C468-EVERYTHING
which item below does NOT play a role in system implementation? A. investigating current deficits and needs of the organ. B. go live planning C. applying system changes as needed D. enter user training
A. investigating current deficits and needs of organization
which item below does NOT play a role in system implementation? A. investigating current deficits and needs of the organization. B. go live planning C. applying system changes as needed D. enter user training
A. investigating current deficits and needs of organization
Match each term with its healthcare information system.
Admission, discharge, and transfer system- Administrative Information Systems Radiology information system Clinical Information Systems Financial system Administrative Information Systems Clinical documentation system Clinical Information Systems Scheduling system Administrative Information Systems
Informatics Nurse
Advance knowledge and proficiency in the use of IT as it applies to nursing practice.
Informatics Nurse Specialist
Advanced degree in nursing informatics. Able to lead informatics research, project management and administration.
Informatics Nurse
Advanced preparation in information management. Proficient in applications to support all areas of nursing practice.
Order Entry System
-Ensures accuracy of physicians orders
Example of Essential Component of EHR
-Evidence based decision support
Responsibility of the Project Implement Team
-Execution of system changes -Active involvement in user participation -Knowledge of current workflows
LOGICAL examples of protecting info
-Firewall -Biometrics -Authentication -Automatic sign off
Information Science
-Focus on how to gather, process and transform info into knowledge. -Includes 5 Sciences; Communication, Computer, Social, Library and Cognitive
Experienced Nurse
-Fully intergrade informatics throughout the course of her practice, not just for basic data entry and retrieval. -Knows how to pull trends out of data.
System Implementation Phase
-Go live planning -Training of end users -Execute system changes
Health Informatics System
-Group of systems used within a hospital that support and enhance healthcare
2 Governing Authorities to protect Information
-HIPPA -ANA code of ethics
Patient Information
Standard (temp, weight), General, Targeted, Personalized (specific info on condition pt has been dx with ex DII), Tailored (Gleaned from EMR EHR focuses specifically on conditions IND Based)
Fill in the blanks: The implementation of __________ __________ within the EHR is essential for healthcare organizations to meet the criteria of Meaningful Use.
Standardized Terminology
EBP Provides
Standardized best practices, reduces time nurses spend gathering and assessing data, and provide care w/ clinical research
Cognitive informatics can be defined as
o study the connection between the brains and minds way of collecting and processing info
ANA American Nurses association
ode of ethics obligates us to protecting patient information
A nurse is struggling to work full-time in a hospital setting time while completing her Masters.
online classroom
vision statement
open ended statements of what is to be accomplished (goals) objectives - specify how and when goals will be met
system selection phase:
organization seek out vendor company that provides a system that best fits the need 3 doc: -request info doc -request proposal doc -request quote document
system selection phase:
organization seek out vendor company that provides a system that best fits the need 3 doc: -rquest info doc -request proposal doc -request quote document
Nursing Information System
Standardized nursing language (SNL) 2 approaches 1. Nursing Process Approach & Critical Pathway - Multi Disciplinary teams throughout. Physician orders are present for the team to observe and follow, allows the team to update the POC when variances in the PT condition are noted. 2. Protocol Approach - Streamline documentation of assessment, med info, discharge info and education
True/false The EHR can become a powerful way for learners to make important connections about caring for patients with a specific disease process or to learn concepts of pathophysiology or pharmacology.
TRUE
Clinical Decision Support Tool Characteristics
Takes specific patient data, analyzes it and provides recommendations (next action)
Health Privacy Working Group
The _____ has developed a list of 11 precautions providers can take that if followed, according to legal experts, would severely limit a provider's liability exposure.
Patient Protection and Affordable Care Act (PPAC)
The ______ creates patient-centered medical homes (PCMHs) and accountable care organizations (ACOs) that attempt to coordinate patient care around the patient—a new, multidisciplinary approach to health care delivery that is expected to achieve cost savings and better outcomes.
Health Information Technology for Economic and Clinical Health Act (HITECH)
The ______ is a provision of ARRA that made changes to HIPAA, updating the law to include requirements for providers to notify patients of information breaches within set timeframes and to notify news organizations if more than 500 patients had their information breached.
Telehealth
Delivery of information to healthcare providers and consumers and the delivery of services to clients at remote sites through the use of telecommunication and computer technology
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
EBP
The use of research and evidence to inform clinical practice, an approach to provide care that integrates nursing experience and intuition with valid and current clinical research to achieve the best PT outcomes
Nursing Informatics
The use of technology and information to help support all aspects of nursing practice
Nursing informatics
The use of technology and information to help support all aspects of nursing practice
Telehealth
The use of telecommunication technologies and computers to provide healthcare information and services to clients at another location.
What are two common characteristics of telehealth?
The use of video streaming technology Transmission of biological data from a remote location
Which statement describes nurses as knowledge workers? a. Nurses design and maintain knowledge. b. Nurses generate knowledge as a product. c. Nurses evolve knowledge based on information. d. Nurses provide efficient means of capturing knowledge.
b. Nurses generate knowledge as a product.
What are the features of a clinical decision support tool? *Choose 3 answers* a. Offers technical support b. Provides practice guidelines c. Delivers online information retrieval d. Issues computerized alerts and reminders e. Provides access to printed policies and procedures
b. Provides practice guidelines c. Delivers online information retrieval d. Issues computerized alerts and reminders
What represents the greatest potential threat to data security? a. Hospital system networks b. Removable storage devices c. Data stored on local hard drives d. Internet access on hospital computers
b. Removable storage devices
You are the informatics nurse at a hospital. You are running a random report evaluating users on your new electronic health record (EHR). You notice that the charge nurse from the emergency department just underwent a radical mastectomy and is recovering on the surgical floor. You then notice that four nurses from the ER have accessed this record. What should you do? *Choose 3 answers* a. Talk to the patient and let her know her friends care about her condition. b. Talk to each nurse and explain the legal and ethical ramifications of accessing the EHR. c. Explain to the patient their information has been breached. d. Provide training to nurses in the emergency department about protected patient information.
b. Talk to each nurse and explain the legal and ethical ramifications of accessing the EHR. c. Explain to the patient their information has been breached. d. Provide training to nurses in the emergency department about protected patient information.
You are a nurse manager at a hospital. The informatics department at the hospital has established a no flash drive policy. In addition, all patient files must be saved on the secure O: drive. What would be an appropriate way to describe these changes to your staff? *Choose 2 answers* a. The hospital is streamlining staff access to computers to prevent medical mistakes. b. The hospital is implementing a security program to prevent patient data for being compromised. c. The hospital is eliminating the need for flash drives to prevent the loss of sensitive data. d. The hospital has decided nurses do not need sensitive patient data.
b. The hospital is implementing a security program to prevent patient data for being compromised. c. The hospital is eliminating the need for flash drives to prevent the loss of sensitive data.
Which statements by the nurse demonstrate understanding of the reason for a clinical information system? *Choose 2 answers* a. The information replaces unit training needs. b. The information retrieved can be used for research. c. It improves compliance with nursing documentation. d. It replaces the need for unit evidenced-based projects.
b. The information retrieved can be used for research. c. It improves compliance with nursing documentation.
Which example is a telehealth non-clinical application?
