Nursing Informatics and Quality Improvement - Quiz 2
A nursing student makes an error in patient care during the simulation activity. Which statement by the nursing instructor can assist the student in learning from the simulation?
"How could you prevent this error in the real world?"
The future of health care will be driven by an integration of new technology with:
(NOT data collection software)
Clinical Support Tools examples
-Computerized alerts and reminders for providers and patients -Drug-drug interaction alerts -Underdose or overdose alerts based on renal or liver functions or age or drug levels -Actionable clinical guidelines -condition specific order sets -Focused pt data reports and summaries -Diagnostic support -Contextually relevant info
Alert fatigue
-Defined as simply disrupting clinical workflow -Can result in dismissed alerts -Contributes to resistance to CDSSs -Alert fatigue and clinical burnout are common byproducts of poorly implemented clinical decision support features that overwhelm users with unimportant information or frustrating workflow freezes that require extra clicks to circumvent.
Rationale for NOT being considered medical device per FDA
-Ebook, audiobooks, medical textbooks: intended to use for reference and not for diagnosing -Mobile apps for providers that is used for education or to reinforce facts already known: Intended for user education and NOT diagnosing -Apps for general patient info: " "
Ethical decision making
-Ethical decision making refers to the process of making informed choices about ethical dilemmas based on a set of standards differentiating right from wrong. -The E-Health Code of Ethics (eHealth code, n.d.), which includes eight standards for the ethical development of health-related Internet sites: (1) candor, (2) honesty, (3) quality, (4) informed consent, (5) privacy, (6) professionalism, (7) responsible partnering, and (8) accountability. -the concept of nonmaleficence ("do no harm") will be broadened to include those individuals and groups whom one may never see in person, but with whom one will enter into a professional relationship of trust and care.suggests that both autonomy and justice are enhanced with universal access to information, but that tensions may be created in patient-provider relationships as a result of this access to outside information. Healthcare workers need to realize that they are no longer the sole providers and gatekeepers of health-related information; ideally, they should embrace information empowerment and suggest websites to patients that contain reliable, accurate, and relevant information
Apps for being considered medical device per FDA
-Mobile apps that provide or facilitate supplemental clinical care, by coaching or prompting, to help patients manage their health in their daily environment - Examples include apps that coach patients with conditions such as cardiovascular disease, hypertension, diabetes or obesity, and promote strategies for maintaining a healthy weight, getting optimal nutrition, exercising and staying fit, managing salt intake, or adhering to pre-determined medication dosing schedules by simple prompting. -Mobile apps that provide patients with simple tools to organize and track their health information - Examples include apps that provide simple tools for patients with specific conditions or chronic disease (e.g., obesity, anorexia, arthritis, diabetes, heart disease) to log, track, or trend their events or measurements (e.g., blood pressure measurements, drug intake times, diet, daily routine or emotional state) and share this information with their health care provider as part of a disease-management plan. -Mobile apps that provide easy access to information related to patients' health conditions or treatments (beyond providing an electronic "copy" of a medical reference) -Examples include apps that use a patient's diagnosis to provide a clinician with best practice treatment guidelines for common illnesses or conditions such as influenza;Apps that are drug-drug interaction or drug-allergy look-up tools. -Mobile apps that are specifically marketed to help patients document, show, or communicate to providers potential medical conditions - Examples include apps that serve as videoconferencing portals specifically intended for medical use and to enhance communications between patients, healthcare providers, and caregivers;Apps specifically intended for medical uses that utilize the mobile device's built-in camera or a connected camera for purposes of documenting or transmitting pictures (e.g., photos of a patient's skin lesions or wounds) to supplement or augment what would otherwise be a verbal description in a consultation between healthcare providers or between healthcare providers and patients/caregivers. -Mobile apps that perform simple calculations routinely used in clinical practice-Examples of such general purpose tools include medical calculators for Body Mass Index (BMI), Total Body Water / Urea Volume of Distribution, etc. -Mobile apps that enable individuals to interact with PHR systems or EHR systems-Examples include apps that provide patients and providers with mobile access to health record systems or enables them to gain electronic access to health information stored within a PHR system or EHR system. -Mobile apps that meet the definition of Medical Device Data Systems -Examples include apps that are intended to transfer, store, convert format, and display medical device data, without controlling or altering the functions or parameters of any connected medical device.
Areas for mHealth growth
-Preventive medicine and health promotion can be leveraged through education and awareness applications; -Portable diagnostic devices that allow monitoring of human conditions in clinical settings or offsite locations; -Applications for data management, training medical personnel, and mobile payments
Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH)
-Under this act, healthcare organizations can qualify for financial incentives based on the level of meaningful use achieved -the HITECH Act specifically incentivizes health organizations and providers to become "meaningful user
Information theory
-accuracy of coding (technical/semantic), -effectiveness -efficiency of info transferred -data is unique to patient.
evolution of HI
-book publication -journal publishing -professional organizations -conferences -university level education programs -development of certification programs
Mobile health (mHealth)
-defined as the use of wireless communication to support efficiency in public health and clinical practice -To facilitate mHealth, mobile applications (apps) have been developed, which can be executed either on a mobile platform or on a web-based software application that is tailored to a mobile platform but is executed on a server. Mobile medical apps are accessories to a regulated medical device or are software that transforms a mobile platform into a regulated medical device. These mobile devices may include, but are not limited to, mobile phones or smartphones, tablet computers, smartwatches, and point-of-care (POC) devices.
What is bioinformatics?
...
Different Web address (domain) suffixes indicate who is responsible for creating the website. A Web address sponsored by the government would have which suffix? A. .edu B. .gov C. .org D. .com
.gov
Which domain name do Internet users consider to be a reliable source of quality health education information?
.org
EBP
1) Identifying a problem 2) Finding relevant evidence 3) Appraising that evidence 4) Applying evidence to: IMPROVE CLINICAL OUTCOMES
The authors cover a lot material on ethics, and Beauchamp and Childress have contributed a great deal to the scholarship on informed consent and other areas. What follows below are highlights and additions. Ethics is a branch of philosophy, so other philosophical branches inform this branch. Ethics focuses on understanding the nature, purposes, justification, and founding principles of moral rules and the system they comprise. It deals with "values" relating to human conduct. For better or worse, the "oughts" of ethical behavior are merely hortatory meaning they exhort what ethical people should or should not do. They lack expressed legal effect of law, although they may have an indirect effect through codes of ethical conduct and professional sanctioning. Thus, there is no legal force to ethical principles or any of the behaviors below. Also, be careful of the meaning assigned to the term "right". Under Holfeld's concepts on legal rights and decision-making, a right triggers a correlative duty requiring an obligation of an actor to do or not do some act. Its jural opposite is no right or duty meaning the actor has no obligation to do or not do some act. So, a right legally may have the same meaning of right ethically. Morals deal with the "rights" and "wrongs" of behavior, where morality may be defined in terms of rational actors who engage in principled conduct. A normative construct of morality might be a set of behaviors advanced by a group or society that anyone who meets certain intellectual and volitional conditions would behave as a rational actor (moral agent) and adhere or follow them. This is one way of viewing "morality," but its definition varies, depending on whether the definer uses a descriptive or normative approach. So, there may linkage with norms for behavioral responses, advocacy, acceptance and justification. Virtues differ from Values. Virtues usually refer to the characteristics or traits (e.g. consequentialist theory: personal traits, attitudes, or skills) that embody moral excellence coming from actions (deontological view). Virtues are seen as intrinsic "goods" where people behave rightly without the need for rules or codes of conduct. Thus, it relies more on character traits, not rules. Virtues guide us to ends which are "values." A list of virtues might include acceptance, accountability, appreciation, assertiveness, awe, beauty, bravery, caring, and more. Values are those qualities we hope to acquire in life that emanate from understanding. Once we have them, we keep them. A value represents a standard of conduct that is measured in terms of good and bad, and the list of values, like the virtue's list is long. Then there are Ethical Principles are universal rules of conduct that are derived from the aforementioned ethical theories. These principles are the practical basis for identifying what kinds of actions, intentions, and motives are "valued." These principles provide a generalized framework that assists health care providers to make choices when faced with an ethical dilemma. The key principles in health care include (1) autonomy (right of a person to make his or her informed decisions), (2) beneficence (being kind or good to others), (3) nonmaleficence (avoiding harms to others), and (4) justice (acting fairly or equitably (social justice theory). The authors list autonomy and nonmaleficence with values, but in health care they are listed as major principles that promote patient care.
1. What is ethics and how do virtues, values, and morals apply to healthcare informatics?
Ans. a. HPI at 70.
1. What process systematically examines viewpoints related to rights and wrongs? a. Ethics b. Mathematics c. Sociology d. Psychology e. Scientology
Ans. d. HPI at 73-74. Note: foreseeability or an ability to know (should know) or reasonably anticipate a probable outcome. So, negligence is an unreasonable departure from an accepted standard of care for an actor that causes harm.
10. What distinguishes a negligent act from an intentional act? a. Carelessness b. Purposefulness c. Foreseeability d. Both a. and c. correct choices. e. All of the above are correct choices.
Ans. e. HPI at 74.
11. What does the ethical principle of justice refer to? a. Fairness b. Equity c. Equality d. Both a. and c. are correct choices. e. All of the above are correct choices.
Ans. a. HPI at 85. Note: given the length of time from passage of The Health Insurance Portability and Accountability Act of 1996 or HIPAA to present day, no one should be using the acronym HIPPA.
12. What is the major rule covering the privacy of protected health information? a. HIPAA b. HIPPA c. ZIPPA d. HPIA e. LEHI
Ans. e. HPI at 89.
13. Which of following purposes apply to HITECH? a. Enhancing coordination of services. b. Reducing health disparities. c. Increasing security for HI and PHI. d. Reducing health care inefficiencies. e. All of the above are correct choices.
Ans. e. HPI at 89.
14. Which of the following are potential sources for protected health information cover? a. Mental Health b. Physical Health c. Health Care d. Health Care Payments e. All of the above are correct choices.
Ans. e. HPI at 99-100.
15. What are potential classes of sanctions arising from a HIPAA breach? a. Civil Fines b. Criminal Penalties c. State Torts d. State Board Suspension e. All of the above are correct choices.
The authors define bioethics as the study and formulation of health care ethics. Bioethics takes on relevant ethical problems experienced by health care providers in the provision of care to individuals and groups. They also cite Husted and Husted (1995) for the proposition that the fundamental background of bioethics that forms its essential nature: 1. The nature and needs of humans as living, thinking beings 2. The purpose and function of the health care system in a human society 3. An increased cultural awareness of human beings' essential moral status (p. 7) Bioethics is a philosophical discipline deals with ethical and legal issues in medicine and health care. According to the Center for Practical Bioethics, bioethicists ask the following types of questions: what is the right thing to do and the good way to be; what is worthwhile; what are our obligations to one another; Who is responsible, to whom and for what; What is the fitting response to this moral dilemma given the context in which it arises; and on what moral grounds are such claims made?1 These types of questions address a variety of moral issues raised during patient care. Bioethics is multidisciplinary. It blends philosophy, theology, history, and law with medicine, nursing, health policy, and the medical humanities. The National Institute of Environmental Sciences notes the field of bioethics includes medical ethics (health care issues), research ethics (human and animal research issues), environmental ethics, and public health ethics.2 Bioethicists work for academic institutions, hospitals and medical centers, government agencies, private corporations and foundations. Bioethicists usually have a graduate degree in bioethics or a related discipline, such as philosophy, law, medicine, nursing, public health, psychology, political science, biology, or theology. Thus, insights from various disciplines are brought to bear on the complex interaction of human life, science, and technology. In health care, health care providers often face ethical and moral dilemmas arising out of their care for patients and the modern health care delivery system. Modern science and technology advance their capabilities to deliver care, but they also create concerns for patient rights, decision-making, and quality of care and outcomes. An ethical dilemma involves a difficult choice or issue that requires the application of standards or principles to solve. Issues that challenge us ethically. A moral dilemma is a conflict, where the actor must also make a choice, and the choice relies on one or more underlying moral reasons and reasoning.
2. What is bioethics?
Ans. b. HPI at 70 and W 5 Forum Responses.
2. What traits embody moral excellence? a. Values b. Virtues c. Torts d. Crimes e. Misdemeanors
The various ethical approaches can be used to help health care professionals make ethical decisions in all areas of practice. The focus of this text is on informatics. Informatics theory and practice have continued to grow at a rapid rate and are infiltrating every area of professional life. New applications and ways of performing skills are being developed daily. Therefore, education in informatics ethics is extremely important. Typically, situations are analyzed using past experience and in collaboration with others. Each situation warrants its own deliberation and unique approach because each individual patient seeking or receiving care has his or her own preferences, quality of life, and health care needs in a situational milieu framed by financial, provider, setting, institutional, and social context issues. Health care professionals must take into consideration all of these factors when making ethical decisions. The authors point out that the use of expert systems, decision support tools, evidence-based practice, and artificial intelligence in the care of patients creates challenges in terms of who should use these tools, how they are implemented, and how they are tempered with clinical judgment. All clinical situations are not the same, and even though the result of interacting with these systems and tools is enhanced information and knowledge, the health care professional must weigh this information in light of each patient's unique clinical circumstances, including that individual's beliefs and wishes. Patients are becoming consumers, and many health economists want the US health care market to behave like a perfect market. To make decisions, patient-consumers are demanding access to quality care and the information necessary to control their lives. Health care professionals need to analyze and synthesize the parameters of each distinctive situation using a specific decision-making framework that helps them make the best decisions. Getting it right the first time has a tremendous impact on expected patient outcomes. The focus should remain on patient outcomes while the informatics tools available are ethically incorporated. But this consumerism and economic approach based on market justice theory and rational behavior may raise more ethical dilemmas, especially if there is rationing. That is—some actors will get more health care because they can afford it while others may be left with less health care and fewer choices. Knowledge leads to power, and empower consumers and health care providers may or may not act rationally
3. How might one apply "ethics" to informatics?
Ans. c. HPI at 70.
3. What qualities in life reflect a standard of conduct based on right and wrong? a. Torts b. Grievances c. Values d. Morals e. Virtues
HIPAA is evolving and the latest update was the Omnibus Rule, which follows up on the HITECH Act. Recall HIPAA was enacted in 1996, but Congress delegated responsibility to HHS to draft the rules required for implementation. That did not happen until 2003. And like all rules, they must adapt and change with time. Originally, the federal government for several purposes, including better portability of health insurance as a worker moved from one job to another; deterrence of fraud, abuse, and waste within the health care delivery system; and simplification of the administrative functions associated with the delivery of health care, such as reimbursement claims sent to Medicare and Medicaid. Simplification of administrative functions entailed the adoption of electronic transactions that included sensitive health care information. So, the original legislation was about health insurance access and portability of it to help people keep it. Who knew. To protect the privacy and security of health information, two sets of federal regulations were implemented. The Privacy Rule became effective in 2003, and the Security Rule became effective in 2005. Many practitioners that refer to HIPAA are not referring to the comprehensive federal statute enacted in 1996 but rather to the Privacy Rule and the Security Rule—that is, the federal regulations that were adopted years after HIPAA became law. The HITECH Act has had a significant impact on HIPAA's Privacy and Security Rules in the following ways: 1. HHS is to provide annual guidance about how to secure health information. 2. Notification requirements in the event of a breach in the security of health information have been enhanced. 3. HIPAA requirements now apply directly to any business associates of a covered entity. 4. The rules that pertain to providing an accounting to patients who want to know who accessed their health information have changed. 5. Enforcement of HIPAA has been strengthened. These measures are being implemented to provide further assurance that health information will be protected as the country transitions to a nationwide HIT infrastructure. Several other organizations are also involved in the privacy and security aspects of the HIT infrastructure development. The HITECH Act requires HHS to provide annual guidance to secure health information. PHI can be secured or unsecured. PHI is considered unsecured if the provider does not follow the guidance provided by HHS for implementing technologies and methodologies that make PHI "unusable, unreadable, or indecipherable to unauthorized individuals" (HHS, 2009). PHI can be secured through encryption, shredding and other forms of complete destruction, or electronic media sanitation. A breach is considered discovered as soon as an employee other than the individual who committed the breach knows or should have known of the breach, such as unauthorized access or even an unsuccessful attempt to access information. For example, if a respiratory therapist knows that a colleague has accessed or attempted to access the record of a patient for whom the colleague is not providing care (e.g., the practitioner who accessed her ex-husband's EHR, as discussed previously), the employer is deemed to have discovered the breach as soon as the colleague learned of it. The discovery of a breach triggers the beginning of the time frame during which the provider must fulfill the notification requirements. A provider must fulfill these requirements within a reasonable period of time; under no circumstances may a provider take more than 60 days from discovery of the breach. On Jan. 17, 2013, 563-page "Omnibus Rule" was released Jan. 17, 2013, went effect March 2013. HIPAA covered entities and business associates had 180 days or until Sep. 22, 2013 - to come into compliance with most of the final rule's provisions. The Rule underwent major amending resulting in the following: 1. Strengthening the privacy and security protection for individuals' personal health information (PHI). 2. Modifying the Breach Notification Rule for Unsecured Protected Health Information, putting in place more objective standards for assessing a health care provider's liability following a data breach. 3. Modifying the HIPAA Privacy Rule to strengthen the privacy protections for genetic information. 4. Outlining the Office for Civil Rights' (OCR's) data privacy and security enforcement strategies, as updated for the electronic health record (EHR) era mandated by the HITECH Act. 5. Holding HIPAA business associates to the same standards for protecting PHI as covered entities, including subcontractors of business associates, in the compliance sense. 6. Stipulating that when patients pay by cash they can instruct their provider not to share information about their treatment with their health plan. 7. Setting new limits on how information is used and disclosed for marketing and fundraising purposes. 8. Prohibiting the sale of an individuals' health information without their permission. 9. Making it easier for parents and others to give permission to share proof of a child's immunization with a school. 10. Streamlining individuals' ability to authorize the use of their health information for research purposes. 11. Increasing penalties for noncompliance based on the level of negligence, with a maximum penalty of $1.5 million per violation. 12. Guaranteeing that organizations can operate with certainty that their privacy and security policies comply with all applicable regulations. Notwithstanding the overhaul of the Rule, perhaps, the most attention grabbing changes were the provisions allowing patients to pay out-of-pocket to maintain privacy, strengthening PHI protections and breach notification, and increasing fines violations.
