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Culture of safety

1. Being a commitment of resources 2. Cross collaboration 3. BLAME FREE ENVIRONMENT

legal challenges

1. Credentialing and privileging 2. online prescribing 3. malpractice liability 4. licensing of drs 5. Informed consent and privacy 6. Internet bandwidth

Phases of the project management life cycle (PMLC)

1. Design/plan 2.implementation 3. monitor and control 4. evaluation 5. lessons learned with knowledge transfer

Stage 1 requirements for meaningful use

1. record demographic info. 2. computerized provider order entry 3. Clinical decision support and ability to track compliance 4. Automatic, real-time drug-drug and drug-allergy interaction checks 5. Maintain an active medication list 6. Maintain active medication allergy list 7. Record and retrieve VS 8. Record smoking status for patients 13 yrs and older 9. Mechanisms to protect information created or maintained by certified EHR technology include access control 10. Electronically exchange key clinical information among providers and parent authorized entities 11. Supply patients with an electronic copy of their health info upon request 12. Supply an electronic copy of DC instructions upon request' 13. Report required clinical quality measures to CMS 14. Maintain up to date problem lists of current and active diagnose

Physical restrictions

1.*Lock up in server room 2. surveillance 3. keeping cumputers, files, routers, etc behind locked doors 4. disable the drives 5. protect printers 6. daily backups

Security measures

1.Levels of access as appropriate, on a need to know basis 2.Automatic sign off- in case a HCP has to leave computer abruptly. 3.Firewalls 4. physical restrictions

What are the maximum penalties for refraining from full participation in the mips in years 2017 through 2024? MIPS penalty for failing to comply?

4-9%

Not a phase of information system life cycle: a.Needs b.System implementation c.Selection d.Evaluation

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Information system

A COMBINATION of computer hardware and software that can process data into information to solve a problem.

Firewalls

A barrier created from software and hardware designed to block unauthorized access while permitting authorized communications

What is a continuity of care document?

A document that is integrated with the electronic health records to provide the sharing of data with multiple users

Informatics specialist

A nurse with advanced skills specific to health information management and computer technology. Focus on information needs for practice of nursing, including, education, administration, research, clinical practice, and use critical thinking.

Knowledge workflow

A primary reason nursing participation is essential on the implementaiton team

Kotter change theory begins with

A sense of urgency

reference terminology

A set of concepts with definitional relationships. Necessary to analyze data, develop EBP, and improve quality of care. Ex: SNOWMED-CT, ICNP

Expert system

A type of decision support system that implements the knowledge of one or more human experts without human intervention

HIPAA

ACT that contains penalties for breach of confidentiality within the healthcare environment. Can result in disciplinary action, fines, civil and criminal action, and even termination.

Where to you document an assessment?

ADT

With which act in 2009 did MU originate?

ARRA

Interoperability

Ability of 2 entities human or computer to exchange and predictably use data or info while retaining the original meaning of that data

What is a technical safeguard ephi. Only allow access to authorized uses?

Access control, audit controls integrity, person or entity, authentication transmission security ??

Master Patient Index (MPI)

All client data can be associated with the correct client

Where to document allergies in EHR?

Allergy list

Joint Commission

An independent non for profit organization that accredits and certifies approx. 21,000 hospitals and other HC organizations. A symbol of quality and means organizations are exceeding standards.

Informatics

An interdisciplinary field that draws from, as well as contributes to "computer, decision, information, management, cognitive science, and organizational theory. Its broad scope encompasses natural language processing, data mining, research, decision support, and genomics.

Trojan Horses

Appear to do one function while performing another undesired action. They do not self replicate and are easily confined once discovered. Ex. A regular system login but records usernames and passwords for another program for illicit use.

What is a technical safeguard of ePHI?

Assess control Audit control integrity person or entity Authentification transmission security

Phishing

Attempt to steal sensitive information via the internet

Mobile computing should require:

Authentication encryption to safeguard information

What is role-based. access?

Authenticity

HITECH ACT

Authorized incentive payments for early adopters and lead to the development of MU criteria.

A physician is looking for a current patient's vital signs. Which measure is included in the vital signs section, in addition to temperature, blood pressure, respiration, and heart rate? a.Oxygen delivery B.pain scale c.Oral intake d.Mean arterial pressure

B.pain scale

TCP/IP

Basic network code-allows computers to communicate

Experienced nurse

Be skilled in using information management and computer technology; have strong analytic skills to learn from relationships between different data elements, and be able to collaborate with the informatics nurse specialist to suggest improvement to systems. Specific area of expertise.

Synchronous connected health

Bidirectional communication between patients and healcare providers. VIDEOCONFERENCING, TELESTROKE, TELEPSYCH, ROBOTIC

A nurse is entering a verbal medication order and encounters a warning the entry is a duplicate. Which action does the nurse take?

Call the MD or Pharmacy

MU stage 2 requirments

Called for patients to view, download, or transmit their health information online and for the capability for secure messaging between providers and patients and reporting public health measures.

What happens in the second stage of meaningful use?

Called for patients to view, download, or transmit their health information online, and for the capability for secure messaging between providers and patients and reporting public health measures. Must meet stage 2 requirements fot 2 full years.

personal health record (PHR)

Can follow a person across their life longitudinal. Is a collection of patient data controlled by the patient and accessible by the patient and providers. The consumer enters and maintains all info.

If your patients barcode bracelet is not working and you need to pass meds you would?

Check the armband for damage, change the armband if necessary

Merit-based Incentive Payment System (MIPS)

Combines physician quality reporting system (PQrS) and medicare EHRS that will measure based on quality, resource use, clinical practice improvement and MU of EHRS technology.

