How is information related to data?
Information is data that have been interpreted
Which statement describes nurses as knowledge workers?
Nurses generate knowledge as a product.
Match the level of nurse practice with appropriate skill criteria.
Beginning nurse Uses information systems to manage patients
Match the level of nurse practice with appropriate skill criteria.
Experienced nurse Pulls trends out of data
Match the level of nurse practice with appropriate skill criteria.
Informatics innovator Generates informatics theory
Match the level of nurse practice with appropriate skill criteria.
Informatics nurse specialist Focuses on nursing’s information needs
The RN who works in the area of informatics Informatics nurse
Has an interest or experience, but no formal training in informatics
Plays an active role in research and theory development
Has advanced graduate training in nursing informatics
Ensures that information is disseminated at appropriate times for appropriate uses
To promote desired clinical outcomes
A nursing informatics specialist at a small, rural hospital implemented a clinical information system utilizing an electronic health record (EHR). She obtained input from nurses regarding selection of the specific EHR. She noted that some of the nurses had negative attitudes towards a change to the EHR, but she encouraged them to try the system and note its benefits. She implemented the system after all nurses were trained about the EHR. There were numerous complaints about the EHR, which the Nursing Informatics Specialist decided to ignore since the personnel were new to the system.
Which barrier to implementing technology is present in the scenario?
A computer program was implemented at a hospital that required nurses to wait until the patient arrived in the emergency room and was registered into the program before orders for critical time-sensitive treatment could be written.
How could this program become a barrier to the nurses attempting to deliver patient-centered care?
Which national trend is related to nursing informatics?
Barcode scanning for medication administration
Which of the following requires standardized nursing terminology to meet its criteria?
What is a challenge to the adoption of eHealth strategies?
What is the importance of a nurse’s active participation in electronic patient information?
To ensure patient information will be current and accessible to the healthcare team
What are three types of clinical information systems?
Choose 3 answers
Laboratory system
Order entry system
Monitoring system
What are common features of the various health information systems?
Choose 3 answers
Admission, discharge, and transfer system
Administrative Information Systems
Radiology Information System (RIS)
Administration Information Systems
Administration Information Systems
Administration in an acute care clinic is considering adopting a health information system. A team is formed with members of clinical areas, software vendors, and an executive team of stakeholders.
Which collaborative tasks are important for this team to accomplish with regard to selecting the health information system?
Choose 3 answers
An admission nurse is awaiting notification of whether a patient being monitored by telehealth will be admitted to the hospital. The physician has already documented the admission orders in the digital medical record. Due to miscommunication, the admitting nurse did not access the digital medical record. There was a significant delay in the patient’s admission, which led to decreased patient satisfaction with the admission process.
How can the use of the digital health record improve this process?
Choose 2 answers
It prevents the delay of tests and services.
It allows for easy access to patient information.
What are the essential components of an electronic health record?
Choose 3 answers
Vital signs
Lab results
Demographics
Which function is performed within an electronic health record system?
Bar scanning medications and patients
Bar coded identification cards
A nurse is administering a new medication to a patient who has never taken this medication in the past. The patient is already taking seven different medications at this time.
Which nursing intervention should the nurse do before administering this medication?
YOUR
ANSWER CORRECT
ANSWER
Review the drug-to-drug, drug-allergy check in electronic health record
Nurses should notify a supervisor immediately when observing a breach of patient confidentiality.
To improve healthcare quality by enhancing coordination of services among providers
You are the informatics nurse at a hospital. You are running a random report evaluating users on your new electronic health record (EHR). You notice that the charge nurse from the emergency department just underwent a radical mastectomy and is recovering on the surgical floor. You then notice that four nurses from the ER have accessed this record.
What should you do?
Talk to the patient and let her know her friends care about her condition.
Talk to each nurse and explain the legal and ethical ramifications of accessing the EHR.
Explain to the patient their information has be breached.
Provide training to nurses in the emergency department about protected patient information.
35.
What represents the greatest potential threat to data security?
What are common personal data access security threats in healthcare?
Choose 2 answers
Unencrypted data
Weak passwords
Report the colleague to their employer
Computerization of prescriber order entry (CPOE)
Maintenance of active patient medication lists
What is one way that technology acts as a change agent in the nursing process?
It reduces the time spent on documentation.
A patient is in the ICU after a motorcycle accident. The patient sustained multiple contusions and fractures. Various digital monitoring devices are being used to track the patient’s vital signs, pulse oximetry, and cardiac rhythm.
How can the appropriate use of these technologies impact this patient’s outcome?
Choose 2 answers
Decreased recovery time
Timely treatment of potential complications
It provides observation and documentation of what is happening in the current environment.
What are the features of a clinical decision support tool?
Choose 3 answers
What is a function of a clinical decision support tool?
Intersecting of computer, information, and nursing science
How can clinical decision support tools lead to safer patient care?
Choose 2 answers
Use of a clinical decision support tool
Which informatics tools are commonly used for collecting and analyzing patient data?
Choose 2 answers
Which type of technology offers support during the medication administration cycle?
Viewing of the digital health record during a home health visit
Computer scan the meds and come back later to administer them
What are two common characteristics of telehealth?
Choose 2 answers
The use of video streaming technology
Transmission of biological data from a remote location
What is an important legal consideration in the use of telehealth nursing?
The nurse is licensed in each state in which the remote clients are located.
What is a prominent socioeconomic factor driving telehealth medicine?
An increase in chronic disease conditions
Which example is a telehealth non-clinical application?
Distant patient education via computer
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
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)
information literacy
the ability to recognize when information is needed as well as the skills to find, evaluate, and use needed information effectively
information
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
clinical practice guidelines
allow for the creation of nursing policies; rooted in evidenced based research
CPOE
the name used to describe the process by which the physician or provider enters orders electronically into the HER
Radio Frequency Identifier (RFID)
a type of technology that is used to identify and track supplies and medications within a healthcare environment
Nursing informatics
uses information and technology to communicate, manage knowledge, mitigate error, and support decision making
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
Strategic Planning
the development of a comprehensive, long-range plan for guiding the activities and operations of an organization
Project Scope
the size and details of a collaborative effort
Local area network (LAN) access
the type of connection needed to access the EHR when an internet connection is lost
order entry systems
this type of health information system ensures the accuracy of physician orders
Health information systems
A group of systems used within the hospital to support and enhance healthcare
Perioperative Nursing Data Set (PNDS)
Which nursing terminology contains a nursing diagnosis, interventions and outcomes specific to the perioperative experience
HL7 (Health Level 7)
Acronym used to refer a standard of interoperability and exchange of clinical data
Using the EHR to document care of a patient with a fractured femur is an example of using the EHR in which way?
Information system
How can using simulation technology with your patients improve overall outcomes?