4. What are some of the ways HITECH changed HIPAA?
Ans. b. HPI at 70-72.
4. What area of study combines multiple disciplines to establish health care ethics? a. Ethics b. Bioethics c. Scientology d. Pragmatism e. Sociology
Increasing use of mobile devices and social media sites by health care providers opens the door for potential violations for the unwary. Increasing stringency in laws governing privacy, confidentiality and security coupled with ease of use creates problems. Sometime good intentions can go wrong where intellectual curiosity and desire for learning can lead to unwanted disclosures triggering privacy violations. People may post discussions containing defamatory materials triggering intentional tort liability (electronic media qualifies as written speech). Bring your own device into the health care workplace opens the door for security issues, especially if the device lacks encryption and other security tools. One of the major breach problems is the lost or stolen device lacking encryption. Based on the HIPAA amendments and state-laws on breach notification, breaches are now expensive, time-consuming affairs. Fines can be in the millions. Not only can and do health care providers face sanctions (civil and criminal) from the OCR and potential civil torts, but also they may lead to disciplinary actions by employers and professional licensing boards. Such actions can have a serious negative impact on the professional's reputation and financial well-being. If a health care professional is terminated for invading a patient's privacy or breaching the confidentiality of a patient's information, some state laws require reporting the information to all prospective employers of the professional; other laws require reporting to the state licensing board. These boards may have the authority to publicly discipline a health care professional who has engaged in professional misconduct by invading a patient's privacy, which includes inappropriately accessing a patient's EHR, and breaching confidentiality of patient information, such as allowing or tolerating unauthorized access to a patient's EHR. These types of situations can also cause patients to file complaints with the OCR and lawsuits against the offenders. All professionals must be ever mindful of their obligations to report a breach in the privacy or security of PHI to their employers, even if it entails reporting a colleague.
5. What are the potential ethical and legal problems arising from social media use in health care?
Ans. d. HPI at 71.
5. What device in health care may raise the greatest legal and ethical challenges? a. Coulter Counters b. Imaging Systems c. BP Cuffs d. Smartphones e. Ophthalmoscopes
Ans. c. HPI at 71.
6. What arises from a problematic moral question in health care? a. Decision-Making b. Inquiry Dilemma c. Ethical Dilemma d. Moral Dilemma e. All of the above are correct choices.
Ans. a. HPI at 73.
7. What is the foundation for ethical decision-making in health care? a. Principlism b. Pragmatism c. Socialism d. Communism e. Dynamism
Ans. b. HPI at 73-74.
8. What ethical principle embodies the concept of avoiding harm? a. Autonomy b. Nonmaleficence c. Beneficence d. Social Justice e. Dilemma
Ans. c. HPI at 73-74.
9. What ethical principle reflects free-choice in health care decisions? a. Nonmaleficence b. Beneficence c. Autonomy d. Social Justice e. Dilemma
Privacy
: related to personal information and rules that restrict access to this personal information
A patient is using an online patient education resources and is unable to use a computer mouse effectively. What technology is appropriate for this patient? A. Voice interactivity B. Voice engagement C. Voice commands D. Video game
A
It is termed __________if a nurse knows that a colleague has accessed or attempted to access the record of a patient for whom the colleague is not providing care. A. a breach B. a violation C. negligent behavior D. an infringement
A
The prevalence of healthcare-associated infections demonstrates how the _______ can address healthcare quality issues. A. electronic health record B. paper-based chart C. local database D. All of these are correct.
A
What is the name of the federal legislation in the United States to control how financial institutions handle the private information they collect from individuals? A. Gramm-Leach-Bliley Act (GLBA) B. Sarbanes-Oxley (SOX) Act C. HL7 D. All of these are correct.
A
A Nursing Practice Council is focused on reducing workarounds related to medication administration. Which approach is likely to be more successful?
A Nursing Practice Council is focused on reducing workarounds related to medication administration. Which approach is likely to be more successful?
HI
A combo of computer science, math, and engineering
What represents a copyright infringement
A copied document used without owner's consent
Principlism
A foundation for ethical decision making by rational individuals and belief
The informaticist is aware that any change in workflow design in an organization will initially involve:
A management plan
Close the electronic health record immediately.
A new nurse is documenting in a patient's electronic health record when a visitor approaches the nurse to ask questions. What should the nurse do to ensure confidentiality and security of the patient's electronic health record? A. Close the electronic health record immediately. B. Take the visitor to the nurse's station for assistance. C. Continue documenting the record and answer the visitor's questions. D. None of these is correct.
Reason
A nurse is caring for a patient who experiences a complication after surgery. The nurse understands the cause-and-effect relationship because her knowledge is based in: A. reason. B. empiricism. C. intuition. D. instinct.
A Moral
A nurse is considering a social convention about right and wrong human conduct that has formed a communal social consensus, known as which of the following? A. A value B. A bioethic C. A moral D. A right
A technologically based translator
A nurse is discussing options in the treatment plan with a patient who speaks another language. To enhance interaction and exchange of data and information, the nurse will use which of the following? A. An Internet website on the medical condition B. A family member as a translator C. A technologically based translator D. Another nurse to translate the information
communication with other healthcare providers
A nurse is documenting patient data in the electronic health record, which will assist in: A. all of the above B. communication with other healthcare providers. C. learning new nursing skills D. the communication of patient status updates with the patient's friends
c
A nurse is explaining justice in health care to a nursing student. Which statement is correct? A. "Justice refers to the individual's freedom from controlling interferences by others and from personal limitations that prevent meaningful choices." B. "Justice is intentionally imposing risks that are unreasonable and unintentionally but carelessly imposing risks." C. "Justice refers to fair, equitable, and appropriate treatment no matter what is owed to a person." D. "Justice refers to actions performed that contribute to the welfare of others."
B
A nurse is explaining nursing informatics to a nursing student. Which statement by the nurse is correct, according to the ANA? A. "Nursing science is based in computer engineering and sciences." B. "Nursing informatics integrates nursing science with multiple information and analytical sciences to identify, define, manage, and communicate data, information, knowledge and wisdom in nursing practice." C. "Nursing informatics is a combination of computer science and mathematics." D. "Nursing informatics involves information science and computer technology."
Heart monitor
A nurse is performing a physical assessment on a patient with chest pain. Which of the following is a technology that the nurse would use to obtain objective data on the physical status of the patient? A. Electronic health record B. Heart monitor C. Clinical practice guideline D. Electronic nursing journal
Psychology
A nurse is reading literature on cognitive science and understands that this discipline is influenced by which field of science? A. Physiology B. Sociology C. Psychology D. Chemistry
Data
A nurse is reviewing the conceptual framework of nursing informatics and understands the first concept in this framework is: A. decision making. B. data. C. knowledge. D. informatio
c
A nurse is teaching a nursing student about the use of social media and health care. Which statement is correct by the nurse? A. "Posts on social media can be deleted, so caution in posting is overrated." B. "Social media is safe for nurses to use because individuals can restrict access to posts." C. "Nurses must use social media cautiously to protect patients' rights." D. "Nurses can use social media at work as long as they don't post pictures of themselves with patients."
interpretation of data
A nurse reviews the electronic health record of a patient and identifies a drug allergy to the medication that has been prescribed. The nurse has demonstrated: A. informatics competency. B. interpretation of data. C. generation of new knowledge. D. dissemination of nursing science.
gathering information and data
A nurse reviews the patient's electronic health record prior to meeting the patient. The nurse is: A. acquiring knowledge and wisdom. B. analyzing knowledge and data. C. gathering information and data. D. applying knowledge from the basic sciences.
All of these are correct
A nurse's knowledge work includes interpreting or evaluating trends in: A. laboratory results. B. symptoms. C. outcomes. D. All of these are correct.
acquiring knowledge
A nursing professional reads a nursing journal article on a new patient care technology. This nursing professional is: A. generating knowledge. B. using feedback. C. acquiring knowledge. D. processing knowledge.
Although nurses have an ethical duty to ensure patient safety, increasing demands on professionals in complex and fast paced health care environments may lead to workarounds. What is a workaround
A practice that deviates from accepted and expected practice protocols, a shortcut to save time, an inappropriate action or omission of appropriate actions
workarounds
A practice that deviates from accepted and expected practice protocols, a shortcut, an inappropriate action or omission of appropriate actions
Although nurses have an ethical duty to ensure patient safety, increasing demands on professionals in complex and fast-paced healthcare environments may lead to workarounds. What is a workaround?
A shortcut to save time
Healthcare information systems differ from information systems in other organizations because
A)health care is highly influenced by regulation and comptetition B) health care is professionally driven and hierarchical C) health care is multidisciplinary D) all of these are correct Answer is D
What is the name of the federal legislation in the United States to control how financial institutions handle the private information they collect from individuals? A. Gramm-Leach-Bliley Act (GLBA) B. Sarbanes-Oxley (SOX) Act C. HL7 D. All of these are correct
A. Gramm Leach Bliley Act (GLBA)
The prevalence of healthcare-associated infections demonstrates how the _________ can address healthcare quality issues. A. electronic health record B. paper-based chart C. local database D. All of these are correct
A. electronic health record
HIPAA was enacted by the federal government for several purposes, including:
A.better portability of health insurance as a worker moved from one job to another. B.deterrence of fraud, abuse, and waste within the healthcare delivery system. C.simplification of the administrative functions associated with the delivery of health care, such as reimbursement claims sent to Medicare and Medicaid. D. All of these are correct.
EBP models
ACE Star & Iowa Model
Privacy
According to Healthit.gov (2014) Protecting Your Health Information, the privacy and security of patient health information is a top priority for patients and their families, health care providers and professionals, and the government. This was also previously discussed under HIPAA. It also requires that "key persons and organizations that handle health information to have policies and security safeguards in place to protect your health information whether it is stored on paper or electronically." An important issue related to personal information, about the owner or about other individuals, that focuses on sharing this information with others electronically and the mechanisms that restrict access to this personal information.
What core business system predicts an organization's ability to care for a patient or group of patients?
Acuity
What group of patients can NOT utilize telemedicine
Acutely ill patients
The central source for collecting patient demographic information and communicating it to the other types of healthcare information systems, including clinical and business systems is the:
Admission, Discharge and Transfer system (ADT)
A nurse is caring for an 80-year-old male patient who has a chronic disease and does not have access to the Internet. What factor below may contribute to health disparity for this patient?
Age
The process of data mining helps administrators and researchers: A) sort through data bases in order to discover important patterns in data B) Discover or uncover previously unidentified relationships among the data in a database C) conduct exploratory analyses looking for hidden patterns in data
All of the above
A decision support system in the electronic health record consists of: A. reminders and alerts to improve the diagnosis of a patient. B. screening for drug selection, dosing, and interactions. C. preventive health reminders. D. All of these are correct
All of these are correct
Patients partnering with healthcare professionals to manage their health is an example of: A. empowerment. B. patient engagement. C. connected health. D. All of these are correct.
All of these are correct
Patients who have which of the following characteristics can use telenursing services? A. Are immobilized B. Have a chronic disease C. Live in remote places D. All of these are correct.
All of these are correct
Which of the following is a potential outcome of patient-centered care? A. Patients can provide their subjective experience as an input to improve healthcare delivery. B. Care providers may develop their capacity for reflexivity, which may improve their understanding of the implications of their actions. C. Patients and practitioners can provide insights into the overall organization on how to innovate processes and facilities to respond to local needs. D. All of these are correct
All of these are correct
In addition to organizational commitment of resources to address safety concerns, what is a key feature of a safety culture as identified by the AHRQ?
All of these are correct (Acknowledgment of the high-risk nature of an organization's activities and the determination to achieve consistently safe operations., A blame-free environment where individuals are able to report errors or near misses without fear of reprimand or punishment., Encouragement of collaboration across ranks and disciplines to seek solutions to patient safety problems.)
Healthcare Information and Management Systems Society (HIMSS) has been tracking EHR adoption since 2005 through its Stage 7 awards program. HIMSS Stage 7 (the highest level) consists of:
All of these are correct (EHRs with data sharing, EHRs with data warehousing, Totally paperless documentation)
Employers may use telehealth in a wellness program to:
All of these are correct (Reduce absenteeism and increase productivity, Lower healthcare costs and associated insurance premiums, Create financial incentives for achieving healthcare objectives)
Electronic prompts in a technology-based medication administration system warn against the possibility of drug interaction, allergy, or medication overdose when:
All of these are correct (the physician enters the order in the CPOE system, the pharmacist verifies and dispenses the medication, the medication is about to be administered)
A potential outcome of patient-centered care is:
All of these are correct.
An educational game is:
All of these are correct. (A game designed for learning, a subset of both play and fun, sometimes referred to as a serious game.)
What is the driving force for the increased use of telehealthcare?
All of these are correct. (Demographics, nursing/healthcare worker shortages, excessive costs of healthcare services)
Key opportunities provided by developing a portfolio include:
All of these are correct. (Developing a working relationship, networking with other professionals, providing evidence of key qualities and characteristics to share with potential employers.)
Positive impacts noted with using an informatics system to manage patients with chronic illness include:
All of these are correct. (Guidelines adherence, a decrease in emergency department visits, improved provider documentation
Informatics education tools (educational technologies) must be designed to be:
All of these are correct. (Intuitive and affordable, usable, responsive and evidence-based)
Electronic health records may help promote public health initiatives by:
All of these are correct. (Promoting early detection of potential pandemic occurrences, Automating syndromic surveillance of emergency department records, Generating population-level alerts to be sent to clinicians)
Computer-based instruction may:
All of these are correct. (erase geographic boundaries for students, enhance the presentation of content, improve learning outcomes)
insulin pump
An example of an expert system is the: A. non-programmed intravenous pump. B. insulin pump. C. pulse oximeter. D. the electrocardiographic monitor.
Information literacy is:
An intellectual framework for finding, understanding, evaluating, and using information activities that may be accomplished in part through fluency with information technology and sound investigative methods, but most importantly, through critical reasoning and discernment
A teenaged patient is distracted and not engaged in a patient education class in a healthcare facility. What alternative education method might the nurse recommend for this patient?
An interactive computer game
Cybersecurity
Another federal regulatory agency with a role in the privacy and security of health care data is the (FDA). The FDA oversees the safety of medical devices, which includes addressing the management of cybersecurity risks and hospital network security. Recent guidelines issued recommend that medical device manufacturers and health care facilities take steps to ensure that appropriate safeguards are in place to reduce the risk of failure caused by cyberattack. This could be initiated by the introduction of malware into the medical equipment or unauthorized access to configuration settings in medical devices and hospital networks. As medical devices are increasingly integrated within health care environments, there will be a need for vigilance toward cybersecurity practices to ensure all systems are adequately protected and patients remain safe from harm. Nurse Informaticists are frequently called on to evaluate safety and effectiveness of new devices and software. Considerations of cybersecurity must be included in any evaluation process.
True
Artificial intelligence is the field that deals with the conception, development, and implementation of informatics tools based on intelligent technologies. This field attempts to capture the complex processes of human thought and intelligence. True or false
All of the following are advantage of technology mediated care except:
Assessment technology providing a complete and objective assessment
A nurse is evaluating the effectiveness of nursing interventions and will use which type of knowledge? A. Critical B. Explicit C. Clinical D. Indirect
B
Healthcare organizations typically do not encourage use of personal devices for professional matters, and in many instances they actually have policies in place forbidding employees from using personal devices in the workplace. What is an issue or are issues with "bring your own device" (BYOD)? A. Validity B. Security of PHI C. Portability D. All of these are correct.