Interface (user)

Computer programs that tells two different systems how to exchange data.

Standardized terminology supports the development of?

Decision support software

1)Needs Assessment phase of the systems development life cycle (SDLC)

Determines needs and wants in a information system AKA gap analysis.

The implementation committee tasks

Develop plan (WBS), Committee should represent ALL disciplines.

Gnatt Chart

Developed with an owner for each specific task, subtask, and due date with start and end dates

Integration

Different information systems are able to exchange data in a fashion that is seamless to the end user.

Emerging trends

Digital hospital front doors, Amazon hosted EHRs, Artificial intelligence, voice assistants.

Non clinical telehealth

EX: research/data mining, grand rounds, remote education, and expert in situation.

ePHI

Electronic protected health information is defined in HIPAA as any protected health information that is created, transmitted, stored or received in any electronic format.

HIPAA introduces new threats including

Email and instant messaging may cary PHI that can be intercepted

blame free environment

Encourages reporting of errors or near misses. Focuses on systematic view of errors rather than individual causation.

Security Rule

Establishes a national set of security standards for protecting a certain set of health information that is held or transferred in electronic form. Protect the privacy of individuals health information while allowing covered entities to adopt new technologies to improve the quality and efficiency of patient care.

Telenursing

Evaluates the outcomes of NURSING CARE using technology

SWOT is used in what phase of the information system life cycle?

Evaluation

what are statements examples of the use of evidence-based guidelines in clinical informatics?

Examples of the ways in which practice-based research is being enabled by health IT tools and techniques include recruitment of patients for practice-based research studies via electronic data collection; translation of research into practice by re-engineering practices through strategic adoption of health IT; and identification of risk in a patient population using physician-coded data from an electronic medical system.

Informatics innovator

Expected to be educationally prepared to conduct informatics research and generate informatics theory. Advanced understanding and skills in information management and computer technology.

Beginning nurse

Expected to have fundamental information management and computer technology skills and use existing information systems and establish information management practices

Which act mandated the barcode medication Administration

FDA

ALWAYS TURN OFF

FILE SHARING

What is a physical safeguard ePHI. Policies, procedures, disposal and station for use and access of PHI of limited access, hardware, software and or procedure mechanism to record and exam activities in information that are use for mobile devices

Facility access controls Workstation use Workstation security Device and media controls USB port locks

TIGER

Formed to advance nursing competencies related to informatics. The primary objective was to develop a US nursing workforce capable of using EHR to improve delivery of care. Improving nurse education, practice and delivery of patient care using HIT.

SNOWMED-CT

Globally recognized, controlled healthcare vocabulary, that provides a common language for electronic health applications to exchange data. Sharing data across health specialties and site of care.

3)System implementation phase in the sytem development life cycle (SDLC)

Go live planning, TRAIN STAFF, analyst builds screens and templates according to organization and policies, apply changes to that organization, GO LIVE

what describes an example of opt in or opt out choice regarding the disclosure of personal health information

HIPAA

QSEN Institue

Identified quality and safety competencies for nurses that fit well with an informatics culture. Patient centered care, teamwork, EBP, quality improvement, safety and informatics.

Meaningful use

Improve population health, requires standardized nursing terminology, geared to spur the adoption and use of electronic health records for the purpose of gathering and reporting data that can be used to improve population health. Incentive program to assure EHRSs are used according to standards that achieve quality, safety, and efficiency measures.

Informatics Advantages

Improved records improved data collection Prompts to improve documentation improved safety with better pt. identification, decision support, and tracking Improved communication and access to information

The American Recovery and Reinvestment act (ARRA)

In 2009, along with HITECH provided economic stimuli and incentives for the adoption of EHRs and the goal that each person in the US would have a certified digital health record by 2014.

How do you motivate staff to adopt an EHR?

Include them in implementation

Common reasons for HIPAA breaches?

Insider threat social networking (FB, Twitter, Instagram) scare-ware malware attacks ransomware smartphones embedded computing virtualization wireless networks

Disadvantages of EHR

Integration of behavioral health and primary care workflows. information exchange limited resources Work-arounds: variations in procedures and processes created to accomplish work when systems or workflows are deficient or inefficient which can, and frequently do, defeat positive features such as safety

Continutity of Care

Intended to improve continuity and quality of care, including reduction of errors. Provides a snapshot of a persons current health and healthcare to a provider who does no have direct access to that persons EHR.

Project implementation team/committee

Interdisciplinary team that plans, tests, and trains. The project team needs to be actively involved as end users.

what can be installed to exchange information?

Interface

"EPIC-to-Cemer"

Interface exist?

With change, many feelings can be observed including resistance, and feelings of loss similar to what theory?

Kubler ross's theory of grief

Which is a physicians clinical informatics assessment?

Labs and clinical values

Physical security

Lock up data center and servers surveillance limit access to data center use rack mount servers safeguard workstations protect portable devices by limiting access and via encryption secure and physical backup media disable drivers protect printers and printouts

Which statement describes the application of meaningful use?

Meaningful use means meeting measurable objectives for using an EHR system set forth by the centers for medicare and medicaid services in order to qualify for incentive programs.

What agency oversees MU

Medicare

At risk pt. safety factors

Medication accuracy, Critical lab values

Super User

Members of the implementation committee, who's sole purpose is to support end users.

All states have implemented HIEs with the oversight of

ONC-HIT

Information Security

Occurs when realized that information has value and requires protection. Determines the survivability of the system.

Who do you call for a medication reschedule

Pharmacy

ICNP (International Classification for Nursing Practice)

Point of care reference terminology. Related specifically to nursing diagnosis, outcomes, intervention statments.

4)Maintenance Phase of the systems development life cycle (SDLC)

Problem solving, debugging, files back up routinely and install and system upgrades, make sure it's working as intended.