Distant patient education via computer
Needs assessment
During which phase of the information life cycle should the "musts" and "wants" be determined
is to promote pt safety
EHR Functionality
electronic health record
EHR has been used as a generic term for all electronic healthcare systems and recently became the favored term for the lifetime computerized record. • Clinical messaging and e-mail • Results reporting • Data repository • Decision support • Clinical documentation • Order entry the data in the EMR is the legal record of patient care during an encounter at the healthcare delivery system and is owned by that system. Information in the EHR may be owned by the patient or stakeholder although recent developments favor a more consumer-centric approach. Unlike the EMR, the EHR provides interactive patient access as well as the ability for the patient to append information.
TRUE
EHRs alert nurses of many mistakes or contradictions in medications.
FALSE
EHRs are not as organized as most paper systems.
knowledge worker
Individual with a high degree of expertise, education, or experience who creates, distributes, and applies knowledge
Evidence-based practice
Informatics systems can help practitioners provide better patient outcomes by bringing _______ to the bedside.
Decubitus Ulcer can chart in electronic health record
Information System
Using the EHR to document care of a patient with a fractured femur is an example of using the EHR in which way?
Information System
How is information related to data?
Information is data that have been interpreted
Evidence-based Practice
Information literacy is considered a bridge to this recommended method of making nursing practice decisions.
Is an elemental process within informatics where one can file, store, and manipulate data
Information management
A nurse documents care of a patient with a decubitus ulcer in the electronic health record. Which term describes the electronic health record in this situation?
Information system
Using EHR to document care of pt with fx femur is an example of using the EHR in which way?
Information system
Using HER to documment care of pt with fx femur is an example of using the HER in which way?
Information system
Health Information Technology (HIT)
Information systems and other information technology used to record, monitor, and deliver patient care as well as perform managerial and organizational functions
HIPAA
Initiated the move toward a more informatics-based system of health care delivery with the goal of using technology to alleviate some of the concerns with the delivery system, especially coordinated care and billing problems
Computer Hardware
Input device, CPU, Secondary Storage, Output Device
What can healthcare staff do to keep patient information that has been access with a mobile device protected?
Install device updates when available
Real time
Institutions can use informatics systems to perform research in ________, which allows the institutions to almost instantly know the results of particular interventions.
Which informatics tools are commonly used for collecting and analyzing patient data?
PDAs- personal digital assistant bedside computers
Physician is looking for a current patient's vital signs. Which measure is included in the vital sign section in addition to temperature blood pressure respiration and heart rate?
Pain scale
Notification of this person is essential following a data breach
Patient (record owner)
Which statement describes patient generated Health data
Patient generated Health data is health related data created recorded or gathered by patients are family members are other caregivers to help address of health concern
What are examples of information stored in an electronic health record?
Patient history's medical test medication's and images
What is a benefit a meaningful use?
Patient outcomes are improved
Personal Health Record (PHR)
Patient's lifetime medical record
TRUE
Patients often have access to EHRs.
FALSE
Most nurses accept telehealth as an equally effective alternative to in-person care.
Joint Commission
Most states require facilities to have this agency's accreditation to receive any Medicaid funding.
Critical Pathways/Protocols Approach
Multidisciplinary team members can contribute to care plans along the care continuum.
Examples of the Critical Pathways and Protocols Approach:
Multidisciplinary team members can contribute to care plans along the care continuum.Multidisciplinary team members can contribute to care plans along the care continuum.Allows the multidisciplinary care team to update the plan of care when variances in the patient's condition are noted.
nursing terminology systems with nursing diagnosis
NANDA, ICNP, CCC, Omaha System, PNDS, and SNOMED-CT.
ANA Terminologies
NANDA, NIC, NOC, CCC, ICNP, PNDA, Omaha System
Structured languages, also called taxonomies, are critical tools for nursing. Which of these is NOT an example of a current taxonomy?
NANDIC
nursing terminology with nursing interventions
NIC, ICNP, and CCC, Omaha System, PNDS, SNOMED-CT
nursing terminology with nursing outcomes
NOC, ICNP, CCC, Omaha System, PNDS, SNOMED-CT
LAN Local area access
Name of type of connection needed to access the EHR when internet connection is lost
Telehealth (Ethical and Legal Implications)
Need for extensive documentation to avoid malpractice, providers need to be licensed in every state they practice Telehealth
CPOE
Needs downtime procedure or policy prior to implement
Informatics Innovator
No advanced degree required. Visionary in the field; expanding NI theory and policy decisions.
Logical Security
Non-tangible protocols used for identification, authentication, authorization, and accountability. Example includes automatic sign-off after a period of no activity.
Blogging
Not a national trend related to nursing informatics
Less consumer accountability
Not an emerging trend in healthcare
How does info literacy support EBP in nursing?
Nurse can use research and apply/consult resources/peers/internet
Theory guided evidence
Nurse theorists stated that nurses are not incorporating WHAT into Evidence Based Practice?
Which statement describes nurses as knowledge workers?
Nurses generate knowledge as a product.
Knowledge worker
Nurses in this type of role -are continuous learners -use technology to support and inform nursing practice -generate knowledge as a product
Which statement represents one of the principle provisions of the Health Information Portability and Accountability Act (HIPAA) related to information security?
Nurses should notify a supervisor immediately when observing a breach of patient confidentiality.
The unique combination of sciences creates a blend that is greater than the sum of its parts this definition can describe an unique component of
Nursing Informatics
A family member is unsure what to do for a home hospice patient who is restless and agitated during the night.
real time monitoring
benefits using EHR
reduced medication error, improves provider documentation
which of the following are considered benefits using HER?
reduced medication error, improves provider documentation
CPOE benefits
reduction in transcription errors; a decrease in elapsed time from order to implementation; standardization and more completeness of orders; fewer medication errors; and the ability to incorporate CDS, alerts for critical lab values, and prompts when certain tests are due
types of terminologies in EHR
reference and point of care
Ontology
A set of concepts formally organized by meaning SNOMED-CT, ICNP
EMR Basic Components
Clinical messaging, email, data repository, clinical docum
Nomenclature
A set of terms composed according to pre-established rules established rules LOINC, NANDA-I
Terminology
A set of terms representing concepts in a particular field or domain, for example, problems, observations
Personal Emergency response systems
A signaling device worn as a pendant to ensure safety and to access emergency care when needed is?
ARRA (American Recovery and Reinvestment Act)
Authorized incentive payments to specific types of hospitals and healthcare professionals for adopting and using interoperable health information technology and EHRS
Which term is used to describe information that is always assessable for use by authorize users?
Availability
Which information would be useful and planning quality care for the next shift?
Available critical care beds
Nursing Process Approach
Provides medication information to help prevent medication errors or interactions.
What are the features of a clinical decision support tool?
Provides practice guidelines Delivers online information retrieval Issues computerized alerts and reminders
What is a function of a clinical decision support tool?
Providing clinicians with knowledge and person-specific information
Patient Support Example
Providing education material
Duplicate orders cause quality issues in patient care. What helps to resolve this problem?
Providing training and reminders
Order entry system
Type of health information system that ensures the accuracy of physician orders
what is health information system?
a group of systems used within a hospital that support and enhance healthcare
Simulation
through experiences with robotic "patients" or mannequins, students can practice skills and improve critical thinking and clinical decision making.
Nursing Informatics
Uses nursing knowledge along with information and communication technology to promote the health of individuals, families and entire populations
wisdom
Using knowledge and experience to manage and solve problems
Information systems
Using the EHR to document care of a patient with a fractured femur is an example of using the EHR in which way
Big Data
Very large data sets that are beyond human capability to analyze or manage without the aid of information technology
Which type of technology offers support during the medication administration cycle?