B
It is termed ___________ if a nurse knows that a colleague has accessed or attempted to access the record of a patient for whom the colleague is not providing care. A. negligent behavior B. a breach C. a violation D. an infringement
B. a breach
Videoconferencing technology: A. is very easy to use B. allows professionals to communicate more effectively and frequently with in-home patients C. must be used for telehealth D. all of these are correct
B. allows professionals to communicate more effectively and frequently with in-home patients
A strength of the FITT Model is that it: A. observes the steps users are likely to take to use the interface to accomplish typical tasks. B. encourages the evaluator to examine the fit between each 2 of the components: user and technology, task and technology, and user and task. C. is the least expensive testing method D. all of these are correct
B. encourages the evaluator to examine the fit between each 2 of the components: user and technology, task and technology, and user and task.
What is the human technology interface? A. software being designed to make technology work faster B. hardware and software that support humans interacting with technology C. hardware designed to facilitate its software D. educating users on the use of the system
B. hardware and software that support humans interacting with technology
A hardware security tool that helps protect an organization against security breaches by issuing masks to protect the identity of a corporation's employees who are accessing the internet is a: A. masking program B. proxy server C. antivirus program D. firewall
B. proxy server
____________ is the ability to manage results of all types electronically including laboratory and radiology procedure reports, both current and historical. A. electronic searching B. results management C. data warehousing D. digital manipulation
B. results management
Healthcare organizations typically do not encourage use of personal devices for professional matters, and in many instances they actually have policies in place forbidding employees from using personal devices in the workplace. What is an issue or issues with "bring your own device" (BYOD)? A. validity B. security of PHI C. portability D. All of these are correct
B. security of PHI
Some organizations provide offsite employees such as homecare nurses with a network interface device that does not have secure info stored on it. These devices are known as: A. secure devices B. thin clients C. networking facilitators D. All of these are correct
B. thin clients
Behaviors leading to unintentional data breaches includes: A. safeguarding an input device B. walking away from a work station without logging off C. using numerical characters in a password D. two of these are ridiculous
B. walking away from a work station without logging off
What are three peripheral devices used in telahealth
BP cuff, pulse ox, thermometer
Evaluation and Management Coding
Before you can determine your E&M, code you must first identify the p lace of service, type of service , and the patient status. The place of service refers to where the service was rendered There are several categories to choose from, but the two most common are the inpatient and outpatient settings. This is pretty straightforward. The type of service refers to t he type of service provided . Some examples of types of services include consultation, hospital admission, office visit, and so forth. Again, pretty straightforward. As a student in your practicum rotations, nearly all of your place s and types of service will be outpatient office visits. Finally, you need to identify the patient's status. Patient status refers to whether or not the patient is a new patient or an established patient of your practice. By definition, a new patient is one who has not received professional service from a provider from the same group practice within the past 3 years. Conversely, an established patient has received professional service from a provider of your office within the last 3 years. So, let's look at an example. Let's say that Jane is scheduled to see you today for a CC of sore throat. She has a medical record on file in your system, and you see that her last visit was in 2012 with your partner, Dr. Tom. Is she considered an established patient or a new patient? She is considered a new patient because e ven though she has been seen by someone in your office previously, it has been more than 3 years since her last visit. There are three key components that determine risk-based E&M codes. 1. History 2. Physical 3. Medical Decision Making (MDM) Each one of these components (history, physical, and MDM) must have a specific number of elements documented to meet the visit requirements .
experimental design
Benefits: 1) RCT 2) Tightly controlled criteria: ensures only difference between control & experimental group is the treatment (or placebo). 3) What is the degree of confidence that the intervention caused the effects?
PBE
Benefits: 1) attention to patient characteristics 2) use of large samples 3) uncovers best practices 4) minimizes potential for false associations between treatments and outcomes
What is unstructured, represents more than 75% of an organization's data, is not contained in databases and is easily overlooked, but helps identify patterns and provides meaningful insights?
Big data
Transcendent presence requires:
Both centering and clearing the mind of potential distractions, and calling the patient by name and using gentle touch to convey interest and responsiveness
Psych Info, OTR Seeker, and SpeechBITE are examples of:
Both online databases and credible information sources
The function of a scheduling system are:
Both to coordinate staff, services, equiptment, and allocation of patient beds, and to track resources within a facility while managing the frequency and distribution of those resources
How much is spent on health care in the United States per year? A. Greater than $1 billion B. Less than $1 trillion C. Greater than $2 trillion D. Less than $2 billion
C
In what type of game does a person use a device, such as a smartphone, to overlay additional information onto the real world? A. Casual game B. Educational game C. Augmented reality game D. Serious game
C
Radio frequency identifier (RFID) technology may gradually replace bar-code technology in the medication administration cycle because RFID provides: A. opportunities to check patient identification before administration of the medication. B. replacement of bar codes in blood banking. C. reduced potential that a counterfeit medication is inadvertently introduced into the supply. D. All of these are correct.
C
Which of the following terms is defined as any physical or mental health information created, received, or stored by a "covered entity" that can be used to identify an individual patient, regardless of the form of the health information. A. Provider health information B. Patient health information C. Protected health information D. All of these are correct.
C
Acceptable use policies in an organization typically restrict downloads of files by employees because: A. employees may waste work time B. downloads interfere with backup and storage of data C. downloads increase vulnerabilities to viruses D. all of these are correct
C. downloads increase vulnerabilities to viruses
An informatics nurse is consulting with a health care organization for expansion of the electronic health record (EHR). Which of the following is a barrier to expansion of EHRs in healthcare organizations? A. nursing staff work support B. lack of meaningful use incentives C. financial barriers D. need to decrease interoperability
C. financial barriers
Organizations are able to monitor who is using the organizational network and what files that user has accessed, because any use of an electronic network: A. constitutes fair use B. protects against spam C. leaves a digital footprint D. all of these are correct
C. leaves a digital footprint
Which of the following terms is defined as any physical or mental health information created, received, or stored by a 'covered entoty' that can be used to identify an individual patient, regardless of the form of the health information. A. provider health info B. patient health info C. protected health info D. All of these are correct
C. protected health info
An ID badge is an example of authentication by: A. something the user knows B. something the user is C. something the user has D. all of these are dumb
C. something the user has
__________ is the term that denotes the ease with which people can use an interface to achieve a particular goal. A. workaround B. situational awareness C. usability D. all of these are correct
C. usability
Which system primarily solves the problems of poor handwriting and incomplete medication orders?
CPOE
Which if the following statements best describes caring as defined by Watson's Theory of Human Caring?
Caring is healing consciousness and intentionality to care and promote healing.
Which statement best describes caring as defined by Watson's Theory of Human Caring?
Caring is healing consciousness and intentionality to care and promote healing.
Casuist approach
Casuistry is a specific ethical reasoning method that analyzes the facts of a case in a sound, logical, and ordered or structured manner.
What term refers to a nurse taking a few calming breaths, clearing his or her mind of clutter, and silently saying the patient's name a time or two before beginning the patient encounter?
Centering
Meaningful Use
Certification Commission for Healthcare Information Technology certifies an EHR
Which of the following factors are drivers of the growing trend toward telehealth and technology use and will influence nursing practice significantly in the next decades?
Chronic diseases and conditions
Who are the consumers of telahealth technology
Chronically ill, isolated, concerned families, etc.
The analyzing tool used to identify the three health conditions and factors that determined discharge destination and length of stay for home care patients was:
Classification and regression tree
What is a system designed to support heath care providers in making decisions about the delivery and management of patient care
Clinical Decision Support System
All of These are correct
Clinical decision support systems help users to: A. consider consequences of alternative actions. B. provide stores of information. C. make decisions in unfamiliar circumstances. D. All of these are correct.
A Nursing Practice Council is focused on reducing workarounds related to medication administration. Which approach is likely to be more successful?
Collecting data in the institution by asking nurses to journal examples of workarounds.
Computer-aided translators (CAT tool)
Computer Aided Translation (CAT), is a broad term used to describe software that human translators use during the translation process to improve their productivity. Most professional translators use CAT tools. With a CAT tool, translators can work faster, eliminate repetitive translations, automatically correct mistakes, and achieve higher consistency of translations. Typical CAT tools are text editors that support bilingual file formats, and have built-in translation memory.
Vendor-owned cloud computing might offer the benefit of reduced costs of maintaining hardware and IT support in an individual healthcare system. What is the main reason that cloud computing is not widely accepted in health care?
Concern about information security and privacy.
human mental workload.
Considering principles of cognitive informatics when designing technology interfaces helps to mitigate A. information processing. B. use of resources. C. human mental workload. D. None of these is correct.
Autonomy: Freedom: Veracity: Privacy: Beneficience: Fidelity:
Contemporary Bioethical Standards:
The American Telemedicine Association released a clinical care guideline for TeleICU. In this guideline, they identified three practice models. Which practice model refers to monitoring the patient without interruption for a designated period of time?
Continuous Care model
_________ laws in the world of technology are notoriously misunderstood. The same laws that cover physical books, artwork and other physical materials apply in the digital world and violations can lead to prosecution.
Copyright
what enhances administrative tasks within health care organizations, provides the framework for reimbursement, and supports best practices, quality control, and resource allocation?
Core business systems
A Community of Practice (CoP) would be best described as
Cost of set-up and maintenance Delays in documentation e-Messaging between providers Continuous need for updates and lack of accountability for doing so
Hybrid or blended delivery of courses means that:
Courses have both face-to-face and online learning episodes
HIPAA was enacted by the federal government for several purposes, including: A. better portability of health insurance as a worker moved from one job to another. B. deterrence of fraud, abuse, and waste within the healthcare delivery system. C. simplification of the administrative functions associated with the delivery of health care, such as reimbursement claims sent to Medicare and Medicaid. D. All of these are correct.
D
According to research by Agarwal et al (2010), communication inefficiencies in healthcare result in: A) time wasted B) costly errors C) Inefficient use of resources D) all of these are correct
D) All of these
Organizational Financial systems: A) manage the expenses and revenue for providing healthcare B)report the fiscal outcomes in order to track them against an institution's organizational goals C)help determine an organization's strategic direction D) all of these are correct
D) all of these
A decisions support system in the electronic health record consists of: A. reminders and alerts to improve the diagnosis of a patient B.screening for drug selection, dosing, and interactions C. preventative health reminders D. All of these are correct
D. All of these are correct
HIPAA was enacted by the federal government for several purposes, including: A. better portability of health insurance as a worker moved from one job to another. B. Deterrence of fraud, abuse, and waste within the healthcare delivery system. C. Simplification of the administrative functions associated with the delivery of healthcare, such as reimbursement claims sent to Medicare and Medicaid. D. All of the above
D. all of the above
An organization's confidentiality policy should clearly define: A. which data are confidential B. procedures for releasing confidential information C. procedures to follow if confidential information is accidentally released without authorization D. all of these are correct
D. all of these are correct
Health information and data in the electronic health record consists of: A. demographics B. medical diagnoses C. medication lists and allergies D. all of these are correct
D. all of these are correct
Positive impacts noted with using an informatics system to manage patients with chronic illness includes: A. guidelines adherence B. a decrease in ED visits C. improved provider documentation D. all of these are correct
D. all of these are correct
Task analysis involves: A. inputs needed for the task B. how a task must be accomplished C. constraints on actors choices on carrying out the task D. all of these are correct
D. all of these are correct
Surveys of potential or actual users of a website can be conducted to: A. observe the steps users are likely to take to use the interface to accomplish typical tasks B. encourage the evaluator to examine the fit between each two of the components: user and technology, task and technology, and user and task. C. reveal problems with the decision rules used to tailor content to users. D. assess preferences for a number of design characteristics such as display color, menu buttons, text, photo size, icon metaphor, and layout by selecting, on a computer screen, their preferences for each item from 2 or 3 options.
D. assess preferences for a number of design characteristics such as display color, menu buttons, text, photo size, icon metaphor, and layout by selecting, on a computer screen, their preferences for each item from 2 or 3 options.
Successful pre-live strategies in a change management plan developed for implementing an electronic health record will include all of the following except: A. involving subject matter experts to validate workflow B. formal training activities C. hosting end user usability testing sessions D. disciplinary measures for addressing resistance by professionals
D. disciplinary measures for addressing resistance by professionals
How much is spent on healthcare in the United States per year? A. less than $1 trillion B. greater than $1 billion C. less than $2 billion D. greater than $2 trillion
D. greater than $2 trillion
A nurse is documenting in the electronic health record and uses standardized terminology, which is important because: A. it reduces inoperability B. it prevents info from being shared C. it ensures the right diagnosis code will be used D. it captures and codifies the work of nursing
D. it captures and codifies the work of nursing
What is an analytic, logical process with the ultimate goal of forecasting or predicting?
Data Mining
_______ ________ is an analytic, logical process with the ultimate goal of forecasting or prediction.
Data mining
Nursing Informatics focuses on what four concepts
Data, Information, Knowledge, Wisdom
Nursing informatics focuses on ..
Data, information, knowledge, wisdom
What is an economic benefit of telehealth
Decrease in admissions for chronically ill patients
Which of the following are driving force(s) for increased use of telehealthcare? (Select all that apply)
Demographics Nursing/healthcare worker shortages Excessive costs of health care services
Identify one of the driving factors of telehealthcare
Demographics, healthcare worker shortages, excessive costs of heathcare
PBE
Difficulty in controlling for differences (vomitus or phlegm?)
The gap between those who have access to online information and those who do not is called the:
Digital Divide
The first step in implementing an EHR into an organization is the vendor selection process. The other factor included in the first step is:
Documenting the desired functions of the EHR
Estimating how much exposure to the potential hazard would cause varying degrees of health effects is known as:
Dose-response assessment
What estimates how much exposure to a potential hazard would cause varying degrees of health effects?
Dose-response assessment
observational design
Drawbacks: 1) selection bias (patients are not randomly assigned/selected) 2) patients with same diagnosis may have many differences in actual condition
experimental design
Drawbacks: 1) time consuming & expensive 2) hard to generalize to patients, settings, interventions
Which data mining concept identifies a variable by exposing more data?
Drill down
Which statement is false?
EBP takes away from the critical-thinking skills used by healthcare professionals.
Theoretical Approaches to Healthcare Ethics
Each method reflects an important aspect of ethical experience, adds to the others, and enriches the ethical imagination. Diverse ethical insights can be integrated to support a particular bioethical decision, and that decision can be understood as a new, ethical whole.
Which of the following genres are goal oriented
Educational game and simulation
_______ refers to making learning fun. A. Edutainmaint B. scaffolding C. game playing D. simulation
Edutainmaint
What is a longitudinal electronic record of patient health information produced by encounters in one or more care settings
Electronic Health Record (EHR)
Online communication among healthcare teams is called:
Electronic communication and connectivity
Healthcare technologies frequently result in all of the following, except:
Elimination of patient safety issues
A major goal of the eHealth Initiative is to
Empower consumers to understand their health needs
True
Ethical dilemmas arise when issues raise questions that cannot be answered with a simple, clearly defined rule, fact, or authoritative view. t/f
The Hippocratic tradition
Ethics approach that was applied to relatively homogenous societies where beliefs were similar
B.
Ethics is best described as: A. ever-changing principles that guide decision making. B. a process of systematically examining varying viewpoints related to moral questions of right and wrong. C. paradigmatic changes that involve rhythmic processes central to the healthcare system. D. a revolution in health care brought on by technologic change.
Core public health functions include all of the following except:
Evaluating web pages for information quality
True
Every nurse must commit to lifelong learning and the use of knowledge in practice in order to be successful. True or False
Research that generates knowledge for nursing practice is called
Evidence Based Practice
ETHICAL Model for Decision Making
Examine the ethical dilemma. Thoroughly comprehend the possible alternatives. Hypothesize ethical arguments. Investigate, compare, and evaluate the arguments for each alternative. Choose the alternative you would recommend. Act on your chosen alternative. Look at the ethical dilemma and examine the outcomes while reflecting on the ethical decision.
data and information
Experts in computer science strive to understand how the mind processes: A. data and information. B. knowledge. C. sensory input. D. None of these is correct.
A nurse is evaluating the effectiveness of nursing interventions and will use which type of knowledge?
Explicit
Knowledge that can be exchanged or shared in the form of data, manuals, product specifications, principles, policies, or theories is known as:
Explicit knowledge
What occurs to determine the length, amount, and pattern of exposure to the potentially hazardous material?
Exposure assessment
True
Extended and expanded access to clinical research findings and decision support tools has been significantly influenced by the advent of computerization and the Internet. T/F
Human-to-human data generated in authentic interactions is not as valuable as technology-generated data.
FALSE
Which type of delivery of material to students has a 5% information retention rate?
Face-to-face
A proactive method for developing a safety culture that learns from mistakes is:
Failure modes and effects analysis
A domain suffix is a good way to determine credibility of a website.
False
A password consisting of the ampersand character (&) and the user's birthdate is strong.
False
An EHR may help to lower healthcare costs by integrating patient information from multiple sources
False
An important consideration for a successful education intervention is the means by which a provider learns best
False
An important consideration for a successful education intervention is the means by which a provider learns best. T/F
False
Big data is the process of using software to sort through data to discover patterns and ascertain or establish relationships.
False
Current telehealth technologies are focused on clinicians being able to see patients and not interact with them since audio and streaming video capabilities are costly
False
Focusing on all the information found on the Internet will help the healthcare professional find the best and most accurate data
False
Health care does not generate big data.