Nurses role in informatics

Project manager, provides oversight of the 5 phases of EHRS implementation, facilitates communication

An important part of a nurse informaticist's role is to report and use the data to evaluate the quality of healthcare against recognized quality standards. which statement describes quality reporting

Quality reporting should have better documentation, fewer medical errors, cost saving and improved care coordination.

When developing a new clinical workflow what is one of the first steps?

Recruit

Confidentiality

Refers to a situation in which a relationship has been established, and private information is shared but not disclosed.

What describes the relationship between meaningful use and merit based?

Reimbursement

administrative safeguard

Restricting access of all authorized users of the EHR according to their position in the HC system

Asynchronous apps

STORE AND FORWARD-radiographic images, photos, videos!

An informatics nurse and ER nurse are conducting an analysis of a patient admission from the ER. Which tool should these nurses use for a process analysis?

SWOT

Strategic planning is driven by all except:

Short term goals

The healthcare organization has a different surgery system that is integrated with the organizations main electronic health record. What should this healthcare team do to ensure all information is properly charted?

Sign out and back in

Audit trial

Software used for detecting problems, and flaws in apps by recording activity by users and systems

What meaningful use stage can you generate and transmit rx electronically?

Stage 3

Health Level 7 (HL7)

Standards for the exchange of clinical data and how the data are coded.

SWOT analysis

Strengths, weaknesses, opportunities and threats. Helps identify gaps in the current system.

Health Information Technology for Economic and Clinical Health (HITECH)

Strongly recommends that hospitals and healthcare providers increase the meaningful use of health information technology (HIT). To decrease overall health costs and IMPROVE POPULATION HEALTH OUTCOMES.

Clinical Decision Support

Supports decision making and efficiency. Decreases pt. safety risks and increasing positive pt. outcomes. Uses alerts, clinical pathways, order sets, dashboards, diagnostic support, and drug-drug interaction tools.

Superuser

Supports the system in a given unit and assists users with functionality and procedural issues

Information literacy

The ability to read and understand the written word and numbers as well as the ability to recognize when information is needed.

NANDA

The first terminology to be recognized by the ANA

what is an objective of user acceptance testing of a health information system?

The goal of user acceptance testing is to make sure the software, website or application can handle all required tasks in real-world scenarios, according to user specifications.

The relationship of standardized terms to financial reward r/t meaningful use

The implementation of standardized terminology within an EHRS is essential for health-care organizations to met the criteria of meaningful use.

What is the objective of user acceptance testing of a health information system

The objective of the UAT was to give HFR users an opportunity to test all functionalities, identify any defects or bugs, and check whether the system met the required, agreed-on specifications.

2)System selection phase in the system development life cycle (SDLC)

The organization seeks out a vendor company that provides a system the best fit needs. 3 documents used (Request for information (RFI), request for proposal (RFP), request for quote (RFQ) documents.

Alert fatigue

The phenomenon where too many CDSS warnings, or recommendations are presented and providers begin to dismiss them regardless of the importance

data mining

The process uses software to look for hidden patterns and relationships in large data sets.

privacy

The right to control access and disclosure or nondisclosure of information pertaining to oneself and to control the circumstances, timing, and extent to which information may be disclosed.

You are contacted by a confused user because their legend changes on the screen they go into, would you tell them?

The screen symbols change on each screen depending on the activities done

Data governance

The term used to refer to the collection of policies, standards, processes, and controls applied to an organizations data to ensure that it is available to appropriate persons when and where it is needed, in the format that is needed, and is otherwise properly secured.

Telehealth

The use of telecommunication technologies and computers to provide healthcare info and services to patients at another location.

What facility first used BMCA:

The veterans hospital of topeka, kansas

A nurse informaticist uses tools and methods to influence the change management process. which change theories?

Theory applied to informatics - Lewin's Change Theory

The goal of meaningful use

To exchange clinical structured data in a manner that is accurate and complete to improve care in a cost effective way.

Scope Creep

Unapproved change in a project, which can cause serious delays or even project failure

What represents privacy security risks for telehealth?

Unauthorized access to data during collection, transmission and storage. Device apps have flaws. Hackers and malware.

An informatics nurse is developing a web based application for patient care. Which statement accurately describes the internet?

Unregulated networks of networks

Ways to protect providers personal mobile devices?

Upgrade malware programs and updates

Evidence based practice (EBP)

Use current best evidence for patient decisions to improve the consistency and quality of patient outcomes. Foundation of clinical guidelines and clinical decision support tools.

Classification system

Used to categorize the details of a clinical encounter. Ex: NANDA, CPT, NIC, ICD-10, CCC, LONIC

Which statement best describes nursing informatics?

Uses nursing knowledge along with information and communication technology to promote the health of individuals, families and entire populations

Ad Hoc

When necessary or needed. Creates report on a as needed basis

What tool highlights improved efficiency and supports integration minority?

Workflow analysis

What is a physical safeguard of ePHI.?