By 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
Characteristics of an experience nurse:
Fully integrate informatics throughout the course of his/her practice, not just for basic data entry and retrieval
Know how to pull trends out of data
Characteristics of a beginner nurse:
Uses information systems to manage patients
CPOE, Barcode Medication Administration, and Clinical Decision Support are all examples of:
Information Technologies (functions within the information systems)
Clinical pathways and computer-generated care plans (examples of clinical decision support) are examples of
how informatics can affect nursing
A patient’s height, weight, code status, and date of birth are all examples of:
Data
Emerging trends in healthcare
Error reduction
A push for patient safety
Additional regulatory requirements
This is the purpose or reason for an organization’s existence
The mission
Reasons why it’s important that selection committee Board Members understand software and electronic processes:
It can affect success or failure of the project
It can impact business goals
They often determine budget allocations
Strategic planning is driven by:
Organization’s mission and values
Services offered
Long-term goals
National trends related to nursing informatics:
Barcode medication administration
CPOE
Clinical decision support tools
4 Phases of the Information system life cycle
Needs assessment phase – organization performs a gap analysis determining the “needs” and “wants” in an information system
System selection phase – Organization seeks out a vendor company that offers them a system that best fits their needs; RFI (request for information document), RFP (request for proposal), RFQ (request for quote)
System Implementation Phase – go-live planning; training of end-users; execute system changes
Maintenance Phase – problem solving/debugging; backup files; installing system upgrades
Why is the nurse’s active participation in electronic patient information important?
To ensure the information is current and accessible to the healthcare team
Responsibilities of the project implementation team:
Knowledge of current workflows
Active involvement in user participation
Execution of system changes
A common request contained in a Request for Information (RFI) document includes:
Company history
Essential component of the EHR:
Evidence-based decision support
Assessment findings
Patient demographics
Vital signs
Function of EHR
Barcode Medication Administration
Benefits to using the EHR:
Reduces medication error
Improves provider documentation
Provide patient support (patient education material such as reducing sodium intake)
Primary goal of EHR functionality in contrast to that of a health information system:
To promote patient safety
Health information systems is an umbrella term that incorporates the following:
Administrative Information Systems (Registration system, financial system, scheduling systems)
Clinical Information Systems (laboratory systems, pharmacy systems, clinical documentation systems [EHR])
Potential challenges that can occur when implementing an EHR throughout a medical center with various outpatient clinics:
Standardization of data/different data needs for each outpatient clinic
How does the EHR help patients receive quality care when going from one facility to another?
By providing continuity of care; it allows healthcare professionals to see what the patient has been receiving, thereby providing the appropriate treatment
Which 2 items could the RN use to access a patient’s meds from a med administration system such as a Pyxis?
Barcoded ID card/employee badge
Biometrics such as a fingerprint
A registration system is also commonly referred to as
an ADT system (admission, discharge, transfer)
Why is it important to secure staff nurses active participation when implementing a health information system:
Nurses’ knowledge of current patient care workflow may improve implementation decisions
Why are standardized terminologies important to nursing
They improve communication among interdisciplinary teams
The development of Standardized Terminologies in Nursing Informatics is driven by the following principles:
Accessibility
Ubiquity (can be applied and available wherever needed)
Longevity
Reusability
Why is it important that departments collaborate with one another when selecting a health information system:
Collaboration leads to knowledge sharing
Clinical information systems are effective for all of the following:
The information retrieved can be used to foster research
It can improve clinician workflow
Improves nursing documentation compliance
Financial systems are designed to:
Manage the expenses and revenue of providing healthcare
Report and track fiscal outcomes as they relate to organizational goals
Help to determine the organization’s strategic decision
What challenge might an organization face when trying to implement a health information system throughout their various specialty clinics:
Identifying the different data needs for each specialty practice
Clinical decision support examples:
Pop ups within an EHR
Computer generated care plans
Clinical based guidelines
Smart infusion pumps (have built in library; locks out when wrong calculation is entered)
Clinical pathways (very common within post-op patients)
Electronic drug references
Organization’s culture of safety:
Being a commitment of resources (organization has provided you with training, tools, technology, to properly treat patient)
Cross-collaboration (continuously collaborating with other healthcare workers; cross-monitoring [double nurse check off, like insulin])
Blame-free environment (if errors occur, we can use these as a teaching opportunity)
Information Security
Greatest threats for data security = unauthorized personnel getting access to equipment; use of removable storage devices (flash drive)
2 governing authorities that govern nurses to protect patient information
HIPAA
ANA Code of Ethics
Physical ways to protect patient information:
Surveillance cameras
Use of restricted areas
Shredding hard copies of material
Logical ways to protect patient information:
Installing firewalls
Use of biometrics (scanning fingerprints)
Authentication (user-specific passwords)
Automatic sign-off
Store and forward – used in telehealth
form of transferring data from one location to another; used a lot of times with pathology reports and radiology images
Telehealth good for
Access to care (rural areas)
Continuity of care (telemonitoring)
Ratio of patients to available providers (tele consultants)
Increase in chronic diseases (needing to be managed 24/7)
Ethical and legal implications with telehealth
Telehealth nurses need to keep extensive documentation on a visit
Nurses need to be licensed in every state that they practice telehealth
Clinical applications in telehealth:
Transmitting a chest xray to be read (store and forward technology)
Mobile device to monitor patient
Live video conferencing
Non-clinical applications in telehealth:
Research using online database
Professional development online
Administrative meeting using live video conferencing
Nursing informatics
specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, knowledge, and wisdom in nursing practice.
Informatics Nurse Specialist (INS)
is a nurse who has received educational preparation to conduct informatics research and generate informatics theory and who has a broad vision of what can be attained using information technology.
How does computer literacy differ from information literacy?
Computer literacy refers to a familiarity with the use of personal computers, while information literacy is the ability to recognize when information is needed as well as the skills to find, evaluate, and use needed information effectively.
distance learning
The delivery of content and stimulation of learning primarily through the use of telecommunication technologies and often used for corporate training.
Virtual reality
It is a widely used form of multimedia that fully envelops learners in an environment providing the next best option to performing the skill on a real person but without any risks to the learner or the client.
Computer resistance by nurses is often the result of:
Computer anxiety, limited computer skills, and poor communication on the part of administration to consult nurses during the change process.
advantage for using a nursing information system?
Advantages are:
-Better access to information.
-Reduction of medication errors.
-Better Communication.
Order entry system can do all of the following
-Alert all departments to carry out physician orders
-Provide the current status of each order
-Check duplicate orders
***Except
Integrate results of data collected at the bedside
Clinical information systems (CIS)
are used to access client data that are used to plan, implement, and evaluate care.
Statement best describes meaningful use?
This is an initiative geared to spur the adoption and use of electronic health records for the purpose of gathering and reporting data that can be used to improve population health.
Statements best reflects acceptance of the International Classification for Nursing Practice (ICNP) as a standard for nursing terminology?
Present nursing classification systems map it to a very high degree
Electronic Medical Record (EMR)
An electronic version of the client data found in the traditional paper medical record.
One criterion for eligibility for meaningful use requires the adoption and use of EHRs that have been certified. Statements best describes the certification process?
Certification provides the assurance that the EHR system has the technical capacity, functionality, and security to meet the meaningful use criteria.
Closely approximates the currents version of the personal health record (PHR)
Secure application through which an individual may access, manage and share health information he or she has entered or was supplied by providers, pharmacies, and labs
Predictors of Personal Health Records (PHRs) use include which of the following?
Awareness of PHRs, ease of access, personal motivation, higher levels of education and health literacy.
Potential barriers to Personal Health Record (PHR) use that must be considered include the following?