False
In a store-and-forward telehealth transmission, digital images, video, audio, and clinical data are immediately transmitted securely to a specialist or clinician at another location, where they are studied by the relevant specialist or clinician and then are captured and stored on the client's computer or device
False
In a store-and-forward telehealth transmission, digital images, video, audio, and clinical data are immediately transmitted securely to a specialist or clinician at another location, where they are studied by the relevant specialist or clinician and then are captured and stored on the client's computer or device. T/F
False
In the United States, telehealth nurses are required to be licensed only in the state from which they are providing telehealth services, even if they are interacting with patients in other states.
False
Interactive screening forms housed on a patient portal have been shown to increase the number of emergency room visits.
False
Stage 1 Meaningful Use criteria focused on health information exchange and patient control over health data.
False
Storing healthcare data through cloud computing would allow for expandability and increased security.
False
T/F A password consisting of the ampersand and the user's birthdate is strong.
False
T/F Current telehealth technologies are focused on clinicians being able to see patients and not interact with them since audio and streaming video capabilities are costly.
False
T/F It is safe to open an email from a known sender.
False
T/F Stage 1 meaningful use criteria focused on health information exchange and patient control over health data.
False
The eHealth Initiative is largely successful because of interoperability among healthcare systems and the adoption of national data standards.
False
The health educator is aware that health literacy is the same as being able to read and write.
False
The time between research dissemination and clinical translation is typically one to two months
False
An informatics nurse is consulting with a healthcare organization for expansion of the electronic health record (EHR). Which of the following is a barrier to expansion of EHRs in healthcare organizations?
Financial barriers
Health informatics can facilitate all aspects of health care, especially in the __________ of knowledge and ________research, where we attempt to bridge the gap between what we know and what we do.
Generation; translational
How much is spent on health care in the United States per year?
Greater than $2 trillion
A Community of Practice (CoP) would best be described as
Groups of people who share a concern or a passion for something they do and learn how to do it better as they interact regularly
systems theory
HI Theories: -interacts with environment (open). NI falls under this!
complexity theory
HI Theories: adapts to organization and environment, non-linear
1950/punchcards
HI history: Evolution began in the _____s when computers started to be used in health care (____________ were the very first computers to code/reproduce data [Charles Babbage]).
HIPPA
HIPAA was enacted in 1996. While it is best known among consumers and healthcare professionals for its protection of personal health information (PHI) and the additional forms that each of us are asked to sign when we go to provider offices, HIPAA also ensures portability of insurance for individuals moving from one job to another, legal protection for PHI, and mandates standards for the electronic data interchange of healthcare data for encounter and claims information, and was intended to simplify the claims submission process by eliminating paper claims. HIPAA established legal sanctions for institutions and individuals who fail to protect PHI. As healthcare professionals, we are cognizant of HIPAA requirements before we share PHI via writing, electronic means, faxes, telephone, or in person. Specific measures to protect PHI include limiting record access to individuals with a right to know, signed disclosures to release information, encryption of e-mail and files, fax cover sheets, designated persons who may receive PHI, and the use of passwords to guarantee that PHI is only disclosed with persons designated by the consumer as having a right to know. HIPAA has also changed sign-in procedures for patients, disposal of forms containing PHI, and how we use whiteboards to show patient information.
knowledge discovery
HOW knowledge is discovered
A radiology information system equipped with a PACS provides all of the following except:
Hard copy film storage
What seeks to determine the type of health problems that could be caused by exposure to a potentially hazardous material?
Hazardous Identification
When individuals have the capacity to obtain, process and understand health information, this is known as:
Health Literacy
______ is another purpose of the HITECH Act. This term is defined as differences or gaps in the care experienced by one population compared with another population.
Health disparities
Individuals having the capacity to obtain, process, and understand health information is known as:
Health literacy
Bioinformatics tools:
Help biomedical informaticists and healthcare personnel tackle the analysis of large data sets
The dynamic system development method (DSDM) is
Highly interactive
Clinical Support Tools
Historical examples include practice guidelines carried in clinicians' pockets, patient cards used by providers to track a patient's treatments, and tables of important medical knowledge. The primary goal of implementing a CDS tool is to leverage data and the scientific evidence to help guide appropriate decision making
Data integrity can be compromised through which of the following? (select all that apply)
Human error or hackers Transmission errors
Information theory
In Nelson's Model, foresight of nurse is incorporated: data + knowledge=wisdom
1992
In ______ the ANA designated NI a specialty within nursing and outlined the scope & standards of practice.
the role of the informatics nurse specialist (INS) as it relates to patient safety
Included ensuring that technology systems are configured properly and maintained by regularly checking and monitoring the systems. While doing so the INS is making sure that their human potential, the users, are capable of using the systems accurately to avoid errors. the INS also participates in the System Development Life Cycle (sdlc) to ensure the adoption of the proper tool that provides meaningful information and enhances patient care while preventing errors and promoting safety for the patient
The HITECH Act had which of the following goals?
Increase information exchange
What are the benefits of nursing terminologies
Increased visibility, Better communication, improved patient care, enhanced data collection, adherence to standards
According to the Food and Drug Administration, the broad definition of personalized medicine is:
Individualized care
How would you best describe the throughput or processing components of computers?
Inputted data can be visualized by manipulating the mouse and keyboard input devices and the computer monitor is a unique example of a visible throughput component.
Simulation episodes are concluded with ______. (Select all that apply)
Instructor feedback Debriefing Interactive review of the simulated episode by the team
Telehealth interfaces allow patients to: (Select all that apply)
Interact with a virtual clinician (actually a computer program) interact when they want to
research
Is it applicable?
research
Is the source reliable?
Knowledge Discovery Data Mining
KDDM
A novice nurse is more likely to use which aspect of the Foundation of Knowledge Model?
Knowledge Acquisition
A novice nurse is more likely to use which aspect of the Foundation of Knowledge Model?
Knowledge acquisition
KDDM
Knowledge building can be done via _______ and PBE.
True
Knowledge can be defined as the awareness and understanding of a set of information. T/F
A novice professional is more likely to be a:
Knowledge consumer
What is possible because data mining looks at the data from different vantage points, aspects, and perspectives, and brings new insights to the data set?
Knowledge discovery
When working with data, _______ _________ is key, as data mining looks at the data from different vantage points, aspects, and perspectives and brings new insights to the data set.
Knowledge discovery
Professionals who craft discipline theories are primarily:
Knowledge generators
Researchers and discipline experts are likely to be:
Knowledge generators
What represents a challenge that healthcare organizations face in their ability to exchange information with other organizations?
Lack of public trust for privacy
A sense of ownership must initially be secured from which of the following to prevent a disruption in the implementation plans for the electronic health record?
Leadership
What is meant by the statement that learning is a multispatial function?
Learning can take place in both physical and virtual spaces.
When a knowledge worker leaves an organization, the knowledge they possess:
Leaves with them
What is the key impediment of telehealth
Licensure
Webcasts are:
Live video presentations via the Web
When the Drummond group certifies an EHR, this means the EHR meets the minimum standards for what
Meaningful Use
1970
Medical informatics appeared in the early _____s and was defined as the use of a computer to process medical data and information.
According to Stetler et al (1998), the best quality evidence is:
Meta-analysis
computer/information
NI is a specialty that integrates nursing science, ___________science, and ________ science.
Most common diseases, such as diabetes, cancer, stroke, heart disease, depression, and asthma, are affected by:
NOT AGES AND GENES
An example of a nonclinical use of telehealth is:
NOT Administrative supervision
A Practice Council is focused on reducing workarounds related to medication administration. Which approach is likely to be more successful?
NOT Developing an education program to improve understanding of medication administration.
A safety culture is a blame-free environment where individuals are able to report errors or near misses without fear of reprimand or punishment. Conversely, a just culture emphasizes individual accountability and:
NOT Encourages error reporting and seeks to understand workflow and process issues that lead to errors
The benefits of EHR use recognized in early studies include all of these, except:
NOT Enhanced capacity to perform surveillance and monitoring for disease conditions
Epidemiology is:
NOT Incidence, prevalence, and control of disease)
Characteristics of explicit knowledge include:
NOT Knowledge exchanged or shared in manuals, policies, and theories
What defines interdisciplinary collaboration?
NOT Nurses attending a state nurses' association meeting
Which data mining model uses the organization's same business model, but makes improvements by simply thinking differently?
NOT SEMMA (I think CRISP-DM)
Generating new knowledge from the implementation of a study that is based on, but unrelated to, several original studies is known as:
NOT Translational science
What is an example of nonclinical use of telehealth?
NOT administrative supervision
Educational games, simulations, and virtual worlds:
NOT all of these are correct
RFID technology may gradually replace bar-code technology in the medication administration cycle, because RFID provides:
NOT all of these are correct
Which of the following are characteristics of a collaborative learning environment?
NOT both peer support and instructor as facilitator
What creates information that becomes the basis for knowledge in the field of public health?
NOT examination of school aged children
Which factor will support the increased use of telehealth in the future?
NOT increased need for immediate healthcare information
What is a knowledge worker's primary resource?
NOT knowledge
One can capture and codify tacit knowledge by engaging in:
NOT lifelong learning
When persons living with a chronic disease use the Internet for blogging about their health challenges or participating in online discussion forums, this is known as:
NOT self-management
Successful collaborative learning is based on which?
NOT supporting individualized competition
What describes the impact the informatics specialist has on the practice of nursing?
NOT using a portable medication cart
privacy and confidentiality
New technologies used in health care, such as smartphones and Google Glass, create potential ethical issues associated with: A. cognitive load. B. interoperability. C. the human technology interface. D. privacy and confidentiality
Quantitative data focuses on:
Numbers and frequencies
What are the components of the of the metaparadigm of nursing
Nurse, patient, health, environment
Knowledge Workers
Nurses who work with information and generate information and knowledge as products they are described
The systematic standardized way of describing nursing practice and increasing data sets, taxonomies, nomenclatures, and classification systems is called
Nursing Terminologies
What are NANDA, NIC, NOC, CCC, PNDS, etc
Nursing Terminologies
What are three of the sciences used for Nursing Informatics
Nursing science, Information science, Computer science (Cognitive science)
Workflow analysis
Observation and documentation of workflow to better understand what is happening in the current environment and how it can be altered is referred to as process or workflow analysis. A typical output of workflow analysis is a visual depiction of the process, called a process map. The process map ranges from simplistic to fairly complex and provides an excellent tool to identify specific steps.
too conceptual, intangible, or abstract Disregard or do not take into account a person's psychological factors, personality, life history, sexual orientation, religious, ethnic, and cultural background
Opponents of principlism claim principles Are
How is public health informatics different than health informatics?
PHI focus is on promoting health and disease prevention in populations and communities.
Ability to share knowledge
Paper documentation (paper record) hinders which of the following? A. Ability to use nursing terminology B. Ability to care for patients C. Ability to apply research to patient care D. Ability to share knowledge
To become a successful owner of an EHR in the healthcare organization, it must be:
Part of the facility's long term vision
The number one focus of EHR as stated by the IOM is
Patient Safety
The main goal of a clinical support system is ...
Patient safety
Which of the following teaching methods yields the highest retention over a 24 hour period?
Peer teaching
Integrating technology into the medication administration cycle helps to reduce errors by:
Performing electronic checks against a database of safe medication administration parameters and providing alerts
According to McGonigle, a simulation should contain four components: pre-brief, enactment, debrief, and assessment (PEDA). The students receive the simulation information in what component? A. pre-brief B. assessment C. enactment D. debrief
Pre-brief
Autonomy: free-will or agency Beneficence: to do good Nonmaleficence: not to harm Justice: social distribution of benefits and burdens
Principlism Based on
Information
Processing in Nursing Informatics will assist in the transformation of data into ______________, and _____________ into knowledge. A. healthcare B. research C. wisdom D. information
random controlled trials
RCT
An adverse event response team:
Reenacts or simulates adverse events to better understand the organizational or procedural processes that failed
The part of the e-portfolio that explains how critical decisions were made and the decision outcomes is called:
Reflective commentary
Care Ethics
Responsiveness to the needs of others dictates providing care, preventing harm, and maintaining relationships Based on relationships and a caring attitude toward others less guided by rules. Focus is on the needs of others and one's responsibility to meet those needs
What assesses the risk of the hazardous material causing illness in the population?
Risk characterization
The American Telemedicine Association released a clinical care guideline for TeleICU. In this guideline, they identified three practice models. Which practice model refers to periodic consultation within a predetermined time frame?
Scheduled care model
Blockchain
Security of health data remains one of the challenges for HIEs and, in general, interoperability of health data and information. Blockchain is a standard increasingly put forth as a solution. Best known for its use for bitcoins, blockchain is extremely secure when coupled with encryption.
A nursing instructor is designing an assignment that requires social interaction and is goal oriented. Which learning environment would meet these learning requirements?
Simulation
A nursing instructor is designing an assignment that requires social interaction and is goal-oriented. Which learning environment would meet these requirements?
Simulation
What indicates that the healthcare professional is fully present with the patient during an encounter?
Sitting in a chair at the patient's bedside while conducting an admission assessment
What is a data driven method to eliminate defects, avoid waste, or assess quality control issues, and is aimed at decreasing disparities in a business and manufacturing process through dedicated improvements?
Six Sigma
_________ _________ is a data driven method to eliminate defects, waste, or assess quality control issues.
Six Sigma
What translates commands into computer language?
Software
All of these are correct
Some of the disciplines involved in cognitive science include: A. psychology and philosophy. B. neuroscience and linguistics. C. biology and physics. D. All of these are correct.
An ID badge is an example of authentication by:
Something the user has
CAT tool functionality
Spell checkers, autocorrect—automatically highlight and fix spelling and grammar mistakes. In-context review—display multimedia documents with images, text box sizes and layout in real time in both source and target language. Integrated machine translation—suggest translations for segments from a connected MT engine. Adaptive machine translation—offer translations for segments from a connected MT engine as autosuggest pop-ups, learn from user input (examples: Lilt, YarakuZen, SDL Trados Studio 2017). Concordance—retrieve instances of a word or an expression and their respective context in a text corpus, such as a translation memory database, to check their usage. Electronic dictionaries—allow term search inside the tool, track usage statistics. Text search tools—find phrases or terms in the text for reference. Alignment—build translation memories texts from source text and its translation. When a translation company adopts a CAT-tool, they often use alignment to create their first TM databases.
What is an important need for public health informatics regarding data collection?
Standardizing vocabulary and coding structure.
1
Standards of practice for NI: What step #? Assessment
6
Standards of practice for NI: What step #? Evaluation
5
Standards of practice for NI: What step #? Implementation
3
Standards of practice for NI: What step #? Outcome identification
2
Standards of practice for NI: What step #? Problem/Issue identification
4
Standards of practice for NI: What step#? Planning
implementation
Standards of practice for NI: a) Coordination of activities b) Health promotion & teaching c) Consultation
Problem/Issue identification
Standards of practice for NI: analyze assessment data to see if there are problems/issue with it
assessment
Standards of practice for NI: collect data, information, knowledge
planning
Standards of practice for NI: devise a strategy to attain expected outcomes
outcome identification
Standards of practice for NI: what is the outcome of this specific plan?
A meta-analysis helps to generate new practice evidence and nursing knowledge by
Statistical method to combine results of quantitive studies
KDDM
Steps are: -data selection -target data -preprocessed data -transformed data (data mining) -patterns (interpretation/evaluation) -knowledge
Clinical data captured electronically and transmitted then interpreted by clinicians is known as:
Store and forward Telehealth
Advantage(s) of EHR use include: (Select all that apply)
Support for home telemonitoring Improved communications Improved medication administration safety
The system approach used by public health to detect early outbreaks of disease is called:
Surveillance data
Biomedical informatics is the science underlying the acquisition, maintenance, retrieval, and application of biomedical knowledge and information to improve patient care, medical education, and health sciences research.
TRUE
Computational biology can be defined as the development and application of data-analytical and theoretical methods, mathematical modeling and computational simulation techniques to the study of biological, behavioral, and social systems.
TRUE
On the biomedical side of informatics, we must be cognizant of the fact that medical data typically are extracted from personal, confidential, and legally protected medical records. The protection of human subjects must be paramount and all ethical, legal, and social (ESLI) issues must be addressed.
TRUE
Personalized medicine (also known as precision medicine) may be thought of as the tailoring of medical treatment to the individual characteristics, needs, and preferences of a patient during all stages of care, including prevention, diagnosis, treatment, and follow-up.
TRUE
Reflection on practice to gain insight into why an approach was successful (or not) in a practice situation helps a nurse to build:
Tacit knowledge
Telehealth
Telehealth is still an evolving technology; while the offsite interventions or contacts often lead to less time being wasted on non-care-oriented tasks because of the efficiencies offered by the technology applications, its use must never be associated with less care. It is also important to note that nursing activity in telehealth still follows the same best practice standards as those espoused in conventional care.
What is considered the most familiar communication tool in telehealth?