Workstation use Workstation security device and media controls USB port locks

repository

a central location in which data is stored and managed

A patient informs the nurse that the discharge medications are to be sent to the pharmacy of choice. Where should the nurse enter this information? a. Home medication entry b. Admission history c. Patient summary d. Medication reconciliation entry

a. Home medication entry

During which phase of the systems development life cycle should a system be activated to effectively be used by end users? a. Implementation b. Validation c. Testing d. Development

a. Implementation

A physician called the nurse to change the recent medication order made on a patient. Where does this nurse make the edit? a. In the order entry tab b. In the medication administrative summary c. In the order summary tab d. In the physicians favorites section

a. In the order entry tab

Where can a nurse find a copy of the POLST document? a. In the scanned documents section or media tab b. In the clinical managers office c. In the hard copy of chart components d. In the patients room

a. In the scanned documents section or media tab

A nurse receives an alert that there are new orders for review. Where does this nurse look to verify this information? a. Order summary tab b. Kardex c. Situation, background, assessment, recommendation (SBAR) tab d. Order entry tab

a. Order summary tab

Which term is used to describe someone who gains access to computers belonging to another person or organization? a.A hacker b.An expert programmer c.A ransomware attacker d.A phisher

a.A hacker

What are three roles of a nurse informatics specialist? Choose 3 answers. a.Assists users with functionality, procedural issues, and basic troubleshooting b.Provides expert advice, opinions, and recommendations from a consultant's area of expertise c.Develops and trains all user groups on clinical computer applications and online documentation processes d.Acts as a liaison between nursing and information services and is both a nursing resource and representative e.Acts as the sole decision maker for the organization and the vendor when acquiring a new system f.Approves the budget presented by the project manager when transferring data from the old system

a.Assists users with functionality, procedural issues, and basic troubleshooting b.Provides expert advice, opinions, and recommendations from a consultant's area of expertise d.Acts as a liaison between nursing and information services and is both a nursing resource and representative

Which information would be useful in planning quality care for the next shift? a.Available critical care beds b.Satisfaction rates c.Hospital acquired infection rates d.Core measures

a.Available critical care beds

What do informatics and computational science have in common? a.Both fields are interdisciplinary. b.Both fields are combined in the healthcare environment. c.Both fields involve data retrieval from standardized health systems. d.Both fields involve working with people and technology

a.Both fields are interdisciplinary.

Meaningful use (MU) of electronic health records (EHRs) is part of the Medicare and Medicaid incentive program. Which two statements best describe MU? Choose 2 answers. a.Certified information technologies provide the necessary functions to enable eligible providers to be compensated. b.Minimum standards for population health are described in MU. c.Ten stages are described for MU. d.MU is used by inpatient and outpatient facilities.

a.Certified information technologies provide the necessary functions to enable eligible providers to be compensated. d.MU is used by inpatient and outpatient facilities.

Which informatics competency supports the adoption of a medication administration system? a.Change management b.Ability to develop a spreadsheet of controlled drugs c.Knowledge of pharmacy vendors d.Leading a systems integration team

a.Change management

What Is an effective use of the bar code medication administration system? a.Combining it with a computerized provider order entry, a pharmacy system, and an eMAR system b.Implementing it with computerized provider order entry, a multidose medication system, and the admissions and discharge system c.Deploying it with a pharmacy system and providing policies regarding access to information and data collection d.Combining it with an eMAR, multidose medication system, and an automated dispensing cabinet

a.Combining it with a computerized provider order entry, a pharmacy system, and an eMAR system

What are the expected outcomes of interoperable systems? a.Error reduction, revenue improvement, and increased communication b.Strategic planning consolidation and evidenced-based care c.Documentation of patient safety, improved staffing, and automated admissions d.Surgical suite automated and improved reports

a.Error reduction, revenue improvement, and increased communication

Which law or regulation pertains to the privacy and security of healthcare-related information? a.Health Insurance Portability and Accountability Act (HIPAA) b.Health Information Technology for Economic and Clinical Health (HITECH) Act c.National Institutes of Health (NIH) guidelines d.Hospital Readmissions Reduction Program (HRRP)

a.Health Insurance Portability and Accountability Act (HIPAA)

What can healthcare staff do to keep patient information that has been accessed with a mobile device protected? a.Install device updates when available b.Set a time limit on the device for users c.Keep the idle device in a lock box d.Use the device only at work

a.Install device updates when available

What Is an advantage of using the bar code medication administration (BCMA) within a healthcare setting? a.It allows for real-time, automated documentation of the administration of the patient's medication. b.It gives the patient more time to communicate with his nurse. c.It decreases the amount of charting the nurse needs to do. d.It helps the nurse assess the patient better.

a.It allows for real-time, automated documentation of the administration of the patient's medication.

What Is a gap analysis in the electronic health record (EHR) process? a.It is a list of features and functions desired but not immediately available in the new system as identified b.It is information the vendor reveals that is missing elements of the system after the contract is signed c.It is a bridge between research and clinical practice that is established. d.It allows the information systems department to lead the team to automate the current workflow.

a.It is a list of features and functions desired but not immediately available in the new system as identified

Which is not an emerging trend in healthcare? a.Less consumer accountability b.A push for patient saftey c.Error reduction

a.Less consumer accountability

A provider electronically orders blood work at a laboratory. The provider must ensure the local lab system can properly communicate with the provider's system for the results to be usable. Which is the correct term that would be found in these systems? a.Logical observation identifiers names and codes (LOINC) b.Current procedural terminology (CPT) c.Systematized nomenclature of medicine-clinical terms (SNOMED-CT) d.Advanced encryption standard (AES)

a.Logical observation identifiers names and codes (LOINC)

Informatics nurses support the quality reporting. What are two quality reporting characteristics informatics nurses practice? Choose 2 answers. a.Managing data, information, and knowledge b.Providing patient support c.Developing tools and methods d.Maintaining organizational databases

a.Managing data, information, and knowledge c.Developing tools and methods

Data security, accuracy, and integrity management are vital aspects of the informatics nurse role. How does an informatics nurse institute manual and automated procedures to manage data security, accuracy, and integrity? a.Monitors patterns and exceptions b.Maintains a stable system c.Implements security controls d.Separates duties among the information technology employees

a.Monitors patterns and exceptions

Which statement accurately represents the National Quality Forum (NQF)? a.NQF is a not-for-profit, membership-based organization that works to improve healthcare through meaningful measurement. b.NQF assesses fines for infractions of privacy and security via the Health Insurance Portability and Accountability Act (HIPAA). c.NQF has provided over 19 million dollars in funding for meaningful use legislation. d.NQF is an organization being discontinued due to the promoting interoperability (PI) initiative.

a.NQF is a not-for-profit, membership-based organization that works to improve healthcare through meaningful measurement.

