Nursing Informatics
Over time, three axioms have evolved for developing effective human-computer interactions.
1-Users must be an early and continuous focus during interface design; 2-The design process should be iterative, allowing for evaluation and correction of identified problems; 3-Formal evaluation should take place using rigorous experimental or qualitative methods.
Advantages to communication systems include:
A real-time approach.Facilitation of care across the entire team.Enhanced flow of communication.Promotion of information exchange.
Reusable clinical models of content are called
Archetypes
What are the three relational components of Omaha Home Healthcare Systems?
Assessment, Intervention and outcome are the 3 components and they are used to create a comprehensive problem solving model for practice research and education
Name an Information systems that is used to document patient care.
Clinical information system (CIS)
Raw facts are often called:
Data
Translates steps for research into clinical practice
Iowa Model
Data integrity refers to
how complete and correct data is
This health professional is a knowledge worker who gathers and inputs correct data and uses the CBIS to find pertinent information to assist in the care of patients
A Nurse
What are the four common core business systems.
Admission, discharge, and transfer system (ADT), Financial, Acuity systems, Scheduling Systems
ANA CNPII
American Nursing Association Committee for Nurses Practice information and Infrastructure
The conception, development, and implementation of informatics tools based on intelligent technologies.
Artificial intelligence (AI)
Advantages Order Entry Systems (OESs)
Assist with Automation of the traditional way orders have been initiated; provide Clear and legible orders; used as A major safeguard against errors; Provide greater patient safety; Can Accommodate decision support and automated alert functionality
Typical health care settings for human-technology interfaces include:
Barcoded identification systems, Defibrillators. Patient-controlled medication pumps. Electronic thermometers.Pagers.
This system uses data acquisition, processing, dissemination, and feedback of information and assists nurses in the continuous cycle of knowledge generation and transmission
CBIS or Computer based information system
A system designed to document the six steps of the nursing process; facilitates patient care documentation at the point of care
CCC Clinical Care classification
The most widely accepted codes for billing; used to code all medical procedures
CPT Common procedure Terminology codes
When properly created, these systems can help prevent costly complications and enhance the overall outcomes for patients with chronic illness and Provide a Standardized plan of care. Increase the value of individual care. Control the costs and risks. Assimilate information obtained over a patient's lifetime.
Case management information systems
Health Care Organization Information Systems: A variety of information systems are used within healthcare organizations to collect, process, and distribute patient-centered data and create a record of the medical history of the patient. Five specific types of systems are used in health care. What are they?
Case management information systems Communication systems, Core business systems, Order entry systems, Patient care support systems
A person involved with the information technology infrastructure of an organization. This role is sometimes called chief knowledge officer.
Chief information officer (CIO)
Person focused on organizational-based scientific and technical issues; responsible for technological research and development as part of the organization's products and services.
Chief technology/Technical officer (CTO)
The most common type of patient care support system. Designed to collect patient data in real time. Data is readily available to clinicians and team members and contains observations, interventions, and outcomes.
Clinical Information System (CISs) are
Name some Information systems that might be found in a healthcare setting:
Clinical information system (CIS), Decision support system (DSS), Executive support system, Geographic information system (GIS) Management information system (MIS), Office system, Transaction processing system (TPS), Hospital information system (HIS)
There are four types of Patient Care Support Systems, they are
Clinical information systems, Pharmacy information systems, Laboratory information systems, Radiology information systems
the science of understanding what information is housed in and processed by the brain.
Cognitive informatics (CI)
A field that involves both cognitive informatics and artificial intelligence
Cognitive science
Patient Care Support Systems are used for:
Collecting data about patients and distributing that information to all members of the healthcare team to work in tandem.
These systems contain equipment, hardware, software, storage, and networks that work together for a specific purpose like healthcare information management
Computer based information systems
Tools help to reduce the cost and development time while enhancing the actual quality of the end product.