Telephone
FDA Oversight for Medical Devices
The FDA intends to apply its regulatory authorities to select software applications intended for use on mobile platforms. Given the rapid expansion and broad applicability of mobile apps, the FDA is issuing this guidance document to clarify the subset of mobile apps to which the FDA intends to apply its authority. Many mobile apps are not medical devices, meaning such mobile apps do not meet the definition of a device by the FDA. therefore, the FDA does not regulate them.Some mobile apps may meet the definition of a medical device but because they pose a lower risk to the public, the FDA intends to exercise enforcement discretion over these devices (meaning it will not enforce requirements under the FD&C Act). One example is a mobile app that makes a light emitting diode (LED) operate. If the manufacturer intends the system to illuminate objects generally (i.e., without a specific medical device intended use), the mobile app would not be considered a medical device. If, however, through marketing, labeling, and the circumstances surrounding the distribution, the mobile app is promoted by the manufacturer for use as a light source for providers to examine patients, then the intended use of the light source would be similar to a conventional device such as an ophthalmoscope.
What is computational biology?
The actual process of analyzing and interpreting data.
What is an example of a pull system
The clinician selecting an icon to review possible medication for the treatment of congestive heart failure
A nurse educator is selecting a method of patient education and is considering an educational pamphlet. Which of the following is a disadvantage of a pamphlet for patient education?
The cost of design and production of a pamphlet
Biomedical informatics is:
The interdisciplinary science of acquiring, structuring, analyzing, and providing access to biomedical data, information and knowledge. As an academic discipline, biomedical informatics is grounded in the principles of computer science, information science, cognitive science, social science, and engineering, as well as the clinical and basic biological sciences.
reach a rational justifiable decision
The main goal of any ethical decision is to: A. promote professionalism. B. promote trust. C. generate knowledge. D. reach a rational justifiable decision.
Confidentiality
The mandate that all personal information be safeguarded by ensuring that access is limited to only those who are authorized to view that information. Consequently, stringent confidentiality laws and more widespread availability and use of social and mobile media, numerous ethical and legal dilemmas have been posed to all healthcare workers. What are not well defined are the expectations of healthcare providers regarding this technology. In some cases, APNs have been subjected to video and audio recordings by patients and families when procedure is performed. Providers must be aware of the institutional policy regarding audio/video recording by patients and families, as well as the state laws governing two-party consent. Such laws require consent of all parties to any recording or eavesdropping activity
ICD-10 Coding
The most common code sets used are the diagnostic and procedural coding or classification systems. The oldest and most established system is the ICD, which is promulgated and maintained by the World Health Organization (WHO). The United States converted to ICD-10-CM on October 1, 2015. An international standard does not exist for procedures. In the United States, there are separate standards for inpatient procedures and ambulatory care procedures. ICD-9-CM, volume 3, was historically used for inpatient procedures, with a new system, ICD-10-PCS, adopted on October 1, 2015. In late 2016, WHO publicly announced its development efforts for ICD-11. Specifically, ICD-11 will be designed to be compatible with electronic health applications and information systems.
HL7
The most common healthcare messaging standard for text information Messaging standards ranging from patient administration to order entry to medical records management to personnel management, among other functions.
Qualitative research on a practice intervention provides insights into:
The patient's subjective opinion of the effectiveness of the intervention
a set of standards differentiating right from wrong.
The process of making informed choices about ethical dilemmas based on
Optimization is:
The process of moving conditions past their current state and into more efficient and methods of performing tasks
Patient-centered care means that practitioners should focus on:
The subjective experience of patients
Describing educational games, simulations, and virtual worlds, which of the following statements are true? (Select all that apply)
They all share some characteristics. It's difficult to find a "pure" experience in any of the genres. Simulations may have game-like qualities, and virtual worlds may be used to present a simulation.
The casuistry approach
This approach to ethical decision making grew out of the concern for more concrete methods of examining ethical dilemmas.
A benefit for healthcare professionals of using technology for patient education is:
To improve the compliance and documentation of education
A benefit for nurses to using technology for patient education is
To improve the compliance and documentation of education
A benefit for nurses to using technology for patient education is:
To improve the compliance and documentation of education
Cognitive informatics can be defined as ...
To study the connection between the brains and minds way of collecting and processing information
Clinical uses for telehealth
Transmitting images for assessment or diagnosis. One example is transmission of digital images, such as images of wounds for assessment and treatment consults. Transmitting clinical data for assessment, diagnosis, or disease management. One example is remote patient monitoring and transmitting patients' objective or subjective clinical data, such as monitoring of vital signs and answers to disease management questions. Providing disease prevention and promotion of good health. Examples include case management provided via telephone or smartphone app and patient education provided through asthma and weight management programs conducted in schools. Using telephonic or video interactive technologies to provide health advice in emergent cases. One example is performing teletriage in call centers or real-time stroke consultation between a rural health center and an academic medical center. Using real-time video. One example is exchanging health services or education live via videoconference.
A challenge to the American healthcare system is improving the quality of care while controlling costs.
True
A clinical use for telehealth technologies includes providing disease prevention and promotion of good health. One example is telephonic or smartphone app case management and patient education provided through asthma and weight management programs conducted in public schools.
True
A comprehensive surveillance effort supports timely investigation and identifies data needs for managing the public health response to an outbreak or terrorist event. Informatics tools are becoming increasingly important in these public health efforts.
True
A required step in the Iowa Model that translates research into practice is a critique of related evidence.
True
A risk assessment may also be called a "threat and risk assessment." A "threat" is a harmful act, such as the deployment of a virus or illegal network penetration. A "risk" is the expectation that a threat may succeed and the potential damage that can occur.
True
A three-dimensional virtual world often mimics a real-world environment, although it may also include impossible abilities, such as flying unaided T/F
True
A three-dimensional virtual world often mimics a real-world environment, although it may also include impossible abilities, such as flying unaided.
True
According to the Agency for Healthcare Research and Quality, one way to balance the competing cultural values of blamelessness versus accountability is to establish a "just culture."
True
Algorithms are typically computer-based recipes or methods with which data mining models are developed.
True
An e-portfolio may foster improved communication with a mentor or others through professional networking.
True
An important part of the safety culture is cultivating a blame-free environment.
True
Before data can be analyzed or critically reviewed to determine outcomes or assessment, they must be collected and aggregated. A. true B. false
True
Boosting is what the term implies—a means of increasing the power of the models generated by weighting the combinations of predictions from those models into a predicted classification.
True
Brushing is a technique in which the user manually chooses specific data points or observations or subsets of data on an interactive data display.
True
Caring consciousness is energy within the human-environmental field of a caring moment.
True
Caring consciousness is energy within the human-environmental field of a caring moment. T/F
True
Chronic diseases are of major concern to the United States, not only because of the impact they have on individuals, but also because of the tremendous cost associated with providing treatment for patients with these conditions. Adult-onset diabetes, for example, has reached epidemic proportions. A national health information technology infrastructure will help providers better identify those patients who are at risk for developing this disease and provide treatment strategies to avoid it. True or False
True
Clinical decision making is guided by targeted information delivery ensuring that the five rights of CDS are implemented: the right information provided to the right person in the right format through the right channel at the right time in workflow.
True
Cognitive task analysis usually starts by identifying, through interviews or questionnaires, the particular task and its typicality and frequency.
True
Data analysis in quantitative studies may allow the researcher to make inferences to a population beyond the sample, as long as the sample was representative of the population. In contrast, generalizing to a larger population is not a goal of qualitative research. Rather, in qualitative research the goals are exploration and deeper understanding of a phenomenon that has not been widely studied. A. True B. False
True
Data mining tools scan databases and identify previously hidden patterns.
True
Decision trees are a powerful tool that can be used to mine large data sets and discover previously unknown relationships among the data.
True
Decision trees are useful for large data and use an algorithm to explain how to separate and stop the splitting of data.
True
Drill down analysis typically begins with identifying variables of interest to drill down into the data.
True
Embedding EBP into professional documentation can increase the compliance with Joint Commission core measures, such as providing information on influenza and pneumococcal vaccinations to at-risk patients.
True
Evidence-based practice was developed in 1972 as the result of a physician and prisoner of war's belief that not all medical interventions were necessary.
True
Exploratory data analysis (EDA) is an approach or philosophy that uses mainly graphical techniques to gain insight into a data set.
True
Games are goal-oriented and may be competitive in nature. Games should be fun and perhaps a bit "fantastical" and light-hearted.
True
Healthcare professionals have an ethical duty to ensure patient safety.
True
Healthcare professionals must be involved in "meaningful" data collection and reporting
True
Implementation best practice data would be available if more healthcare organizations moved more quickly to adopt use of the electronic health record.
True
In deep transpersonal caring, both the caregiver and the care recipient may experience healing
True
Information prescriptions direct patients and families to credible websites and to wikis and blogs that may help them understand their health issues.
True
Interoperable EHRs are a foundation of developing HIEs
True
Libraries have begun to demonstrate their understanding and support of collaborative learning by providing group study rooms.
True
Many health-related websites now support a Spanish language format.
True
Most EHR benefits studies are hypothesis-testing studies.
True
Most software developers allow for a back-up of the software to be used in the case of a hardware failure.
True
Once technology is integrated into the organization, biomedical engineers can become valuable partners in promoting patient safety through appropriate use of these technologies.
True
One of the most important tools to reduce medication errors is the use of electronic records and information systems to provide point-of-care decision support and automation.
True
Organizational financial systems frequently interface with materials management, staffing, and billing systems
True
Organizational leaders must drive the culture change by making a visible commitment to safety.
True
Ownership of the electronic health record must be felt by all levels of staff before implementation will be successful.
True
Public health may be identified as an occupation that focuses on protecting communities through an understanding and blend of science, policy development, and government decisions.
True
Quantitative data collection tools or instruments include questionnaires, interviews, surveys, quizzes, assessments, e-mail interviews, and Web-based surveys.
True
RFID technologies have both supply chain and patient care applications to patient safety.
True
Repetition of previous research studies is more valued in advancing new knowledge than too many original studies.
True
Research has shown that patients have expressed satisfaction with telehealth.
True
Research results have shown that data mining is an analytical process that can be effective for planning the appropriate interventions for many areas of health care.
True
Researcher Titler (2007) suggests there is a need for the development of theoretical formulations to guide research and systematic reviews.
True
Risk factor systems are used throughout the United States and may be local, regional, or national in scope.
True
Risk factor systems are used throughout the country and may be local, regional, or national in scope. Similarly, specific risk assessment tools exist for specific health issues.
True
Simulated experiences in nursing education should contain the PEDA (pre-brief, enactment, debrief, and assessment) elements to provide important opportunities for students to hone critical thinking and clinical skills in a safe and supportive environment.
True
Six Sigma is a data-driven method to eliminate defects, avoid waste, or assess quality control issues. It aims to decrease discrepancies in business and manufacturing processes through dedicated improvements. Six Sigma uses the DMAIC steps: define, measure, analyze, improve, and control.
True
Smart pump technologies are designed to safely administer high-hazard drugs and to reduce adverse drug events during intravenous medication administration. Smart pumps have software that is programmed to reflect the facility's infusion parameters and a drug library that compares normal dosing rates with those programmed into the pump.
True
Surveillance data systems, such as infectious disease trackers that collect data on adverse health effects, are invaluable tools for public health officials to tap for planning, evaluating, or implementing public health interventions.
True
T/F An electronic health record may lead to better clinical decision making by integrating patient information from multiple sources.
True
T/F Browser privacy settings can control how cookies are used
True
T/F Chronic diseases are of major concern to the United States, not only because of the impact they have on individuals, but also because of the tremendous cost associated with providing treatment for patients with these conditions. Adult onset diabetes for example, has reached epidemic proportions. A national health information technology infrastructure will help providers better identify those patients who are at risk for developing this disease and provide treatment strategies to avoid it.
True
T/F Cognitive task analysis usually starts by identifying, through interviews or questionnaires, the particular task and its typicality and frequency.
True
T/F Human technology interface problems are a major cause of patient monitoring incidents. It is not always that the technology itself is faulty. In fact, the technology may perform flawlessly, but the interface design may cause human error.
True
T/F The HIPAA privacy requirements, which went into effect 14 Apr 03, limited the release of protected health information without the patient's knowledge and consent.
True
T/F The electronic health record may be used to identify patients who qualify for research studies.
True
T/F The popularity of social and mobile networking applications is one indication of how new web-based technologies are changing preferences.
True
Technology can provide a mechanism to improve care delivery and create a safer patient environment, provided it is implemented appropriately and considers the surrounding workflow
True
Telehealth can positively impact the healthcare outcomes for patients with chronic diseases, particularly those with higher acuity levels who are at significant risk of having a medical crisis that might necessitate emergency or unplanned acute interventions. Many other patients with chronic diseases are less susceptible to a health crisis but would greatly benefit from home telemonitoring to improve care and reduce costs.
True
Television channels in hospitals may be dedicated to communicating healthcare messages
True
The American Recovery and Reinvestment Act of 2009 was implemented to encourage healthcare organizations to adopt the meaningful use of the electronic health record.
True
The Cochran Collaboration was established in 1993, and is a database of the reviews of clinical trials
True
The HIPAA privacy requirements, which went into effect on April 14, 2003, limited the release of protected health information without the patient's knowledge and consent. True or False
True
The Patient Safety and Quality Improvement Act of 2005 mandates the creation of a national database of medical errors and funded several organizations to analyze these data with the goal of developing shared learning to prevent medical errors.
True
The availability of data and speed of data exchange can have a significant impact on critical public health functions, such as disease monitoring and syndromic surveillance.
True
The data processed into public health information can be obtained from administrative, financial, and facility sources. Included in this data stream may be encounter, screening, registry, clinical, laboratory, and surveillance data.
True
The electronic health record may be used to identify patients who qualify for research studies
True
The future of health care lies in an organization's ability to effectively communicate and work together with others via technology in order to improve patient care.
True
The overall question the risk assessment has to answer is, "How much risk is acceptable?"
True
The popularity of social and mobile networking applications is one indication of how new Web-based technologies are changing communication preferences. True or False
True
Using social media in education may promote the development of skills that will support professional collaboration as students enter the practice arena.
True
Virtual reality can be used successfully to train and educate healthcare professionals.
True
Virtual worlds are intended for users to inhabit and interact, and the term today has become largely synonymous with interactive 3D virtual environments, where users take the form of avatars visible to others graphically.
True
When RFID tags are embedded in patient identification bracelets, they can help with patient tracking during procedures and testing, or function as part of the EHR by communicating pertinent information to clinicians at the bedside.
True
With telehealth, the assessment of the patient's vital signs are more accurate than the set taken in the physician's office; true/false
True
observation and documentation of workflow to better understand what is happening in the current environment and how it can be altered is reffered to as process or workflow analysis.
True
observational design
Two types- prospective: data is generated after the study retrospective: data is generated before the study (chart review)
Confidential information in a secure network is most typically breached by
Unauthorized use by authorized users
clinical decision support tools
Understanding of clinical practice decision making using cognitive science principles promotes the development of: A. administrative processing systems. B. clinical decision support tools. C. knowledge warehouses. D. All of these are correct.
The Agency for Healthcare Research and Quality is a government sponsored organization that seeks to improve patient outcomes through:
Use of technology focused on evidence-based practice
Reimbursement Coding: Current Procedural Terminology Codes (CPT)
Used to code procedures for billing The CPT system offers the official procedural coding rules and guidelines required when reporting medical services and procedures performed by physician and nonphysician providers . CPT codes are recognized universally and also provide a logical means to be able to track hea l thcare data, trends, and outcomes. Each service or procedure is represented by a five-digit code that is presented in six sections , including evaluation and management; anesthesiology; surgery; radiology; pathology; and medicine.
Digital natives, or Generation Y, would be most receptive to education delivered by:
Video games
A patient is using an online patient education resources and is unable to use a computer mouse effectively. What technology is appropriate for this patient?
Voice interactivity
grand/middle/micro
What are the 3 types of theories that guide HI (theoretical foundation)?
wisdom, courage, self-control, and justice
What are the 4 cardinal virtues according to Plato? A. wisdom, courage, self-control, and revenge B. wisdom, courage, self-control, and justice C. imagination, courage, self-control, and justice D. wisdom, independence, self-control, and justice
open/systems
What type of theory is NI?
feedback
When a nurse uses information from other sources to help rethink, revise, and apply knowledge to a clinical situation, this information is known as: Answers: A. feedback. B. knowledge processing. C. knowledge engineering. D. None of these is correct
research
When should it be used?
