Informatics Exam 1

What are the recognized benefits of telehealth on patient care?

Reduced travel time, Access to specialists, Enhanced patient care, Increased productivity

remote monitoring

Remote patient monitoring system that continuously tracks a patient's health indicator

Benefits of HIE

Safer, more effective care for patients Increased consumer education and patient involvement in their own healthcare Improved public health reporting and monitoring Redundant or unnecessary testing is eliminated Reduced healthcare costs

According to the United States Census Bureau's 2012 Current Population Survey, what percentage of U.S. households are without Internet access?

0.25

Which of these was the top telehealth target of 2013?

CHF

Role of Informatics in Clinical Nursing

Coordinating the implementation of electronic health records Act as the liaison between the nurse and the IT programmers Create the training courses on the new technologies

What has been identified as the greatest barrier to the implementation of telehealth technology?

Cost of implementation and upkeep

Which of these is a component of an effective data management infrastructure?

Data acquisition strategies,Data mining techniques,Health care standards

Nursing Informatics Competencies

Technical Utility Leadership

Whose responsibility is it to identify potential gaps in patient confidentiality?

HCPs

Health Information Technology

Health care reform in which multiple provisions were put into place to improve the quality and efficiency of healthcare especially among those who are at risk for healthcare inequality

Research among nurses currently working as telenurses suggests what change should be made to nursing education curriculum?

Telehealth should be included in basic nursing studies

What term is used to identify the ability of two or more organizations to use their IT systems to pass and use exchanged information effectively for a common purpose?

Interoperability

What is likely the cause of an older adult's inability to access health care information on the internet?

Lacks technical computer skills

Telehome care

The transmission of digital auto and video data during an interactive health care encounter between participants in different locations

blogs

Website or web page on which an individual records opinions and experiences on a regular basis

telecommunication

communication at a distance that uses technology

Which of the following choices is an example of an advantage telehealth provides for nurses?

distance learning

what is a sciences that make ups nursing informatics?

electronic health record (EHR)

Seven Emerging Technologies

genetics/genomics diagnostic tools 3D printing robotics biometrics EMR CPOE

Nursing informatics

speciality, recognized by the ANA, that helps nurses fully develop information communication technology to improve the delivery of care

What patient benefit has telehealth provided for rural hospitals that has allowed those hospitals to enhance their ability to provide trauma care?

A decrease in the cost of care, A decrease in the length of stay at the initial hospital, A decrease in transfer time to trauma centers

What does current research state concerning patient care outcomes related to telehealth services?

outcomes have been significant and positive

Example of Web 2.0

social media platforms, wikis, blogs

example of remote monitoring

unobtrusive tele-monitoring

The use of devices and sensors to collect and automatically transmit health information (e.g., vital signs) without voice interaction between the patient and health provider is known as what?

unobtrusive telemonitoring

information example

vitals that are plotted on a graph

infrastructure component examples

Data acquisition, health care standards, clinical event monitors and data repositories, clinical event monitors and data repositories, data mining techniques, digital sources of evidence and surveillance for real-time error detection

Lewin's Force Field Analysis

Explains the nature of change and how to manage it within organizations

Real-time

Immediate tele-health interactions that occurs when parties are communicating with each other without delay

What is the primary source of educational preparation for the telenurse?

On-the-job training

Considerations for Telehealth Implementation

Training Competencies License Reimbursement

Example of Data

Vitals, ethnicity, LOS, age

Healthcare.gov is an example of what type of internet site?

health portal

Research on the effect of telehealth services on health outcomes has demonstrated the most significant positive impact on what health issues?

heart and psych conditions

What is the greatest concern about information presented on the World Wide Web?

its validity isn't guaranteed

Elements of telehome care

monitoring enhancing advancing

Which of the following is not an example of a Web 2.0 tool that can be useful when seeking health information?

online dating websites

knowledge

synthesis of information

What is a major advantage of a handheld computer when considering the care of patients?

