Ch20: Informatics

An informatics nurse is heading a team working on evaluating a newly implemented nurse-driven protocol for urinary catheter care. The team has completed the evaluation and is now ready to document the findings. One of the team members asks, "Why do we need to document this information. Isn't the fact that we evaluated the protocol enough?" Which response by the informatics nurse would be most appropriate as the priority reason for this documentation? "Documentation demonstrates that the monies were used correctly." "Documentation supports why we implemented the protocol." "Documentation helps ensure that any practice improvements needed can occur." "Like any documentation, it is evidence that we completed the evaluation."

"Documentation helps ensure that any practice improvements needed can occur." Although documentation of the evaluation can serve many purposes, comprehensive documentation of the evaluation helps to ensure that any practice improvements needed will occur.

An informatics nurse specialist teaches a group of staff nurses how to document client care in the new electronic health record. To document assessment findings, the nurses are to select the correct information from a drop-down list. During the teaching session, one of the nurses asks, "Why do we have to use this list. Why can't we just type in what we want to say?" Which response by the informatics nurse specialist would reflect the most important reason for documenting in this way? "This type of documentation is what the system will support." "It avoids issues related to typing that most nurses have." "Documenting this way allows nurses' actions to be measured." "This type of free-text documentation is more effective for communication."

"Documenting this way allows nurses' actions to be measured." Whenever possible, data should be entered into the system using standard terminology instead of free text where the nurse could type in any desired text. Data entered that represents client assessment, interventions, and resultant outcomes needs to be consistent so the care delivered by nurses can be quantified and nursing's contributions represented. Also, using standard terms allows the development of reports and data that can help to make assignments based on client care needs. If nursing data are not stored in a standardized electronic format, the value and contributions of nursing to client outcomes may not be measurable or retrievable (Welton & Harper, 2016).

An informatics nurse specialist has completed the evaluation of an update to a current clinical information system used by the staff at the local hospital and has documented the results. Documentation reveals the need for an improvement in the screen display. Which action would be next? Train Test Analyze and Plan Implement

Analyze and Plan Evaluation may be the last phase of the system development lifecycle, but it represents an essential step for nurses to be involved in before circling back to Analyze and Plan based on the results of the evaluation. This step is important to complete before making updates or improvements to a system already in place. Once this step is completed, the other steps of the system development lifecycle would follow.

An informatics nurse is demonstrating how to use an updated version of an electronic documentation system to a group of staff nurses. The nurse shows the staff that they can follow the same steps that they used with the previous system but need to add one additional final step to the process. The informatics nurse's actions reflect which concept of usability? Minimizing cognitive load Consistency Naturalness Simplicity

Consistency

An informatics nurse specialist is evaluating a newly implemented electronic medication alert system for usability. Which area would the nurse evaluate? Select all that apply. Interoperability Consistency Naturalness Simplicity Improvability

Consistency Naturalness Simplicity Usability is characterized by the concepts of simplicity, naturalness, and consistency. Interoperability is a separate element that reflects the system's ability to share information across the health care continuum. Improvability is addressed with optimization, which includes strategies for improvement.

An informatics nurse is teaching a clinic staff about a newly implemented patient portal being used. The informatics nurse determines that the teaching was effective when the staff identify which aspect as being the focus of this technology? Improved participation in health promotion Greater client engagement Improved client outcomes Improved client monitoring

Greater client engagement

An informatics nurse is reading a journal article about standard terminologies. The nurse demonstrates a need to reread the article when identifying which example as reflecting a standard terminology? NANDA Nursing Diagnoses PubMed Nursing Interventions Classification Clinical Care Classification System

PubMed Standard terminologies include NANDA-I nursing diagnoses, Nursing Interventions Classification, and Clinical Care Classification System. PubMed is a database of peer-reviewed journals that can be used for a literature search.

An informatics nurse specialist is meeting with a primary care provider's staff members. The office has agreed to implement a patient portal. When describing this tool, the nurse specialist would identify which aspects as being possible for clients? Select all that apply. Contact a specialist Schedule office appointments Access their medical history Communicate with the health care provider Undergo a diagnostic test

Schedule office appointments Access their medical history Communicate with the health care provider Depending on the vendor, patient portals can enable the client to access their medical history and other health information; communicate securely and conveniently with providers; and schedule appointments. Having a diagnostic test or contacting a specialist usually are not components of patient portals.

An informatics nurse specialist is working with a team designing an update to a clinical information system being used by the nursing staff. When selecting the language to be used with the system, which characteristic would be most appropriate to address? Select all that apply. Terminology is clear and concise for the nurses Terminology reflects the technological aspects of a system Terminology reflects the users work context Terminology is ambiguous to the user Terminology is familiar to the user

Terminology is clear and concise for the nurses Terminology reflects the users work context Terminology is familiar to the user All language used in an EMR or clinical information system should be concise and unambiguous. Terminology used also must be that which is familiar and meaningful to the end users in the context of their work; no terms related to computers, technology, HL7, databases, and so forth should appear in the user interface.