During which phase of the informatics system life cycle should the musts and wants be determined? a.Needs assessment b.System implementation c.Maintenance d.System selection

a.Needs assessment

What are examples of information stored in an electronic health record (EHR)? a.Patient histories, medical tests, medications, and images b.Past surgeries, genealogy, medications, and images c.Medications, images, heuristics, and exercise regime d.Metadata, heuristics, travel history, and medical tests

a.Patient histories, medical tests, medications, and images

Which phase of implementation uses small groups of individuals to evaluate potential issues that may occur when making a new systems transition? a.Pilot phase b.Big bang conversion phase c.Parallel conversion phase d.Rollback phase

a.Pilot phase

Which is not a responsibility of the project implementation team? a.Present system design to management b.Execution system changes c.Active involvement in user participation d.Knowledge of current workflows

a.Present system design to management

This defines the detail of collaborative effort: a.Project scope b.Proposal strategy c.Project plan d.Activity guide

a.Project scope

How can a nurse informaticist increase interoperability? a.Promote the use of standard vocabulary for documentation and coding b.Create different passwords for multiple systems that are used daily c.Allow each clinical area to develop its own workflows d.Ensure there is no interface between the lab and the hospital charting system

a.Promote the use of standard vocabulary for documentation and coding

Duplicate orders cause quality issues in patient care. What helps to resolve this problem? a.Providing training and reminders b.System overrides c.Alerts to patients d.Chart review

a.Providing training and reminders

Which merit-based incentive payment system (MIPS) category replaces the reporting program that assesses care provided to Medicare patients,to ensure patients get the right care at the right time? a.Quality b.Cost c.Improved activities d.Advancing care information

a.Quality

What are two of the five rights of clinical decision support? Choose 2 answers a.The right time in the workflow b.The right place in the software c.The right person d.The right interface

a.The right time in the workflow c.The right person

What is a goal of the health information exchange (HIE)? a.To allow insurance companies and providers to be able to share data b.To enable the coordination of services for providers and patients c.To eliminate service duplication at all levels of care d.To grant patients access to downloading a portal for providers

a.To allow insurance companies and providers to be able to share data

Meaningful use was signed into law in 2009 to provide a means for eligible providers, hospitals, and critical access hospitals to use and communicate data to improve patient outcomes. What Is the purpose of stage 1? a.To allow the electronic health record (EHR) to capture and share data b.To improve clinical outcomes c.To allow end users to access advanced clinical processes to analyze data and make care improvements d.To gain the trust of the patients

a.To allow the electronic health record (EHR) to capture and share data

What Is a goal of meaningful use? a.To engage patients and families in their healthcare b.To engage nurses to do more narrative charting c.To increase healthcare disparities d.To increase healthcare costs

a.To engage patients and families in their healthcare

Alert Fatigue can arise when a nurse is prompted to concentrate on important conditions or recommendations based on a patient's clinical data. What are two consequences of alert fatigue? Choose 2 answers. a.User dissatisfaction b.Improved safety c.Reduced productivity d.Decrease overrides

a.User dissatisfaction c.Reduced productivity

The emergency room (ER) staff is hesitant to use the discharge planning module in the new electronic health record (EHR). What Is a method the nurse informaticist should use to encourage staff to utilize the new application in the EHR? a.​​Enlist feedback from staff or users b.Perform system maintenance c.Review steering committee recommendations d.Require staff to review policies and procedures

a.​​Enlist feedback from staff or users

Technical security

access control audit control person or entity authentication transmission security

Meaningful use was changed to

advancing care information and rolled out under the MIPS, "promoting interoperability"

What can you put on your laptop to avoid security breaches?

authentications

The hospital announced its integration engine has stopped functioning. What does this mean for system interoperability throughout the organization? a. Nurses will have to search the EHR for any new patient data b. VS will need to be entered manually c. The data can still flow between operations d. Lab results will continue to post in a timely manner

b. VS will need to be entered manually

A nursing unit uses a medication administration system with locked cabinets to access patient medications. What Is needed for secure access? a.A unit-wide password that changes every month b.A biometric device with a touch screen that scans the index finger c.A key carried by the medication nurse on each shift d.A four-digit code shared by the entire staff changed each month

b.A biometric device with a touch screen that scans the index finger

Which two care settings would benefit the most from employing a nurse informaticist? 2 answers a.A freestanding laboratory b.A correctional facility with a clinic c.A healthcare organization planning a physical expansion d.A homeless shelter

b.A correctional facility with a clinic c.A healthcare organization planning a physical expansion

A patient is receiving an IV anticoagulant infusion. The nurse needs to know when the next partial thromboplastin time (PTT) should be drawn to determine dosing. How should this nurse find this information? a.By asking the charge nurse b.By reviewing the orders and results c.By reviewing the eMAR for infusion start time d.By calling the pharmacy

b.By reviewing the orders and results

A common request contained request for information document includes a: a.Cost analysis b.Company history c.Hardware and software list d.Execution timeline

b.Company history

Which codes support outpatient billing? a.Codes for clinical diagnosis and care b.Current procedural terminology (CPT) c.Systematized nomenclature of medicine clinical terms (SNOMED CT) d.Disease classification scheme

b.Current procedural terminology (CPT)