Computer-aided software engineering (CASE) tools. Containing a repository with information about the system, CASE tools have value in their ability to make sure the models follow diagramming rules and are consistent and complete
supports health care management by providing the framework for reimbursement support of best practices, and resource allocation.
Core business systems
Input such as using the keyboard to place information in the search engine describes the term
Data
the process by which collected data is processed to identify trends and relationship patterns.
Data analysis
any information entered into a computer system is called
Data input
What concepts form the basis of the nursing informatics framework?
Data, information, knowledge, and wisdom are all concepts that form the basis of the conceptual framework for nursing informatics.
A type of organization or standards developed for transmission of medical images and their associated information, used in hospitals worldwide for production display, storage retrieval and printing of medical images
Dicom or Digital imaging and communication in medicine
Viability of Knowledge, for knowledge to be viable it must be:
Easily accessed, Accurate, Timely, Presented in a way that is understandable and organized so that new knowledge can be generated.
Proficient in a specialty; Highly skilled in using computer technology skills and information management skills to support his or her specialty area of practice;Pulls trends out of data and makes judgments based on this information; Uses current systems, but will collaborate with informatics nurse specialist regarding concerns or suggestions provided by staff
Experienced Nurse
True or false Storage is never considered part of processing,
False
The Dynamic Systems Development Method (DSDM) Phase 2 of the DSDM is the Project Life Cycle. The Project Life Cycle is the longest of the development phases, consisting of five steps:
Feasibility, Business studies, Functional model iteration, Design and build iteration. Implementation
The open EHR supports useable archetypes that maintains these three sections:
Header, definition and ontology
A type of EHR organization and standards who's purpose is to improve care delivery, optimize work flow, reduce ambiguity and enhance knowledge transfer among stake holders; its structure defines data and elements, specifies how the data is coded and requires specific rules to be followed such as specifying the length of the fields and the code nomenclature
Health Level 7 or HL7
International classifications of disease or injury
ICD 9 and ICD 10
Codes that describe the disease or injury
ICD Codes
A unified language for nursing practice that facilitates the development of the cross mapping of existing terminologies; uses specific guidelines to develop nursing diagnosis outcomes and intervention statements; implemented as a point of care and reference terminology
ICNP International classifications of Nursing Practices
The four steps to the Iowa model are:
Identification, research, adaption, implementation and evaluation
Conducts informatics research and generates informatics theory; has vision of what is possible, a keen sense of timing to make things happen; is Creative in developing solutions; Leads the advancement of informatics practice and research; has a sophisticated level of skills and understanding in computer technology and information management; is cognizant of the interdependence of systems, disciplines, and outcomes, and is able to finesse situations to obtain the best outcome
Informatics Innovator
Nurses who demonstrate advanced and specialized nursing informatics competencies. Includes practicing nurses, nursing administration, nurse researchers and educators who have mastered skills and use technology in design, plan and coordinate the use of technologies and informatics theory in nursing
Informatics innovator
Participates in the design and development of information systems, quality assurance programs and new applications for nursing, develops inventive ways to access data and interact with info systems:
Informatics innovator
Process of making enhancements or improvements and creative, novel, and inventive solutions in the informatics specialty.
Informatics innovator
A nurse with specialized skills, knowledge, and competencies in informatics. An RN with an interest or experience working in an informatics field. A generalist in the field of informatics in nursing.
Informatics nurse (IN)
An RN with advanced education who possesses additional knowledge and skills specific to computer technology and information management; Focuses on nursing's information needs, which include education, administration, research, and clinical practice; Application and integration of the core informatics sciences: information, computer, and nursing science; Uses critical thinking, process skills, data management skills, systems life cycle development, and computer skills
Informatics nurse specialist (INS)
An RN with formal, graduate education in the field of informatics or a related field and is considered a specialist in the field of nursing informatics
Informatics nurse specialist (INS)
Processed data that that has meaning is
Information
Why do we need information systems in health care?