All of these
Which of the following activities is/are used to build a foundation of knowledge in professional practice? A. Reading research and theory articles B. Attending continuing education programs C. Consulting with expert colleagues and using clinical practice guidelines D. All of these
To manage and communicate data, information, knowledge, and wisdom in the delivery of nursing care
Which of the following best describes the central goal of nursing informatics? A. To manage and communicate data, information, knowledge, and wisdom in the delivery of nursing care B. To foster interdisciplinary collaboration and communication in a healthcare organization C. To increase efficiency of care delivery and help to manage costs D. To promote patient safety and prevent falls by assigning a fall risk number to hospitalized patients
Wisdom
Which of the following can be described as the appropriate use of knowledge to manage and solve human problems? A. Research B. Wisdom C. Transformation D. Information
Nonmaleficence
Which of the following terms matches this definition: "Do no harm, or an obligation not to inflict harm intentionally" A. Confidentiality B. Ethical decision making C. Nonmaleficence D. Privacy
What is the ability to APPLY appropriate use of knowledge to manage and solve human problems
Wisdom
Workflow design
Workflow is a term used to describe the action or execution of a series of tasks in a prescribed sequence. Another definition of workflow is a progression of steps (tasks, events, interactions) that constitute a work process, involve two or more persons, and create or add value to the organization's activities. In a sequential workflow, each step depends on the occurrence of the previous step; in a parallel workflow, two or more steps can occur concurrently. The term workflow is sometimes used interchangeably with process or process flows, particularly in the context of implementations. Observation and documentation of workflow to better understand what is happening in the current environment and how it can be altered is referred to as process or workflow analysis. A critical aspect of the informatics role is workflow design. Nursing informatics is uniquely positioned to engage in the analysis and redesign of processes and tasks surrounding the use of technology.
The widely accepted definition of a knowledge worker is one who:
Works with information and generates information and knowledge
research
_________ based care improves outcomes.
Rapid application development is:
a fast way to add functionality through prototyping and user testing
Ethics is best described as:
a goal-oriented approach to answering questions that potentially have multiple acceptable answers.
Clinical decision support (CDS)
a process designed to aid directly in clinical decision making, in which characteristics of individual patients are used to generate patient specific interventions, assessments, recommendations, or other forms of guidance that are then presented to a decision-making recipient or recipients that can include clinicians, patients, and others involved in care delivery.
Ethics
a process of systematically examining varying viewpoints related to moral questions of right and wrong. Regardless of the theoretical definition, common
blame free environment
a safety culture is a blame free environment where individuals are able to report errors or near misses without feat of reprimand
care plan
a set of guidelines that outline the course of treatment and the recommended interventions that should be implemented to achieve optimal results
_______ is a tool designed to emulate some aspect of the clinical practice environment, which may be focused on a single task or designed to mimic a complete patient care situation.
a simulator
_______ is a tool designed to emulate some aspect of the clinical practice environment, which may be focused on a single task or designed to mimic a complete patient care situation. A. all of these are correct B. a game C. a simulator D. scaffolding
a simulator
The HITECH Act had which of the following goals
a. Improve healthcare quality b. Reduce healthcare costs c. Improve and protect public health All of these are correct. ***
A novice nurse is more likely to use which aspect of the Foundation of Knowledge Model? a. Knowledge acquisition b. Knowledge processing c. Knowledge generation d. Knowledge dissemination
a. Knowledge acquisition
A specialized system of data collection to detect trends in the incidence and severity of a specific disease or health related syndrome and is also known as: a. Syndromic surveillance b. Public health informatics c. Data warehousing d. Knowledge generation
a. Syndromic surveillance
Reflection on practice to gain insight into why an approach was successful (or not) in a practice situation helps a nurse to build: a. Tacit knowledge b. Explicit knowledge c. Organizational knowledge d. Collaborative knowledge
a. Tacit knowledge
A wish list item was the ability to access information when and where we want it, irrespective of modality thereby maximizing mobility and other personal resources. This may lead to cell phones becoming the main avenue of access for more than text messages, speech, and video clips. Knowledge acquisition and utilization will then become ubiquitous and pervasive; new work roles will emerge to cope with this new and different technology. a. True b. False
a. True
Artificial Intelligence is the field that deals with the conception, development, and implementation of informatics tools based on intelligent technologies. This field attempts to capture the complex processes of human thought and intelligence. Select one: a. True b. False
a. True
Cognitive science is the interdisciplinary field that studies the mind, intelligence, and behavior from an information processing perspective. Select one: a. True b. False
a. True
Connectionism is the component of cognitive science that uses computer modeling through artificial neural networks to try to explain human intellectual abilities. Select one: a. True b. False
a. True
Epistemology is the study of the nature and origin of knowledge--what it means to know Select one: a. True b. False
a. True
Neural networks are interconnected simple processing devices or simplified models of the brain and nervous system that consist of a considerable number of elements or units (analogs of neurons) linked together in a pattern of connections (analogs of synapses). Select one: a. True b. False
a. True
The development of the concept, and a possible model, of u-nursing (ubiquitous nursing), which, as well as having implications for the practice of nursing, also has profound implications for all aspects of the education and continuing professional development of nurses a. True b. False
a. True
The shift of information access, acquisition, and interpretation, for both provider and patient, may result in overload in terms of content and comprehension. a. True b. False
a. True
There will be continuing growth of patient informatics, perhaps as a growth and evolution of the current concept of consumer health informatics, and with the increasing centrality of the patient as the controlling force in the whole enterprise. a. True b. False
a. True
Wang described cognitive informatics (CI) as an emerging transdisciplinary field of study that attempts to bridge the gap of understanding how information is processed in the mind and in the computer. Select one: a. True b. False
a. True
We currently have nurse-managed telehealth services in United Kingdom dermatology clinics, open-source software for development of Web-based nursing informatics education in Germany and nurse-led development of a personal health record system in the United States. a. True b. False
a. True
Wisdom is knowledge applied in a practical way, translated into actions, or to use knowledge and experience to heighten common sense and insight to exercise sound judgment in practical matters? Select one: a. True b. False
a. True
Presenting a research project at a national conference is an example of: Select one: a. disseminating knowledge b. acquiring knowledge c. generating knowledge d. sharing wisdom e. none of the above
a. disseminating knowledge
Which of the following is not a goal of evidence based practice? a. improve nurse satisfaction b. decrease practice variability c. increase patient safety d. eliminate unnecessary cost
a. improve nurse satisfaction
Integrating technology into the medication administration cycle helps to reduce errors by: Select one: a. performing electronic checks against a database of safe medication administration parameters and providing alerts. b. reducing the workload and increasing the efficiency of clinicians. c. Employing human factors engineering principles to streamline workflow processes. d. All of the above.
a. performing electronic checks against a database of safe medication administration parameters and providing alerts.
Organizations can ensure information integrity in a network by developing policies to
a. specify how data are actually input. b. indicate who has the authorization to change such data. c. track how and when data are changed and by whom. d.ALL THE ABOVE (correct answer)
Qualitative research on a practice intervention provides insights into: Select one: a. the patient's subjective opinion of the effectiveness of the intervention b. the scientific basis of the intervention c. the cost effectiveness of the intervention d. All of the above
a. the patient's subjective opinion of the effectiveness of the intervention
Freedom:
ability and right to make choices
Results Management
ability to manage results of all types electronically with laboratory and radiology procedures
NI competency
accessing electronic resources
A nurse is playing an educational game that requires quick action and intervention, which is known as a(n):
action game
Emerging technologies in nursing and health care education, simulation is used to allow students
actively use informatics in an authentic and realistic context
With the use of emerging technologies in nursing and health care education, simulation is used to provide students with:
actively using informatics in an authentic and realistic learning context
KDDM
advantages: allows us to look at a lot of data in one snapshot
KDDM
advantages: data can be pulled from large samples or entire populations
KDDM
advantages: the computers use learning methods that perform better than a person could manually.
KDDM
advantages: the data is based on info collected from the patient, so it can be used to support decisions for individual patients
adverse response team. definition and example
adverse response teams work to reenact or simulate adverse events to better understand the organizational or procedural processes that failed
Information literacy is an intellectual framework for finding, understanding, evaluating, and using information. These activities are accomplished in part through: A. all of these are correct B. sound investigative methods C. fluency with information technology D. critical reasoning and discernment
all of these are correct
One should never blindly trust information found on a webpage. When possible, you should check: A. the data of the most recent update B. contact information C. links to external sources and previous attained knowledge from other reputable sources D. all of these are correct
all of these are correct
Quantitative data collection tools are instruments generate numerical data rather than text-based data. Examples of these types of tools include: A. all of these are correct B. questionnaires C. quizzes and assessments D. interviews, e-mail interviews, and surveys, including web-based surveys
all of these are correct
Which of the following are professional databases? A. Cumulative Index to Nursing and Allied Health Literature (CINAHL) B. MEDLINE C. PsycInfo D. All of these are correct
all of these are correct
Which of the following is a major source of qualitative data? A. all of these are correct B. written document C. direct observation D. in-depth interview
all of these are correct
EHR
allows for bringing together large amounts of data for research
Point-of-care-testing (POCT)
allows for testing and diagnosis at the patient's side and can be conducted anywhere the patient is, such as the home, physician office, ambulance, or hospital bedside. This technology allows for quick, on-the-spot testing, with immediately available results. Additionally, these results can be downloaded directly into the EHR through interface engines. This decreases the risk of error in manually entered results, and the results are immediately available to caregivers for making treatment decisions.
RCT
also know as experiment design
The best definition of nursing informatics is ...
an integration of nursing science, computer science, and information science
data mining
analysis of data
Ethical dilemmas
arise when moral issues raise questions that cannot be answered with a simple, clearly defined rule, fact, or authoritative view.
Principlism
arose as societies became more heterogeneous and members began experiencing a diversity of incompatible beliefs and values.
What field attempts to capture the complex process of the human thought and intelligence
artificial intelligence
During the ________, the student should be provided with a detailed explanation of how he or she will be evaluated and graded that relates to the goal, educational outcomes, and, if applicable, course/program outcomes; also during this component, the student's performance is rated. A. debrief B. assessment C. enactment D. pre-brief
assessment
All of the following are advantages of technology-mediated care except
assessment technology provides a complete and objective picture of the patient experience.
In what type of game does a person use a device, such as a smartphone, to overlay additional information onto the real world?
augmented reality game
In what type of game does a person use a device, such as a smartphone, to overlay additional information onto the real world? A. casual game B. augmented reality game C. serious game D. educational game
augmented reality game
Knowledge that can be exchanged or shared in the form of data, manuals, product specifications, principles, policies, theories is known as: a. Tacit knowledge b. Explicit knowledge c. The foundation of knowledge d. Knowledge feedback
b. Explicit knowledge
Wisdom 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? Select one: a. True b. False
b. False
A Community of Practice (CoP) would best be described as: a. Groups of people working on a unit in an institution or organization b. Groups of people who share a concern or a passion for something they do and learn how to do it better as they interact regularly c. Groups of people who work together in a specialty area d. Groups of people who share the same educational levels
b. Groups of people who share a concern or a passion for something they do and learn how to do it better as they interact regularly
Which of the following creates the information that becomes the basis for knowledge in the field of public health? a. Theoretical analysis of recent research b. The collection and processing of population health data c. Examination of school aged children d. None of the above.
b. The collection and processing of population health data
Smart pumps are designed for safe administration of high-hazard drugs and to reduce adverse drug events (ADE) during intravenous (IV) medication administration. What happens when a hard alarm is generated by a smart pump? Select one: a. A licensed clinician or a pharmacist can override a hard alarm and administer the drug as programmed. b. The pump must be reprogrammed so that the rate and dose for administration of the high hazard IV drug falls within the facility's safe infusion parameters. c. The nurse must call the physician for a verbal order to turn off the smart pump technology and administer the drug as ordered. d. Members of the bio-medical engineering department can reprogram the pump to avoid these nuisance alarms.
b. The pump must be reprogrammed so that the rate and dose for administration of the high hazard IV drug falls within the facility's safe infusion parameters.
How does translational research differ from basic research? a. Translational research is less scientific than basic research. b. Translational research is specifically aimed at practice application. c. Basic research is always conducted in a laboratory, and translational is not. d. There is no difference between translational research and basic research.
b. Translational research is specifically aimed at practice application.
Using knowledge without being consciously aware of what aspect of knowledge we are using at any given moment during our practice, is known as knowledge: a. Processing b. Transparency c. Feedback d. Management
b. Transparency
The NGC of the Agency for Healthcare Research and Quality (AHRQ) and the Cochrane collaboration are examples of evidence based practice initiatives that: a. conduct randomized controlled trials for translation into practice. b. gather and interpret research findings and develop practice guidelines. c. mine quasi-experimental and qualitative research findings for practice evidence. d. survey practice experts for opinions on best-practices.
b. gather and interpret research findings and develop practice guidelines.
As nurses work with information and generate information and knowledge as a product, they can be described as: Select one: a. seasoned nurses b. knowledge workers c. practice managers d. innovators e. none of the above
b. knowledge workers
An adverse event response team works to: Select one: a. anticipate workflow issues and develop processes and procedures to promote safety. b. reenact or simulate adverse events to better understand the organizational or procedural processes that failed. c. counsel and/discipline employees who engage in risky or reckless behaviors. d. All of the above.
b. reenact or simulate adverse events to better understand the organizational or procedural processes that failed.
Fidelity:
being faithful to what has been promised
Bioethical standards
bioethical decision-making model centers on the healthcare professional's implicit agreement with the patient or client (1) autonomy, (2) freedom, (3) veracity, (4) privacy, (5) beneficence, and (6) fidelity.
HI
both a discipline and a specialty within health professions
Clearing the mind of preconceived notions and expectations based on a patient's diagnosis is known as:
bracketing
When we enter the uncharted world of the other without preconceived notions about what to expect, we are practicing:
bracketing
A Nursing Practice Council is focused on reducing workarounds related to medication administration. Which approach is likely to be more successful? a. Developing an explicit policy requiring adherence to medication administration guidelines. b. Searching the literature for nursing research studies related to medication administration workarounds. c. Collecting data in the institution by asking nurses to journal examples of workarounds. d. Accompanying nurses during medication administration to discover workarounds
c. Collecting data in the institution by asking nurses to journal examples of workarounds.
Vendor owned cloud computing might offer the benefit of reduced costs of maintaining hardware and IT support in an individual healthcare system. What is the main reason that cloud computing is not widely accepted in healthcare? a. Concern about vendor support and functionality of the products. b. Concern about usability and interoperability of systems. c. Concern about information security and privacy. d. Concern about data storage and retrieval.
c. Concern about information security and privacy.
The estimate of how much exposure to the potential hazard would cause varying degrees of health effects is known as: a. Hazard identification b. Risk characterization c. Dose-response assessment d. Exposure assessment
c. Dose-response assessment
A novice nurse is more likely to be which type of knowledge worker? a. Knowledge broker b. Knowledge generator c. Knowledge consumer d. None of the above.
c. Knowledge consumer
Another name for data that has meaning is: Select one: a. mean data b. data accuracy c. information d. wisdom e. none of the above
c. information
RFID technology may gradually replace bar-code technology in the medication administration cycle because RFID provides: Select one: a. opportunities to check patient identification before administration of the medication. b. easy integration into the electronic health record. c. reduced potential that a counterfeit medication is inadvertently introduced into the supply. d. None of the above.
c. reduced potential that a counterfeit medication is inadvertently introduced into the supply.
What identifies resources, patterns, and variance in care to prevent costly complications related to chronic conditions, and enhance the overall outcomes for patients with chronic illness?
case management information system (CMIS)
Case-based ethical reasoning that considers the facts of a case in a sound.
cau
Taking a few calming breaths, clearing the mind of clutter, silently saying the patient's name once or twice before beginning the patient encounter is known as:
centering
The Husted Bioethical Decision-Making Model
centers on the healthcare professional's implicit agreement with patient/client Based on six contemporary bioethical standards: autonomy, freedom, veracity, privacy, beneficence, and fidelity.
dialectical, goal-oriented approach to answering questions that have the potential of multiple acceptable answers.
characteristics regarding ethics are:
Generating Knowledge
collecting health data and mining that data for relationships and understanding is an example of
NI competency
computer literacy (use of equipment)
A simulated medical record or simulated electronic health record has four components. Which of the following is one component? A. static webpage shells B. computers with internet access C. all of these are correct D. spreadsheet
computers with internet access
New professionals and students can be thought of as knowledge ____________ because they use the knowledge of experienced professionals or search for sources of knowledge related to their practice.
consumers
A dedicated clinician is required on the receiving end of the transmissions from patients at home
cost and difficulty scheduling
Electronic health records may help to promote public health initiatives by: a. promoting early detection of potential pandemic occurrences b. automating syndromic surveillance of emergency department records c. generating population-level alerts to be sent to clinicians d. All of the above
d. All of the above
Early detection of possible outbreaks can be achieved by gathering data on: a. Absences from work or school b. Purchases of health-care products, including specific types of over-the-counter medications c. Laboratory test orders d. All of the above.
d. All of the above.
Electronic prompts in a technology based medication administration system warn against the possibility of drug interaction, allergy or medication overdose when: Select one: a. the physician enters the order in the CPOE system. b. the pharmacist verifies and dispenses the medication c. the nurse prepares to administer the medication d. All of the above.
d. All of the above.
Key aspects of the Informatics Nurse Specialist Role (INS) in patient safety include: Select one: a. ensuring that the technology systems are properly configured and maintained. b. routinely monitoring and checking these systems while making sure that their human potential, the users, are capable of using the systems accurately to avoid errors. c. participating actively in the SDLC to ensure adoption of a robust tool that provides meaningful information and enhances patient care while preventing errors and promoting patient safety. d. All of the above.
d. All of the above.