time management

An example of telehealth advancing the health care field is the development of the subfield of teledermatology. T/F

true

Health information exchange (HIE) is the mobilization of health care information electronically across organizations within a region, community, or hospital system. T/F

true

The HIPAA Breach Notification Rule document contains regulatory requirements for telehealth. T/F

true

digital divide factors

Age, education, ethnicity, financial status, residence, culture and beliefs

Query-based exchange

Allows HCPs to search and request information regarding a patient's health history

Directed Exchange

Allows HCPs to send information to and receive information from other providers in a patient's case (information is sent securely)

Consumer-mediated exchange

Allows consumer(patient) to mange their health information via the internet

Which association sets standards for and offers certification in telehealth nursing?

American Academy of Ambulatory Care Nursing

Who defined telemedicine as "the electronic exchange of patient information between two sites for improving the patient's health status," and defined telehealth as "a broader term extending beyond the delivery of clinical services"?

American telemedicine association

social media platform

Any electronic communication through which a user creates online communities to share information, ideas, personal messages, and other content

The nurse who effectively uses information technologies is most importantly affecting what aspect of professional nursing in the future?

Assuring that patient care is meeting an acknowledged standard of care

What is the fundamental benefit of telehomecare for the patient?

Avoidance of time-consuming office appointments, Quality of life is improved, Decreased costly office visits, Care is provided in the patient's home

Organizational and Leadership Challenges

Balancing the human element with technology Balancing cost and benefits Training a technology-enabled nursing workforce and assuring ongoing competency Assuring that technology use is ethical

Nursing Skills for Informatics

Being able to use technology to facilities, mobility, communication, and relationships Having expertise in knowledge information, acquisition, and distribution Understanding and using genomics in nursing

Web 2.0

Classification of the World Wide Wed that combines concepts, trends, and technologies that focuses on user collaboration, sharing of user generated content, and social networking

How is wiki most useful to nursing?

Collaborative work on a group project

What is the first step in forecasting and meeting future data management needs?

Collecting information on what data is currently being managed

Data

Collection of information acquired by observation, measurement, or experiment and used as a basis for calculation or inference

Where can telehealth be used to connect with patients?

Colleges and universities, patient's homes,Remote parts of the world

infrastructure components

Components of informatics that promote patient safety and enable EBP

Which of the following theories or disciplines is related to nursing informatics?

Computer science

Errors in patient identification can affect which of the following?

Costs to patients, providers, and payers,Patient safety,Testing

Effective Data Management Strategies

Define data policy Clearly define roles and responsibilities Develop data quality procedures Verify and validate data Document specific data Adhere to stated data management practices Carefully plan and document Define procedures Audit often Develop a data storage and archiving plan Create a data secrete approach containing tested layers controls

TIGER initiative

Designed to develop a shared vision and strategy for improving nursing practice, education and the delivery of patient care

TIGER Information Literacy Components

Determine the nature and extent of information Access needed information effectively and efficiently Evaluate information and its sources critically and incorporate selected information into your knowledge base and value system Individually or as a member of a group, use information effectively to accomplish a specific purpose Evaluate outcomes of the use of information

3 Forms of HIE

Directed Exchange Query-Based Exchange Consumer-Mediated Exchange

Components of Lewin's Force Field Analysis

Driving Forces Restraining Forces Equilibrium

Which is an example of sensational writing style?

Drop 30 pounds in five days with this new miracle pill!!!!

Which of the following emerging technologies provides health care professionals with access to critical patient information from multiple providers 24 hours a day, 7 days a week?

Electronic health record (EHR)

Interoperability of HIE

Enables the exchange of key health information, breaks down information, facilitates communication across organizations, and positively affects patient care

data integration

Ensures the accuracy of the complete health record

How is the TIGER initiative assuring that the profession of nursing is best prepared to participate in the era of digital health care delivery?

Ensuring that all nurses are educated in the use of informatics

What action did the American Nursing Association (ANA) take in 1995 to recognize the importance of nursing informatics?