Viewing of the digital health record during a home health visit
Learning Management System
through the use of technology, instructors and students can post course content and/or interactions to aid in learning.
Distance Learning
through the use of technology, the learning experience takes place outside the traditional classroom.
what is not a reason why its important that selection committee board memebers understand software and electronic processes?
thye aren't the end users who need to be trained in the system. They just have to have general understanding of it.
why is the nurses active participation in electronic pt infomration important?
to ensure the information is current and accessible to the healthcare team
why is the nurses active participation in electronic pt information important?
to ensure the information is current and accessible to the healthcare team
The goal of Meaningful Use
to exchange clinical structured data in a manner that it is accurate and complete to improve patient care in a cost-efficient way.
clinical applications of telehealth
transmiting a chest xray to be read, mobile device to monitor pt, live video conferencing to check pt or caregiver to make sure dressing change is correct or administering medication
TRUE/False Smart technology enables reminders to be set up, so providers remember to administer medications.
true
The EHR is a longitudinal electronic pt record of all healthcare encounters, TRUE or False
true
The Quality and Safety Education in Nursing (QSEN) project's six competencies are patient-centered care, cooperation, evidence-based practice, quality improvement, safety, and informatics. Including informatics as a core competency has led to its increasing importance.
true
True/ False Nursing informatics includes assisting with marketing activities such as website development, media presence, and social networking.
true
True/ False Nursing informatics includes electronic sources that provide the nurse with information regarding professional organizations, evidence-based practice, competencies, insurance, and licensing.
true
True/ False The Technology Informatics Guiding Education Reform Initiative (TIGER) calls for nursing education to keep up with rapidly changing technology and encourages nurses' active participation in the development of electronic records.
true
True/ False Theoretically, monitoring systems free up nurses from taking patients' heart rate readings.
true
True/False If a system is pleasant to look at, user satisfaction is typically high.
true
True/False Most new systems result in very small errors.
true
True/False Nursing informatics includes assisting with marketing activities such as website development, media presence, and social networking.
true
True/False Nursing informatics includes electronic sources that provide the nurse with information regarding professional organizations, evidence-based practice, competencies, insurance, and licensing.
true
True/False The EHR is a longitudinal electronic pt record of all healthcare encounters.
true
True/False The Quality and Safety Education in Nursing (QSEN) project's six competencies are patient-centered care, cooperation, evidence-based practice, quality improvement, safety, and informatics. Including informatics as a core competency has led to its increasing importance.
true
True/False the position of the computer can be seen as a potential barrier if its constricts the view between pt and healthcare professional
true
True/False waiting until the end of the shift to document your pt assessments into the HER could be considered a barrier to pt. centered care
true
True/false the position of the computer can be seen as a potential barrier if its constricts the view between pt and healthcare professional
true
True/false waiting until the end of the shift to document your pt assessments into the EHR could be considered a barrier to pt centered care
true
true/false Clinical pathways and computer generated care plans are examples of how information can affect nursing practice.
true
true/false? clinical pathways and computer generated care plans are examples of how information can affect nursing practice?
true
decision support software
type of computer application that analyzes data and presents them in a fashion that facilitates decision making. It can incorporate lab values, standards of care, and other patient-specific information. It also contains alerts that help to promote safety. extends human capabilities
RFID radio frequency identifier
type of technology that is used to ID and track supplY and medication within healthcare environment TRUE *medical equipment and pt location
RFID radio frequency identifier
type of technology that is used to ID and track supply and medication within healthcare environment *medical equipment and pt location
Standard
typically describes procedures that all patients will encounter, such as being weighed or having their temperature taken during a doctor's visit
They will need to be trained on the system
Why is it not important that selection committee board members understand software and electronic processes
To ensure the info is current and accessible to the healthcare team
Why is the nurses active participation in electronic patient information important
The difference between knowledge and wisdom is that
Wisdom is knowledge that is applied in an appropriate manner.
uniformity
With a number of different telehealth guidelines from different organizations, ______ is needed in the future.
Knowledge Work
Work of gathering data, which is then used to create information and knowledge which is completed by nurses and other healthcare workers
applications of nursing informatics
Worklists to remind staff of planned nursing interventions • Computer-generated client documentation including discharge instructions and medication information • Monitoring devices that record vital signs and other measurements directly into the client record • Computer-generated nursing care plans and critical pathways • Automatic billing for supplies or procedures with nursing documentation • Reminders and prompts that appear during documentation to ensure comprehensive charting • Quick access to computer-archived patient data from previous encounters • Online drug information
The American Reinvestment and Recovery Act of 2009 contains substantial resources for institutions like GSGH to build out their telehealth capabilities.
You are a nurse at Good Samaritan General Hospital in 2009. You have been hearing from colleagues at other hospitals about telehealth technologies, though GSGH has remained on the sidelines with respect to the technology, saying it's too expensive. However, after reading the newspaper one day, you realize that something has happened in Washington, D.C., that could solve the telehealth expense issue for GSGH. What did you read? The American Reinvestment and Recovery Act of 2009 contains substantial resources for institutions like GSGH to build out their telehealth capabilities. The Affordable Care Act of 2010 includes provisions to help institutions afford more telehealth solutions. The American Reinvestment and Recovery Act of 2009 would supplement funds for state budgets for telehealth. The Lily Ledbetter Act of 2009 would allow women to sue employers for not paying them the same as their male counterparts.
Once the system recognizes you, it takes down everything that is said in the room, even what can be overheard on TV.
You are a nurse at Good Samaritan General Hospital, which has just adopted a new smart technology informatics system. The system enables nurses to document by voice-recognition software and enables automatic login at a workstation; the system recognizes you and takes your documentation by voice. As a nurse, which of the following facts, if true, would cause you concern that the voice-recognition documentation may not be accurate? You don't have to go back and correct anything you document anymore. The system occasionally requires you to repeat what you said. The system asks you to restate your name and ID prior to taking any information. Once the system recognizes you, it takes down everything that is said in the room, even what can be overheard on TV.
a decision support system
You are a nurse at Good Samaritan General Hospital. You have been directed to develop an informatics system or systems that can help all levels of management make better decisions. The hospital's CEO has asked you to find a system that will benefit all levels of decision making, from the bedside to the boardroom. The CEO has said that you must ensure that the providers and professionals maintain the freedom to make choices. What administrative informatics system would best match your CEO's request? a registration system a contractual system a decision support system a financial system
Bioinformatics is
an interdisciplinary science with a focus on data management and interpretation for complex biological phenomena that are analyzed and visualized using mathematical modeling and numerical methodologies with predictive algorithms
point to point interface
an interface that directly connects two information systems. Communication and transfer of data take place only between these systems. older, achieved through customized programming and for this reason is expensive and labor-intensive to build and maintain
Nursing Information Systems:
assist nurses in providing high-quality patient care by giving them access to pertinent patient care information and providing the opportunity to document patient assessments, care provided, procedures performed, and medications given. Data can be collected and stored electronically and is available to other members of the multidisciplinary team.