A safety culture is a blame-free environment where individuals are able to report errors or near misses without fear of reprimand or punishment. Conversely, a just culture emphasizes individual accountability and: Select one: a. encourages workarounds in the interest of saving time as long as no harm occurs. b. encourages error reporting and seeks to understand workflow and process issues that lead to errors. c. emphasizes zero tolerance for reckless behavior. d. B and C e. All of the above.
d. B and C
Multiple false alarms may lead to alarm fatigue and compromise patient safety by slow response or no response to physiologic alarms. Strategies to improve alarm response include: Select one: a. increasing the sensitivity of the physiologic monitors and feeding alarms directly to beepers or phones carried by nurses. b. feeding alarm data into a reporting database for further analysis. c. encouraging nurses to round with physicians to provide input into alarm settings. d. B and C e. All of the above.
d. B and C
Core public health functions include all of the following except: a. Assessment and monitoring of the health of communities and populations at risk to identify health problems and priorities; b. Formulation of public policies designed to solve identified local and national health problems and priorities; c. Assuring that all populations have access to appropriate and cost-effective care d. Evaluating web pages for information quality
d. Evaluating web pages for information quality
When a nurse creates new knowledge by changing and evolving knowledge based on experience, education, and input from others, he/she is: Select one: a. acquiring knowledge b. processing knowledge c. using feedback d. generating knowledge e. disseminating knowledge
d. generating knowledge
The gold standard of research for evidence is: a. the opinion of experts b. qualitative research c. quasi-experimental research d. the randomized controlled trial.
d. the randomized controlled trial.
A meta-analysis helps to generate new practice evidence and nursing knowledge by: a. combining results of quantitative and qualitative studies. b. examining the theoretical basis of the research literature c. providing guidelines for designing laboratory based experiments to generate new evidence. d. using statistical methods to combine the results of several quantitative studies.
d. using statistical methods to combine the results of several quantitative studies.
EHR
data can include billing info, doctor/nurse notes, lab results, treatments, outcomes, pretty much anything that is recordable
PBE
data gathered from current practice to identify what care processes work in the real world.
computer technology has ushered in what has been called the "Information Age" an age when:
data, information, and knowledge and are all accessible
The ______ is a student-centered discussion during which the participants and observers reflect on performance during the scenario and make recommendations for future practice. A. debrief B. enactment C. pre-brief D. assessment
debrief
The ________ is a student-centered discussion during which the participants and observers reflect on performance during the scenario and make recommendations for future practice.
debrief
What are at least two economic benefits of telehealth
decreased ER visits, decreased length of stay, decreased admissions
PBE
demonstrates association but NOT causation
Heuristic Evaluation
detects problems early in the design process
the decision support function of an EHR does all the following except ...
determines staffing patterns
Successful pre-live strategies in a change management plan developed for implementing an electronic health record will include all of the following except:
disciplinary measures for addressing resistance by professionals
What policy should be in place prior to the implementation of CPOE
downtime policy
EHR
drawback: massive data requires massive storage, extraction, analysis, and management
EHR
drawbacks: Is the data useful? Was the data entered correctly? Is it complete data?
Although nurses have an ethical duty to ensure patient safety, increasing demands on professionals in complex and fast paced health care environments may lead to workarounds. What is a workaround? Select one: a. A practice that deviates from accepted and expected practice protocols. b. A shortcut to save time. c. An inappropriate action or omission of appropriate actions. d. A and B. e. All of the above.
e. All of the above.
According to the American Nurses Association, nursing is: Select one: a. the protection, promotion, and optimization of health and abilities b. the prevention of illness and injury c. alleviation of suffering through the diagnosis and treatment of human response d. advocacy in the care of individuals, families, communities, and populations e. all of the above
e. all of the above
Epidemiology is a. identifying things that come upon the people; b. incidence, prevalence and control of disease; c. case finding d. b and c e. all of the above
e. all of the above
Nursing science is practiced by: Select one: a. nurse educators b. nurse researchers c. clinical nurses d. nurse practitioners e. all of the above
e. all of the above
Wisdom is: Select one: a. knowledge applied in a practical way or translated into actions b. insight to exercise sound judgment in practical matters c. the synthesis of our experience, insight, understanding and knowledge d. knowing when and how to apply knowledge e. all of the above
e. all of the above
The prevalence of healthcare-associated infections (1.7 million cases per year) demonstrates how the _______ can address quality issues.
electronic health record
The American Association for Justice (2013) suggests that to improve care delivery and minimize error, the most important tools to employ are:
electronic records and information systems to provide point of care decision support and automation
What is not the overall goal for using computerized provider order entry systems in healthcare organizations?
eliminate poor handwriting
The Hippocratic tradition
emerged from relatively homogenous societies where beliefs were similar and the majority of societal members shared common values.
The virtue ethics approach
emphasizes the virtuous character of individuals who make the choices. Suggests that individuals use power to bring about human benefit; one must consider the needs of others and the responsibility to meet those needs. has seen a resurgence in the last 30 years.
______ is the term for the student actually assuming the role or performing the activity. A. debrief B. pre-brief C. enactment D. assessment
enactment
A safety culture is a blame-free environment where individuals are able to report errors or near misses without fear of reprimand or punishment. Conversely, a just culture emphasizes individual accountability and what
encourages error reporting and seeks to understand workflow and process issues that lead to errors
just culture. definition and example
encourages error reporting and seeks to understand workflow and process issues that lead to errors; it emphasizes zero tolerance for reckless behavior
The HITECH Act
established the Office of the National Coordinator for Health Information Technology (ONC) within the U.S. Department of Health and Human Services (HHS). The ONC is headed by the national coordinator, who is responsible for overseeing the development of a nationwide HIT infrastructure that supports the use and exchange of information in order to Improve healthcare quality Reduce the cost of health care Improve people's health by promoting prevention, early detection, and management of chronic diseases Protect public health by fostering early detection and rapid response to infectious diseases, bioterrorism, and other situations Facilitate clinical research Reduce health disparities Better secure patient health information
NI competency
ethical use of information systems
Caring functions include all of the following, except:
ethics
NI competency
evidence based practice skills
Having healthcare practitioners working in individual professional silos has proven to be effective for improving quality patient outcomes.
false
Healthcare professionals acquire most of what they need to know for lifelong practice in basic education programs.
false
It is no longer necessary for the informatics specialist to use a theoretical framework to support his/her plan for change
false
Labratory information systems typically only report high values for blood specimens
false
Tacit knowledge is easy to convey, transmit, or share.
false
Technologies are usually not disruptive to the profession-patient caring encounter.
false
The nature of the work in the healthcare system prevents it from benefiting from the workflow designs of other businesses
false
The work of healthcare professionals is primarily physical
false
While relationship-centered care promotes enhanced mental and physical well-being in patients, it has little effect on professionals.
false
another name for the clinical information system is the patient care monitoring system
false
most workflow redesign efforts focus on large changes, resulting in wide-spread change that accompanies transformational activities
false
paper based orders have been shown to be just as efficient and safe as computerized physician order entry
false
workflow analysis must be conducted as a stand-alone effort
false
When a nurse uses information from other sources to help rethink, revise, and apply knowledge to a clinical situation, this is known as:
feedback
What is the term for how the learner interacts with the game? A. simulation B. virtual world C. game play D. game mechanics
game play
systems life cycle model
guides new system implementation, used in project management
Proxy Server
hardware security tool that helps protect an organization against security breaches
EHR
helps analyze patterns in data
learning theory
helps understand how patients and healthcare providers interact and various ways people learn
Telehealth is provided for which of the following patient populations? (Select all that apply)
homebound patient or those with limited access to transportation rural populations who lack access to primary care those recently discharged from hospitals
A student nurse is starting clinical experience. What will creating an e-portfolio demonstrate to a future employer?
how the student used critical thinking to make decisions
observational design
how treatment works in actual practice; yields valuable info regarding disease risks and potentially effective treatments
PBE
how we practice and it is working
there are many advantages of an EMR, which one would NOT be included
improved patient privacy
The factor that prevents many healthcare organizations from adopting meaningful use technology is:
increasing cost
NI competency
information literacy (retrieval)
technology to reduce medical errors
integrating technology into the medication administration cycle can reduce errors by preforming electronic checks against a database of safe medication administration parameters and providing alerts. things that can be done to improve alarm response include feeding alarm data into a reporting database for further analysis and encouraging nurses to make rounds with physicians to provide input to alarm settings
PBE
internal validity: what scenarios did they look at? External validity: how well can this study be generalized?
Casuistry
is a case-based ethical reasoning method that analyzes the facts of a case in a sound, logical, and ordered or structured manner.
DICOM (think digital)
is a messaging standard that is used to communicate diagnostic and therapeutic information on digital images and associated data.
Data Mapping
is defined as the process of linking interoperable components from one system to another, involving mapping "one component to another," and is an essential component for interoperability (McBride, Gilder, Davis, & Fenton, 2006). The International Organization for Standardization (ISO) defines data mapping as "the process of associating concepts or terms from one coding system to concepts or terms in another coding system and defining their equivalence in accordance with a documented rationale and a given purpose" Each map originates from a data or code set known as the source. The code or data set in which one is attempting to find a code or data representation with an equivalent meaning is known as the target.
Bioethics
is the study and formulation of healthcare ethics.
A nurse is documenting in the electronic health record and uses standardized terminology, which is important because:
it captures and codifies the work of nursing
ADSS or CDSS should support, not replace what of a clinician or manager
judgement, critical thinking skills
There are solutions to health problems that are not implemented in a timely fashion because of the lack of access to important health information, a condition known as the:
know-do gap
Wisdom is: (select all that apply
knowledge applied in a practical way or translated into actions insight to exercise sound judgment in practical matters the synthesis of our experience, insight, understanding and knowledge
A novice nurse is more likely to be which type of knowledge worker?
knowledge consumer
Which group is mainly users of knowledge who do not have the expertise to provide the knowledge they need for themselves?
knowledge consumers
Intranets, extranets, knowledge directories, blogs, and wikis are examples of
knowledge management tools
Explicit Knowledge
knowledge that can be exchanged in data, manuals, principles, policies, & theories
When students in an online course engage in discussion in an electronic forum they are involved in what type of interaction?
learner-learner
Organizations are able to monitor who is using the organizational network and what files that user has accessed, because any use of an electronic network:
leaves a digital footprint
NI
manages and communicates: -data -info -knowledge -wisdom
alarm fatigue
many false alarms can lead to alarm fatigue which can compromise patient safety by slow response or no response to physiologic alarms
radio frequency identification (RFID) technology
may eventually replace bar code technology in the medication administration process because RFID technology can reduce the potential of a counterfeit medication being inadvertently introduced into the suply
Syndromic surveillance
mechanism that is used to identify disease clusters early, before diagnoses, to confirm and report findings to public health agencies
When healthcare agencies provide access to information on websites they
must adhere to responsible information standards
The best definition of EBP is ...
nursing practice that is informed by research generated evidence of the best practice
PBE
obtaining evidence FROM practice.
Moral dilemmas
occur when some evidence indicates that an act is morally right and some evidence indicates the act is morally wrong; yet the evidence on both sides is inconclusive; or an individual believes that on moral grounds, he or she cannot commit an act (Beauchamp & Childress, 1994, p. 11).
What is the clinicians ability to enter meds and other orders into the computer
order entry managment
Simulators encompass a broad range of devices including, but not limited to: (Select all that apply)
partial task trainers, such as an IV insertion arm/screen based simulations, including simulated EHR's simulated environments replicating a realistic patient care area complex computer drive human patient simulation manikins
When persons living with a chronic disease use the Internet for blogging about their health challenges or participating in online discussion forums, they are engaging in:
peer to peer support
Integrating technology into the medication administration cycle helps to reduce errors by:
performing electronic checks against a database of safe medication administration parameters and providing alerts.
When a nurse is largely competent in carrying out care, efficient with interventions, but inattentive to communication and nonverbal cues projected by patients and families, we say the professional is:
physically present
What group of providers are impacted the most by CPOE
physicians
New technologies in digital communications, electronic health records and telehealth raise issues related to:
privacy and confidentiality
NI competency
professional development/leadership: -ethical -procedural -safety -management issues
People who share a specialized knowledge are called
professionals
A hardware security tool that helps protect an organization against breeches
proxy server
Examples of peripheral devices used in home telehealth include: (select all that apply)
pulse oximeters peak flow meters spirometers
Beneficience:
refers to actions performed that contribute to the welfare of others
When professionals observes their work for a different perspective and generate insights about how healthcare services and processes could be improved, they are practicing:
reflection
A nurse is writing a narrative of a nursing care experience for an editorial in a nursing journal. What is this nurse demonstrating?
reflective practice
Anne is feeling overwhelmed with her personal issues and the complexity of the patients she cares for. She decides to keep a personal journal to provide her with insights into her patient experiences, and help her get back to her caring roots. This strategy is known as:
reflective practive
What are modules of CDSS
reminders, alerts, drug/drug - drug/allergy checking, guidance, protocols, speech recognition
Telehealth interactions today help to insure that professionals can:
replicate usual clinical interactions in all specialties across a distance
Translation Memory
reuses past translations to improve translation productivity. It works by splitting text into short segments and storing their translations in a database. Whenever a segment is repeated, the translator can reuse a fitting previous translation, or sometimes paste a translation of a similar segment with minor edits.
Autonomy:
right of individual to choose for her/himself
Veracity:
right to truth/truthfulness
An educational game- one designed for learning- is a subset of both play and fun and is sometimes referred to as a(n): A. augmented reality game B. educational game C. casual game D. serious game
serious game
EBP
shared goal of transforming healthcare to be reliable, safe, and effective
Strategies for active listening include all of these, except:
sharing test results
What is the term for an imitation of a real-life event or circumstance?
simulation
What is the term for an imitation of a real-life event or circumstance? A. simulation B. game mechanics C. game play D. virtual world
simulation
Public Health Nursing is about monitoring disease outbreaks within communities. What are the ways that Public Health Departments monitor possible disease outbreaks? (Select all that apply)
situational awarenesssurveillancedetection of potential health threatscountermeasures
NI competency
skills for computer-based patient records
B
t is important to use standardized terminologies in nursing practice, because: A. data cannot be shared between clinicians. B. it provides continuity of care between care providers and identifies trends. C. it encourages free text documentation by clinicians. D. All of these are correct.
Reflection to gain insight into why, or why not, an approach was successful in a practice situation helps a professional build:
tacit knowledge
technology and the CPOE
technology prompts in medication administration system warn against possible medication interaction, allergies or medication overdose when a doctor enters and order in the Computerized Physician Order Entry, when the pharmacists verifies and dispenses a medication and when a nurse prepares to administer the medication
What allows the clinician to be in contact with a patient without a face to face encounter
telehealth
Telehealth used in the medical field is known as:
telemedicine
An ethics approach that was applied to relatively homogenous societies where beliefs were similar and the majority of societal members shared common values is known as:
the Hippocratic tradition
RCT
the best way to collect data
RCT
the gold standard in research design
The key concepts of nurse, patient, health, environment are know as ...
the nursing metaparadigm
Patient-centered care means that practitioners should focus on:
the subjective experience of patients
A key benefit of using electronic data collection is the ability to transmit data to another computer directly for compilation and analysis, thereby cutting down on the risk of error. A. True B. False
true
All healthcare organizations ultimately strive for effective delivery of patient care
true
An important issue associated with internet-based data collection is whether participants actually are who they say they are, and whether they actually have the variable of interest or are just pretending to be someone or something they are not. A. true B. false
true
As a result of the provisions of American Recovery and Reinvestment Act (ARRA), healthcare organizations can qualify for financial incentives based on the level of meaningful use achieved
true
Because nursing informatics combines all four nursing practice areas (clinical, research, administration, and education), the ability to recognize the need for a specific kind of information and then locate, evaluate, and effectively use the information within the nursing informatics paradigm will catapult nurses ahead of other healthcare professionals in applying and engaging various facets of technology. A. True B. False
true
Bioinformatics is the branch of biology that is concerned with the acquisition, storage, display, and analysis of the information found in nucleic acid and protein sequence data. Computers and bioinformatics software are the tools of the trade.
true
Both the molecular biomarkers and the protein-based network biomarkers have limitations because of their static nature. To increase the ability to make early diagnosis, identify disease-specific biomarkers and therapeutic targets, and predict patient outcome, dynamic network biomarkers (DNBs) were created, monitored and evaluated at different stages and time-points of the disease, based on non-linear dynamical theory and complex network theory.
true
Computers can aid greatly in the storage, tabulation, and retrieval of qualitative data by acting as the equivalent of an electronic filing cabinet. Data analysis can also be aided by simple data management programs, such as Excel, Access, or NVivo, in which a user can categorize data and link categories which key words. A. True B. False
true
Copyright violators may be fined or prosecuted.
true
DNBs differ from molecular biomarkers and network biomarkers to describe and identify disease progress situations and interactions rather than the static nature and approach.
true
Data analysis is the process by which data collected during the course of a study is processed to identify trends and patterns of relationships.
true
Data can be converted into information and knowledge by either inductive or deductive reasoning. Most qualitative methods used an inductive approach in which the researcher generated hypotheses (versus the deductive approach typical of quantitative studies, in which hypotheses are tested). A. true B. false
true
Each person processes and assimilates knowledge in a unique way.
true
Examining the workflow surrounding technology use promotes safer patient care delivery
true
Farr and Cressy (2015) found that intangible tacit knowledge was just as important to the personal perception of quality of performance as more standardized rational measures.
true
Healthcare professionals who take care of their own health are more likely to be effective in patient and family care.
true
Interactions with patients are shaped by the healthcare professional's knowledge, experiences, ethics, and competencies.
true
Many health care organizations experience the effects of poorly implemented clinical technology solutions, which may be in the form of redundant documentation, non-value added steps, and additional time spent at the computer rather than in direct care delivery
true
Self-reflective practice is a way to boost self-awareness and promote self-care.
true
T/F The human interfaces for each of the various technologies are different and can even differ among different brands or versions of the same device.
true
Technology ought not to be implemented for the sake of automation unless it promises to deliver gains in patient outcomes and proper workflow
true
The HapMap will help researchers identify patterns of variations in human DNA sequences in an effort to find the genes responsible for many diseases.
true
The Human Genome Project (HGP) began in 1990 and was completed in 2003.
true
The future of genomic study and use of technology will help healthcare practitioners identify the best treatment for an individual through a review of genetic testing.
true
The popularity of social and mobile networking applications is one indication of how new Web-based technologies are changing communication preferences.
true
The promise of DNBs lies in the fact that they can help us uncover disease-specific biomarkers that we can map to compute and diagnose pre-disease circumstances and conditions.
true
There is a unique culture of data sharing previously unknown among biological researchers since molecular data and measurement tools are now publicly available.
true
Three projects are pivotal in genomics: The HGP focused on the DNA sequence from a single individual, the HapMap project focused on variation in the genome and on human populations, and the Cancer Genome Atlas Project is concerned with how cancer affects the genomes.
true
Workflow analysis can be conducted as a stand-alone effort. When the process is addressed alone, the effort is termed process improvement.
true
a standardized plan of care assists healthcare professionals with treatment protocols to maximize patient outcomes and support best practices
true
examining the workflow surrounding the use of technology enables better use of the technology and more efficient work
true
meaningful use measures have pushed healthcare organizations to reexamine the use of clinical technologies within their organization and approach implementations in a new way
true
Feedback
uses information sources to help rethink, revise, and apply knowledge
EBP
using EVIDENCE to guide practice.
