admission, discharge and transfer (ADT) system
Clinical Information Systems Examples of Effectiveness
The information retrieved can be used to foster research, improves nursing documentation compliance, It can improve clinician workflow
HL7 (Health Level 7)
Acronym used to refer a standard of interoperability and exchange of clinical data
Financial Systems are designed to do what
Manage the expenses and revenue of providing healthcare, report and track fiscal outcomes as they relate to organizational goals, help to determine the organizations strategic direction
EHR implementation challenges in a medical center with various specialties
Identifying the different data needs for each specialty practice
Clinical Decision Support Tool Characteristics
Takes specific patient data, analyzes it and provides recommendations (next action)
Clinical Decision Support Tool Examples
Computer generated care plans, alerts, smart pumps, electronic drug references
Culture of Safety Principles
- Commitment of resources
- Cross collaboration
- Blame free environment
Security Threats to data/information
- Unauthorized personal accessing equipment
- Use of removable storage devices
Governing Authorities protecting Information
- HIPPA
- ANA code of ethics
HIPPA Privacy Act
- Patients have ownership rights to their records
- Patients can amend own records if information is incorrect
Physical/Logical Means of Protecting Information
Physical – surveillance cameras, restricted areas, hard copy records being shredded
Logical – firewall protection, biometrics, authentication, automatic sign off on computers
Telehealth (Store and Forward Technology)
Means of transferring data or images from one location to another, most often used for pathology reports and radiology images
Telehealth Driving Factors
Access to care (removing geographical barriers), continuity of care, mobile devices, follow up calls, more patients than providers, increase in chronic diseases
Telehealth (Ethical and Legal Implications)
Need for extensive documentation to avoid malpractice, providers need to be licensed in every state they practice Telehealth
Telehealth (Clinical vs Non-Clinical Applications)
Clinical – imaging that needs to be read, mobile device to monitor patient, live video conferencing
Non-clinical – online database search, administrative team using video conferencing
Nursing Informatics Concepts
Data, Information, Knowledge, Wisdom
Informatics System Considerations
Technical Specifications – Downtime for Maintenance
Response Time – Time it takes system to process request
Architecture – Structure of system, open comm. each other
Connectivity – Interface the system in multiple ways
Testing – In different place than being used
Compatibility – With other systems
Computer Technology
Collection of data for analysis used to justify the efficiency of particular interventions & improve quality care
Computer Hardware
Input device, CPU, Secondary Storage, Output Device
ANA Terminologies
NANDA, NIC, NOC, CCC, ICNP, PNDA, Omaha System
ARRA (American Recovery & Reinvestment Act
Provides funds for adoption of technology and provides the right for every individual to receive electronic copy of EHR
EMR Basic Components
Clinical messaging, email, data repository, clinical docum
CIS
Access to client data to Plan, Implement, Evaluate Care
Clinical Term
Enables the capture of data for patient care docum
Computer System
Hardware, Software, Data, Procedures, Users
CPOE
Needs downtime procedure or policy prior to implement
CPU
BRAIN, computer chip processes all computer functions and uses
NO integration
C-3PO and RUG’s
EBP Attributes
Increased job satisfaction, improved quality of care
EBP
The use of research and evidence to inform clinical practice, an approach to provide care that integrates nursing experience and intuition with valid and current clinical research to achieve the best PT outcomes
EDI Electronic Data Interchange
Permits multiple systems to acquire and share data
EBP Provides
Standardized best practices, reduces time nurses spend gathering and assessing data, and provide care w/ clinical research
EMR
Electronic version of the client data found in the traditional medical record
EMR Provides
Legal record often restricted to a single visit of care, building block of EHR
HIPPA Compliant Codes
ICD, ABC, Common Procedural Terms
HIPPA Provides
Legal protections for personal health info, set standards for electronic data interchange of claims data, named specific code sets for use in Medicare related transactions and priv
HITECH (Health Information Technology for Economic and Clinical Health)
Strengthened HIPPA security and privacy protection, provides financial incentive for user of EHR
Nurse uses Data
Accessing Information, Collecting Data, Inputting Data, Analyzing Data
Informatics Innovator
Process of making enhancements or improvements..creative
Informatics Nurse
Advance knowledge and proficiency in the use of IT as it applies to nursing practice.
Interfacing Types
- Point to Point – Enables 2 systems to communicate, expensive, has to have customized program
- Interface Engine – Interfacing across several different systems.
Internet Security Measures
- Firewall – Prevents unwanted access to the system and it’s information
- Limit web page access
- Server Security – Information stored is not accessible to other systems if they are attacked
- Update security software
Intranet/Extranet
Intranet – Private networks that cannot be accessed outside the organization
Extranet – Network outside the organization that enables customers and suppliers access to the services.
MIPPA (Medicare Improvement for Patients and Providers Act)
Financial Incentive for e-prescribing physicians
Telehealth Issues
Lack of reimbursement, infrastructure, plug-play standard, license and liability issues, concerns r/t privacy confident.