logical security
authentication automatic sign off firewalls installation of antivirus and spyware detection software
What can a nurse, working in a hospital, use to access a patient's electronic health record and prescription drugs from a medication administration system? a. Nursing license b. Bar coded identification cards c. Magnetic strip on driver's license d. Nurse manager's log on information
b. Bar coded identification cards
What are common features of the various health information systems? *Choose 3 answers* a. Physicians only are allowed to enter data b. Creates a comprehensive record of the patient's medical history c. Are standardized to be exactly the same to allow for continuity of care d. Is unique in the way they function and provide information to clinicians e. Collects, processes and distributes patient centered data to manage and provide care
b. Creates a comprehensive record of the patient's medical history d. Is unique in the way they function and provide information to clinicians e. Collects, processes and distributes patient centered data to manage and provide care
What is a challenge to the adoption of eHealth strategies? a. Variability in Web access capabilities of health care consumers b. Creating economic incentives and policies that providers view as essential to accomplishing their financial and professional goals c. Readiness to adopt mechanisms to comply with HIPAA d. Difficulty in finding appropriate health care Web site designers
b. Creating economic incentives and policies that providers view as essential to accomplishing their financial and professional goals
Administration in an acute care clinic is considering adopting a health information system. A team is formed with members of clinical areas, software vendors, and an executive team of stakeholders. Which collaborative tasks are important for this team to accomplish with regard to selecting the health information system? *Choose 3 answers* a. Determine which type of computer to use b. Determine who will be accountable for the project c. Access patient records to view personal information d. Determine how resources will be allocated to support the system e. Assess potential for process improvement while using the system
b. Determine who will be accountable for the project d. Determine how resources will be allocated to support the system e. Assess potential for process improvement while using the system
Which mechanism is used to streamline caregivers' workflow that needs to include past medical history, patient demographics, immunizations, and medication history? a. Database warehouse b. Electronic health record c. Health information system d. Managed care information system
b. Electronic health record
Pulls trends out of data a. Beginning Nurse b. Experienced Nurse c. Informatics Innovator d. Informatics Nurse Specialist
b. Experienced Nurse
A nurse manager identifies several advanced practice nurses at an ICU workstation responding to multiple patient alarms. She notices that the acuity of one patient drastically increases the demand for staff resources. How can workflow analysis impact practice in this situation? a. It dictates a protocol approach to review and modify hospital policy. b. It provides observation and documentation of what is happening in the current environment. c. It provides evidence for development of an online triage program to improve team dynamics. d. It involves the upper administration input on proper use of hospital resources in future similar events.
b. It provides observation and documentation of what is happening in the current environment.
What is one way that technology acts as a change agent in the nursing process? a. It increases time spent on documentation. b. It reduces the time spent on documentation. c. It increases the need for advanced degrees for nurses. d. It reduces the amount of education required for nurses.
b. It reduces the time spent on documentation.
What are three types of clinical information systems? *Choose 3 answers* a. Registration system b. Laboratory system c. Order entry system d. Scheduling system e. Monitoring system
b. Laboratory system c. Order entry system e. Monitoring system
A nursing informatics specialist at a small, rural hospital implemented a clinical information system utilizing an electronic health record (EHR). She obtained input from nurses regarding selection of the specific EHR. She noted that some of the nurses had negative attitudes towards a change to the EHR, but she encouraged them to try the system and note its benefits. She implemented the system after all nurses were trained about the EHR. There were numerous complaints about the EHR, which the Nursing Informatics Specialist decided to ignore since the personnel were new to the system. Which barrier to implementing technology is present in the scenario? a. Inadequate training b. Lack of continued support c. Lack of end user involvement d. Ignoring attitudes early in the process
b. Lack of continued support
Information data security
unauthorized personnel getting access to equipment, removable storage devices flashdrive
Telehealth can be provided to a wide range of patients, except
use of assistive devices
Data Mining
uses data applications and sifts through large amounts of data and looks for previously hidden trends.
What are the essential components of an electronic health record?
vitals labs demographics
software
what interprets and tells the computer what to do at any given moment. each program( set of instructions) have a different language that uses to break inputs into binary code for the computer to execute
data integrity
whenever the data are accessed by a user, the data are as complete as when entered or created. Nurses are familiar with this concept because they have been maintaining data integrity for decades through documentation practices
scope of mission
Defines the type of activities and services that will be performed. clearly identified to help employees and customers understand the priorities
A process of various ways of understanding and examine the moral life is called
Ethics
benefit for providers using NI
For example, other providers can use data collected and documented by nurses using automated systems, thereby helping to eliminate silos of information typically amassed by each individual group. In addition, multidisciplinary critical pathways are used by nurses and providers to plan and document care for a client. The aggregate critical pathway data may be analyzed for trends related to overall effectiveness of client care
True/ False Because patient information is confidential, patients should not be granted access to their own information.
False
True/ False PHRs improve patient outcomes through decreased patient satisfaction.
False
True/ False Patient information should be labeled with as many patient identifiers as possible to ensure that data is not unintentionally interpreted as another patient's information.
False
True/False Smart technology decreases the time nurses spend documenting vital signs by about 15%.
False
MIPPA (Medicare Improvement for Patients and Providers Act)
Financial Incentive for e-prescribing physicians
Logical means of protecting patient information
Fire wall, biometrics authentication passwords automatic sign offs
E-SIGN
Gave e-signatures the same weight of law as handwritten signatures—a major milestone in the legitimacy of electronic transactions and, in the medical field, informatics solutions
The two governing bodies that obligate nurses to protect patient information are
HIPAA and the Nursing Code of Ethics by the ANA.
2 governing bodies that obligate nurses to protect pt information:
HIPPA nursing code of ethics by ANA
this acronym is used to refer a standard of interoperability and the exchange of clinical data
HL7 health level 7
System Implementation Role
Go-live planning, applying system changes as needed, end-user training
HIS Health information systems
Goal is to help organization work more effectively Efficiently
Connected Health
Model or platform by which technology assisted healthcare is delivered between at least two points, involving either synchronous or asynchronous exchange
types of clinical systems
Monitoring Systems, Order Entry Systems, Laboratory Systems, Radiology Systems, Pharmacy Systems, and other Ancillary Systems
CDSS (Clinical Decision Support System)
Supports healthcare practitioners in making patient-care decisions by integrating patient data with current clinical knowledge
Physically protecting patient information:
Surveillance cameras, use of restricted area, and shredding paper material.
knowledge
Synthesis of information from several sources to produce a single concept or idea
FALSE
A PHR contains only information entered by the patient.
Network PHR
A PHR that allows consumers access to their PHRs, even if they are spread across many different providers, insurers, or systems.
Stand-Alone PHR
A PHR that is not tied to any particular health system's electronic health record. It is portable between providers and institutions
Tethered PHR
A PHR that is tied to a specific health care system or provider. The consumer can see what was entered by the system's health care providers, but if the consumer goes to another provider in a different system, this information will not be included in the PHR.
Smart card
A ______ is a new development in EHR that stores medical information.
teleconsultants
A cardiologist with a rural office practice has no one to cover his patients when he is away.
Which two practice environments employ informatics nurses?
A clinical systems vendor and a medical device manufacturer
Company history
A common request contained in a request for information (RFI) document includes what
Information System
A computer system that uses hardware and software to process data into information in order to solve a problem
Which two care settings would benefit the most form employing a nurse informaticist?
A correctional facility with a clinic and a healthcare organization planning a physical expansion
FALSE
A telehealth system should begin on as large a scale as possible.