Transparency
using knowledge without being consciously aware of what aspect of knowledge
Knowledge Transparency
using knowledge without conscious thoughts
A meta-analysis helps to generate new practice evidence and nursing knowledge by:
using statistical methods to combine the results of several quantitative studies.
What is the term for a live, online, interactive three-dimensional environment in which users interact using speech or text via a personalized avatar?
virtual world
What is the term for a live, online, interactive three-dimensional environment in which users interact using speech or text via a personalized avatar? A. game play B. game mechanics C. virtual world D. simulation
virtual world
Two ethics approaches that emphasize considerations for human needs and responsibility to meet needs are:
virtue and care ethics
Behaviors leading to unintentional data breaches include:
walking away from a workstation without logging off
What will best provide an organization with the data to better understand its operational and clinical performance?
well developed metrics
hard alarm on a smart pump
when a smart pump generates a hard alarm the pump must then be reprogrammed so that the dose and rate for administration of the high hazard intravenous (IV) drug falls within the facility's safe administration parameters
EBP
where knowledge & clinical decisions meet
Nurses are knowledge workers, knowledge work is
work that entails a significant amount of cognitive activity
Object-oriented systems development (OOSD) uses object-oriented modeling to represent real:
world objects
Integrating technology into the medication administration cycle helps to reduce errors by: A. performing electronic checks against a database of safe medication administration parameters and providing alerts. B. increasing the workload and efficiency of clinicians. C. Employing human factors engineering principles to streamline workflow processes. D. All of these are correct.
A
What term refers to a nurse taking a few calming breaths, clearing his or her mind of clutter, and silently saying the patient's name a time or two before beginning the patient encounter? A. Centering B. Cognitive focus C. Psychological being D. All of these are correct.
A
An organization's confidentiality policy should clearly define: A. which data are confidential. B. procedures for releasing confidential information. C. procedures to follow if confidential information is accidentally released without authorization. D. All of these are correct.
All of these are correct
Health information and data in the electronic health record consist of: A. demographics. B. medical diagnoses. C. medication lists and allergies. D. All of these are correct.
All of these are correct
Positive impacts noted with using an informatics system to manage patients with chronic illness include: A. guidelines adherence. B. a decrease in emergency department visits. C. improved provider documentation. D. All of these are correct.
All of these are correct
Task analysis involves: A. inputs needed for the task. B. how a task must be accomplished. C. constraints on actors' choices on carrying out the task. D. All of these are correct.
All of these are correct
A nurse is playing an educational game that requires quick action and intervention, which is known as a(n): A. strategy game. B. action game. C. building game. D. adventure game.
B
A nursing instructor is designing an assignment that requires social interaction and is goal-oriented. Which learning environment would meet these requirements? A. Virtual world B. Simulation C. Tutorial D. Gaming
B
A nursing student makes an error in patient care during the simulation activity. Which statement by the nursing instructor can assist the student in learning from the simulation? A. "Did you see that your peers did not make this mistake?" B. "How could you prevent this error in the real world?" C. "Why did you do that?" D. "What did you to do prepare for this simulation?"
B
Multiple false alarms may lead to alarm fatigue and compromise patient safety by slow response or no response to physiologic alarms. Strategies to improve alarm response include: A. increasing the sensitivity of the physiologic monitors and feeding alarms directly to beepers or phones carried by professionals. B. feeding alarm data into a reporting database for further analysis. C. discouraging healthcare professionals from rounding with physicians because they are often guilty of ignoring alarms. D. All of these are correct.
B
Telehealth used in the medical field is known as: A. teleradiology. B. telemedicine. C. telepathology. D. telenursing.
B
There are solutions to health problems that are not implemented in a timely fashion because of the lack of access to important health information, a condition known as the: A. digital divide. B. know-do gap. C. health divide. D. knowledge divide.
B
What is the term for a live, online, interactive three-dimensional environment in which users interact using speech or text via a personalized avatar? A. Simulation B. Virtual world C. Game mechanics D. Game play
B
When we enter the uncharted world of the other without preconceived notions about what to expect, we are practicing: A. centering. B. bracketing. C. meditation. D. All of these are correct.
B
Which of the following factors are drivers of the growing trend toward telehealth and technology use and will influence nursing practice significantly in the next decades? A. Overabundance of nursing and healthcare workers B. Chronic diseases and conditions C. Uneducated consumers D. All of these are correct.
B
______ is a tool designed to emulate some aspect of the clinical practice environment, which may be focused on a single task or designed to mimic a complete patient care situation. A. A game B. A simulator C. Scaffolding D. All of these are correct.
B
The American Telemedicine Association released a clinical care guideline for TeleICU. In this guideline, they identified three practice models. Which practice model refers to monitoring the patient without interruption for a designated period of time? A. Responsive (reactive) care model B. Reimbursement for care episode model C. Continuous care model D. Scheduled care model
C
The American Telemedicine Association released a clinical care guideline for TeleICU. In this guideline, they identified three practice models. Which practice model refers to periodic consultation within a predetermined time frame? A. Reimbursement for care episode model B. Responsive (reactive) care model C. Scheduled care model D. Continuous care model
C
The ________ is a student-centered discussion during which the participants and observers reflect on performance during the scenario and make recommendations for future practice. A. enactment B. pre-brief C. debrief D. assessment
C
What is the term for an imitation of a real-life event or circumstance? A. Virtual world B. Game play C. Simulation D. Game mechanics
C
When a nurse is largely competent in carrying out care, efficient with interventions, but inattentive to communication and nonverbal cues projected by patients and families, we say the professional is: A. fully present. B. demonstrating transcendent presence. C. physically present. D. All of these are correct.
C
When persons living with a chronic disease use the Internet for blogging about their health challenges or participating in online discussion forums, they are engaging in: A. self-diagnosis. B. self-management. C. peer-to-peer support. D. All of these are correct.
C
A nurse educator is selecting a method of patient education and is considering an educational pamphlet. Which of the following is a disadvantage of a pamphlet for patient education? A. The digital divide B. Inconsistency in the education provided C. The dynamic nature of written education D. The cost of design and production of a pamphlet
D
A nurse is caring for an 80-year-old male patient who has a chronic disease and does not have access to the Internet. What factor below may contribute to health disparity for this patient? A. Gender B. Citizenship C. Religious preference D. Age
D
A nurse is writing a narrative of a nursing care experience for an editorial in a nursing journal. What is this nurse demonstrating? A. Situational practice B. Evaluative practice C. Intuitive practice D. Reflective practice
D
A teenaged patient is distracted and not engaged in a patient education class in a healthcare facility. What alternative education method might the nurse recommend for this patient? A. A book on the disease B. Educational handouts C. A health brochure D. An interactive computer game
D
All of the following are advantages of technology-mediated care except: A. effective use of technology helps to improve clinical workflow. B.clinical decision support system technology reminds clinicians of critical interventions that have not yet been implemented. C. smart pump technology provides maximum dose safeguards. D. assessment technology provides a complete and objective picture of the patient experience.
D
Although nurses have an ethical duty to ensure patient safety, increasing demands on professionals in complex and fast-paced healthcare environments may lead to workarounds. What is a workaround? A practice that deviates from accepted and expected practice protocols B. A shortcut to save time C. An inappropriate action or omission of appropriate actions D. All of these are correct
D
Patient-centered care means that practitioners should focus on: A. their interpretation of the patient's experience. B. objective signs and symptoms .C. data gathered by technology. D. the subjective experience of patients.
D
Patients partnering with healthcare professionals to manage their health is an example of: A. empowerment .B. patient engagement. C. connected health. D. All of these are correct.
D
Patients who have which of the following characteristics can use telenursing services? A. Are immobilized B. Have a chronic disease C. Live in remote places D. All of these are correct.
D
Smart pumps are designed for safe administration of high-hazard drugs and to reduce adverse drug events during intravenous medication administration. What happens when a hard alarm is generated by a smart pump? A. A licensed clinician or a pharmacist can override a hard alarm and administer the drug as programmed. B. Members of the biomedical engineering department can reprogram the pump to avoid these nuisance alarms. C. The nurse must call the physician for a verbal order to turn off the smart pump technology and administer the drug as ordered. D. The pump must be reprogrammed so that the rate and dose for administration of the high-hazard intravenous drug falls within the facility's safe infusion parameters.
D
Which of the following is a potential outcome of patient-centered care? A. Patients can provide their subjective experience as an input to improve healthcare delivery. B.Care providers may develop their capacity for reflexivity, which may improve their understanding of the implications of their actions. C.Patients and practitioners can provide insights into the overall organization on how to innovate processes and facilities to respond to local needs. D. All of these are correct.
D
Acceptable use policies in an organization typically restrict downloads of files by employees because:
Downloads increase vulnerabilities to viruses
In the United States, telehealth nurses are required to be licensed only in the state from which they are providing telehealth services, even if they are interacting with patients in other states. T/F
False
It is safe to open an email attachment from a known sender.
False
Stage 1 meaningful use criteria focused on health information exchange and patient control over health data
False
The eHealth Initiative is largely successful because of interoperability among healthcare systems and the adoption of national data standards. T/F
False
The top patient safety issues are identified as early discharge and polypharmacy
False
The top patient safety issues are identified as early discharge and polypharmacy. T/F
False
What is the name of the federal legislation in the United States to control how financial institutions handle the private information they collect from individuals?
Gramm-Leach-Bliley Act (GLBA)
What is the human-technology interface?
Hardware and software that support humans interacting with technology
Multiple false alarms may lead to alarm fatigue and compromise patient safety by slow response or no response to physiologic alarms. Strategies to improve alarm response include:
Multiple false alarms may lead to alarm fatigue and compromise patient safety by slow response or no response to physiologic alarms. Strategies to improve alarm response include:
_________________ is the ability to manage results of all types electronically including laboratory and radiology procedure reports, both current and historical.
Results management
The human interfaces for each of the various technologies are different and can even differ among different brands or versions of the same device.
True
When someone disregards established policies and procedures, it is thought of as reckless behavior.
True
When someone disregards established policies and procedures, it is thought of as reckless behavior. T/F
True
Smart pumps are designed for safe administration of high-hazard drugs and to reduce adverse drug events during intravenous medication administration. What happens when a hard alarm is generated by a smart pump?
The pump must be reprogrammed so that the rate and dose for administration of the high-hazard intravenous drug falls within the facility's safe infusion parameters.
A clinical use for telehealth technologies includes providing disease prevention and promotion of good health. One example is telephonic or smartphone app case management and patient education provided through asthma and weight management programs conducted in public schools. T/F
True
According to the Agency for Healthcare Research and Quality, one way to balance the competing cultural values of blamelessness versus accountability is to establish a "just culture." T/F
True
An electronic health record may lead to better clinical decision making by integrating patient information from multiple sources.
True
Browser privacy settings can control how cookies are used.
True
Chronic diseases are of major concern to the United States, not only because of the impact they have on individuals, but also because of the tremendous cost associated with providing treatment for patients with these conditions. Adult-onset diabetes, for example, has reached epidemic proportions. A national health information technology infrastructure will help providers better identify those patients who are at risk for developing this disease and provide treatment strategies to avoid it.
True
Clinical decision making is guided by targeted information delivery ensuring that the five rights of clinical decision support are implemented: the right information provided to the right person in the right format through the right channel at the right time in workflow.
True
Clinical decision making is guided by targeted information delivery ensuring that the five rights of clinical decision support are implemented: the right information provided to the right person in the right format through the right channel at the right time in workflow. T/F
True
Human-technology interface problems are a major cause of patient monitoring incidents. It is not always that the technology itself is faulty. In fact, the technology may perform flawlessly, but the interface design may cause human error.
True
In deep transpersonal caring, both the caregiver and the care recipient may experience healing. T/F
True
Information prescriptions direct patients and families to credible websites and to wikis and blogs that may help them understand their health issues. T/F
True
Simulated experiences in nursing education should contain the PEDA (pre-brief, enactment, debrief, and assessment) elements to provide important opportunities for students to hone critical thinking and clinical skills in a safe and supportive environment. T/F
True
Telehealth can positively impact the healthcare outcomes for patients with chronic diseases, particularly those with higher acuity levels who are at significant risk of having a medical crisis that might necessitate emergency or unplanned acute interventions. Many other patients with chronic diseases are less susceptible to a health crisis but would greatly benefit from home telemonitoring to improve care and reduce costs. T/F
True
The Patient Safety and Quality Improvement Act of 2005 mandated the creation of a national database of medical errors and funded several organizations to analyze these data with the goal of developing shared learning to prevent medical errors.
True
The Patient Safety and Quality Improvement Act of 2005 mandated the creation of a national database of medical errors and funded several organizations to analyze these data with the goal of developing shared learning to prevent medical errors. T/F
True
________ is the term that denotes the ease with which people can use an interface to achieve a particular goal
Usability
It is termed __________if a nurse knows that a colleague has accessed or attempted to access the record of a patient for whom the colleague is not providing care.
a breach
Videoconferencing technology:
allows professionals to communicate more effectively and frequently with in-home patients
Surveys of potential or actual users of a website can be conducted to:
assess preferences for a number of design characteristics such as display color, menu buttons, text, photo size, icon metaphor, and layout by selecting, on a computer screen, their preferences for each item from two or three options.
The prevalence of healthcare-associated infections demonstrates how the _______ can address healthcare quality issues.
electronic health record (EHR)
A strength of the FITT model is that it:
encourages the evaluator to examine the fit between each two of the components: user and technology, task and technology, and user and task
Which of the following terms is defined as any physical or mental health information created, received, or stored by a "covered entity" that can be used to identify an individual patient, regardless of the form of the health information.
protected health information
A hardware security tool that helps protect an organization against security breaches by issuing masks to protect the identity of a corporation's employees who are accessing the Internet is a(n):
proxy server
Radio frequency identifier (RFID) technology may gradually replace bar-code technology in the medication administration cycle because RFID provides:
reduced potential that a counterfeit medication is inadvertently introduced into the supply.
The HIPAA privacy requirements, which went into effect on April 14, 2003, limited the release of protected health information without the patient's knowledge and consent.
true
Healthcare organizations typically do not encourage use of personal devices for professional matters, and in many instances they actually have policies in place forbidding employees from using personal devices in the workplace. What is an issue or are issues with "bring your own device" (BYOD)?
security of PHI
Examples of peripheral devices used in home telehealth include: (select all that apply) spirometers peak flow meters Pyxis medication carts pulse oximeters
spirometers peak flow meters pulse oximeters
Some organizations provide offsite employees such as homecare nurses with a network interface device that does not have secure information stored on it. These devices are also known as
thin clients