No or poor internet access, poorly designed applications, limited clinical integration
Statements most accurately describes evidence based practice (EBP) ?
Evidence based practice requires that decisions about healthcare be based on the best available, current, valid, and relevant evidence providing quality essential to transform healthcare.
CINAHL (Cumulative Index to Nursing and Allied Health Literature)
The primary database used for searching nursing literature.
Represents the most effective strategy for fostering evidence-based practice among staff nurses?
Provide a series of educational programs on how to search databases, critique research articles and incorporate research findings into interventions.
What is SNOMED-CT and what relevance, if any, does it have to the adoption and meaningful use of EHRs?
SNOMED-CT refers to Systematized Nomenclature of Human and Veterinary Medicine Clinical Terms, a globally recognized vocabulary that provides a common language for EHRs, that supports interoperable data collection.
What is the role of the Informatics Nurse Specialist (INS) in the adoption and use of standard terminologies?
The INS needs to play an active role on a local, national, and international level in the adoption and use of standard terminologies.
Standardized healthcare terminology is important to nursing for this reason?
Standardized terminology provides the ability to share accurate, up to date information among different providers and settings while ensuring uniform meaning and supporting the development of nursing knowledge.
The American Recovery and Reinvestment Act and Health Information Technology for Economic and Clinical Health Act were important to U.S. HIT policy for which reason?
The Department of Health and Human Services was authorized to establish programs to improve healthcare quality, safely, and efficiency through HIT inclusive of the call for health information exchange (HIE).
The TIGER initiative states that transformation of the healthcare delivery system through the development of a national health information infrastructure requires nursing leaders who understand and promote good use of HIT. Statement that represents a way that might help to create this type of leadership?
The integration and expansion of nursing informatics competencies throughout nursing programs, and nurse leadership programs in particular.
Based upon your reading, what do you see as the future areas for health information technology policy development?
Large datasets resulting from Meaningful Use and other incentives will provide increased bodies of evidence to support HIT policy decisions that weigh national as well as global implications.
Best typifies the role of the Informatics Nurse Specialist (INS) in relationship to legislation?
The INS needs to be aware of the implications of legislation for HIT design and use and to appropriately educate users.
The Health Insurance Portability and Accountability Act (HIPAA) is best known for:
created legal protection for PHI
The American Recovery and Reinvestment Act of 2009 (ARRA)
provided funds for health information technology (HIT)
Strategic Planning
The development of a comprehensive long-range plan for guiding the activities and operations of an organization.
Examples of goals of information systems strategic planning
-To enhance the organizations image
-To support business and clinical decisions
-To make effective use of emerging technologies
**Except
-to limit the need for other technologies
Benchmarking
is the continual process of measuring services and practices against the toughest competitors in the healthcare industry.
Usability is important to informatics nurse specialists for which of the following reasons?
Poor usability can lead to errors, jeopardize patient safety, and impact acceptance and use of technology.
In addition to ease of use and potential for unintended error, usability also considers which of the following?
efficiency, user satisfaction, and training issues
Well-designed systems can lead to which outcomes?
Improved information availability, displays, and interpretation
Integration
is the process by which different information systems are able to exchange data in a fashion that is seamless to the end user.
Interface
a computer program that tells two different systems how to exchange data
Health Level 7 (HL7)
A standard for the exchange of clinical data between information systems by means of an extensive set of rules that apply to all data sent.
Data Analysis
is the processing of data collected during the course of a study to identify trends and patterns of relationships.
What is the role of nursing in the adoption and use of standard terminologies?
Nursing needs to adopt standard terminologies as a means to collect data that has a uniform meaning across settings as a way to increase the body of nursing knowledge.
The Patient Protection and Affordable Care Act:
Guarantees access to healthcare for all Americans and incentives to change clinical practice to foster better coordination and quality of care.
System Security involves protection against
deliberate attacks, errors, omissions, disasters and viruses
automatic sign-off
Mechanism that logs a user off the system after a specified period of inactivity on his terminal or computer.
Confidentiality
The sharing of private information in a situation in which a relationship has been established for the purpose of treatment, or delivery of services, with the understanding that this information will remain protected.
Firewall
is a combination of hardware and software that forms a barrier between systems, or different parts of a single system to protect those systems from unauthorized access.
Remote Access
The ability to use a health enterprise’s information system from outside locations such as a physicians office is known as remote access.
What are the driving forces behind the Health Information Exchange (HIE) movement?
Federal legislation, and demand for safer, more efficient healthcare.
How do Health Information Exchanges (HIE) impact healthcare delivery?
HIEs increase the efficiency and potentially the quality of the healthcare delivery system.
What is the relationship between Health Information Exchanges (HIEs) and the EHR?
HIEs help to provide the framework needed to provide widespread data exchange and subsequently support the EHR.
The Health Information Technology for Economic and Clinical Health Act (HITECH) is best known for?
The funds and incentives it provided to increase the use of EHRs by physicians.
Changes in federal privacy and security provisions with major impacts for medical practices, hospitals, health plans, and their business associates include?
the requirement to notify individuals whose PHI has been breached within 60 days of the breach.
Implementation phase
The project timeline is established in this phase of the information system life cycle.
Implementation
A system is installed during the “implementation” phase.
Maintenance of an Information system includes all of the following:
-performing backups
-debugging
-problem solving
**except
-training
The implementation committee
Who determines the project implementation strategy.
Develop a timeline
The first task of the project implementation team.
An advantage to using super users for system training is that __.
Super users have a specialized knowledge of both the system and clinical areas.
education
The most important factor in maintaining the proper use of an Information system.
Training class content should address the following areas:
basic computer literacy, workflow, policies and human factors
Personal Health Record (PHR) use for management of chronic conditions is felt to hold great promise for which reason?
PHR may help health systems achieve greater efficiency through facilitating prescription refills, communication, and improved coordination of chronic conditions as well as quality of care.
Client engagement is considered to be critical to achieving healthcare reform. Fully functional PHRs support which of the following principles that engage clients in their own care?
Client control, individualized care based upon client needs and values, and shared knowledge with easy flow of information
Alleged benefits associated with PHRs include the following:
Improved client satisfaction, outcomes and communication with fewer telephone calls and outpatient visits
What is the basic premise underlying pay-for-performance?
Evidence-based care alone is sufficient to qualify for financial rewards.
Statements most accurately reflects what the Informatics Nurse Specialist (INS) needs to know when working with end users to purchase or design an information system relative to reimbursement of services?
Can the current system, or the system under consideration, support reimbursement requirements? Compliance deadlines? Automatic capture of charges?
Following actions on the part of the Informatics nurse best exemplifies strengthening the Meaningful use of EHR systems?
Review information system screens to ensure that Meaningful Use fields cannot be bypassed and educating end users on the need to collect data needed for Meaningful Use even though they may not view it as relevant to the client’s presenting symptoms.
Benefit of the electronic medical record
A reduction in errors and quality of communication
Order entry system
Type of system supports the nurse by automatically notifying the dietary department to hold a clients breakfast, the pharmacy to send the appropriate medications, and the radiology department to schedule the test for barium enema.
Expert
system use artificial intelligence to model a decision that experts in the field would make.
In what way can Clinical decisions support systems save healthcare dollars?