Information systems shape healthcare organizations as they affect communication, speed, and storage and access of information and data.
The extent to which systems and devices can exchange data and interpret that shared data is
Interoperability
Any treatment based upon clinical judgment and knowledge that the nurse performs to enhance patient client outcomes
Intervention
The nurse is interested in researching a topic of interest in clinical nursing practice. What options are most suitable for researching existing information?
Interviewing a specialist, Online websites Professional databases
What is the last step in the Iowa Model?
Iowa model lists Implementation and Evaluation as the final research step, to ensure patient outcomes
Logical observation identifiers, names and codes used in laboratory and clinical observation
LOINC
The first information systems in use and largely served as the model for all other systems. Reports on blood, body fluid, tissue samples, and biological specimens are processed through this system
Laboratory information Systems
Students build their knowledge through interactions with the course content.
Learner-Content Interactions
Students build their knowledge by finding, retrieving and using information that they need.
Learner-Learner Interactions
a form of systemic review that relies on technology to combine the results of multiple studies for statistical analysis
Met-analysis
a form of systemic review that combines information for statistical analysis
Meta-analysis
Describes the patients reaction to the disease and treatment
NANDA
Diagnoses used to identify human responses to health promotion, risk and disease; each diagnosis has a definition and defining characteristics
NANDA North American Nursing Diagnosis Association International
The minimum data elements necessary for defining the cost & quality of nursing care
NMDS Nursing Minimum data set
A classification system that describes patient outcomes sensitive to nursing interventions
NOC Nursing outcomes classification
A nurse who specializes in nursing informatics and who works with the CIO, CTO, nurses, and other staff to integrate, improve, and use the CBIS.
Nurse informaticist
The 3 elements that make up the NMDS (nursing minimum data set) are:
Nursing Care, patient demographics and service elements
facilitates the integration of knowledge, data, and information to support nurses and other providers in the various roles they play; enhances The Foundation of Knowledge model by supporting nurses in their quest for information and knowledge.
Nursing Informatics (NI)
A standardized classification system of interventions that describe activities that nurses perform
Nursing Interventions Classifications NIC
A system that evaluates the effects of nursing care as part of healthcare; consists of outcomes and can be used across the clinical setting and in specialty areas; applies to an individual, family or community
Nursing Outcome Classification NOC
The Foundation of Knowledge Model provides a framework for the four building blocks of Nursing Informatics; the four building blocks are:
Nursing Science, information science, computer science and cognitive science
A system widely used in areas such as home health care, hospice, public health, school health and prisons
OHHCS Omaha Home Health Care OHHCS
Using this software, any programmer can implement, modify, apply, reconstruct, and restructure the source codes available from existing, well-tested products.
OSS Open Source Software OSS is an excellent solution to the problem of sharing patient data across the healthcare network. The healthcare system is slowly beginning to recognize its benefits. Yet it also has some security issues.
Attempts to recreate real world objects such as hospitals and nurses into abstract computer software objects
Object-Oriented Systems Development (OOSD)
The system is designed to solve the needs of users.
Object-Oriented Systems Development (OOSD)
Structural frameworks for organizing information; represents knowledge as a set of concepts with in a domain, using a shared vocabulary to denote the types, properties and interrelationships of those concepts; used in artificial intelligence, semantic web, and many other areas
Ontology
Study of that which is compositional in nature and a partial representation of the entities within a domain and the relationships that hold between them. An explicit specification of a conceptualization
Ontology
The most important systems in use in health care today:
Order Entry Systems (OESs)
A measurable behavior or perception that is measured along a continuum and is responsive to nursing interventions; can apply to an individual, family or community
Outcome
Includes anything that returns information back to a user, multiple printed or electronic formats, often associated with printed documents
Output
A set of standardized perioperative nursing vocabulary that provides nurses with a clear precise and universal language for clinical problems and surgical treatments; provides wording and definitions for nursing diagnoses, interventions and outcomes providing clinicians with the same terminology to describe patient care in the perioperative setting.