An informatics nurse specialist is conducting an in-service program for a group of informatics nurses. The nurse specialist is reviewing the components of the system development lifecycle and determines that the education was successful when the group identifies the phases of the lifecycle as similar to the: growth and development process. outcome evaluation process. nursing process. grief process.

nursing process. The concepts or phases of the system development lifecycle are very similar to the concepts of the nursing process but with an informatics or technology focus. While as a practicing nurse, the areas of Assess, Plan, Implement, and Evaluate make up the foundational concepts of care, the SDLC requires focus in the areas of Analyze and Plan, Design and Build, Test, Train, Implement, Maintain, and Evaluate.

An informatics nurse specialist has received an update from the vendor who is providing the electronic health record. During which phase of the system development lifecycle would this update be made? Evaluate Implement Test Maintain

Maintain Tasks such as updates from a vendor for the electronic health record would be made during the maintenance phase of the system development lifecycle. During the test phase, all components of the system are tested to make sure that they are working as designed and will support the workflow. The implementation phase involves the activation of the system. The evaluation phase determines if the system is doing what it is designed to do and how effective it is in achieving this goal.

An informatics nurse specialist is interviewing several nurses who have participated in testing a new electronic assessment tool. The nurses report that the tool "feels so familiar, like we know exactly what it is that we're supposed to do." The nurse specialist interprets this as indicating which concept? Consistency Forgiveness Naturalness Simplicity

Naturalness

An informatics nurse is assisting with the design of an clinical information system for use by the staff of a health center. The nurse is working to ensure that the system reflects usability by making sure that the screen display is visually clean and uncluttered and that it provides only the information needed for decision making. Which concept of usability is the nurse incorporating? consistency naturalness forgiveness simplicity

simplicity Simplicity in design refers to everything from lack of visual clutter and concise information display to inclusion of only functionality that is needed to effectively accomplish tasks. A "less is more" philosophy is appropriate, with emphasis being given to information needed for decision making. Naturalness refers to how automatically "familiar" and easy to use (intuitive) the application feels to the user. Consistency involves a pattern. For example, the more users can apply prior experience to a new system, the lower the learning curve, the more effective their usage, and the fewer their errors. Forgiveness means that a design allows the user to discover it through exploration without fear of disastrous results. This approach accelerates learning while building in protections against unintended consequences.

An informatics nurse specialist is using data visualization to present information about client populations admitted to the health care facility. Which type of format would the nurse most likely use? Select all that apply. Bar graphs Pie charts Infographics Textual summaries Spreadsheet

Bar graphs Pie charts Infographics

A client comes to the primary care provider's office for a routine follow-up visit. While completing the assessment, the nurse tells that client about a new patient portal that the office has begun to use. The client asks the nurse, "I guess this is a good thing, but what is it and what does it do?" Which response by the nurse would be appropriate? Select all that apply. "It allows you to get information about your health status and care." "It allows you to request refills for your prescriptions." "It's a site you can access through your home computer or smartphone." "You can use it to set up contact with your health insurance company." "You can communicate with your provider through the system."

"It allows you to get information about your health status and care." "It allows you to request refills for your prescriptions." "It's a site you can access through your home computer or smartphone." "You can communicate with your provider through the system." A patient portal is a tool that promotes client engagement in his or her health and healthcare. Portals can be accessible via a home computer or a smartphone, making engagement even easier. Although services vary depending on the vendor, common services include access to medical history and other health information; communicating securely and conveniently with providers; and requesting prescription refills. Typically, patient portals do not include access to health insurance companies.

A nurse asks an informatics nurse, "How can I make sure that the passwords I create are strong enough to prevent a security problem?" Which action would be appropriate for the informatics nurse to suggest to the nurse? Select all that apply. "Make sure that your password is at least eight characters long." "Try using a mnemonic that works only for you." "Avoid using multifactor authentication whenever possible." "Sharing your password with a coworker is okay but not with anyone else." "Wait at least 2 months before you reuse a password."

"Make sure that your password is at least eight characters long." "Try using a mnemonic that works only for you." To create strong passwords and promote data security and privacy, you should never share your password; never reuse passwords; use passwords that are easy to remember but hard to guess, such as by using a mnemonic device that works for you but is unlikely to work for someone else; use at least eight characters for your password; and consider using strong authentication or multifactor authentication to prevent unauthorized users from accessing your account via a device not belonging to you.

The nursing student is discussing the benefits of electronic charting with a precepting nurse who is frustrated with computerized documentation. Which statement by the student requires intervention from the nursing instructor? "You don't have to worry about trying to read poor handwriting." "The computer reminds the nurse to enter information and inhibits omissions." "You save time because you don't have to look for the physical chart." "You can make extra money with overtime pay with end-of-shift charting."

