Concept of Informatics- Mod 48
The nurse is caring for a client who has a condition that is not responding to standard interventions. How could accessing the clinical decision support system (CDSS) help with this client's care? A) Provides evidence-based recommendations for care B) Decreases the need to use critical thinking skills C) Tells the nurse what the next step should be D) Supports the nurse's "gut" instinct when providing care
Answer: A Explanation: A) A CDSS uses a knowledge base and programmed rules, protocols, and guidelines developed using evidence-based guidelines to match against client data in the electronic health record (EHR) to deliver alerts or recommendations to the provider. The system will not provide a definitive next step for care, and the nurse still needs to use critical thinking skills to determine the best approach for the individual client. The CDSS may or may not support the nurse's "gut" instinct.
What function might be made easier for healthcare organizations through the use of a computerized contract management system? A) Tracking changes in reimbursement rates B) Sharing information between billing systems C) Managing material and supply inventories D) Planning organizational budgets
Answer: A Explanation: A) A computerized contract management system helps facilities track rates of reimbursement and real-time changes in policies for different health insurance plans. Financial systems help share information between billing systems, manage material and supply inventories, and plan organizational budgets.
Which organization specifically focuses on improving healthcare quality, safety, and outcomes through improving the use of information technology (IT) and systems? A) Healthcare Information and Management Systems Society (HIMSS) B) American Medical Informatics Association (AMIA) C) Alliance for Nursing Informatics (ANI) D) Technology Informatics Guiding Educational Reform (TIGER)
Answer: A Explanation: A) HIMSS works to improve healthcare quality, safety, and outcomes through improving the use of IT and systems. AMIA is dedicated to developing health informatics that support client care and teaching. ANI supports information leadership, practice, education, policy, and research. TIGER integrates technology and informatics competencies into nursing education and practice.
Which statement regarding the term "point of care" is correct? A) "Point of care" refers to the use of a portable device to provide care near the client. B) "Point of care" refers to the location that nurses document care of the client. C) "Point of care" refers to care that takes place away from the client. D) "Point of care" refers to care that takes place in the client's home.
Answer: A Explanation: A) One of the selling points of an electronic health record is that charting at point of care is possible, which helps to increase efficiency. Point of care refers to interventions or testing that takes place using a transportable, portable, or handheld device near the client. Point of care does not refer to the location where documentation takes place or to care that takes place away from the client or specifically in the client's home.
The nurse is facing a problem with a long-term care client that is different from anything encountered by the nurse in the past. What nursing action is appropriate prior to taking the problem to the research committee? A) Perform a review of the literature. B) Ask the client's family if this is a recurring issue. C) Bring the problem up for discussion in the next staff meeting. D) Ask the physician for assistance.
Answer: A Explanation: A) When encountering a problem, the nurse can conduct a literature review to find applicable information. Asking the client's family if the problem is recurring will not help the nurse determine the course of care. The physician is not consulted for nursing problems. A staff meeting may provide some other opinions but will not give the nurse information regarding studies related to the client's problem.
The nurse is preparing an educational brochure to teach clients how to determine the validity of content obtained from health-related internet websites. Which information should the nurse plan to include in this teaching tool? Select all that apply. A) Source for the information B) Sponsor of the website C) Ways to identify if the site is selling a product D) Number of visitors to the website E) Date the content was last reviewed
Answer: A, B, C, E Explanation: A) When analyzing online information, the source of the information should be validated. The sponsor of the website should be clearly identified. The site should be studied to see if a product is being sold. A date when the data was last reviewed or updated should be visible. It is not necessary to locate the number of visitors to the website.
The nurse administrator of a local hospital is attending training on the new informatics system the hospital will be implementing. Which information should the nurse administrator be able to manage from the dashboard? Select all that apply. A) Staffing B) Budgets C) Clients D) Quality initiatives E) Plans of care
Answer: A, B, D Explanation: A) Many electronic health records give administrators tools to manage budgets, staffing, quality initiatives, and productivity information. The use of dashboards puts all of this information at the administrator's fingertips. The dashboard does not include client-specific or identifying information, such as plans of care.