ADT System (Admission, discharge, transfer)
A registration system is also commonly refereed to as
clinical applications of telehealth
--transmitting a chest xray to be read --mobile device to monitor pt --live video conferencing to check pt or caregiver to make sure dressing change is correct or administering medication
HIPPA Privacy Act
-Patients have ownership rights to their records -Patients can amend own records if information is incorrect
Maintenance Phase
-Problem solving, debugging -Back up files -Installing system upgrades
Computerized Physician Order Entry (CPOE)
-Process by which the physician or provider enters orders electronically into the EHR
How does the EHR helps patients receive quality care when going from one facility to another?
-Provides continuity of care -Review previous care and provide appropriate treatment
The Mission
-Purpose or reason for an organizations existence
Benefits of EHR
-Reduce medication errors -Improved provider documentation
Organization performs gap analysis Needs and wants
#1 Needs assessment phase
Organization seeks vendor Company thats fits needs RFI request for information document RFP, requst for proposal do you have what we need , rate needs and wants, can company meet needs RFQ request for quote
#2 System selection phase
Go Live, training, system changes
#3 System Implementation phase
Problem solving, debugging, backup files, installing system upgrages
#4 Maintenance phase
characteristics of clinical decision support
* takes your pt specific data or information and analyzes it or compares it against specific rule and then it provides some type of recommendations. * provided prompt, alert, reminder, helping build care plan * saying a pt may be septic based on such value.
data
a collection of numbers, characters, or facts that are gathered according to some perceived need for analysis and possibly action at a later point in time
Company history
a common request contained in a request for information document
Company history?
a common request contained in a request for information document
Which of the following requires standardized nursing terminology to meet its criteria? a. HIPAA b. Meaningful Use c. HITECH Act d. The TIGER initiative
b. Meaningful Use
Informatics affecting Nursing Practice
Clinical pathways and computer generated care plans are examples of how informatics can affect nursing practice True, examples of clinical decision support
Clinical practice guidelines
Clinical practice guidelines can allow for the creation of nursing policies. True rooted in evidenced based research
HIS Health information systems
Administrative Information system and Clinical Information systems
What is a challenge to the adoption of eHealth strategies?
Creating economic incentives and policies that providers view as essential to accomplishing their financial and professional goals
3 principles that help make up an organization culture of safety
- being a commitment of resources ( organzation provides you with training,technology and tools you need for pt care -cross collaboration- as memebers of a healthcare team we ar continously collabeting with one -Blame free environment-deprefiening to discuss prvention in future
3 principles that help make up an organization culture of safety
- being a commitment of resources (organization provides you with training, technology and tools you need for pt care -cross collaboration- as members of a healthcare team we are continuously collaborating with one another -Blame free environment-debriefing to discuss prevention in future
technology has helped to influence the culture of safety by
- having doctors put orders in on computer - seeing orders for pt from different departments - giving medication and its signaling if there an allergy or drug to drug interaction with what you're are going to give - cross collaboration with other nurses having to be 2nd witness
socioeconomic and driving factors for telehealth
-*access to care* to remove geographical barriers -*continuity of care* pt lives far away and needs to follow up or disabled and cat make could send them home with mobile monitoring device -*ratio* of pts as there are available providers teleconsultants can help -increase in chronic disease condition.
ethical and legal factors of telehealth
-- need for telehealth nurses to keep extensive documentation -- have to be licensed in every state they practice telehealth
informatics nurse
--The RN who works in the area of informatics --Has an interest or experience, but no formal training in informatics __Ensures that information is disseminated at appropriate times for appropriate uses
nonclinical applications of telehealth
--nurse is doing research with online database --administrative team is holding meetings with live video conference not using pt purposes
Ways to physically protect pt information
--surveillance cameras --use of restricted area --shredding paper material
Store-and-Forward Technology
-A form of transferring data or an image from one location to another -Pathology/ Radiology
Socio Economic Factors that are helping support the need for telehealth
-Access to care -Continuity of care -Patient to Dr. ratio
Standardized Terminologies
-Accessibility, ubiquity, longevity and reusability
Component of EHR
-Assessment findings -Demographics -Vital Signs
Function of EHR
-Barcode Medication Administration
Information Technologies
-CPOE -Barcode Medication Administration -Clinical Decision Support
National Trends related to Nursing Informatics
-CPOE -Barcode Medication Administration -Clinical decision support tools
Clinical Practice Guidelines
-Can allow for the creation of nursing policies (example of clinical decision support)
Examples of How Informatics can Affect Nursing Practice
-Clinical pathways -Computer generated care plans
3 Principles that make up an organization culture of safety
-Commitment of resources -Cross collaboration -Blame free environment
A common request contained in a Request for Info) RFI documentation includes
-Company history
Strategic Planning
-Comprehensive long range plan for guiding the activities and operations of an organization
Knowledge Worker
-Continuous learner -Uses technology to support and inform nursing practice -Generate knowledge as a product *
Information
-Data that has been interpreted
Reasons why the Selection Committee Board Members need to understand software and electronic processes
-Impact business goals -Affect success or failure -Determine budget allocations
Foundation of Knowledge Model
-Knowledge is used to meet the needs of the healthcare delivery system -3 Elements (acquisition, process and dissemination)
Clinical Info Systems
-Lab -Pharmacy -EHR
Clinical Decision Support
-Looks at your patient specific data and compares it or analyzes it and provides further recommendations -Pop up reminders
Nursing Informatics
-National Certification Exam
Non Clinical Application of Tele
-Not being used for patient services
Perioperative Nursing Data Set (PNDS)
-Nursing terminology contains a nursing diagnosis, interventions and outcomes specific to the perioperative experience
Strategic Planning is Driven By
-Organization mission and values -Long term goals * -Service offered
Needs Assessment Phase
-Organization performs a gap analysis determining the "needs and wants"
System Selection Phase
-Organization seeks out a vendor company that offers them a system that best fits their needs -RFI (request for info), RFP (request for proposal), RFQ (request for quote)
Emerging Trends in Healthcare
-Patient safety -Error reduction -Additional regulatory requirements
Data
-Patients HT, WT, Code status and DOB
Administrative Info Systems
-Registration -Financial -Scheduling
HL7 (Health Level 7)
-Standard of interoperability and clinical data exchange
PHYSICAL examples of protecting info
-Surveillance camera -Restricted areas -Shred important documents
Information Literacy
-The ability to recognize when info is needed as well as the skills to find, evaluate and use effectively.
Computerized Physician Order Entry (CPOE)
-The process by which the physician or provider enters orders electronically into the EHR
Project Scope
-The size and detail of a collaborative effort
Nursing Informatics *
-The use of information and technology to support all aspects of nursing practice -Including direct delivery of care, administration, education, and research.
Why is the nurses active participation in electronic information important?
-To ensure the info is current and accessible to the healthcare team
What is the primary goal of EHR functionality in contrast to that of the health information system?
-To promote patient safety
Clinical Applications of Tele
-Transmitting chest x ray read -Mobile device to monitor -Live video
Local Area Network (LAN)
-Type of connection needed to access EHR when an internet connection is lost
Radio Frequency Identifier (RFID)
-Type of technology that is used to identify and track supplies and medications -Also can track medical equipment and patients
Beginner Nurses
-Uses information systems to manage patients.
socioeconcomic and driving factors for telehealth
-access to care to removed greographical barriers -conitnuity of care pt lives far away and needs to follow up or disabled and cat make could send them home with mobible monitoring device -ratio- pf pts as there are avaiable providers telconsultants can help -increase in chronic disease condition.