Established the informatics certification examination

All health related websites can be trusted to provide reliable information. True or False

False

As a nurse, you probably won't use informatics knowledge and skills on a daily basis. T/F

False

Data management can be defined as the functional ability to collect, analyze and apply information

False

LONIC is an example of a mobile technology. T/F

False

Reimbursement of services across state lines is handled no differently than reimbursement of services within the state. T/F

False

Telemental health is the delivery of a recorded therapy session to a patient. T/F

False

The digital divide has no effect on consumers' ability to receive quality health care information. T/F

False

Under the Code of Ethics for Nurses with Interpretive Statements (ANA, 2015), the nursing informaticist has a duty to the physician first and foremost. T/F

False

data management

Functional ability to collect, aggregate, organize, move and represent information in a useful way

What nursing services are available through telehealth?

Home telenursing, Minor injury consulting, Electronic referrals with nurse practitioners, Connects to call centers

How can cognitive theory help the informatics nurse in designing decision-making tools?

Improves understanding of how nurses process information when making decisions

store and forward

Interaction that occurs when information is captured or collected at a pre-determined point in time and transmitted to health care providers for later evaluation

Which familiar nursing equipment is computer-driven?

Medication scanning system, Digital thermometer, Intravenous administration pumps, Barcode patient identification bracelets

Characteristics of technology in healthcare

Mobile, relevant, data driven, intuitive, connected, cost-effective

Benner's Novice to Expert Model

Novice —> advanced beginner —> competent —> proficient —> expert

What is the primary benefit of an electronic prescription medication records system for those affected by natural disasters like Hurricane Katrina?

Patients are assured uninterrupted access to their prescription medications.

What are the technical standards addressed when considering the implementation of a telehealth system?

Policies and procedures, Safety and function standards, Redundant systems

Benefits of Telehealth

Rescues travel time and expenses for staff Convenient for patients Makes healthcare more accessible Increases job satisfaction by providing flexible hours, opportunities to learn a new skills, and enhanced interactions with patients

What has been the focus of telehealth regarding the delivery of psychiatric care?

Service to areas where access has been historically difficult

digital divide

Social issue referring to the differing amounts of information available for those who have access to Information and Communications Technologies and those who do not

What is the foundational focus of nursing informatics?

The management of patient-focused information

Health Information Exchange (HIE)

The mobilization of health care information electronically across organizations within a region, community or hospital system

telehealth nursing

The practice of nursing over a distance using telecommunications technology Encompasses the delivery, management, and coordination of care and services using devices that transmit voice, data, and video communication signals

Addressing and ensuring confidentiality, data security, and patient privacy are within the scope of nursing informatics. T/F

True

An example of information would be vital signs plotted on a graph. T/F

True

Blogs are typically written in conversational, first person style. T/F

True

Electronic clinical decision support is an advantage of using mobile technology in health care. T/F

True

Hospitals should consider scheduling additional staff during the early phases of EHR implementation to ensure adequate time for all staff to learn to use the system. T/F

True

One of the challenges to developing an effective data management infrastructure is supporting knowledge maintenance over time. T/F

True

Telenursing is the practice of nursing over distance using telecommunications technology. T/F

True

The Novice to Expert Theory was proposed by Patricia Benner. T/F

True

The goal of the TIGER Initiative is to enable nurses to use informatics and emerging technologies to make health care safer, more effective, efficient, and patient-centered. T/F

True

The term "digital divide" is used to describe the gap between those who have ready access to information and communication technology and those who do not have access. T/F

True

When you are conducting research online, it is important to know who funds the website. True or False

True

telehealth

Use of electronic information and telecommunications technology to support long-distance clinal health care, patient/professional health related education, public health, and health administration

The demonstration of which competency is required of nurse managers?