The nurse is part of the clinical information system committee at a major healthcare organization. When designing a plan to ensure the protection of client information, which approaches should the nurse suggest this committee include in the implementation plan? Select all that apply. A) Design policies to address password protection and login information. B) Determine how to handle clients who desire to "friend" staff through social media. C) Identify applications that interface with smartphones. D) Create interfaces so that health data can be inputted by the client. E) Teach users to not leave protected health information unattended.
Answer: A, B, E Explanation: A) The committee is creating a plan to ensure the protection of client information. The committee needs to design polices for password protection and login information, determine mechanisms to handle clients and staff who communicate through social media, and teach users to not leave protected health information unattended. Identifying applications that interface with smartphones and creating interfaces so that clients can input health data are not approaches to ensure the protection of client information.
Which action by the nurse will help minimize the risk of eyestrain when engaging in computerized documentation? A) Use a firm board to rest the palm. B) Use an antiglare screen cover. C) Obtain a paper chart for nursing documentation. D) Use a lumbar support.
Answer: B Explanation: A) An antiglare screen cover may decrease the eyestrain that the nurse is experiencing. The nurse will not be allowed to chart on paper because the nursing documentation is electronic. A firm, flat board or hard surface to rest the palm is the best way to protect the wrist from injury. A lumbar support helps with appropriate body posture for the back.
Advances in technology have made what information available to healthcare providers at the client's bedside? A) Vital signs B) Radiologic images C) Allergy alerts D) Dietary restrictions
Answer: B Explanation: A) Even before many advances in technology, nurses and other healthcare providers had access to the client's current vital signs, allergy alerts, and dietary restrictions by viewing the client's paper chart at the client's bedside. However, they usually could not view radiologic images at the bedside. Now, with advances in technology, results from laboratory and radiologic exams can often be viewed at the client's bedside.
Which best describes how the use of a clinical decision support system can help the nurse plan care for a client with a particular condition? A) It can help the nurse find out what was done on the previous admission. B) It can help the nurse identify evidence-based guidelines for this client's condition. C) It can help the nurse use standardized nursing language during documentation. D) It can help the nurse search the internet for information about surgical procedures.
Answer: B Explanation: A) Nursing care should always be based on evidence-based guidelines, which the nurse can access through a clinical decision support system. Although informatics can help the nurse find out what was done on the previous admission, use standardized language for documentation, and search the internet for information about the surgical procedure, none of these will help the nurse plan evidence-based care.
The nurse is documenting in the electronic medical record (EMR) after providing care in the client's room. The client asks the nurse why a computer is being used. Which response by the nurse is appropriate? A) "The information that is uploaded is available for anyone to view." B) "Computers improve client care because information is readily available." C) "The computer decreases documentation time for nurses." D) "Computers allow you access to your medical record."
Answer: B Explanation: A) Nursing informatics is the science of using computers in nursing practice to improve client care by making client information easily accessible for the client and other healthcare workers who are participating in the client's care. Documenting client information by computer does not necessarily reduce charting time, depending on the system used. The client's information is protected by privacy laws. Clients have the right to access their medical records regardless of whether they are paper or electronic.
What is the primary advantage of electronic reminders in the electronic health record? A) They help nurses decrease the length of stay. B) They help nurses increase client safety. C) They help nurses document assessments. D) They help nurses track quality metrics.
Answer: B Explanation: A) The primary direct advantage of electronic reminders is that they help improve client safety, often by reminding nurses to use certain screening tools or complete certain assessments. By increasing safety, these reminders can indirectly reduce length of stay. Note, however, that electronic reminders don't actually help nurses document assessments, nor do they track quality metrics.
A rural home health nurse is caring for a client recovering from a myocardial infarction. The client is concerned that the community clinic does not have the ability to provide the necessary monitoring for the health problem. Which response by the nurse supports the use of informatics to meet client needs? A) "It is not necessary for you to be monitored after a myocardial infarction." B) "We can send your information to the cardiologist using telehealth." C) "You are right. We will be sending you to the city every month." D) "We use an intranet in this facility."