PNDS Perioperative Nursing Data Set
This set of standardized terminology provides the means of sharing patient data between providers, departments, facilities and other settings; it supports the nursing process by supporting the foundation for determining the patients needs & establishing the plan of care for the perioperative clinical setting
PNDS Perioperative Nursing Data Set
This order systems is used for entry, dispensing, verification, and authorization. These systems often interface with other clinical systems. They can help prevent adverse medication interactions by flagging pharmacists when there are potential problems
Pharmacy information systems
Coordinating the processes to enable business processes at an organization housing the systems to work together is called_____________ interoperability
Process
The retrieval, analysis, or synthesis of data is called
Processing
data focused on number and frequency analysis, which matches perfectly to technology use.
Qualitative data
data that focuses on words, experiences, scenarios, value, and meaning.
Qualitative data Qualitative data is not measurable in terms of tangible variables, such as numbers
These systems commonly include picture archiving and communication system (PACS), which may be stand-alone or be integrated with radiology and clinical information systems.
Radiology information systems (RIS)
This system may schedule, provide results, and store information related to diagnostic radiology procedures.
Radiology information systems (RIS)
A method of testing that allows user feedback to influence added functionality. This is done through beta testing, which puts the product in the hand of future users.
Rapid Application Development RAD
The advantage of this system is the relative speed in which a product can be perfected and rolled out. In addition, potential problems can be addressed before the product is released to the wider market.
Rapid Application Development RAD
Mary is the NI specialist in a large orthopaedic hospital. Mary needs to ensure that bedside nurses are able to access lab value meanings on their handheld devices. The need for this technology is great, and Mary needs this functionality immediately. Which SDLC approach will best meet Mary's need for near-immediate implementation?
Rapid approach Development The purpose of Rapid Application Development is to use workshops and focus groups to build a prototype application using real data and feedback from user-testers.
Helps manage data using the relational model and could link a patient's table to a treatment table.
Relational database management systems (RDMS)
A standardized systemized nomenclature of human and veterinary medicine clinical terms
SNOMED CT
Guaranteeing that the meaning of the exchange data remains the same on both ends of the transaction is_____________ interoperability
Semantic
The ability to exchange data from one point to another is _____________ interoperability
Technical
What are the three types of interoperability
Technical, Semantic and Process
One approach that address the organizational, managerial, and interpersonal communication issues that often slow down SDLC projects, has 3 steps: Pre-project, Project life cycle, Post-project
The Dynamic Systems Development Method (DSDM)
a way to deliver efficient and effective information systems that fit with the strategic business plan of an organization.
The System Development Life Cycle (SDLC)
Johanna is a nurse who is finding it difficult to communicate information as it relates to transferring patients between floors.Which type of health care system could Johanna consider suggesting to the NI of the hospital?
The core business system because it allows the health care team to facilitate admission, discharge, and transfer (ADT) of patients.
In regards to Demands of Health-Related Information, what are some demands or requirements for standardized technologies?
The demands on standardized nursing terminologies include accessibility, ubiquity, longevity, and reusability
Acquiring knowledge from one situation and applying it to a similar situation. It moves thoughts and ideas from one area to another for the generation and dissemination of knowledge.
Translational research
True or False Computer based information systems includes patient care equipment.
True
True or False Healthcare information systems are Computer based information systems, or CBIS
True
True or False Nurses use all of the aspects of the Foundation of Knowledge Model, regardless of their area of practice.
True
The key to the success of RAD, rapid application development.
Usability
Using fingerprints for administration of medications, and kicking a form back because a mandatory area wasn't completed are both types of:
Verification of data by the IS
James has a patient diagnosed with a rare disease that James has little experience with. He has read numerous case studies of successful treatment used in a foreign country, and he would like to discuss this with a nurse or physician who has previously worked on a case. James sets up a face-to-face call with a nurse 4,000 miles away. What type of human-technology interface is he using?