Use telecommunication devices., Evaluate revision of patient care systems., Use spreadsheets., Recognize the relevance of nursing data.

examples of telehealth

Videoconferencing, internet, store-and-forward information, streaming media, and terrestrial/wireless communications

information

data that is interpreted

data integration error example

error in identifying a patient, failure to use front-end solutions

Tele-assessment is a form of remote patient monitoring via telehealth. T/F

false

Which is NOT a responsibility of a nurse informaticist?

identifying budge deficits

operational factors for the development of telehealth

infrastructure equipment facilities set up team

Which of the following are examples of informatics applied in nursing?

nursing science, information science, computer science

What type of interoperability makes it possible for information being exchanged to be acted on by the receiving system without the help of a person?

semantic

Five criteria for online sources for health information

source, data, funding, privacy, evidence

Which services are made possible through telehealth?

tele-monitoring, text messaging, electronic consult, teleconferencing

One of the challenges of integrating genetics and genomics into health care is that many nurses know little about the field and lack the competence needed to effectively counsel and teach patients in this regard. T/F

true

SmokefreeTXT—a program designed by the National Cancer Institute's Tobacco Control Research Branch that delivers tips, motivation, encouragement, and information via text messages—is an example of an mHealth program. T/F

true

Which of these is not a competency needed for telenursing?

Determine your malpractice insurance carrier's position on telehealth

Barriers of telehealth

Expansion of usage is limited Technology is limited Expensive Requires a solid infrastructure Requires nurses to have license and certification Reimbursement from insurance companies is difficult Hard to evaluate the outcomes

TIGER Basic Computer Competencies

Focuses on information technology, managing files, word processing, spreadsheets, databases, presentations, web browsing, and communications

Lewin's field theory focuses on what aspect of change related to adopting new innovations?

Forming a positive attitude about change

benefits of technology in healthcare

Quick access to health care information, integration of electronic clinical decision support, remote communication, lower health care costs overall

Research supports what benefits of using remote monitoring for chronically ill patients?

Reduced costs, Reduced emergency room visits, Reduced hospital readmission rates

Lewin's Theory of Change

Unfreezing: Desire to change or the recognition that change needs to occur Moving:Actual process of change Concerns thoughts, feelings, behaviors, or a combination of all three Refreezing: change Establishing the new way as the status quo

What is the greatest benefit of telehomecare for the chronically ill patient?

allows for ongoing monitoring

Which aspect of professional nursing is most impacted by the influences of informatics?

critical/cognitive thinking

Which of these is within the professional role of nursing informatics?

data integration

A doctor sends a patient's medical history directly to another doctor through a secure, encrypted messaging system. This is an example of what form of health exchange?

direct exchange

"How will telehealth affect the financial bottom line?" is a question related to which organizational factor?

infrastructure

Who defined telenursing as "telecommunications technology in nursing to enhance patient care"?

international council of nursing

Despite differences in hardware and operating systems, which is a primary design feature common to all mobile computers?

interoperablity

In order for two organizations to experience interoperability for information exchange, what must both organizations have?

standards are like-minded

Which of these is not a characteristic of mobile technology?

stationary

Competencies of Telehealth nursing

technical (understanding equipment) interpersonal documentation professional resource management practice

example of real-time

tele-assessment, telesupport/televisit, tele-therapy

examples of store and forward

tele-diagnosis, tele-evaluations, tele-consultations

Telehealth usually requires very few resources to implement, but requires great financial support to maintain. T/F

False

which issues are of concern to a health care agency when determining the feasibility of implementing telehealth for patients?

Research, Technical issues, Medico-legal issues, Reimbursement

Goal of TIGER initiative

Provide smart, people-centered, affordable technologies that are universal, useful and standards-based Provide leadership that drives, empower, and executes Provide evidence-based, interoperable intelligence systems that support education and practice in order to foster quality care and safety Create collaborative learning communities that maximize the possibilities of technology towards knowledge development and dissemination, driving rapid deployment and implementation of best practices Enforce consistent, incentive-based initiative that supports advocacy and coalition building Communicate standardized, person-centered, technology-enabled processes to facilitate teamwork and relationships across the continuum of care Create a respectful learning community of diverse stakeholder that embrace shared values to drive innovation and technology

Which of the following are benefits of HIE?