What Is the correct order of the system development life cycle phases? a.Analysis, evaluate, planning, designing, implementation b.Designing, planning, implementation, analysis, evaluate c.Designing, planning, analysis, implementation, testing d.Designing, planning, testing, implementation, analysis

b.Designing, planning, implementation, analysis, evaluate

Evidence-based guidelines are used daily in the clinical field. What Is one area of the electronic medical record (EMR) in which evidence-based guidelines are found? a.In the note field under the physician's assessment b.In the standing physician's orders for a sepsis diagnosis c.In the home medication list d.In the intake and output record

b.In the standing physician's orders for a sepsis diagnosis

Which strategy is useful when employing Lewin's change model, when considering a new health information system? a.Disregard the opinions of individuals who oppose the new system b.Involve employees in the decision-making process of the new system c.Convene with the organization's chief officers and vendor of the new system d.Terminate anyone who disagrees with the choice of the new system

b.Involve employees in the decision-making process of the new system

What Is important for a nurse informaticist to know about change control? a.It is extremely technical and involves certified analysts and informaticians. b.It helps prioritize limited resources and ensures system standards are upheld. c.It needs to be completed since it is part of meaningful use regulation for reimbursement.

b.It helps prioritize limited resources and ensures system standards are upheld.

What Is clinical decision support? Choose 2 answers. a.It reminds clinicians to call desk support for help. b.It provides clinicians with suggested care information. c.It reminds busy clinicians of items easy to forget or overlooked d.It reminds clinicians to check the patients and call the provider.

b.It provides clinicians with suggested care information. c.It reminds busy clinicians of items easy to forget or overlooked

What Is the intent of the 2003 Health Insurance Portability and Accountability Act(HIPAA) security rule? a.It is a certification by the Office of the National Coordinator for health information technology. b.It sets the national standards to protect individuals' electronic personal health information. c.It covers electronic security of United States citizens. d.It is the enforcement of protected health information (PHI).

b.It sets the national standards to protect individuals' electronic personal health information.

What are two items that exempt eligible clinicians from a merit-based incentive payment system (MIPS)? Choose 2 answers a.Small, rural, underserved practices of fewer than 15 clinicians b.Low-threshold provider who bills Medicare less than $90,000 yearly c.Virtual group of practitioners with different specialties and locations d.Two hundred or fewer Medicare patients seen annually

b.Low-threshold provider who bills Medicare less than $90,000 yearly d.Two hundred or fewer Medicare patients seen annually

Which statement describes patient-generated health data (PGHD)? a.PGHD is health-related data generated in clinical settings through encounters with providers primarily responsible for capturing or recording data b.PGHD is health-related data created, recorded, or gathered by patients (or family members or other caregivers) to help address a health concern. c.PGHD data is too expensive to store in the cloud or on local servers; therefore, most healthcare organizations avoid collecting it. d.PGHD collection has ceased at most healthcare organizations because clinicians lack the time to read, analyze, and validate the dat

b.PGHD is health-related data created, recorded, or gathered by patients (or family members or other caregivers) to help address a health concern.

A nurse is creating a patient list and notes that there are "< >" symbols surrounding the patient's name. Which action should this nurse complete to determine what the symbols indicate? a.Contact the help desk b.Select the legend c.Ignore the brackets d.Ask the unit manager

b.Select the legend

Who should a nurse informaticist exclude from participating in scheduled meetings to discuss change control? a.Hospital leaders b.Subject matter experts c.Chief informatics officer d.Executive director

b.Subject matter experts

Which mobile device feature may reside on a device indefinitely? a.Email messages b.Text messages c.Voice messages d.Instant messages

b.Text messages

What Is the main purpose of standardized nursing terminologies? a.They are a requirement for billing. b.They allow uniformity and easier retrieval of nursing-related data. c.They make documentation easier and take less time. d.They support the retrieval of common patient issues.

b.They allow uniformity and easier retrieval of nursing-related data.

Why does systemized nomenclature of medicine (SNOMED)international use standardized terminology? a. To allow translation of foreign languages between systems b. To ensure clinical terminology in one system correlates to those in another system c. To ensure the correct medications are administered d. To allow software vendors to easily design electronic medical records (EHR)

b.To ensure clinical terminology in one system correlates to those in another system

What Is the focus of cognitive science in nursing informatics? a.To examine the effects of computerized systems on nursing care delivery b.To explore the nature of knowledge and its components, development, and use c.To capture data at the point of care and present it in a manner that facilitates the care of an individual patient

b.To explore the nature of knowledge and its components, development, and use

Which is an accurate statement regarding alerts in the electronic health record? a. The alerts are added to the EHR by the vendor to prevent lawsuits b. The alerts should be ignored if there are to many which can become distracting c. An alert indicates an immediate or potential adverse event that can occur d. An alert is an audit trail of items that are deleted from within the EHR.

c. An alert indicates an immediate or potential adverse event that can occur

What are two barriers of adopting the use of clinical decision support tools in an electronic health record EHR? a. Changes with meaningful use b. Implantation challenges c. Data sources are shared with the EHR providing CDS d. Multiple data sources with adequate information exchange

c. Data sources are shared with the EHR providing CDS d. Multiple data sources with adequate information exchange

What can a nurse informaticist do to enhance the reporting of quality data? a. Develop prerequisites for health IT systems that will build linkages between nursing care and patient outcomes. b. Provide reports to centers for medicare and Medicaid services on quality data c. Implement standard capturing tools for reporting quality data in the electronic Health record (EHR) d. Educate providers on computerized provider order entry (CPOE)

c. Implement standard capturing tools for reporting quality data in the electronic Health record (EHR)