Telehealth
-extensive documentation -licensed in every state -
EMR Adoption Stages
0-Organization 1. All 3 key ancillary departments (lab, pharm, radiology) installed 2. CDR - Clinical Data Repository provides physician access for reviewing orders and results. Possibly HIE Capable. 3. Nursing/Clinical Documentation - EMAR, first level of clinical decision support is implemented. 4. CPOE implementation 5. Closed loop med administration w/ bar codes is implemented, 5 rights of med. administration 6. Full physician documentation, full radiology and PACS 7. No more paper charts
Meaningful Use Core Requirements for hospitals
1. Record demographic information 2. Computerized provider order entry. 3. Clinical decision support and the ability to track compliance with rule(s). 4. Automatic, real-time drug-drug and drug-allergy interaction checks 5. Maintain an active medication list. 6. Maintain an active medication allergy list. 7. Record and retrieve vital signs (height, weight, b/p, BMI, growth charts for ages 2-20 years). 8. Record smoking status for patients 13 years old and older. 9. Mechanisms to protect information created or maintained by the certified EHR technology that include access control. 10. Electronically exchange key clinical information among providers. 11. Supply patients with an electronic copy of their health information upon request. 12. Supply patients with an electronic copy of their discharge instructions upon request. 13. Report required clinical quality measures to CMS. 14. Maintain up-to-date problem lists of current and active patient diagnoses.
Culture of Safety Principles
1. Commitment of resources 2. Cross collaboration 3. Blame free environment
Internet Security Measures
1. Firewall - Prevents unwanted access to the system and it's information 2. Limit web page access 3. Server Security - Information stored is not accessible to other systems if they are attacked 4. Update security software
Governing Authorities protecting Information
1. HIPPA 2. ANA code of ethics
physical security
1. Lock up the server room 2. Set up surveillance 3. Make sure the most vulnerable devices are in that locked room 4. Use rack mount servers 5. Safeguard the workstations 6. Keep intruders from opening the case 7. Protect the portables 8. Pack up the backups 9. Disable the drives 10. Protect your printers place stuff in restriced areas
Information Life Cycle Phases
1. Needs assessment phase 2. System selection phase 3. System implementation phase 4. Maintenance phase
HIPPA Privacy Act
1. Patients have ownership rights to their records 2. Patients can amend own records if information is incorrect
Interfacing Types
1. Point to Point - Enables 2 systems to communicate, expensive, has to have customized program 2. Interface Engine - Interfacing across several different systems.
Telehealth Options
1. Store & Forward- items are transferred to experts who read and interpret information and send back results 2. Real Time- interactive conferencing
Security Threats to data/information
1. Unauthorized personal accessing equipment 2. Use of removable storage devices
biggest patient privacy data breach risks
1.off-line data such as stolen or lost storage media or computers 2. increased access to patient healthcare information from points both inside and outside of healthcare facilities and from mobile devices such as personal digital assistants (PDAs), laptops, and smartphones also raise the potential risk of unauthorized access to private health information 3. e-mail and use of web 2.0 apps for health education, reminders, and patient provider communication
Requires Standardized nursing terminology to meet its criteria
Creating economic incentives and policies that providers view as essential to accomplishing their financial professional goals
What is a challenge to the adoption of Ehealth strategies
Creating economic incentives and policies that providers view as essential to accomplishing their financial professional goals
Knowledge consumer
: A Novice Nurse is an example of
EHR (electronic health record)
A database of an individual's healthcare data during healthcare encounters. Is comprised of any patient data stored in electronic form
The Health Insurance Portability and Accountability Act of 1996 (HIPAA)
A federal law that required the creation of national standards to protect sensitive patient health information from being disclosed without the patient's consent or knowledge. Allows pts to have ownership to the record. they also have correction rights this helps to secure pt medical information
Health information systems
A group of systems used within the hospital to support and enhance healthcare
Which term is used to describe someone who gains access to computers belonging to another person or organization?
A hacker
consumers who want to know more about their health
A health care system is considering offering patients access to a PHR that will include elements of the EHR. Which group of consumers is most likely to use a PHR? Consumers with little technical knowledge consumers with dementia and many chronic conditions and little knowledge about these diagnoses consumers who want providers to make decisions about their care consumers who want to know more about their health
What is the meaning of confidentiality of patient records?
A healthcare provider can disclose health information with specific permission
: A decision support system is
A rule based system that uses a knowledge base and a set of rules to make action recommendations
The system's learnability is poor.
A new informatics system at Good Samaritan General Hospital has thrown the staff into a tailspin. Staff cannot figure out the system, despite several training sessions and attempts to ease the system onto the units and floors. It takes as many as six to nine months for staff to develop any sort of comfort with the system. However, once they learn it, the system proves much more efficient than the previous system. If staff members don't use the system for a few weeks, they often struggle to learn it again. Judging from these results, what can you say about the user friendliness of the system? The system's learnability is poor. The system's efficiency is poor. The system's memorability is great because once they learn the system, staff members are efficient. The staff's satisfaction with the system is high because they become more efficient with its use over time.
MIPS (Merit-based Incentive Payment System)
A new program that combines other incentive programs that combines physician quality reporting system (PQRS) and the Medicare EHRS, that will be measured based on quality, resource use, clinical-practice environment, and meaningful use of EHRS technology
Informatics Specialist
A nurse with advanced skills specific to health information management and computer technology with expertise in systems development life cycles
Data (not information until it has been analyzed)
A patients height, weight, code status, and date of birth are all examples of what
point of care terminology
A point-of-care terminology, frequently referred to as an interface terminology, is what the clinicians see on the screen and consists of terms of which clinicians are familiar with. usually made up of synonyms from the reference terminology and supports entry of patient-related information into computer programs.
When printing discharge instructions for a patient the nurse notices the position electronically entered the prescriptions for discharge medication's. Which other form of information is needed along with the patient's discharge instructions for these medications prescribed?
A print a document with detailed supplemental information
SWOT Analysis
A process that examines the strengths, weaknesses, opportunities and threats of a given situation
RFID
A radio frequency identifier (RFID) is a type of (information) technology that is used to identify and track supplies and medications within a healthcare environment
Data Integrity
Ability to collect; store; and retrieve correct, complete, and current data so that the data are available to authorized users when needed
information literacy
Ability to recognize when information is needed as well as the skills to find, evaluate, and use needed information effectively
Telehealth Driving Factors
Access to care (removing geographical barriers), continuity of care, mobile devices, follow up calls, more patients than providers, increase in chronic diseases
Explain the effect of socioeconomic factors on the use of telehealth.
Access to care, to remove geographical barriers... serving rural areas as well. Continuity of care—patient lives far away and needs follow up or are disabled and can't make... could send them home with a mobile monitoring device. Or could video conference. Ratio of patients as there are available providers—teleconsultants can help. Increase in chronic disease condition.
CIS
Access to client data to Plan, Implement, Evaluate Care
Standardized Terminologies in Nursing Informatics Development is Driven by what Principles
Accessibility, ubiquity, longevity, reusability
Nurse uses Data
Accessing Information, Collecting Data, Inputting Data, Analyzing Data
HL7 (Health Level 7)
Acronym used to refer a standard of interoperability and exchange of clinical data
HL7 Health level 7
Acronym used to refer to standard interoperability and the exchange of clinical data
Authentication
Action that verifies the authority of users to receive specified data
You did not adopt a systematic, strategic approach to the problem.