Knowledge
The synthesis of information from several sources to produce a single concept or idea Ex. journal about BP
LAN
Connect a few computers to the server over a large area ex. doc’s placing orders from home.
Needs to be Integrated
ICD-9, G-Codes, ICD-10, CPT, HCSPC
Network
Combination of hardware and software that allows communication & electronic transfer between computers
Connects Multiple computers in different locations
Novice
Beginner w/ no experience with situations in which they are expected to perform a task…taught rules to guide actions
Nursing Informatics
Integration of nursing science, computer science, and information science to manage and communicate data, information, knowledge, and wisdom into nursing practice.
Nursing Information System
Standardized nursing language (SNL) 2 approaches
- Nursing Process Approach & Critical Pathway – Multi Disciplinary teams throughout. Physician orders are present for the team to observe and follow, allows the team to update the POC when variances in the PT condition are noted.
- Protocol Approach – Streamline documentation of assessment, med info, discharge info and education
Qualitative Research
Concerned with finding out more about the human experience, accomplished through interviews and over a long period of time. EX How interventions could impact an entire population, content analysis, computers can code responses to questionnaires which can them be inputted in the informatics system for analysis.
Quantitative Research
Concerned with objectivity, tight control over situations, define relationships between variables, seek correlation between data. EX Tries to discover how an intervention has impacted subjects IN DEPTH, tangible relations between variables.
EMR Adoption Stages
0-Organization
- All 3 key ancillary departments (lab, pharm, radiology) installed
- CDR – Clinical Data Repository provides physician access for reviewing orders and results. Possibly HIE Capable.
- Nursing/Clinical Documentation – EMAR, first level of clinical decision support is implemented.
- CPOE implementation
- Closed loop med administration w/ bar codes is implemented, 5 rights of med. administration
- Full physician documentation, full radiology and PACS
- No more paper charts
Patient Information
Standard (temp, weight), General, Targeted, Personalized (specific info on condition pt has been dx with ex DII), Tailored (Gleaned from EMR EHR focuses specifically on conditions IND Based)
Telemedicine
Improve pt outcomes by permitting pts to
remain at home, allows pts to communicate w/
provider about blood glucose test or video
conference w/ them directly to develop pt
specific education opportunities, directed by
doctors
Telehealth Options
- Store & Forward- items are transferred
to experts who read and interpret
information and send back results - Real Time- interactive conferencing
Teleconferencing
Use of computers, audio, & video equip.
and high-grade dedicated telephone line,
cable/sat connections to provide
interactive communication between 2+ ppl
at 2+ sites
Telehealth
Use of telecommunication technologies &
computers to provide healthcare info &
services to clients at another location
- consumers are chronically ill, isolated,
assisted living families - decrease er visits, decrease LOS,
decrease Admissions, increased
productivity for clinical
Web 2.0
Online tool that permits collaboration and
sharing online, such as facebook, twitter;
Provides education- wikis, web logs, virtual
worlds, facebook
TIGER
Technology Informatics Guiding Education
Reform
Standardized Terminology Supports
Data Mining (the practice of examining large databases in order to generate new information)
Defined as the ability to recognize when information is needed as well as the skills to find, evaluate and use needed information effectively
Information literacy
Term used to describe data that has been interpreted
Information
Focus on how to gather, process and transform information into knowledge. It also incorporates features from 5 other sciences
-communication science
-computer science
-social science
-library science
-cognitive science
Information science
Using the EHR to document care of a patient with a fractured femur is an example of using the EHR in which way
Information systems
How can using simulation technology with your patient improve overall outcomes
Allowing them hands-on practice and immediate feedback of the skill being learned
Nurses in this type of role
-are continuous learners
-use technology to support and inform nursing practice
-generate knowledge as a product
Knowledge worker
The beginner nurse is expected to fully integrate informatics throughout the course of his/her practice, not just for basic data entry and retrieval. They also know how to pull trends out of data
False, these are qualities of the experienced nurse
Nursing informatics as a specialty does not have its own certification exam
False, does have a national certification
Clinical practice guidelines can allow for the creation of nursing policies
True, rooted in evidenced based research
CPOE, bar code medication administration, and clinical decision support are all examples of what
Information technologies, not systems but functions within a system
The name used to describe the process by which the physician or provider enters orders electronically into the EHR
Computerized Physician Order Entry (CPOE)
A radio frequency identifier (RFID) is a type of technology that is used to identify and track supplies and medications within a healthcare environment
True, type of information technology
Clinical pathways and computer generated care plans are examples of how informatics can affect nursing practice
True, examples of clinical decision support
The use of technology and information to help support all aspects of nursing practice
Nursing informatics
The basis for which knowledge is used to meet the needs of the healthcare delivery system
It is derived from its 3 key elements of knowledge acquisition, knowledge processing and knowledge dissemination
The foundation of knowledge model
A patients height, weight, code status, and date of birth are all examples of what
Data, not information until it has been analyzed
Not an emerging trend in healthcare
Less consumer accountability
The purpose or reason for an organizations existence
The mission
The development of a comprehensive long range plan for guiding the activities and operations of an organization
Strategic planning, long-range
Why is it not important that selection committee board members understand software and electronic processes