What are three informatics nurses roles are used in the design phase during the system development of life cycle? a. Change manager, system analyst and key stakeholder b. Project champion, scope author, product manager c. Subject matter expert, developer and usability tester d. Testing consultant, budget planner and help desk analyst

c. Subject matter expert, developer and usability tester

Which two practice environments employ informatics nurses? Choose 2 answers. a.A stem cell laboratory b.A certified human milk bank c.A clinical systems vendor d.A medical device manufacturer

c.A clinical systems vendor d.A medical device manufacturer

When printing discharge instructions for a patient,the nurse notices the physician electronically entered the prescriptions for discharge medications. Which other form of information is needed along with this patient's discharge instructions for these medications prescribed? a.The patient's bill for the visit to reference b.The nurse's information card for the patient to contact him with any further questions c.A printed document with detailed, supplemental information d.A printed chart for the patient to take with her

c.A printed document with detailed, supplemental information

Which term is used to describe information that is always accessible for use by authorized users? a.Security b.Privacy c.Availability d.Integrity

c.Availability

What is not a national trend r/t sng informatics? a.CPOE b.Barcode for meds c.Blogging as a means to give shift report

c.Blogging as a means to give shift report

An end-of-shift report is given at the nurses' station desk, but it is not completed right away due to competing priorities of answering the telephone, limited access to desktop workstations, addressing patient situations, etc. Which action can a nurse suggest to initiate change? a.Complain to colleagues and do nothing b.Research how other hospitals provide shift reports, and report findings to unit manager c.Complete a time study report comparing logging data at a stationary desk versus using a workstation on wheels (WOW) d.Lodge a formal complaint with the hospital's administration

c.Complete a time study report comparing logging data at a stationary desk versus using a workstation on wheels (WOW)

What are three types of networks or information exchanges? a.Wide area network (WAN), central processing unit (CPU), and cellular b.Internet, controller area network (CAN), and local area network (LAN) c.Local area network (LAN), internet, and wide area network (WAN) d.Scrum, internet, and general packet radio services (GPRS)

c.Local area network (LAN), internet, and wide area network (WAN)

Which two tools are used to change a clinical workflow? Choose 2 answers. a.Spreadsheets b.Scorecards c.Observation d.Swim lane charts

c.Observation d.Swim lane charts

What Is a benefit of meaningful use (MU)? a.Data is secure. b.Participation is mandatory. c.Patient outcomes are improved. d.Patient interaction is minimized.

c.Patient outcomes are improved.

Why would the results of a patient report containing wait time data in the hospital emergency room be of interest to the hospital's CEO? a.The information would be helpful to the CEO in determining if a bigger cafeteria is needed b.The CEO can use the information when budgeting for a new surgery wing for the hospital. c.The information is a piece of the puzzle needed when the CEO is determining patient satisfaction d.The information can be presented to the hospital board when the CEO asks for a raise.

c.The information is a piece of the puzzle needed when the CEO is determining patient satisfaction

This is a purpose or reason for an organization's existence a.The plan b.The objective c.The mission d.The goal

c.The mission

A patient is being admitted to the hospital, and the nurse is obtaining a medical history from the patient. When asking the patient for a list of her medication, the patient replies,"I already gave the ER information on my medication. Can you not look it up?" Which action should this nurse take? a.The nurse should call the ER and ask the patient's previous nurse for a list of the patient's medications. b.The nurse should call the patient's emergency contact on the chart to acquire the patient's home medications. c.The nurse should review the home medication section in the hospital's electronic health record (EHR) to see if the information has been added and reviewed. d.The nurse should ask the patient for her preferred pharmacy to obtain the list.

c.The nurse should review the home medication section in the hospital's electronic health record (EHR) to see if the information has been added and reviewed.

A patient is being transferred to a trauma hospital in the area. The current hospital uses a different electronic health record (EHR)than the receiving hospital. Which process allows interoperability of the health information exchange (HIE) between the two hospital systems? a.The staff at the trauma hospital will need to request the patient's records be faxed to them from the transferring hospital b.The transferring hospital should copy the patient's chart and send it with the patient via USB drive. c.The staff at the trauma hospital will obtain the patient's Consolidated-Clinical Document Architecture (C-CDA) via the EHR by the transferring hospital. d.The patient's family will be present at the trauma hospital to provide the medical information needed.

c.The staff at the trauma hospital will obtain the patient's Consolidated-Clinical Document Architecture (C-CDA) via the EHR by the transferring hospital.

What Is included in meaningful use stage 3? a.Direct patient billing for care provided b.Improvement in healthcare outcomes c.The use of electronic prescribing d.The use of patient engagement and coordination of care

c.The use of electronic prescribing

What Is the responsibility of a superuser? a.To document information in an electronic health record (EHR) and extract and analyze data b.To develop and train all user groups on clinical computer applications c.To support the system in a given unit and assist users with functionality and procedural issues d.To provide expert advice, opinions, and recommendations from a consultant's area of expertise

c.To support the system in a given unit and assist users with functionality and procedural issues

Most breaches of confidentiality occur as a. result of?

carelessness

What describes the concept of interoperability within a healthcare organization? a. It is the storage of patient encrypted data in large data warehouses b. It refers to charting during a surgical procedure c. It receives data in a timely manner in the patients record d. It is the ability to correctly interpret data across systems

d. It is the ability to correctly interpret data across systems

Which analytic method is used to forecast the likelihood of an adverse event a. Data modeling b. Real time analytics c. Business intelligence d. Predictive monitoring

d. Predictive monitoring

What Is the meaning of confidentiality of patient records? a.The patient's private information can be shared, only in paper form. b.The provider's policies delegate which health information an individual can share. c.A policy requires health information to be stored in a secure area within the hospital d.A healthcare provider can disclose health information with specific permission.

d.A healthcare provider can disclose health information with specific permission.

