FN - Unit 3 - Chapter 21: Informatics and Health Care Technologies
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 involves working primarily with computers and programming codes." "It refers to the use of the electronic health record." "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 is discussing the implementation of a new documentation system with a group of staff nurses who are using the system. Which response by the group would indicate to the nurse that the system's usability is effective? Select all that apply. "We've noticed that this system really helps to save us valuable time." "Using the system is highly intuitive." "This system makes it challenging to complete tasks." "This system fits nicely into how we work." "The screen has a lot of confusing information on it."
"We've noticed that this system really helps to save us valuable time." "Using the system is highly intuitive." "This system fits nicely into how we work." The National Institute of Standards and Technology defines usability as "the extent to which a product can be used by specified users to achieve specified goals with effectiveness, efficiency, and satisfaction in a specified context of use" (NIST, 2017). Sometimes the way screens are formatted can be confusing, making it a real challenge to perform nursing tasks in a way that makes sense. Making clinical systems easy to use, intuitive, and supportive of nurses' workflow is what usability is all about. A system with effective usability can save time, reduce errors, and improve end-user satisfaction. A system that makes it challenging to complete tasks or screens that contain large amounts of information do not promote usability.
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 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? Analyze and Plan Test Train 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 assisting with the evaluation of a new health information technology system implemented at the facility. When conducting the literature review, which source would be appropriate for the informatics nurse to use? Select all that apply, Cumulative Index to Nursing and Allied Health Literature (CINAHL) PubMed Cochrane database Mayo Clinic WebMD
Cumulative Index to Nursing and Allied Health Literature (CINAHL) PubMed Cochrane database Searches should be conducted in peer-reviewed journals by searching available databases such as Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, and Cochrane Reviews. Mayo Clinic and WebMD would not be appropriate sites to use to search for peer-reviewed journals.
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?' Forgiveness Efficient interactions Naturalness Effective use of language
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 is participating in an online continuing education course about nursing informatics. The nurse demonstrates successful comprehension of the course by identifying which individual as being considered the first informatics nurse? Florence Nightingale Dorothea Orem Hildegard Peplau Virginia Henderson
Florence Nightingale Many have documented that the first informatics nurse was Florence Nightingale, who compiled and processed data to improve sanitation conditions in military hospitals during the Crimean War in the 1850s. Orem, Peplau, and Henderson are nursing theorists.
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? Identify clients at risk for infection Determine client satisfaction with care Correlate the client's diagnosis with intervention Evaluate client care
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.
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. Improvement in health care quality Increased health disparities Greater client engagement Reduction in privacy breaches of client information Reduced health of populations
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 conducting an orientation for the staff of a primary care provider's office about a new web-based tool that they will be implementing. The goal of the tool is to promote client engagement. The informatics nurse specialist is most likely orienting the staff to which system? Patient portal Telehealth Telemedicine Telecare
Patient portal A primary client engagement tool is the patient portal, a web-based tool that can be securely accessed and provides several functions to increase engagement. Telehealth is defined as 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. Telemedicine involves the use of telecommunications technologies to support the delivery of all types of medical, diagnostic, and treatment-related services, usually by health care providers or nurse practitioners. Telecare generally refers to technology that allows consumers to stay safe and independent in their own homes.
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? Patient portal Electronic health record Clinical information system Predictive analytics
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.
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? Client engagement technology Data aggregation technology Telemedicine and mobile 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.
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.
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? Data Knowledge Information Wisdom
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 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? simplicity naturalness consistency forgiveness
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.