Answer: B Explanation: A) Through telehealth advances, clients who live in remote areas can have their information monitored by specialists using computers. Because of this technology, clients do not need to make frequent visits to specialists for monitoring and evaluation of progress. A client who has experienced a myocardial infarction does require monitoring. The intranet is used within an agency or system and is not a tool that can be accessed from the outside.
A group of staff nurses is discussing the importance of uniform language within healthcare documentation. Which statement made by the one of the nurses indicates an understanding of uniform language in healthcare documentation? A) "Uniform language is useful only when communicating with other staff nurses." B) "Uniform language is the consistent use of the same terminology among all providers." C) "Uniform language decreases the value of nursing interventions in the eyes of other providers." D) "HIPAA and HITECH are examples of uniform languages used by nurses."
Answer: B Explanation: A) Uniform language is the consistent use of the same terminology among providers, facilities, institutions, and organizations. It is useful when communicating both with nurses and with providers from other disciplines. Uniform language can increase the visibility of nursing interventions and thus increase their value in the eyes of other providers. NANDA, NIC, and NOC are examples of uniform languages used by nurses, not HIPAA and HITECH.
Several nurses are discussing the use of electronic medical records when providing client care. Which statements by the nurses indicate that they understand the advantages of electronic health records (EHRs)? Select all that apply. A) "The record reduces the cost of healthcare." B) "The record allows trending of client progress." C) "Client education can be documented in the system." D) "Quality metrics can be observed to reduce readmission rates." E) "Coordination of care is improved."
Answer: B, C, D, E Explanation: A) Electronic health records can assist the nurse by allowing trending of client progress, documentation of client education, and observation of quality metrics to help decrease readmission rates. Electronic health records also allow improved coordination of care between providers because they are all working off one chart. The use of the electronic health record does not directly reduce the cost of healthcare.
A client diagnosed with cancer is receiving care through a facility that is 100 miles from the client's home. After the nurse explains how telehealth will be used to enhance this client's care, which client statements indicate that teaching about telehealth has been effective? Select all that apply. A) "I will have to move closer to the provider." B) "My health record can stay where I am." C) "I can participate in the videoconference." D) "I will have to change doctors." E) "This will help lower some costs of care."
Answer: B, C, E Explanation: A) Using telehealth, the client can live and stay in the home and does not need to move closer to the treatment or monitoring facility. The client will not be required to change healthcare providers. Telehealth allows for the client to participate in a videoconference, keep health records in the home agency, and lower many of the costs that could be incurred with frequent travel.
Which factor increases nurses' use of clinical decision support systems (CDSS)? A) Out-of-the-way workstations B) Nursing experience C) Caring for a new client D) Reminder pop-ups
Answer: C Explanation: A) Nurses tend to use CDSS more frequently when they are caring for a client with which they are unfamiliar. However, nurses tend to decrease use of a CDSS when they have more nursing experience, when there are too many reminders, or when the workstation is not conveniently located.
In preparation for the next quality improvement committee meeting, the nurse accesses the clinical decision support system to run an outcomes report. How should the nurse anticipate the committee using this report? A) To eliminate unnecessary care B) To measure the length of hospital stays C) To assist in modifying policies and procedures D) To validate appropriate place of treatment
Answer: C Explanation: A) Outcome tracking helps identify faulty processes and assists in modifying policies and procedures to improve client outcomes for a particular diagnosis or department within a health organization. Utilization review is designed to eliminate inappropriate or unnecessary medical care, length of stay, and place of treatment.
What is one advantage of the standardization of health records in relation to client education? A) It allows the nurse to print information for the client rather than reviewing the information in person. B) Families can receive education rather than clients in order to ensure that the client receives proper care at home. C) Clients can receive the same education about their condition regardless of where they receive treatment. D) Clients can look up their health information at home after discharge.