They aid in diagnosis and provide access to practice guidelines which subsequently decrease the length of hospital stays and costs for treatment.
At which point during the strategic planning process should the data be collected?
when scanning the external and internal environments
Statements best summarizes the accreditation process in healthcare?
It provides assurance to the public that the facility or program meets nationally accepted standards.
Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
Accrediting bodies focuses on the improvement of the quality of care delivered to the public, the development standards of quality in conjunction with health professionals, and encourages organizations to meet or exceed these standards through the accreditation process.
Which of the following reflect Joint Commission some of the key points for information management standards for healthcare organizations?
Both of the above
The Joint Commission continues to add standards that impact the design and use of information systems. The following represent example of some of these requirements:
Uniform data sets throughout a healthcare delivery system and medication reconciliation updates upon admission, transfer, and discharge.
What role, if any, does Information technology have in Magnet journey?
Information systems support the process by providing aggregate data related to quality improvement.
Telehealth differs from telemedicine in that __.
Telehealth encompasses telemedicine, but is a broader term that emphasizes the provision of information to health care providers and consumers.
Tele or videoconferencing
Used as a tool to facilitate the delivery of telehealth services.
Issues associated with the practice of telehealth and telenursing?
Lack of reimbursement, privacy and confidentiality concerns, licensure and liability issues.
Example of a low-tech telehealth application?
A home glucose monitoring program that uses a touch tone phone to report glucose results.
Might be considered to be advantages for consumers associated with the delivery of healthcare services via telehealth?
increase access to otherwise underserved populations, decreased travel time and costs, and access to services for consumers who are “on the road”
Telenursing
is the use of telecommunications and computer technology for the delivery of nursing care.
How is Information related to data?
Information is data that have been interpreted
How does Information literacy support the use of evidence based practice (EBP) in nursing?
-The nurse can discern research findings that can be applied to practice.
-nurses must frequently consult resources including peers and general internet searches.
Information system
A nurse documents a care of a patient with a decubitus ulcer in the electronic health record. This term describes the electronic health record in this situation.
Statement describes nurses as knowledge workers?
Nurse generate knowledge as a product
Beginning nurse vs Experienced nurse
Beginning nurse, uses information systems to manage patients.
Experienced nurse, pulls trends out of data
** Informatics innovator – generates Informatics theory
** Informatics nurse specialist – focuses on nursings information needs
Informatics nurse vs. Informatics nurse specialist
Informatics nurse:
-RN who works in the area of informatics
-Has an interest or experience, but no formal training in informatics
-Ensures that information is disseminated at appropriate times for appropriate uses
Informatics nurse specialist:
-Plays an active role in research and theory development
-Has advanced graduate training in nursing informatics
Data mining
Uses database applications to sift through large amounts of data and looks for previously hidden trends.
A nurse is reviewing a patient’s pneumonia vaccination status in the electronic medical record. The nurse determines the patient needs this vaccine before discharge to meet the requirements of a current clinical pathway. Why would the nurse use Information systems in this manner?
To promote desired clinical outcomes
A nursing Informatics specialist at a small, rural hospital implemented a clinical information system utilizing and electronic health record (EHR). She obtained input from nurses regarding selection of the specific EHR. She noted that some of the nurses had negative attitudes towards a change to the EHR, but she encouraged them to try the system and note its benefits. She implemented the system after all nurses were trained about the EHR. There were numerous complaints about the EHR, which the Nursing Informatics Specialist decided to ignore since the personnel were new to the system.
Which barrier to implementing technology is present in the scenario?
Lack of continued support
A computer program was implemented at a hospital that required nurses to wait until the patient arrived in the emergency room and was registered into the program before orders for critical time-sensitive treatment could be written.
How could this program become a barrier to the nurses attempting to deliver patient-centered care?
The time spent waiting for the program to register the patient could delay critical care being delivered in a timely manner.
Which national trend is related to nursing informatics?
Barcode scanning for medication administration
ICNP
Standardized nursing terminology is composed of nursing diagnoses, nursing actions, and nursing outcomes
Meaningful Use
Requires standardized nursing terminology to meet its criteria
What is a challenge to the adoption of eHealth strategies?
Creating economic incentives and policies that providers view as essential to accomplishing their financial and professional goals.
What is the importance of a nurse’s active participation in electronic patient information?
To ensure patient information will be current and accessible to the healthcare team.
A nurse is working on a medical surgical unit and is concerned over a patient’s worsening heart failure. The nurse calls the provider to discuss the assessments.
How does the electronic medical record facilitate a collaborative discussion in this situation?
-The provider can visualize the chest xray remotely
-The provider has access to the data being discussed
3 types of clinical information systems
Laboratory system, Order entry system, and Monitoring system
Common features of the various health information systems?
-Creates a comprehensive record of the patient’s medical history
-Is unique in the way they function and provide information to clinicians
-Collects processes and distributes patient centered data to manage and provide care.
Administrative Information Systems vs. Clinical Information Systems
Administrative Information Systems:
-Admission, discharge, and transfer system
-Financial system
-Scheduling system
Clinical Information Systems:
-Radiology Information system
-Clinical documentation system
Registration system
Health information system is used to collect and store client identification and demographic data that are verified and updated at the time of each visit.
Administration in an acute care clinic is considering adopting a health information system. A team is formed with members of clinical areas, software vendors, and an executive team of stakeholders.
Which collaborative tasks are important for this team to accomplish with regard to selecting the health information system?
-Determine who will be accountable for the project
-Determine how resources will be allocated to support the system
-Assess potential for process improvement while using the system
An admission nurse is awaiting notification of whether a patient being monitored by telehealth will be admitted to the hospital. The physician has already documented the admission orders in the digital medical record. Due to miscommunication, the admitting nurse did not access the digital medical record. There was a significant delay in the patient’s admission, which led to decreased patient satisfaction with the admission process.
How can the use of the digital health record improve this process?
-It prevents the delay of tests and services.
-It allows for easy access to patient information.
Essential components of an electronic health record.
Vital signs, lab results, Demographics
Function is performed within an electronic health record system.
Bar scanning medications and patients
What can a nurse, working in a hospital, use to access a patient’s electronic health record and prescription drugs from a medication administration system?
Bar coded identification cards
Electronic Health Record (EHR)
mechanism is used to streamline caregivers workflow that needs to include past medical history, patient demographics, immunizations, and medication history
Benefits of using an electronic health record (EHR) system in an ambulatory care clinic?
-Decrease medication errors
-Increase clinic reimbursement
-Improve provider documentation
-Increase delivery of guideline based care
A local medical clinic is attempting to develop an electronic health record (EHR) system.
Which challenges should the organization anticipate?
-Identifying data needs for differing nursing practice specialties
-Implementing standardization of documentation across physician offices
A nurse is administering a new medication to a patient who has never taken this medication in the past. The patient is already taking seven different medications at this time.
What nursing intervention should the nurse do before administering this medication?
Review the drug-to-drug-allergy check in electronic health record.
Classify the mechanism as either physical or logical security measures for protecting electronic information.
Physical:
-Placing computers, servers and routers in restricted
-Setting up surveillance
Logical:
-Authentication
-Installing a firewall
-Automatic sign-off
Statement represents one of the principle provisions of the Health Information Portability and Accountability Act (HIPAA) related to information security?