After doing extensive research, you find that the vendor's informatics solution is the cheapest and best on the market. You adopt the system and implement it right away. However, it turns out that the staff is less efficient on the new system because its appearance and operation are very different from the old system. You have to do extensive, costly training to help staff learn the new system. However, they are slow adopters of the system even with the training because they do not think the old system was a problem. Which of the following was a mistake you made in leading this project? You didn't make a mistake; the staff must be more open to change You chose your current vendor's system after doing extensive research on new systems. You did not adopt a systematic, strategic approach to the problem. You wasted time and money training the staff on how to operate the system.
How can using simulation technology with your patients improve overall outcomes?
Allowing hands on practice and immediate feedback of the skill being learned.
Simulation Technology Improving patient outcomes.
Allowing them hands-on practice and immediate feedback of the skill being learned
User Interface
Allows humans and computers to cooperatively perform tasks and specific goals
Critical Pathways/Protocols Approach
Allows the multidisciplinary care team to update the plan of care when variances in the patient's condition are noted.
HIPAA (Health Insurance Portability and Accountability Act)
Also known as the Kennedy-Kassebaum Bill, it is the first federal legislation to protect automatic client records and to mandate that all electronic transactions include only HIPAA compliant codes
Classification
An arrangement of concepts based on essential characteristics. Arranged in a single hierarchy ICD, CPT, NIC, NOC
Real-time monitoring
An elderly homebound patient is concerned about the palpitations she is feeling.
Match the situation with the appropriate and effective telecommunication strategy.
An elderly homebound patient is concerned about the palpitations she is feeling. = real time monitoring A nurse is struggling to work full-time in a hospital setting time while completing her Masters. = online classroom A cardiologist with a rural office practice has no one to cover his patients when he is away. = teleconsultants A family member is unsure what to do for a home hospice patient who is restless and agitated during the night. = real time monitoring
transmitting radiologic images to a different time zone for results on midnight shift
An example of clinical use of telehealth is
grand rounds, Administrative supervision, research using the internet
An example of nonclinical use of telehealth is
What is a prominent socioeconomic factor driving telehealth medicine?
An increase in chronic disease conditions
The best definition of nursing informatics is
An integration of nursing science, computer science and information science.
Medical Informatics
Application of informatics to all of the healthcare disciplines as well as to the practice of medicine
Asynchronous Applications
Applications such as remote patient monitoring (RPM) that is patient-centric and allows consumers to participate in their own care by using designated health technology to share health. metrics and data with their healthcare provider.
Tailored
As a nurse informatics specialist at Good Samaritan General Hospital, you have been developing patient education resources that direct information to patients based on their health needs. Not every patient receives the same type of information. John Wilkinson is a frequent patient at GSGH due to his COPD, high blood pressure, and type 2 diabetes. He now has been admitted for bipolar disorder. When a nurse gives Mr. Wilkinson a pamphlet describing bipolar disorder, Mr. Wilkinson says "I am a frequent patient here, and I deserve more than a pamphlet. You know me!" Which of the five types of patient education methodologies should you recommend that the nurse use with Mr. Wilkinson? General Targeted Personalized Tailored
working through low health and computer literacy levels in GSGH patients
As a nurse informatics specialist at Good Samaritan General Hospital, you have been seeking ways to engage patients more in their health care after they leave GSGH. Survey after survey has demonstrated that GSGH patients are among the least health and computer literate in the area. You decide to develop an at-home personal health tool that can be installed on any personal computer. It allows patients to keep track of their health and communicate closely with their providers after their hospital stay. You are excited about the opportunity and potential of this new development. Upper management is also very excited and has thrown their support behind it after seeing it test very well. However, what hurdle are you most concerned about overcoming prior to the implementation of the system? making the program compatible for both Macs and PCs obtaining GSGH management's support for the move working through low health and computer literacy levels in GSGH patients getting your program to work correctly
Knowledge Processing
As nurses become more experienced which cone in the Foundation of Knowledge Model is formed?
Logical
Authentication Installing a firewall Automatic sign-off
What are three roles of a nurse informaticist specialist?
Assists users with functionality, procedural issues, and basic troubleshooting. Provides expert advice, opinions, and recommendations from a consultants area of expertise. Acts as a liaison between nursing and information services and is both a nursing resource and representative
Telehealth (Clinical vs Non-Clinical Applications)
Clinical - imaging that needs to be read, mobile device to monitor patient, live video conferencing Non-clinical - online database search, administrative team using video conferencing
A type of ROM used by the computer when it's turned on
BIOS input/output (I/) System
CPU
BRAIN, computer chip processes all computer functions and uses
EBR Evedenced base research
Clinical Decision Support
database
Bank of aggregated information that allows for data mining
What can a nurse, working in a hospital, use to access a patient's electronic health record and prescription drugs from a medication administration system?
Bar coded identification cards
Which function is performed within an electronic health record system?
Bar scanning medications and patients
EHR Function
Bar-code medication administration
Medication Administration System (Pyxis) Access
Barcode ID badge, fingerprint
Function of EHR
Barcode Medication administration BCMA
Which national trend is related to Informatics
Barcode scanning for medication Admin
Which national trend is related to nursing informatics?
Barcode scanning for medication administration
Initiative to reduce medical errors
Barcodes and radio frequency identification (RFID) barcode technology when used in conjunction with an electronic medication administration record substantially reduced errors
Quality of research
Barriers to the application of evidence based practice includes all except
Time, Access to libraries, Knowledge on how to research for information, Assigned to using research
Barriers to the application of evidence based practice includes:
Decision Support Tools or Decision-Support Software (DSS)
Based on the premise that the amount of knowledge today exceeds the retention abilities of any one person. This tool is designed to extend human capabilities, and is used in healthcare and other industries.
Licensing issues
Because a medical provider can use telehealth to treat someone in another state, ______ may occur.
Novice
Beginner w/ no experience with situations in which they are expected to perform a task...taught rules to guide actions
Match the level of nurse practice with appropriate skill criteria. Answer options may be used more than once or not at all.
Beginning nurse - Uses information systems to manage patients Experienced nurse - pulls trends out of data Informatics innovator - Generates informatics theory Informatics nurse specialist - Focuses on nursing's information needs
A nursing unit uses a medication administration system with locked cabinets to access patient medication. What is needed for secure access?
Biometric device with a touch screen that scans the index finger
What do informatics and computational science have in common?
Both fields are interdisciplinary
Central Processing Unit (CPU)
Brain of the computer. consists of a chip inside the hardbox that processes all the computers uses and functions
HIS Health Information System
Broad term used to describe administrative and clinical systems to streamline work flow processes efficiency
EHR Quality Care Between Facilities
By providing continuity of care, interoperability
A patient is receiving an IV anticoagulation infusion. The nurse needs to know when the next PTT should be drawn to determine dosing. How should this nurse find this information?
By reviewing the orders and results
Store forward telehealth
Clinical data is captured electronically and transmitted to another location where it is studied by another clinician is
NO integration
C-3PO and RUG's
All of the following are socioeconomic advantages of telehealth services EXCEPT: A. Earlier intervention to therapy B. Decreased cost to access services C. Limited access to specialists D. Improved quality of EHR entries
C. Limited access to specialists
information technologies
CPOE barcode medication administration clinical decision support
information technologies?
CPOE barcode medication administration clinical decision support
Information technologies, not systems but functions within a system
CPOE, bar code medication administration, and clinical decision support are all examples of what
Information Technologies
CPOE, bar-code administration, and clinical decision support are all examples of what?
meaningful use criteria
CPOE, e-prescribing, decision-support software,
The Technology Informatics Guiding Education Reform Initiative (TIGER)
Calls for nursing education to keep up with rapidly changing technology and encourages nurses' active participation in the development of electronic records.