"You can make extra money with overtime pay with end-of-shift charting." There are many benefits to electronic charting, though there may be some learning curves involved in knowing how to use electronic formats. It is incorrect to suggest that overtime pay can be earned with end-of-shift charting. Therefore, this statement requires intervention. The other statements are appropriate.

An informatics nurse specialist is talking with a group of health care providers at a local clinic about implementing a patient portal system. During the presentation, one of the providers asks the nurse specialist, "I understand what this portal is, but how will it help our clients?" Which response by the nurse would be appropriate? Select all that apply. "Your clients will be able to manage their chronic problems better." "Your clients will reimburse you for this service." "Your clients will be more motivated to get preventive care." "Your clients will be able to actively participate in their care." "Your clients will be more likely to seek out care if needed."

"Your clients will be more motivated to get preventive care." "Your clients will be able to actively participate in their care." "Your clients will be more likely to seek out care if needed." "Your clients will be able to manage their chronic problems better." Supporting strong client engagement using a tool such as the patient portal has shown to have multiple benefits (ONC, 2016), including better health outcomes (encouraging clients to participate in their own health care can result in better preventive care and improve medication adherence); improved chronic condition management (client access to information and direct communication with providers can increase the quality of life for clients with chronic disease); timely access to care (engagement can result in a level of education that empowers clients to seek the right care at the right time); and client retention (clients who use the portal are nearly 2.6 times more likely to remain clients).

A facility plans to implement a new electronic medication documentation system. An informatics nurse specialist conducts a focus group with staff nurses to gather information. The nurse specialist asks the group about the current system being used, including a step-by-step account of the actions they perform. The nurse specialist also asks the nurses how they see this new system affecting this process and their overall daily tasks. The informatics nurse specialist is demonstrating which ANA informatics competency? Assessment Outcomes identification Coordination of activities Planning

Assessment In this situation, the informatics nurse specialist is demonstrating the competency of assessment by collecting information about the nurses' usual workflow to evaluate current practice as well as determine the needs of the system. The nurse also gathers information about the effect that the new system might have on the nurses' typical workflow. The competency of outcomes identification is reflected by the nurse specialist identifying expected outcomes for the plan based on the information gathered from the interviews. The competency of planning is reflected by the nurse specialist developing a customized plan that addresses the clinical needs voiced by the nurses but at the same time, meets the financial needs of the facility. Coordination of activities is reflected by the nurse specialist organizing the different parts of the plan for an integrated, efficient, cost-effective solution.

An informatics nurse is preparing a training program for staff nurses in the facility. The facility will be implementing a new electronic health record. To ensure the best results, which type of training would the informatics nurse most likely use? Online training Printed tip sheet Web-based training Classroom education

Classroom education The type of training required depends on the implementation project. For the installation of a new EHR, a classroom model of education will most likely be needed. If you are adding only a new module to a current system, web-based or online training may be adequate. If the change is a simple addition to current functionality, a tip sheet or just-in-time training may suffice.

An informatics nurse specialist working at an ambulatory care center is interviewing clients about their experiences in using the center's patient portal. A majority of the clients have voiced dissatisfaction, stating that they "find the display screen confusing and are not sure what to click on to get the necessary information." They also talk about difficulties in trying to find their test results. Based on this information, the nurse specialist identifies a need to talk with the information technology team about ways to make the portal easier for clients to use. The informatics nurse specialist is demonstrating which ANA informatics competency? Professional practice evaluation Resource utilization Environmental health Collaboration

Collaboration The ANA competency of collaboration involves working with the health care consumer, family, and others in the conduct of nursing and informatics practice. The nurse specialist partners with others to effect change and produce positive outcomes. In this situation, the informatics nurse specialist determines a need to improve usability based on the clients' objections, then works with the team to make the portal easier to use. Professional practice evaluation refers to the informatics nurse specialist evaluating his or her own nursing practices in relation to professional practice standards and guidelines, relevant statutes, rules, and regulations. With resource utilization, the informatics nurse specialist would employ appropriate resources to plan and implement informatics and associated services that are safe, effective, and fiscally responsible. With environmental health, the informatics nurse would support practice in a safe and healthy environment.

An informatics nurse specialist is describing the framework underlying informatics practice. Which component of the framework would the nurse specialist describe as discrete entities without interpretation? Information Data Knowledge Wisdom

Data Data is the component that involves discrete entities that are described without interpretation. Information refers to data that have been interpreted, organized, or structured. Knowledge refers to information that is synthesized so that relationships are identified. Wisdom refers to the appropriate use of knowledge to manage and solve human problems.

An informatics nurse is applying the informatics framework to a clinical situation. Which component of the framework would the nurse apply first? Knowledge Wisdom Information Data

Data When applying the informatics framework, the nurse would first take individual data elements and combine them to provide meaningful information that leads to knowledge and enhanced client care delivery. From there the nurse would use the knowledge appropriately to achieve wisdom.