Reduced health-related costs,Safer, more effective care for patients,Improved public health reporting and monitoring

Which stages of change are associated with Lewin's field theory?

Refreezing, moving, unfreezing

One nursing leadership challenge in integrating new technology is assuring that the technology use is ethical. T/F

true

Which one of these questions is not something an organizational leader should consider when implementing telehealth?

Is the staff prepared to lose patients due to changes in procedure?

The term "Web 2.0" is used to describe tools that are only available on tablets and smartphones. T/F

False

Which of the following is not a skill set nurses need to respond to emerging technologies today?

Having expertise in hospital organization, bureaucracy, and management

Lippitt's Phases of Change

1. Identify the issue 2. Evaluate the level of motivation and capacity for change 3. Assess the resources and level of motivation for change 4. Develop a plan of action 5. Establish the initiator's role and communicate expectations 6. Maintain the change using communication and feedback 7. Gradually diminish the role of change initiator when change is apart of the organization's culture

The three concepts involved in Lewin's Force Field Analysis Theory are behavioral disruptions, behavioral compliance, and balance. T/F

False

What is the greatest positive impact that communication among HCPs has on patient care?

Helps them stay informed on standards of care and practices

Which intervention by the nurse demonstrates a paternalistic approach to providing the patient diagnosed with diabetes with foot care information?

Accessing the computer in order to search for and print out information regarding the appropriate care for the feet of the diabetic patient

Which information management process is an example of a spreadsheet a nurse might be familiar with?

Adverse drug reactions, Budget analysis, Attendance records, Staff scheduling

Which of the following is a factor that contributes to the digital divide?

Age, academic background, ethnicity, economics, physical location, and cultural and religious preferences.

Five Keys of Information Infrastructure

Standardized terminologies and structures Digital sources of evidence Health care data exchange system standards Informatics processes for clinical application of evidence Informatics competencie

What does TIGER mean?

Technology Informatics Guiding Education Reform

What is the meaning of a digital divide?

The gap between those who have access to the Internet and those who do not. None of the other options reflect the current definition of digital divide.

Example of Knowledge

assessment of vital signs

The TIGER Nursing Informatics Competency Model includes tasks in which of the following areas?

basic computer skills, information literacy, information management

Which topics should you consider when determining whether the website is trustworthy?

date of publication, privacy, source

what action is moat important for a patient to take when considering whether to base health decisions on information found on the web?

discuss information with HCP

Improvement of which aspect of health is the ultimate goal for the implementation of emerging technologies?

increase in safety

Which statement concerning nursing data and its relationship with informatics is true?

informatics now makes nursing data easily accessible to nursing researchers

Examples of Technology in healthcare

mobile phones, tablets, laptop computers, telehealth, teleconference, downloadable drug references, class podcasts, patient health tracking apps, patient portals, simulated office visits

How is it that nursing is so well suited to having professionals attain computer fluency?

nurses are accustomed to the role of lifetime learners

The focus of informatics is information management, not computers. T/F

True

TIGER Information Management

Process of collecting data processing data and presenting or communicating the processed data as information or knowledge

wisdom

Process that occurs when knowledge is evaluated and then used to identify patterns and solve problem

When considering informatics, what is a decision support system?

Standardized data that is accessed by many interested consumers

Posting user surveys to look for issues is an example of which of the following?

Strategy for success

which form of online communication would be substitute for a traditional nursing seminar?

Webinar

wikis

Website that allows collaborative editing of its content and structure by its users

Office of the National Coordinator for Health Information Technology's Office of Science and Technology

Working to enable the health IT community to convene and rapidly prioritize heath IT challenges and subsequently develop and harmonize standards, specifications, and implementation guidance to solve those challenges Responsible for curating the set of standards ad specifications that support inter-operatively and ensuring they can be assembled into solutions for a variety of health information exchange scenarios