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?
Choose 2 answers
The nurse can discern research findings that can be applied to practice
Nurses must frequently consult resources including peers and general internet searches
A nurse documents care of a patient with a decubitus ulcer in the electronic health record.
Which term describes the electronic health record in his situation?
Information system
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
Informatics nurse
Has an interest or experience, but no formal training in informatics
Informatics nurse
Plays an active role in research and theory development
Informatics nurse specialist
Has advanced graduate training in nursing informatics
Informatics nurse speicalist
Ensures that information is disseminated at appropriate times for appropriate uses
Informatics nurse
Which of the following uses database applications to sift through large amounts of data and looks for previously hidden trends?
Data mining
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 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?
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
Which standardized nursing terminology is composed of nursing diagnoses, nursing actions, and nursing outcomes?
ICNP
Which of the following requires standardized nursing terminology to meet its criteria?
Meaningful Use
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?
Choose 2 answers
The provider can visualize the chest x-ray remotely.
The provider has access to the data being discussed.
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
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
Admission, discharge, and transfer system
Administrative Information Systems
Radiology Information System (RIS)
Clinical Information Systems
financial system
Administration Information Systems
Clinical documentation system
Clinical Information Systems
scheduling system
Administration Information Systems
Which 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?
Registration system
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
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?
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
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
Which mechanism is used to streamline caregivers’ workflow that needs to include past medical history, patient demographics, immunizations, and medication history?
Electronic health record
What are some benefits of using an electronic health record (EHR) system in an ambulatory care clinic?
Choose 4 answers
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?
Choose 2 answers
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.
Which nursing intervention should the nurse do before administering this medication?
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
Which 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?
Choose 2 answers
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 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.
In regards to a secure network, what gives employees confidence that the information they are reading is true?
Integrity
What represents the greatest potential threat to data security?
Removable storage device
What are common personal data access security threats in healthcare?
Choose 2 answers
Unencrypted data
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?
Choose 2 answers
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
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?
Choose 3 answers
Provides practice guidelines
Delivers online information retrieval
Issues computerized alerts and reminders
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
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?
Choose 2 answers
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?
Choose 2 answers
PDAs
Bedside computers
Which type of technology offers support during the medication administration cycle?
Viewing of the digital health record during a home health visit
A 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
Which statements by the nurse demonstrate understanding of the reason for a clinical information system?
Choose 2 answers
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 to the next shift.
Why is this nursing action a problem?
Choose 2 answers
Giving a nursing report via a 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.
Which actions can patient data facilitate quality improvement in the future?
Choose 2 answers
Using the data to implement evidence-based practice procedures
Using the data to monitor infection trends
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