An informatics nurse specialist is collecting data from the clinical information system about the demographics of individuals diagnosed with heart failure admitted to the facility over the past five years. The nurse specialist is preparing a presentation to the facility's executive board. To promote understanding of this complex information, the nurse specialist prepares the data results using a pie chart and a bar graph. The nurse specialist is using which area of analytics? Data visualization Big Data Predictive analytics Data mining

Data visualization Data visualization is the presentation of data in a pictorial or graphical format. It enables decision makers to see analytics presented visually, so they can grasp difficult concepts or identify new patterns. Predictive analytics encompasses a variety of statistical techniques that analyze current and historical facts to make predictions about future or otherwise unknown events. Big Data comprises the accumulation of health care-related data from various sources, combined with new technologies that allow for the transformation of data to information, to knowledge, and ultimately to wisdom. Data mining refers to the process of sorting through large amounts of data to identify patterns and solve problems.

An informatics nurse is part of a team working on developing a clinical information system for a facility. The team is working on ensuring that the system supports usability. During which phase of the system development lifecycle would the team integrate the principles of usability as a priority? Analyze and plan Train Design Test

Design Making clinical systems easy to use, intuitive, and supportive of nurses' workflow is what usability is all about. Although usability is important during all phases, it is during the design phase of the system development lifecycle where knowledge of usability principles is essential.

An informatics nurse specialist is working as part of a team that will be developing and implementing a new client assessment tool. During which phase of the system development lifecycle would the team be integrating information about workflow patterns, standard terminology, and recommendations for screen layout from supportive research? Analyze and plan Design and build Train Test

Design and build Mapping out workflow patterns, using standard terminology, and integrating evidence-based research findings for screen layouts would be accomplished during the design and build phase of the system development lifecycle. During the analyze and plan phase, the team would determine the purpose of the technology and the problem to be solved to establish the need. Testing is done once the technology is designed and built. Training of the end-users occurs after the system is tested but before it is implemented.

An informatics nurse specialist is participating in evaluating the a new clinical information system being used at a provider's office. The nurse specialist has determined what is being evaluated and the question being asked and has completed the literature search. Which action would the nurse specialist do next? Determine the sample size Determine the study design Determine the data elements to be collected Determine how the data will be collected

Determine the data elements to be collected Once the informatics nurse specialist has determined what will be evaluated and the question to ask, and completed the literature search, the next step would be to determine the specific data elements to be collected. Then the informatics nurse specialist would determine the study type, data collection method, and sample size.

An informatics nurse specialist is working on a team that is considering a new technological system for the facility. Which aspect would be most important for the team to do as the first step? Conduct testing of the system Train those who will be using the system Identify the use of standard terminology Determine the need or problem to be solved

Determine the need or problem to be solved Before considering the use of any new technology or an update to the system, analysis and planning must occur. This involves determining the need for the technology or update or identifying the problem to be solved. Once that step is completed, then design (such as using standard terminology), testing and training would occur.

Question 9 of 20 A nurse is reading a journal article about telemedicine. The nurse demonstrates understanding of this concept by identifying which type of service as being provided? Select all that apply. Provider training Diagnostic testing Access to specialist at a different location Administrative meetings Client progress monitoring

Diagnostic testing Access to specialist at a different location Client progress monitoring Telemedicine refers to the use of telecommunications technologies to support the delivery of all types of medical, diagnostic, and treatment-related services, usually by physicians or nurse practitioners. Examples include conducting diagnostic tests, monitoring a client's progress after treatment or therapy, and facilitating access to specialists that are not located in the same place as the client. Telemedicine involves only remote clinical services. Administrative meetings and provider training may be provided by telehealth.

A staff nurse interested in nursing informatics is attending a seminar on the topic. As part the seminar, the concept of standard terminologies is being discussed. The nurse demonstrates a need for further discussion when she identifies which information as a reason for its use? Quantify the care delivered by nurses to clients Directly measure client outcomes Provide a foundation for client care delivery across the care continuum Demonstrate nursing's contribution to client outcomes

Directly measure client outcomes Without the ability to aggregate and analyze data entered into the EHR, it is a challenge to represent nursing's contribution to client outcomes and to the organization's bottom line (Whittenburg & Jacobs, 2015). Data entered that represents client assessment, interventions, and resultant outcomes needs to be consistent so the care delivered by nurses can be quantified and nursing's contributions represented. If nursing data are not stored in a standardized electronic format, the value and contributions of nursing-to-client outcomes may not be measurable or retrievable. Standard terminology is not associated with directly measuring client outcomes.

A group of nurses along with an informatics nurse specialist are conducting user acceptance testing of an update to a clinical information system. During this testing, which question is the group looking to answer? Do the components of the system work for an entire workflow? Can the system function properly when being used by multiple staff? Does the update function and work as intended? Does everything appear on the screen in the proper place?