Nurses should notify a supervisor immediately when observing a breach of patient confidentiality.
What is a principle provision of the Health Information Technology for Economic and Clinical Health (HITECH) Act?
To improve healthcare quality by enhancing coordination of services among providers
You are a nurse manager at a hospital. The Informatics department at the hospital has established a no flash drive policy. In addition, all patient files must be saved on the secure O:drive.
What would be an appropriate way to describe these changes to your staff?
-The hospital is implementing a security program to prevent patient data for being compromised.
-The hospital is eliminating the need for flash drives to prevent the loss of sensitive data.
You are the Informatics nurse at a hospital. You are running a random report evaluating users on your new electronic health record (EHR). You notice that the charge nurse from the emergency department just underwent a radical mastectomy and is recovering on the surgical floor. You then notice that four nurses from the ER have accessed this record.
What should you do?
-Talk to each nurse and explain the legal and ethical ramifications of accessing the EHR.
-Explain to the patient their information has be breached.
-Provide training to nurses in the ER department about protected patient information.
Integrity
In regards to a secure network, it gives employees confidence that the information they are reading is true.
Represents the greatest potential threat to data security.
Removable storage device
Common personal data access security threats in healthcare?
Unencrypted data and weak passwords
A nurse learns that a colleague has accessed electronically stored health information of a patient that the colleague is not involved in treating. What should the nurse do?
Report the colleague to their employer
How does meaningful use of electronic health records (EHR) relate to quality patient care?
-Computerization of prescriber order entry (CPOE)
-Maintenance of active patient medication lists
One way that technology acts as a change agent in the nursing process?
It reduces the time spent on documentation.
A patient is in the ICU after a motorcycle accident. The patient sustained multiple contusions and fractures. Various digital monitoring devices are being used to track the patient’s vital signs, pulse oximetry, and cardiac rhythm.
How can the appropriate use of these technologies impact this patient’s outcome?
-Decreased Recovery time
-Timely treatment of potential complications
A nurse manager identifies several advanced practice nurses at an ICU workstation responding to multiple patient alarms. She notices that the acuity of one patient drastically increases the demand for staff resources.
How can workflow analysis impact practice in this situation?
It provides observation and documentation of what is happening in the current environment.
What are the features of a clinical decision support tool?
-Provides practice guidelines
-Delivers online Information retrieval
-Issues computerized alerts and reminders
What is a function of a clinical decision support tool?
Providing clinicians with knowledge and person-specific information.
How can clinical decision support tools lead to safer patient care?
-They give timely information to nurses and other healthcare providers.
-They reduce waste of nurse’s time looking through the medical record.
A nurse receives a computerized alert of a critical lab value on her patient. This computerized alert informs the nurse that an action needs to be taken and provides suggestions for clinical intervention.
Which technology did the nurse employ to achieve an enhanced safe practice environment?
Use of a clinical decision support tool
During a crisis, a nurse manager is looking for the written, hospital-wide procedural policy. The nurse is unable to locate it.
What can the nurse manager use to solve this issue?
Decision support tools
Which procedures are essential to creating and maintaining a culture of safety during the medication administration cycle?
-Performing double verification among nurses when administering high alert medications
-Barcode scanning the patient and the medication to ensure positive patient ID
Which informatics tools are commonly used for collecting and analyzing patient data?
PDAs
Bedside computers
Type of technology offers support during medication administration cycle?
Viewing of the digital health record during a home health visit
A student is behind on morning medication administration. The instructor is pressuring the student to pass quickly without any errors. One of the clients assigned to the student’s care asks for pain medication.
Which nursing intervention is questionable?
Computer scan the meds and come back later to administer them.
**Not questionable
-Call the charge nurse for assistance
-Double check dose of pain medication with another nurse
-Use PDA to look up rate of infusion for intravenous pain medication
Statements by the nurse demonstrate understanding of the reason for a clinical information system?
-The Information retrieved can be used for research
-It improves compliance with nursing documentation.
A nurse uses an internet blog to give a patient shift report to a nurse coming on the next shift.
Why is this nursing action a problem?
-Giving a nursing report via blog does not meet HIPAA requirements
-Healthcare Information discussed on the blog violates a patient’s privacy.
A nurse manager views patient data collected over the last three months of hospital admissions. Trends show that nosocomial infections have increased on the geriatric unit.
What actions can patient data facilitate quality improvement in the future?
-Using the data to implement evidence based practice procedures
-Using the data to monitor infection trends
Two common characteristics of telehealth?
-The use of video streaming technology
-Transmission of biological data from a remote location
What is an important legal consideration in the use of telehealth nursing?
The nurse is licensed in each state in which the remote clients are located.
What is prominent socioeconomic factor driving telehealth medicine?
An increase in chronic disease conditions
example is a telehealth non-clinical application.
Distant patient education via computer
Telecommunication strategy.
An elderly homebound patient is concerned about the palpitations she is feeling. (Real-time remote monitoring)
A family member is unsure what to do for a home hospice patient who is restless and agitated during the night. (Real-time remote monitoring)
A nurse is struggling to work full time in a hospital setting time while completing her Masters (Online classroom)
A cardiologist with a rural office practice has no one to cover his patient’s when he is away. (Teleconsultants)
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 System
Using EHR to document a care for a patient with a fractured femur is an example of using the EHR in what way?
basically just charting and inputting data is what information system
How can using simulation technology with your patients improve the overall outcomes?
Allowing hands on practice and immediate feedback of the skills being learned.
Knowledge workers
-are continuous learners
-use technology to support and inform nursing practice
-“Generate knowledge as a product”
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
Beginner nurse
uses information systems to manage patients
False
Nursing informatics as a specialty currently does NOT have its own certification exam
True
Clinical Practice Guidelines can allow for the creation of nursing policies.
CPOE, Barcodes Medication Administration, and Clinical Decision Support are all examples of what?
Information technologies
CPOE (Computerized Physician Order Entry)
Name used to describe the process by which the physician or providers 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.
True
Clinical Pathways and computer- generated care plans are examples of how informatics can affect nursing practice.
both are examples of clinical decision support *
Nursing informatics
The use of technology and information to help support all aspects of nursing practice
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
Patient’s height, weight, code status, and date of birth are examples of data
Which is NOT an emerging trend in healthcare
Less consumer accountability
**are emerging trend
-a push for patient safety
-error reduction
-additional regulatory requirements
The mission
The purpose or reason of a organization’s existence
Strategic Planning
This is the development of a comprehensive “long range” plan for quiding the activities and operations of an organizations
Reason why its important that selection committee board members understand software and electronic processes
-It can affect the success and failure of the project
-They often determines budget allocations
-it can impact business goals
**NOT
-they will need to become traines on the system
Strategy Planning is driven by all of the following
-Organizations mission and values
-Services offered
-Long term goals
**except
-short term goals
needs assessment
During which phase of the information life cycle should the “musts” and “wants” be determined
Project Scope
Term that defines the size and details of a collaborative effort
Why is the nurse active participation in electronic patient information?