Answer: C Explanation: A) Standardization of the health record allows clients to receive the same education about their condition regardless of where they receive treatment. Standardization does not negate the nurse's responsibility to review the information in person with the patient or family. Both families and client should receive education as appropriate, regardless of standardization. Clients looking up their health information at home does not depend on standardization of health records.
The nurse on the hospital research committee is assigned the task of compiling information related to the therapeutic and side effects of a specific drug. Which best describes how the nurse can use informatics to gain information about this topic? A) Search for articles about the drug in the hospital's library. B) Email other research committees to find out what they know about the drug. C) Query electronic health records (EHRs) to determine client responses to the drug. D) Look up the drug facts in the latest pharmacology textbook.
Answer: C Explanation: A) Using computers, nurses can now query EHRs to research client responses to drug administration. Searching for articles in the library or looking up drug facts in a textbook does not require the use of informatics. Although emailing does use computers, emailing another research committee for information about a drug is not best practice for nursing research.
Under which circumstance would the use of a geographic information system (GIS) be beneficial for healthcare workers? A) When sharing a traveling client's electronic health record (EHR) with an out-of-state provider B) During a mass casualty incident C) When tracking the sleep pattern of a client D) During an influenza outbreak
Answer: D Explanation: A) A GIS is used to map where infectious diseases are most likely to spread next so that adequate care can be provided. Although sleep patterns can be tracked using GIS, GIS is more beneficial when comparing sleep patterns in different geographic regions rather than tracking sleep patterns of one individual client. GIS is not typically used when sharing a traveling client's EHR with an out-of-state provider or during a mass casualty incident.
Which administrative function related to medical records management may be made easier by the use of informatics? A) Tracking client outcomes B) Making sure charts are coded correctly C) Ordering materials and supplies D) Assigning a client to a hospital room
Answer: D Explanation: A) All of these tasks are made easier through the use of informatics, but only assigning a client to a hospital room is related to medical records management. Tracking client outcomes is part of quality assurance, making sure charts are coded correctly is the job of the billing department, and ordering materials and supplies is related to facilities management
How does the clinical decision support system support human resource functions? A) Determining if staff are correctly coding client care procedures B) Identifying staff who are incorrectly charging for resources used for client care C) Recognizing staff who are not discharging clients according to identified lengths of stay D) Evaluating the number of staff with licensure due to expire
Answer: D Explanation: A) Human resource departments can benefit from computerization by tracking personnel within the healthcare system. Professional licenses and credentials expire and must be renewed. It would be a daunting task to keep track of this information manually for a large facility that employs thousands of healthcare professionals. A computerized system can monitor license expiration and when recredentialing of a provider is required. Coding and charging for resources would be used by the billing department. Information about client discharges according to identified lengths of stay would be used in a utilization review.
The nurse is providing discharge instructions about medications and exercise to a client who was hospitalized with a serious medical condition. Which action by the nurse ensures that the client is fully informed? A) Make sure a relative attends the discharge teaching session. B) Repeat the discharge teaching sessions twice. C) Ask the physician to reinforce teaching prior to discharging the client. D) Print the discharge instructions and hand them to the client prior to discharge
Answer: D Explanation: A) Most hospitals and agencies have computer-generated discharge instructions that the nurse can print to give the client to refer to when at home. This not only prevents calls, but gives the client confidence. Repeating the instructions does not help the client at home. Relatives can forget as easily as the client. It is not the physician's place to reinforce teaching.
The nurse is preparing discharge instructions for a client with a foot wound. How will the clinical information system support this client's learning needs? A) Improves documentation about the client's status B) Summarizes the list of charges that will appear on the client's bill C) Provides a record of all medications received while hospitalized D) Prints discharge instructions to use for teaching
Answer: D Explanation: A) The clinical information system provides access to client information and provides data to help the nurse execute the nursing process. This includes printing discharge instructions to use in client teaching. Although different information systems can do all of these things, only printing discharge instructions will support the client's learning needs. B) The clinical information system provides access to client information and provides data to help the nurse execute the nursing process. This includes printing discharge instructions to use in client teaching. Although different information systems can do all of these things, only printing discharge instructions will support the client's learning needs.