Does the update function and work as intended? During user acceptance testing, which is completed after all other testing is done, the user test drives the new system or new functions to ensure that it is working as designed. Checking that everything appears on the screen in the proper location is done during unit testing. Evaluating if the components work for an entire workflow is done during integration testing. Determining if the system can function properly when used by multiple users is done during performance testing.

An informatics nurse specialist is working with a team to design a clinical information system. To ensure system usability, the team would make sure that the language meets which criterion? Select all that apply. Familiarity for the user Computer-based Clarity Conciseness Jargon-like

Familiarity for the user Clarity Conciseness All language used in a clinical information system should be concise and unambiguous. Terminology used also must be familiar and meaningful to the end users in the context of their work; no terms related to computers, technology, HL7, databases, and so forth should appear in the user interface.

An informatics nurse specialist is gathering data from electronic health records at the facility about clients who have had central venous catheters inserted for more than the recommended time as specified by the facility's protocol. The nurse specialist is collecting this data most likely for which purpose? Evaluate client care Determine client satisfaction with care Correlate the client's diagnosis with intervention Identify clients at risk for infection

Identify clients at risk for infection Predictive analytics encompasses a variety of statistical techniques that analyze current and historical facts to make predictions about future or otherwise unknown events. In health care, organizations often use this information to identify clients who may be at risk for problems. This area of health care analytics is not involved with determining client satisfaction, evaluating client care, or correlating the client's diagnosis with interventions.

An informatics nurse is assisting with the evaluation of a newly implemented system for electronic documentation of client assessments. The nurse is planning to involve staff nurses in this process. When beginning the evaluation process, the informatics nurse would focus on which area first? Identifying what will be evaluated Reviewing available databases related to the topic Collecting the necessary data Developing the question related to what data is to be collected

Identifying what will be evaluated In evaluating technology such as a newly implemented electronic documentation system, the informatics nurse would first need to determine what will be evaluated. Once that is determined, the informatics nurse would develop a clearly focused question to help determine what data will need to be collected and how that data would be reported. Next, the informatics nurse would conduct a literature search, followed by a determination of the specific data elements that would be collected.

An informatics nurse specialist is working as part of a team to develop and implement a new electronic documentation and reporting system at the clinic. The team has analyzed the situation, created a plan based on supporting evidence, created a design, built the program, and has worked out issues with the system. Staff who will be using the system have received education about the system and how it works, as well as how to use it. The team would proceed to which phase of the system development lifecycle next? Maintain Test Implement Evaluate

Implement In this situation, testing has already been completed as evidenced by the information about working out issues in the system. The team's next step would be to implement the system and begin using it since all previous phases of analyze and plan, design and build, test and train have been completed. The implementation phase would be followed by maintenance and then evaluation. analyze+plan, design, test, train, implement, maintain, evaluate

An informatics nurse specialist is part of a team that will be implementing a new clinical information system at the facility. The nurse specialist advocates to include staff nurses who will be using the system to be involved in the process. The nurse specialist advocates for this based on which reason? Promote recognition of nurses by administration Improve the chances that the system will meet the intended need Ensure that the nurses gain familiarity with the system Emphasize the role nurses play in providing care

Improve the chances that the system will meet the intended need Nurses who will be using a clinical information system should be involved in all phases of the system development lifecycle to ensure the best chance that the system will meet its intended need. Participation is not geared to role responsibilities, familiarity, or recognition.

A nurse is reading a journal article about health information technology and the need for this technology to demonstrate meaningful use. Which information would the nurse anticipate reading about as reflective of meaningful use? Select all that apply. Reduced health of populations Improvement in health care quality Increased health disparities Greater client engagement Reduction in privacy breaches of client information

Improvement in health care quality Greater client engagement Reduction in privacy breaches of client information Meaningful use would be reflected by improved quality, safety, efficiency, and reduced health disparities; engagement of clients and family; improved care coordination and population and public health; and maintenance of privacy and security of client health information.

An informatics nurse specialist is involved in the testing of a new clinical information system that is being planned for use by the health network. The system is currently undergoing unit testing. Which information would be addressed during this phase? Select all that apply. Information is in its proper location on screen. The correct information appears on the screen. There are no typographical errors. System works for one particular area. All information is included.

Information is in its proper location on screen. The correct information appears on the screen. There are no typographical errors. All information is included. Unit testing is the initial basic testing; it commonly addresses if the screens contain the correct information, that nothing was left out, that everything is in the right place on the screen, and that there are no typographical errors. Testing that the system works for one particular area or function occurs during function testing.