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
Phases Information system cycle
Needs Assessment Phase
System Selection Phase
System Implementation Phase
Maintenance Phase
A common request contained in a request for information (RFI) document includes what
company history
Role of System Implementation Phase
Go live planning
Training of End Users
Execute system changes
Which term best applies when describing the life cycle of an Information system
Continuous
CPOE (Computerized Physician Order Entry)
Process by which the physician or provider enters orders into the EHR
Evidenced based decision support
Essential component of EHR
Essential component of EHR
Assessment findings
Patients demographics
Vital signs
Barcode Medication Administration (BCMA)
Function of EHR
Benefits in using EHR
Reduces medication errors, improves provider documentation
A benefit of EHR is that it can provide patient support. Example of a patient support
Patient education material such as reducing sodium intake
False
Primary benefit of EHR is a decrease in wait time for diagnostic testing
What is the primary goal of EHR functionality in contrast to that health information system?
To promote patients safety
True
Waiting until the end of the shift to document your patient assessment into the EHR could be considered a barrier to patient centered care
True
The position of the computer can be seen as potential barrier if it constricts the view between patient and healthcare provider.
What is the potential challenge can occur when Implementing an EHR throughout the medical center with various outpatient clinics
Standardization of data/different data needs for each outpatient clinic
Local Area Network (LAN) Access
What is the type of connection is needed to access the EHR when an internet connection is lost
How does the EHR help patients receive quality care when going from one facility to another
By providing continuity of care, interoperability
True
The electronic health record (EHR) is a longitudinal electronic patient record of all healthcare encounters
Which 2 items could the RN use to access patient’s medications from a med administration system such as pyxis
Barcoded ID or employee badge,
Biometrics such as fingerprints
order entry systems
Type of health information system ensures the accuracy of physician orders
A registration system is also commonly refereed to as
admission/discharge/transfer (ADT) system
Health information system
A group of systems used within a hospital that support and enhance healthcare
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 Health information system
Laboratory system, pharmacy system, registration system
Perioperative Nursing data set (PNDS)
nursing terminology contains nursing diagnosis, interventions and outcomes specific to perioperative experience
Accessibility, ubiquity, longevity, and reusability
The development of Standardized Terminologies in nursing informatics is driven by the following principles
Why is it important that departments is collaborate with one another when selecting a health information system?
Collaboration leads to knowledge sharing
Examples of administrative Information system
Scheduling system
Financial system
Admission Discharge and Transfer (ADT)
Clinical Information Systems are effective for all of the following reasons
-The Information retrieved can be used to foster research
-Improves Nursing documentation compliance
-it can improve clinician workflows
Health Level 7 (HL7)
The acronym used to refer a standard of interoperability and the 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
What challenge might an organization face when trying to implement a health information system throughout their various specialty clinics?
Identifying the different data needs for each specialty practice
Information literacy
the ability to figure out the type of information you need, find that information, evaluate it, and properly use it
Informatics
“The big oak tree”
combination of the nursing science,
computer science and information science.
It includes information technologies that can help support nursing practice.
Information technology
“The branch”
electronic healthcare record, your clinical decisions support tools, bar code medication administration, and so on.
information System
“Another branch” : used to collect, create and distribute useful data.
This term describes the development, use and management of an organization’s overall IT infrastructure.
On that branch you would see the subcategories, such as your clinical information systems,
your core business systems, case management systems, and communication systems.
Information Science
“the roots of informatics “
-incorporates features from communication science, computer science, social science, library science, and cognitive science.
It’s primary focus on the input, processing, output and feedback through technology integration.
Information science applies technology to make information usable, and it supports the overall collection and management of information.
Technology has also helped to impact this culture of safety
1) CPOE
2) Cross monitoring: 2 nurses to witness a med/electronic alert
Examples of Clinical Decision support tools
- Electronic alerts and reminders
- Clinical practice guidelines
- Computer-generated care plan
- Smart pumps
- EHR: drug reference guide
- Clinical pathways
Information Security
greatest potential threats are right now:
- unauthorized personnel getting access to the equipment.
- the use of removable storage devices (flash drive to dl info)
2 governing authorities that obligate nurses to protect patient information?
HIPPA (pt’s can have a copy of their record/make corrections)
ANA Code of Ethics
Examples of Logically Protecting pt’s information
installing **Firewall protection
Biometrics (scanning fingerprint)
Authentication (user specific password)
Automatic sign offs
Examples of physically protecting pt’s info
Surveillance Cameras
Restricted Areas
Shredding hard copies
three principles that help to make up an organization culture as safety
1) Commitment of resources
2) Cross-collaboration
3) Blame-free environment
store and forward technology.
a form of transferring data or images from one location to another (radiology images, pathology reports)
Reasoning of Growth of telehealth
- access to care
- continuity of care
- ratio of patients to providers
- increase in chronic disease
EHR Takes patient-specific info:
- Recommends something (example: recheck BP)
**2. Compares it against set of rules or knowledge base
Legal and ethical of telehealth nursing
- Extensive documentation (prevent malpractice)
- Licensed in every state that they practice telehealth
Identify Clinical vs. non-clinical telehealth
Clinical: to directly affect care of pt
-(ex: chest x-ray)
-type of mobile device
-live video conferencing (check proper injection administration)
Non-clinical:
- Team meeting
- Research
- Video-conferencing (not used for pt)
-professional development online
There are two main approaches to the development of these information systems:
1) Nursing Process Approach (admission/dc, progress notes, data collection, safe med admin..)
2) Critical Pathway/Protocols: allows nurses and multidisciplinary team members to access the relevant information in the system
Nursing Process Approach
-Streamlines documentation of assessments and patient-related data.
-Provides discharge information and pertinent patient education materials and resources.
-Provides medication information to help prevent medication errors or interactions.
Critical Pathways/Protocols Approach
-Physician’s orders are present for the multidisciplinary care team to observe and follow.
-Allows the multidisciplinary care team to update the plan of care when variances in the patient’s condition are noted.
-Multidisciplinary team members can contribute to care plans along the care continuum.
What are three types of clinical information systems?
(in critical pathways approach)
Monitoring system
Order entry system
Laboratory system
Definition of Nursing informatics
The integration of nursing science, computer science, and information science to manage and communicate data, information, knowledge, and wisdom into nursing practice
Informatics Nurse Specialist (INS)
a nurse who has received educational preparation to conduct informatics research and generate informatics theory and who has a broad vision of what can be attained using information technology.
How does computer literacy differ from information literacy?
Computer literacy: familiarity with the use of personal computers
information literacy: ability to recognize when info is needed as well as the skills to find, evaluate, and use needed information effectively
distance learning
The delivery of content and stimulation of learning primarily through the use of telecommunication technologies and often used for corporate training
virtual reality
It is a widely used form of multimedia that fully envelops learners in an environment providing the next best option to performing the skill on a real person but without any risks to the learner or the client
Computer resistance by nurses is often the result of which of the following?
computer anxiety, limited computer skills, and poor communication on the part of administration to consult nurses during the change process
An order entry system can do all of the following except
Integrate results of data collected at the bedside
Clinical information systems (CIS)
are used to access client data that are used to plan, implement, and evaluate care.
meaningful use
This is an initiative geared to spur the adoption and use of electronic health records for the purpose of gathering and reporting data that can then be used to improve population health.