They will need to be trained on the system
Strategic planning is not driven by
Short term goals, strategic planning is a long term goal
Not a national trend related to nursing informatics
Blogging
During which phase of the information life cycle should the “musts” and “wants” be determined
Needs assessment
Phases of the information life cycle
- Needs assessment phase
- System selection phase
- System implementation phase
- Maintenance phase
Term that defines the size and details of a collaborative effort
Project scope
Why is the nurses active participation in electronic information important
To ensure the information is current and accessible to the healthcare team
Responsibilities of the project implementation team
execution of system changes, active involvement in user participation, knowledge of current workflows
A common request contained in a request for information (RFI) document includes what
Company history
System implementation role
Go-live planning, applying system changes as needed, end-user training
Term that best describes the life cycle of an information system
Continuous
Examples of an essential components of the EHR
Evidence-based decision support, assessment findings, vital signs, demographic data
What is a function of the EHR
Bar-code medication administration
Benefits to using the EHR
Reduces medication errors, improves provider documentation
Example of patient support
Providing education material
One primary benefit of the EHR is a decreased wait time for diagnostic testing
False
Primary goal of EHR functionality in contrast to that of a health information system
EHR is all about promoting patient safety
Health information system
Broad term used to describe administrative and clinical systems to streamline work flow processes efficiency
Is waiting until the end of the shift to chart patient assessments a barrier to patient centered care
True, try to chart in real time
Can computer position be considered a barrier is placed between the provider and patient
True, pay attention to the patient
What potential challenge can occur when implementing an EHR in a medical center with various outpatient clinics
Standardization of data and different data needs of each clinic
What is the type of connection is needed to access the EHR when an internet connection is lost
The Local Area Network (LAN) access
Patient information included in the EHR
Immunization history, CT scan results, date of birth
How does the EHR help patients receive quality care when going from one facility to another
By providing continuity of care, interoperability
The EHR is a longitudinal electronic patient record of all health care encounters
True, carries with the patient (longitudinal)
What two items could an RN use to access a patients medication from a medication administration system (Pyxis)
Barcode ID badge, fingerprint
Type of health information system that ensures the accuracy of physician orders
Order entry system
A registration system is also commonly refereed to as
Admission, discharge, transfer (ADT) system
A group of systems used within the hospital to support and enhance healthcare
Health information systems
Why is it important to secure staff nurses active participation when implementing a health information system
The nurses knowledge of current patient care workflow may improve implementation decisions
Why are standardized terminologies important to nursing
They improve communication within the interdisciplinary team
Examples of a health information system
Laboratory system, pharmacy system, registration system
Which nursing terminology contains a nursing diagnosis, interventions and outcomes specific to the perioperative experience
Perioperative nursing data set (PNDS)
The development of standardized terminologies in nursing informatics is driven by what principles
Accessibility, ubiquity, longevity, reusability
Why is it important that departments collaborate with each other when selecting a health care system
Collaboration leads to knowledge sharing
Examples of administrative information systems
Scheduling system, financial system, admission, discharge and transfer (ADT) system
Examples of how clinical information systems are effective
The information retrieved can be used to foster research, improves nursing documentation compliance, It can improve clinician workflow
Acronym used to refer a standard of interoperability and exchange of clinical data
HL7 (Health Level 7)
Financial systems are designed to do what
Manage the expenses and revenue of providing healthcare, report and track fiscal outcomes as they relate to organizational goals, help to determine the organizations strategic direction
What potential challenge can occur when implementing an EHR in a medical center with various specialty clinics
Identifying the different data needs for each specialty practice
Characteristics of a clinical decision support tool
Takes specific patient data, analyzes it and provides recommendations (next action)
Examples of a clinical decision support tool
Computer generated care plans, alerts, smart pumps, electronic drug references
3 principles that help make up an organization culture of safety
- Commitment of resources
- Cross collaboration
- Blame free environment
Threats to data/information security
- Unauthorized personal accessing equipment
- Use of removable storage devices
2 governing authorities to protect information
- HIPPA
- ANA code of ethics
HIPPA privacy act
- Patients have ownership rights to their records
- Patients can amend own records if information is incorrect
Examples of physical and logical means of protecting information
Physical – surveillance cameras, restricted areas, hard copy records being shredded
Logical – firewall protection, biometrics, authentication, automatic sign off on computers
Telehealth (store and forward technology)
Means of transferring data or images from one location to another, most often used for pathology reports and radiology images
Driving factors for Telehealth need
Access to care (removing geographical barriers), continuity of care, mobile devices, follow up calls, more patients than providers, increase in chronic diseases
Ethical and legal implications to Telehealth
Need for extensive documentation to avoid malpractice, providers need to be licensed in every state they practice Telehealth
Clinical vs non-clinical applications of Teleheatlh
Clinical – imaging that needs to be read, mobile device to monitor patient, live video conferencing
Non-clinical – online database search, administrative team using video conferencing