A client comes to see the cardiologist for a routine follow-up visit. At the visit, the nurse reviews the client's electronic health record. The nurse is able to access a report from the client's last visit to the primary care provider last month and the report from an emergency department visit two weeks ago for reports of shortness of breath. The record also lists two changes in the client's medication based on the emergency department visit. The nurse's ability to access this information reflects which concept? Optimization Usability Security Interoperability

Interoperability

A nurse working in a primary care provider's office is using the clinical information system to review a client's health information. The nurse is able to review the client's last visit to the primary care provider as well as information from a recent hospitalization, and also a visit that the client made to the cardiologist last week. The nurse's ability to review this information is based on which aspect of the clinical information system? Optimization Usability Security Interoperability

Interoperability Interoperability refers to the ability to share client data across health care systems. The Office of the National Coordinator for Health Information Technology (ONC) defines interoperability as the ability of a system to exchange electronic health information with and use electronic health information from other systems without special effort on the part of the user. Usability refers to the ease of use and intuitiveness of a system. Optimization involves recommendations for improvements to better support and improve care delivery. Security refers to the system's ability to keep information private and confidential.

An informatics nurse specialist is involved with implementing strategies to improve the performance of the clinical information system being used. As part of this process, the nurse specialist is working on updating the plans of care in the system to reflect changes to a procedure based on new evidence. The nurse is also working to streamline the display screens to reduce the need to document the same information in three different areas. The nurse specialist is addressing which aspect of the system? Usability Optimization Standard terminology Interoperability

Optimization Optimization commonly includes strategies to improve processes, maximize effective use, reduce errors, and eliminate workflow inefficiencies. Updating and streamlining reflect such strategies. Usability refers to the ease of use of the system. Standard terminology refers to the use of specific data entry elements that allow the development of reports and data. Interoperability reflects the ability of the system to share data across health care systems.r

An informatics nurse specialist is preparing a presentation for a local community group about advances in technology in health care. Part of the presentation will focus on technological advances to promote greater client participation in managing health. Which component would the nurse likely describe as playing a major role? Electronic health record Patient portal Predictive analytics Clinical information system

Patient portal Although the electronic health record and clinical information systems are important technological advances in health care, engaging clients in their care and working together to improve health with supportive technology is an area that continues to advance. A primary client engagement tool is the patient portal. This web-based tool can be securely accessed and provides several functions to increase engagement. Predictive analytics encompasses a variety of statistical techniques that analyze current and historical facts to make predictions about future or otherwise unknown events. It does not involve client engagement.

An informatics nurse specialist is preparing a presentation about patient portals for a group of primary care providers in an office practice. When describing the tasks that can be accomplished by clients using the portal, which activity would the informatics nurse specialist include? Select all that apply. Paying their bill Scheduling appointments Receiving screening reminders Talking with the provider face-to-face Checking their lab test results

Paying their bill Scheduling appointments Receiving screening reminders Checking their lab test results Patient portals can be securely accessed and provide several functions to increase engagement. Portals can be accessible via a home computer or a smartphone, making engagement even easier. Depending on the vendor, patient portals can enable the client to access medical history and other health information; communicate securely and conveniently with providers (but not necessarily face-to-face); pay bills; review lab test results; schedule appointments; and receive reminders for appropriate screenings (e.g., mammograms, flu shots, colonoscopy).

A nurse is reviewing the medical record of a client at the clinic. The nurse notes that the medication and dosage prescribed for the client was based on information gathered about the client's genetic makeup from the electronic health record. The nurse interprets this as: Genetics Telehealth Genomics Pharmacogenomics

Pharmacogenomics Pharmacogenomics uses information about a person's genetic makeup, or genome, to choose the drugs and drug doses that are likely to work best for that particular person. Genetics scrutinizes the functioning and composition of the single gene. Genomics addresses all genes and their interrelationships in order to identify their combined influence on the growth and development of the organism. Telehealth refers to the use of electronic information and telecommunications technologies to support and promote long-distance clinical health care, client and professional health-related education, public health, and health administration. Technologies include videoconferencing, long distance imaging review, streaming media, and terrestrial and wireless communications and can involve more than just clinical services; it can also include remote nonclinical services such as provider training, administrative meetings, and continuing medical education.

An informatics nurse specialist is extracting data from the facility's electronic health record in an attempt to identify clients at risk for developing catheter-related bloodstream infections. When gathering this data, the nurse specialist is using which technique? Predictive analytics Big data Genomics Data visualization

Predictive analytics Predictive analytics encompasses a variety of statistical techniques that analyze current and historical facts to make predictions about future or otherwise unknown events. In health care, we see this used as organizations attempt to identify clients who are at risk for a condition, which in this case, would be catheter-associated bloodstream infections. Data visualization is the presentation of data in a pictorial or graphical format to enable decision makers to see analytics presented visually, so they can grasp difficult concepts or identify new patterns. Big data comprises the accumulation of health care-related data from various sources, combined with new technologies that allow for the transformation of data to information, to knowledge, and ultimately to wisdom. Genomics addresses all genes and their interrelationships in order to identify their combined influence on the growth and development of the organism.