Which of the following statements best reflects acceptance of the International Classification for Nursing Practice (ICNP®) as a standard for nursing terminology?
Present nursing classification systems map it to a very high degree.
electronic medical record (EMR)
An electronic version of the client data found in the traditional paper medical record
One criterion for eligibility for meaningful use requires the adoption and use of EHRs that have been certified. Certification process:
Certification provides the assurance that the EHR system has the technical capacity, functionality, and security to meet the meaningful use criteria.
Which of the following most closely approximates the current version of the personal health record (PHR)?
Secure application through which an individual may access, manage and share health information he or she has entered or was supplied by providers, pharmacies, and labs.
Predictors of Personal Health Records (PHRs) use include which of the following?
Awareness of PHRs, ease of access, personal motivation, higher levels of education and health literacy
Potential barriers to Personal Health Record (PHR) use that must be considered include the following:
No or poor Internet access, poorly designed applications, limited clinical integration
Which of the following statements most accurately describes evidence-based practice (EBP)?
EBP requires that decisions about healthcare be based on the best available, current, valid and relevant evidence providing quality essential to transform healthcare.
Which of the following represents the most effective strategy for fostering evidence-based practice among staff nurses?
provide a series of educational programs on how to search databases, critique research articles and incorporate research findings into interventions
SNOMED-CT: Systematized Nomenclature of Human and Veterinary Medicine Clinical Terms
a globally recognized vocabulary that provides a common language for EHRs, that supports interoperable data collection.
What is the role of the Informatics Nurse Specialist (INS) in the adoption and use of standard terminologies?
The INS needs to play an active role on a local, national, and international level in the adoption and use of standard terminologies.
Standardized healthcare terminology is important to nursing for which of the following reasons?
provides the ability to share accurate, up-to-date information among different providers and settings while ensuring uniform meaning and supporting the development of nursing knowledge.
The American Recovery and Reinvestment Act and Health Information Technology for Economic and Clinical Health Act were important to U.S. HIT policy for which of the following reasons?
The Department of Health and Human Services was authorized to establish programs to improve healthcare quality, safety, and efficiency through HIT inclusive of the call for health information exchange (HIE).
The TIGER initiative states that transformation of the healthcare delivery system through the development of a national health information infrastructure requires nursing leaders who understand and promote good use of HIT. Which of the following represents a way that might help to create this type of leadership?
the integration and expansion of nursing informatics competencies throughout nursing programs, and nurse leadership programs in particular
The Health Insurance Portability and Accountability Act (HIPAA) is best known for which of the following?
created legal protection for PHI
strategic planning
The development of a comprehensive long-range plan for guiding the activities and operations of an organization is _.
All of the following are examples of goals of information systems strategic planning except _.
to limit the need for other technologies
Usability is important to informatics nurse specialists for which of the following reasons?
Poor usability can lead to errors, jeopardize patient safety, and impact acceptance and use of technology
In addition to ease of use and potential for unintended error, usability also considers which of the following?
efficiency, user satisfaction, and training issues
Well-designed systems can lead to which of the following outcomes?
improved information availability, displays, and interpretation
Integration
the process by which different information systems are able to exchange data in a fashion that is seamless to the end user.
interface
A computer program that tells two different systems how to exchange data
Data analysis
the processing of data collected during the course of a study to identify trends and patterns of relationships.
What is the role of nursing in the adoption and use of standard terminologies?
Nursing needs to adopt standard terminologies as a means to collect data that has a uniform meaning across settings as a way to increase the body of nursing knowledge.
The Patient Protection and Affordable Care Act
guarantees access to healthcare for all Americans and incentives to change clinical practice to foster better coordination and quality of care
System security involves protection against
deliberate attacks, errors, omissions, disasters and viruses
automatic sign-off
a mechanism that logs a user off the system after a specified period of inactivity on his terminal or computer?
confidentiality
The sharing of private information in a situation in which a relationship has been established for the purpose of treatment, or delivery of services, with the understanding that this information will remain protected is __.
Firewall
is a combination of hardware and software that forms a barrier between systems, or different parts of a single system to protect those systems from unauthorized access.
remote access
The ability to use a health enterprise’s information system from outside locations such as a physician’s office
What are the driving forces behind the Health Information Exchange (HIE) movement?
federal legislation, and demands for safer, more efficient healthcare
How do Health Information Exchanges (HIEs) impact healthcare delivery?
HIEs increase the efficiency and potentially the quality of the healthcare delivery system.
What is the relationship between Health Information Exchanges (HIEs) and the EHR?
HIEs help to provide the framework needed to provide widespread data exchange and subsequently support the EHR.
The Health Information Technology for Economic and Clinical Health Act (HITECH) is best known for which of the following?
The funds and incentives it provided to increase the use of EHRs by physicians.
Changes in federal privacy and security provisions with major impacts for medical practices, hospitals, health plans, and their business associates include which of the following?
the requirement to notify individuals whose PHI has been breached within 60 days of the breach
Training class content should address the following area(s):
basic computer literacy, workflow, policies and human factors
Personal Health Record (PHR) use for management of chronic conditions is felt to hold great promise for which of the following reasons?
PHRs may help health systems achieve greater efficiency through facilitating prescription refills, communication, and improved coordination of chronic conditions as well as quality of care.
Client engagement is considered to be critical to achieving healthcare reform. Fully functional PHRs support which of the following principles that engage clients in their own care?
Client control, individualized care based upon client needs and values, and shared knowledge with easy flow of information
Alleged benefits associated with PHRs include the following:
Improved client satisfaction, outcomes and communication with fewer telephone calls and outpatient visits
What is the basic premise underlying pay-for-performance?
Evidence-based care alone is sufficient to qualify for financial rewards.
Which of the following statements most accurately reflects what the Informatics Nurse Specialist (INS) needs to know when working with end users to purchase or design an information system relative to reimbursement of services?
Can the current system, or the system under consideration, support reimbursement requirements? Compliance deadlines? Automatic capture of charges?
actions on the part of the informatics nurse best exemplifies strengthening the Meaningful Use of EHR systems
review of information system screens to ensure that Meaningful Use fields cannot be bypassed and educating end users on the need to collect data needed for Meaningful Use even though they may not view it as relevant to the client’s presenting symptoms
A benefit of the electronic medical record
Improved access to information
Order entry system
system supports the nurse by automatically notifying the dietary department to hold a client’s breakfast, the pharmacy to send the appropriate medications, and the radiology department to schedule the test for a barium enema
Expert Systems
use artificial intelligence to model a decision that experts in the field would make.
In what way can clinical decision support systems save healthcare dollars?
They aid in diagnosis and provide access to practice guidelines which subsequently decrease the length of hospital stays and costs for treatment
At which point during the strategic planning process should the data be collected?
when scanning the external and internal environments
Which of the following statements best summarizes the accreditation process in healthcare?
It provides assurance to the public that the facility or program meets nationally accepted standards.
Telehealth vs telemedicine
telehealth encompasses telemedicine, but is a broader term that emphasizes the provision of information to health care providers and consumers
Which of the following can be used as a tool to facilitate the delivery of telehealth services?
Tele- or videoconferencing
issues with telehealth and telenursing?