Nurses use electronic automation to communicate, document, and make decisions about improving the quality of patient care. Which system, organization, or regulation seeks to improve patient care through investments in electronic automation? a.Healthcare merit-based incentive payment system (MIPS) b.The Centers for Medicare and Medicaid Services (CMS) c.Healthcare computerized provider order entry (CPOE) d.Health Information Technology for Economic and Clinical Health Act (HITECH)

d.Health Information Technology for Economic and Clinical Health Act (HITECH)

What Is a major benefit of nursing informatics? a.It adds new tasks and changes workflow to improve patient care and utilization of resources. b.It helps nurses to be efficient, improve workflow, and finish tasks on time. c.It eliminates excess documentation and increases productivity. d.It improves communication among healthcare providers to improve patient care.

d.It improves communication among healthcare providers to improve patient care.

What describes an administrative safeguard of electronic protected health information (ePHI)? a.Establishing procedures that give all who work for an organization access to ePHI b.Creating a security awareness program as an option for healthcare professionals who access ePHI c.Keeping a list of security incidents if needed by regulating bodies d.Restricting access of all authorized users of the EHR according to their position within the healthcare system

d.Restricting access of all authorized users of the EHR according to their position within the healthcare system

What Is one disadvantage of nurses frequently documenting in the free-text note section of the electronic health record (EHR) rather than within designated flow sheets? a.The practice of completing free-text notes is time consuming. b.Few clinicians will take the time to read free-text notes c.Free-text notes are too long. d.Running a report will not yield the free-text note data.

d.Running a report will not yield the free-text note data.

This is the development of a comprehensive long range plan of guiding the activities and operations of an organization: a.Futuristic goals b.Actively blueprint c.Scheme preparation d.Strategic planning

d.Strategic planning

What reduces and organizes terms for easier searches? a.Harmonic series b.Multiaxial taxonomies c.Monoaxial taxonomies d.Taxonomic vocabularies

d.Taxonomic vocabularies

What Is an output of systems analysis? a.Usability testing scripts b.Iterative code c.Project charter d.Technical requirements

d.Technical requirements

A nurse is to administer insulin coverage, and the electronic health record (EHR) is preventing the nurse from completing the administration documentation. Why has this occurred? a.The nurse is unsure of where to document the medication administration within the EHR. b.The EHR is malfunctioning. c.The nurse's EHR access has been denied. d.The EHR requires the dose verification and sign-off of another nurse

d.The EHR requires the dose verification and sign-off of another nurse

Which statement describes a successful electronic health record (EHR)? a.A project management application was used for development. b.A feasibility study was conducted during the planning stage. c.The project was completed on time. d.The customer's needs were met.

d.The customer's needs were met.

What Is used to evaluate a health information system (HIS)? a.The inpatient quality reporting program b.The technology informatics guiding education reform c.The use of syndromic surveillance d.The electronic medical record adoption model

d.The electronic medical record adoption model

What is not a reason why its important that selection committee board member understand software and electronic process: a.It can affect success or failure of the project b.They often determine budget allocations c.It can impact business goals d.They will need to become trained on the system

d.They will need to become trained on the system

What describes message format standards? a.To ensure the communication of part or all of the electronic health record (EHR) b.To map proprietary layouts to one another to more easily accomplish the exchange of data c.To describe markup languages used in exchanging documents d.To ensure data is structured the same way for the two applications exchanging data

d.To ensure data is structured the same way for the two applications exchanging data

What Is the mission of the Health Level Seven (HL7) organization? a.To enable the federal government to issue provisions and to regulate developed standards b.To set the standards for the equipment used in hospitals and in all areas including medical, pharmacy, and nursing c.To allow to efficiently meet the goals of a global market, assessing and improving the quality of products covered by its standards d.To provide a comprehensive framework and related standards for the exchange, integration, sharing, and retrieval of electronic healthcare information

d.To provide a comprehensive framework and related standards for the exchange, integration, sharing, and retrieval of electronic healthcare information

Value

diagnostics and treatment options were based on value of those test and treatments to patient and organizational outcomes.

When do end users use the system?

implementation

The use of EHRS results in

improved quality, safety, and efficiency while reducing inconsistencies in healthcare, increase pt, and family active involvement in their care, advances the health of the public, safeguards personal health data and information.

interoperability

improves healthcare organizations output interfaces are required for communication between systems and decision support

Phase one of the project management cycle DESIGN

includes the creation and development of tools needed to manage the project: scope and charter documents guide how system will be implemented.

Examples o EBP

infection control Giving o2 to COPD pts. non invasive BP in children

What should providers have on their personal mobile devices?

passwords

MIPS-what is it and how is it similar to MU

quality

When developing a new clinical workflow, what is one of the first steps?

recruit

What term refers to confidentiality?

security

two factor authentification

security?

Admission, transfer, discharge system

system integrated with other admit and clinical systems and tracks a patients activities and looking from hospital or clinic

Nursing informatics

the use of technology and information to help support all aspects of THE NURSING PRACTICE.

What measure is important for the implementation phase to be successful?

training? only after addressing end user needs can implementation be successful

Lewin's Change Theory

unfreezing, changing, refreezing

Kotter change theory steps

urgency-coliation-vision-communication-empower-quick wins-build change- embed change

Telemedicine

use of medical information exchanged from one site to another via electronic communications to improve health status. EX: videoconferencing

What actions should be taken to avoid a security breach?

use the most up to date wireless encryption in the design and build all devices Physical and logical restrictions risk analysis downtime emergency mode data back up

Gap analysis

used to identify needed changes in the current workflow once moving to the new system.