A nurse has a two-way video communication with the specialist involved in the care of a client in a long-term care facility. This is an example of what nursing informatics technology? Telemedicine and mobile technology Client engagement technology Data aggregation technology Population health management technology

Telemedicine and mobile technology Telemedicine and mobile health technology facilitate client engagement, while helping providers deliver more cost-effective care. Telemedicine embraces applications and services that include two-way video communications, e-mail, and wireless phones. Mobile health features multiple technologies integrated into the increasingly wireless and mobile health care delivery system. Client engagement technology would include the concept of client portals (where clients can access an electronic medical record system and personal health information); online appointments scheduling; and personalized, condition-focused alerts/reminders in the form of e-mails, automated telephone calls, or text messages. Data aggregation is a process that involves data collection, analysis, use, reporting, and delivery of feedback throughout the organization. Organizations will use process and outcomes data to measure what they achieve for clients and population-based communities. Population health management technology performs data mining, risk stratification, and analysis. Searches can be conducted for disease trends, diagnoses, procedures, and missed appointments.

An informatics nurse is participating in an online continuing education course about informatics, health information technology, and the use of standard terminology. The informatics nurse demonstrates understanding of the information presented in the course by identifying which aspect as a characteristic of nursing standard terminologies? Select all that apply. The terminology provides a means to code the delivery of nursing care. The terminology rates the concepts associated with care. The terminology is structurally organized to reflect nursing knowledge. The terminology identifies concepts related to the delivery of nursing care. The terminology aids in promoting interoperability.

The terminology provides a means to code the delivery of nursing care. The terminology is structurally organized to reflect nursing knowledge. The terminology identifies concepts related to the delivery of nursing care. The terminology aids in promoting interoperability.

Several nurses are discussing their impressions of the newly implemented electronic health record with an informatics nurse specialist. They say, "There is so much information on one screen, it hard to tell what we should do first. It's not really clear." The informatics nurse specialist interprets the comments as reflecting an issue with which area? Optimization Interoperability Security Usability

Usability The nurses' statement reflects usability. Electronic health records and order-entry systems are complex. Sometimes the way screens are formatted can be confusing, making it a real challenge to perform nursing tasks in a way that makes sense. Interoperability refers to the ability to share data across health care systems. Optimization refers to strategies to improve processes, maximize effective use, reduce errors, reduce costs, eliminate workflow inefficiencies, improve clinical decision support, and improve end-user skills and satisfaction with the system. Security refers to the ability to keep information private and confidential.

A nurse is conducting a client assessment and documenting the findings in the client's electronic health record (EHR). Which description would the nurse most likely enter as data in the system to document the client's activity level? Uses a walker to ambulate to the bathroom at night Walks without any difficulties Is unable to ambulate at all Walks without assistance

Walks without assistance Whenever possible, data should be entered into the electronic health record system using standard terminology instead of free text. Statements such as using a walker to ambulate to the bathroom at night, walks without any difficulty, and is unable to ambulate at all are examples of free text statements.

An informatics nurse specialist is engaged in evaluating a clinical information system. At which time would the nurse specialist anticipate the need to obtain help from a statistician? During the literature search When preparing how to display the data When determining the data collection method Just before documenting the outcome evaluation

When determining the data collection method It would be appropriate to secure the help of a statistician when the informatics nurse specialist is determining the data collection method and sample size. Securing help during the literature search would be too early. When preparing how to display the data or just prior to documenting the outcome evaluation would be too late. The nurse specialist would have had to analyze the data with the help of a statistician before displaying it.

A nurse takes specific elements from the electronic health record and then interprets and organizes them to identify relationships. The nurse applies understanding of the relationships to client care situations to enhance client care delivery. The nurse's action reflects which component of the informatics framework? Information Data Wisdom Knowledge

Wisdom The nurse takes individual elements (data) from the electronic health record and then interprets and organizes that data (information) to identify relationships (knowledge). Taking that knowledge and using it to enhance client care delivery reflects the framework component of wisdom.

An informatics nurse specialist is describing the role of informatics in health care to a group of staff at a facility. The nurse specialist determines that the teaching was successful when the group identifies which as a core practice area? patient portals electronic health record telehealth data analytics

electronic health record The electronic health record (EHR) remains at the core of informatics practice. However, many areas within the scope of informatics deal with technologies peripheral or tangential to the EHR—for example, telehealth, mobile devices, patient portals, data analytics, and technologies for educating nurses in academic settings and for conducting research.

During a recent visit to the clinic, a client tells the nurse, "I've been using my cell phone to track and record the foods that I eat so that I can better understand if I'm making healthy food choices." The nurse interprets the client's statement as reflecting which technology? mHealth Pharmacogenomics Patient portal Telemedicine

mHealth The term "mHealth" is used to describe the rapidly evolving use of mobile technologies to track and improve health outcomes. Nurses, physicians, other care providers, and clients are using apps that enable quick and easy access to screens that provide information and can track progress. Telemedicine refers to the use of telecommunications technologies to support the delivery of all types of medical, diagnostic, and treatment-related services, usually by physicians or nurse practitioners. Examples include conducting diagnostic tests, monitoring a client's progress after treatment or therapy, and facilitating access to specialists that are not located in the same place as the client. Telemedicine involves only remote clinical services. Patient portals are a web-based tool that promote client engagement. Pharmacogenomics uses information about a person's genetic makeup, or genome, to choose the drugs and drug doses that are likely to work best for that particular person.