Lack of reimbursement
privacy and confidentiality concerns
licensure and liability issues
example of a low-tech telehealth application?
a home glucose-monitoring program that uses a touch-tone phone to report glucose results
advantages for consumers associated with the delivery of healthcare services via telehealth?
increased access to otherwise underserved populations
decreased travel time and costs
access to services for consumers who are “on the road”
Telenursing
the use of telecommunications and computer technology for the delivery of nursing care
Information literacy
the ability to recognize when info is needed as well as the skills to find, evaluate, and use needed info effectively
Information
data that has been interpreted
Information Science
focus on how to gather process and transform info into knowledge. It also incorporates features from those 5 other sciences:
- communication science
- computer science
- social science
- library science
- cognitive science
Example of using the EHR to document care of a pt with a fractured femur
Information System
how can using simulation technology with your pts improve overall outcomes?
using assimilation technology allows hands on practice
Knowledge Workers
-continuous learners & specialist in their field
-use technology to support and inform nursing practice
**generate knowledge as a practice
-has advanced formal education
-generates knowledge as a product
-can apply theoretical & analytical knowledge
Experienced Nurse
-know how to pull trends out of data
-fully integrates informatics throughout the course of her practice
Nursing Informatics as a specialty has its own certification exam
Clinical practice guidelines can allow for the creations of nursing policies
Examples of Information Technologies
CPOE, Barcode Medication Administration, and clinical decision
What is the name used to describe the process by which the MD enters orders electronically into the EHR
CPOE Computerized Physician Order Entry
A Radio Frequency Indentifier (RFID)
is a type of technology that is used to id and track supplies & meds within a healthcare environment. (even track pt location)
Clinical pathways and computer generated care plans are examples of how informatics can affect nursing practice
Nursing Informatics
the use of technology and info 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
examples of DATA
the pt’s height, weight, code status, date of birth
Emerging trends in healthcare
-Push for pt safety
- error reduction
-additional regulatory requirements
The Mission
The purpose or reason for an organization’s existence
Strategic Planning
the development of a comprehensive long range plan for guiding the activities and operations of an organization
Strategic planning is driven by
-organization’s mission and values
-services offered
-long term goals
Why it’s important that selection committee Board Members understand software & electronic processes.
-it can affect success or failure of the project
-they often determine budget allocations
-it can impact business goals
A National Trend r/t nursing informatics
-Computerized Physican Order Entry
-Barcode Medication Administration
-Clinical decision support tools
4 Phases of Information System Life Cycle
1) Needs Assessment : gap analysis (needs & wants)
2) System Selection Phase: seeks out a vender company that provides them a system
Three documents used:
- REQUEST FOR INFORMATION (RFI): Get info about the company history
- REQUEST FOR PROPOSAL (RFP): prioritize their needs. Do you have this?
- REQUEST FOR QUOTE (RFQ): Pricing
3) System Implementation Phase :
Training staff
Go Live Planning
End user training
Applying system changes as needed
4) Maintenance Phase: Problem Solving, debugging, files are backed up, system upgrade installation
Description of Information System Life Cycle
Continuous
Project Scope
defines the size & details of a collaborative effort
Responsibilities of Project Implementation Team
-Execution of system changes
-active involvement in user participation
-knowledge of current workflows
CPOE- computerized physician order entry
the Provider enters orders electronically into the EHR
Function of EHR
Barcode Medication Administration
Benefits of using EHR
-reduces medication error
-improves provider documentation
-provide patient support (providing pt education)
Primary Goal of EHR in contrast of healthy information system?
EHR is about promoting Patient Safety
Health info system: A group of systems: enhancing the healthcare organization.
Health Information System (HIS) 2 categories
1) Administrative Information System : registration (admission, discharge, transfer) scheduling, financial
2) Clinical Information System : labs, clinical documentation (EHR), pharmacy
Local Area Network (LAN) Access
a type of connection needed to access EHR when the internet connection is lost
Order Entry System
ensures the accuracy of physician orders.
a registration system, also commonly referred to is which of the following?
ADT system (Admission, discharge, transfer system)
why are standardized terminologies important to nursing?
improve communication among interdisciplinary teams
the development of standardized terminologies
in nursing informatics is driven by the following principle.
accessibility, ubiquity (applied wherever), longevity and reusability (useful for a range of things)
why is it important that departments collaborate with one another when selecting a health information system
Collaboration leads to knowledge hearing
Expert System
a type of decision support system that implements the knowledge of one or more human experts without human intervention.
-Ex: insulin pump, xray, MRI, chest xray
Decision support systems can also be referred to as clinical decision support
EXAMPLES:
-abnormal vital signs = early warning score (EWS)
-gathering cumulative data (CBC, lactic levels = asepsis protocol)
-based off of evidence-based medicine so it relays the best and the most up-to-date information
-computer applications design to facilitate human decision-making processes.
-Decision support systems develop “what if” models in order to analyze the options or choices and then provide alternatives.
- act as preventative reminders for things such as vaccinations, house screening and clinical guidelines for disease treatment.
-Can ensure the 5 rights are implemented
(check drug to drug, allergies
Knowledge Work
non-repetitive, non-routine work that entails a significant amount of cognitive activity.
Ex: interpreting trends in your labs or in patient’s symptoms.
Non-knowledge work examples
calling the lab to check on the results or making up with patient at bed.
Knowledge Worker Roles
The Data Gatherer: collects data & documents findings
The Information User : interpret the data that they have collected and recorded. (pt’s bp is high or pain)
The Knowledge User: compares the data with nursing knowledge
The Knowledge Builder: start to examining clinical data that shows patterns across patients. And then that info starts to create new knowledge.
-when nurses take their longitudinal data & offer pt care suggestions
Different stages of nursing
1) Novice Nurse:
-basic computer skills
-use information systems to manage their pt
-access data and chart electronically
-they support pt’s safety initiatives using information technology
-recognize the role of informatics in nursing.
2) Experience Nurse:
expected to more fully integrate informatics throughout the course of her practice, not just for basic data entry and retrieval
- pull trends out of data.
-supports their specialty area including quality improvement and other activities.
-use evidenced-based databases,
-promote technology applications, they use information systems, and they work with the IT staff to enact system improvements.
3) Informatics Nurse
- proficient with informatics applications to support all areas in nursing practice.
-demonstrate critical thinking, data management, decision making, and system development and computer skills.
-can identify and provide data for decision making.
Information Management
seeks to provide safe patient care through managing patient-related information to ensure that it contains the latest data, is correct, and is readily available to providers.
Knowledge Management
seeks to improve the quality of care an organization provides through knowledge and educational information storage.
Nursing Information System
assist nurses in providing high-quality patient care by giving them access to pertinent patient care information and providing the opportunity to document patient assessments, care provided, procedures performed, and medications given. Data can be collected and stored electronically and is available to other members of the multidisciplinary team.
The Technology Informatics Guiding Education Reform Initiative (TIGER)
calls for nursing education to keep up with rapidly changing technology and encourages nurses’ active participation in the development of electronic records
The Quality and Safety Education in Nursing (QSEN)
project’s six competencies are patient-centered care, cooperation, evidence-based practice, quality improvement, safety, and informatics. Including informatics as a core competency has led to its increasing importance.
nursing terminology