Video conferencing-Video conferencing allows health care teams to engage in real-time, face-to-face interactions, regardless of where each of the team members is located.
Model typically includes six phases, Feasibility, Analysis, Design, Implement, Test, Maintain
Waterfall model
Examples of quantitative data include
a patient's height, weight, and vital signs.
The American Nationals Standards institute (ANSI)
aims to reduce patient risk from harm, decrease healthcare costs, and improve patient outcomes through promoting research and technology applications focused on evidence-based practice (EBP).
Data, such as keyboard input data, is known as
alpha data, which includes all text and numeric outputs of digital monitors
Types of data include:
alpha, numeric, audio, image, and video data. Alphanumeric data that nurses encounter might be patients' names and identification numbers. Audio data might be monitor alerts, alarms, or dictated notes.
A Clinical Information System or CIS is also called
an "electronic patient record," or an "electronic health record."
Information is:
data that has been processed and has meaning because it is organized in a way that people find meaningful and useful
Computer based information systems, or CBIS must have two key elements to function well:
decision making/problem-solving ability AND the quality of data/information inputted.
A system that grades evidential research based on various categories of importance
evidence hierarchy
Nurses interact with technology in all aspects of their practice. When using any technology, the goal of the interaction should be:
improved patient outcomes.
Qualitative data is not measurable in terms of tangible variables, such as numbers, examples of qualitative data include:
information obtained from interviews and direct observations.
Name 3 things crucial things required when more than one information system is used within a healthcare setting:
interaction, security, and functionality of systems are crucial.
Thurmond described four types of web-based learning interactions:
learner-learner, learner-content, learner-instructor and learner-interface interactions.
This type of collective approach gives researchers and nurses much valuable information without having to search in a variety of locations for it.
meta-analysis
The ISO (International Standard for Organization) created the standard ISO 18104:2003 "Health informatics—Integration of a reference terminology model for nursing." At the heart of this ISO standard are two models, what are they:
one model for assessing nursing diagnoses, and another for assessing nursing actions.
Information systems are also used to manage the following:
personnel data, monitor paid hours, and how/when staff is paid for work; types of equipment, availability, clinical materials, and financing of both.
Two types of data exist, what are they:
quantitative and qualitative
Knowledge
refers to the synthesis of information and data that is always evolving. A paper is an example of sharing __________________.
The Center for Evidence-Based Practices (CEBP) focuses on:
research-to-practice initiatives related to early intervention, early childhood education, parent and family support, and family-centered practices.
The agency for healthcare research and quality (AHRQ)
supports health services research initiatives. Their website has a wealth of information regarding health care quality.
Combines data from multiple sources, integrating them into one data set.
systematic review
Knowledge is:
the awareness and understanding of a set of information and ways that information can be made useful to support a specific task or arrive at a decision.
The Foundation of Knowledge Model illustrates:
the dynamic, evolving nature of knowledge. We learn by continually acquiring, processing, generating, and disseminating knowledge. As we share our knowledge, we also receive feedback, leading us to rethink and reshape our own knowledge base in a continual cycle., core level of knowledge
Nursing science is:
the ethical application of knowledge acquired through education, research and practice to provide services and interventions to patients in order to maintain, enhance or restore their health.
The human-technology interface can be defined as
the hardware and software that define the interface employed whenever a human uses technology
Information science is
the science of information studying the application and usage of information and knowledge in organizations and the interfacing or interaction between people organizations and information systems. Integrates features from cognitive science, communication science, computer science, library science and social sciences
Nursing informatics is:
the study and application of technology, information, and computer science to the practice of nursing
Translational research has to do with
translating information that is obtained and applying it into practice.
Healthcare workers rely on _______________research because medical, biomedical, informatics, and nursing research can be translated from the original source and applied directly to bedside and clinical interventions
translational research