An informatics nurse is teaching a client recently diagnosed with heart failure how to use a web-based tool to learn more about this condition. The tool is provided by the client's primary care provider. The informatics nurse is teaching the client about: telehealth. patient portal. telemedicine. pharmacogenomics.

patient portal.

An informatics nurse specialist is conducting an in-service program for a group of staff nurses about this specialty. One of the nurses asks, "What exactly is nursing informatics?" Which response by the informatics nurse specialist would be most appropriate? "It refers to the use of the electronic health record." "It involves working primarily with computers and programming codes." "It combines nursing science with information management and analytical sciences." "It is a specialty that deals with online client educational programs."

"It combines nursing science with information management and analytical sciences." The ANA defines nursing informatics (NI) as "the specialty that integrates nursing science with multiple information management and analytical sciences to identify, define, manage, and communicate data, information, knowledge, and wisdom in nursing practice." It is more than just working with computers or the electronic health record (although this is the core of informatics practice). Client education can be one component of a clinical information system with which nursing informatics may be involved.

An informatics nurse specialist is using technology to collect health care-related data from multiple sources in an attempt to transform that data to answer questions. The nurse plans to use this data to assist with the management of clients regardless of the setting. The nurse is using which area of analytics? Data visualization Big Data Population health Predictive analytics

Big Data Big Data comprises the accumulation of health care-related data from various sources, combined with new technologies that allow for the transformation of data to information, to knowledge, and ultimately to wisdom. Delivering the required analytics functionality to manage clients, regardless of the setting, necessitates the adoption of Big Data technologies into our practice. Data visualization is the presentation of data in a pictorial or graphical format. Predictive analytics encompasses a variety of statistical techniques that analyze current and historical facts to make predictions about future or otherwise unknown events. Population health addresses the health status and health issues of aggregate populations. It brings significant health concerns into focus and addresses ways in which communities, health care providers, and public health organizations can allocate resources to overcome the problems that drive poor health conditions in the population. Population health analytics can help organizations identify clients at risk of needing additional assistance to manage their health.

An informatics nurse is evaluating a new clinical information system for usability. The nurse notes that the system requires the user to complete a maximum of 3 steps to complete a task. The system also provides shortcuts to frequent users of the system. The nurse would determine that which concept of usability is being addressed? Minimizing cognitive load Efficient interactions Naturalness Consistency

Efficient interactions Efficient interactions is demonstrated by actions that facilitate efficient user interactions. An example is to minimize the number of steps it takes to complete tasks and to provide shortcuts for use by frequent and/or experienced users. Consistency involves the ability of the users to apply prior experience to a new system so that the lower the learning curve, the more effective their usage, and the fewer their errors. Naturalness refers to how automatically "familiar" and easy to use (intuitive) the application feels to the user.

A group of nurses are participating in being the first group of staff to use a new electronic pain assessment tool. The group is discussing whether or not the system is easy to use. During the discussion, the group mentions that "the shortcuts provided are really helpful and save valuable time." The informatics nurse specialist interprets this statement as reflecting which concept? Efficient interactions Effective use of language Forgiveness Naturalness

Efficient interactions The statement reflects efficient interactions. One of the most direct ways to facilitate efficient user interaction is to that minimize the number of steps it takes to complete tasks and to provide shortcuts for use by frequent and/or experienced users. Forgiveness means that a design allows the user to discover it through exploration without fear of disastrous results. Naturalness refers to how automatically "familiar" and easy to use (intuitive) the application feels to the user. Effective use of language involves the use of concise, unambiguous language with terminology that is familiar and meaningful to the end users in the context of their work.

An informatics nurse specialist is recommending the addition of an alert system tool to the facility's patient portal. The tool would be designed to send alerts to the client to schedule routine screenings and immunizations. This recommendation most likely reflects which ANA informatics competency? Health teaching and health promotion Consultation Leadership Quality of practice

Health teaching and health promotion The alert system tool for screenings and immunizations would reflect the competency of health teaching and health promotion because it would signal the clients about important health promotion activities. The competency of consultation would involve the informatics nurse specialist providing consultation to influence the identified plan, enhance the abilities of others, and effect change. . The competency of quality of practice is reflected by the nurse specialist's contributions to the quality and effectiveness of nursing and informatics practice, as evidenced by quality documentation and data analysis to improve practice and outcomes. The competency of leadership is reflected by the nurse specialist promoting the organization's goals and vision and mentoring colleagues.