Meaningful Use (MU) Core Requirements
Centers for Medicare and Medicaid Services (CMS) developed core criteria that defined basic functions of EHRSs must demonstrate, including: --basic entry of clinical information --use of several software applications --entry of clinical orders with safety measures
Meaningful use of electronic health records is part of the Medicare and Medicaid incentive program. Which two states best describe meaningful use?
Certified information technologies provide the necessary functions to enable eligible providers to be compensated. Meaningful use is used by inpatient and outpatient facilities
Which informatics competency supports the adoption of a medication administration system?
Change management
ANA Code of Ethics
Code that requires nurses to protect patient confidentiality, including electronic health information
Collaboration when selecting a Health Care System
Collaboration leads to knowledge sharing
Computer Technology
Collection of data for analysis used to justify the efficiency of particular interventions & improve quality care
Network
Combination of hardware and software that allows communication & electronic transfer between computers Connects Multiple computers in different locations
What is an effective use of the barcode medication administration system?
Combining it with a computerized provider order entry a pharmacy system and an eMAR system
Organization culture of safety 3 principles
Commitment of resources, Cross-collaboration, blame free enviornment
RFI request for information
Company historty, how many companies have system
An end of shift report is given at the nurses station desk but it is not complete it right away due to competing priorities of answering the telephone limited access to desktop workstations addressing patient situation's etc. Which action can a nurse suggest to initiate change?
Complete a time to study report comparing logging data at a stationary desk versus using a workstation on wheels
Common features health info systems
Comprehensive medical HX, Unique way to they function and provide info to clinicians, Collects, processes and distributes data to manage and provide care
Clinical Decision Support Tool Examples
Computer generated care plans, alerts, smart pumps, electronic drug references
Interface
Computer program that tells two different systems how to exchange data.
Quantitative research
Computer statistical analysis packages are most frequently used to bring understanding ______.
How does meaningful use of electronic health records (EHR) relate to quality patient care?
Computerization of prescriber order entry (CPOE) Maintenance of active patient medication lists
Qualitative Research
Concerned with finding out more about the human experience, accomplished through interviews and over a long period of time. EX How interventions could impact an entire population, content analysis, computers can code responses to questionnaires which can them be inputted in the informatics system for analysis.
Quantitative Research
Concerned with objectivity, tight control over situations, define relationships between variables, seek correlation between data. EX Tries to discover how an intervention has impacted subjects IN DEPTH, tangible relations between variables.
LAN
Connect a few computers to the server over a large area ex. doc's placing orders from home.
Synchronous Applications
Connected health applications that facilitate real-time, video and voice interaction and bidirectional communication between patients and healthcare providers
Which one of the following is the component of cognitive science that uses computer modeling through artificial neural networks to try to explain human intellectual abilities?
Connectionism
Store-and-Forward Applications
Consists of asynchronous connected-health applications that can transmit recorded health information (ex. Photos) through a secure communication network to a provider
Which term best applied when describing the life cycle of an information system
Continuous
process interoperability
Coordinate systems enabling business processes at the organization and allowing the systems to work together
MIPAA
Created financial incentives for e-prescribing, cementing e-prescribing as the prescription method of the future; encourages e-prescribing by reducing Medicare payments for providers who do not e-prescribe by up to 2% starting in 2014
What are common features of the various health information systems?
Creates a comprehensive record of the patient's medical history Is unique in the way they function and provide information to clinicians Collects, processes and distributes patient centered data to manage and provide care
Culture of Safety
Culture that minimizes the occurrence of adverse events in a non-punitive environment, despite participating in hazardous and high-risk activities.
Which codes support outpatient billing?
Current procedural terminology
Information literacy
Defined as the ability to recognize when information is needed as well as the skills to find, evaluate and use needed information effectively
All the following are considered Information technology safeguards except: A. Computerized prescriber order entry (CPOE) B. Barcode Scanning C. E-prescribing D. Clinical Pathways
D. Clinical Pathways
An electronic client record that does not have the ability to exchange information outside a single healthcare delivery system A. Personal Health Record (PHR) B. Electronic Health Record (EHR) C. Master Patient Index (MPI) D. Electronic Medical Record (EMR)
D. Electronic Medical Record (EMR)
Pts height/weight/codes status/DOB are examples of what?
DATA! once you take data, aalyze and interpret it becomes information
Uses data applications and sifts thru large amts data and looks for previously hidden trends
Data Mining
Which of the following uses database applications to sift through large amounts of data and looks for previously hidden trends?
Data Mining
Standardized Terminology Supports
Data Mining (the practice of examining large databases in order to generate new information)
information
Data that has been interpreted
Nursing Informatics Concepts
Data, Information, Knowledge, Wisdom
Phishing
Deceptive method used to steal sensitive information via the Internet. In the first phase, the recipient typically receives a phish, or email. The second phase involves the victim following through on what they are asked to do, such as completing a form. Once the recipient completes the information, the hackers now have information that they can use for nefarious purposes
decision support software
Decision support is the alerts and reminders used within an EHR. The ability to collect codified data provides vital information that can be used for decision support
During a crisis, a nurse manager is looking for the written, hospital-wide procedural policy. The nurse is unable to locate it.
Decision support tools
What are some benefits of using an electronic health record (EHR) system in an ambulatory care clinic?
Decrease medication errors Increase clinic reimbursement Improve provider documentation Increase delivery of guideline based care
A patient is in the ICU after a motorcycle accident. The patient sustained multiple contusions and fractures. Various digital monitoring devices are being used to track the patient's vital signs, pulse oximetry, and cardiac rhythm. How can the appropriate use of these technologies impact this patient's outcome?
Decreased recovery time Timely treatment of potential complications
What is the correct order of the system development lifecycle phases?
Designing, planning, implementation, analysis evaluate
Administration in an acute care clinic is considering adopting a health information system. A team is formed with members of clinical areas, software vendors, and an executive team of stakeholders. Which collaborative tasks are important for this team to accomplish with regard to selecting the health information system?
Determine who will be accountable for the project Determine how resources will be allocated to support the system Assess potential for process improvement while using the system
Which mechanism is used to streamline caregivers' workflow that needs to include past medical history, patient demographics, immunizations, and medication history?
Electronic health record
E- Heathcare
Electronic health records, health portals and telemedicine are just a few examples of
personal health record (PHR)
Electronic personal health record (PHR) [is]: a private, secure application through which an individual may access, manage and share his or her health information. The PHR can include information that is entered by the consumer and/or data from other sources such as pharmacies, labs, and health care providers. The PHR may or may not include information from the electronic health record (EHR) that is maintained by the health care provider and is not synonymous with the EHR. PHR sponsors include vendors who may or may not charge a fee, health care organizations such as hospitals, health insurance companies, or employers.
Health Information Exchange (HIE)
Electronic sharing of patient information between healthcare providers according to nationally recognized standards.
EMR
Electronic version of the client data found in the traditional medical record
Clinical Term
Enables the capture of data for patient care docum
The emergency room staff is hesitant to use the discharge planning module in the new electronic health record. What is a method the nurse informaticist should use to encourage staff to utilize the new application in the EHR?
Enlist feedback from staff or users
What are the expected outcomes of interoperable systems?
Error reduction, revenue improvement, and increased communication
Evidenced base decision support
Essential component of EHR
evidence based practice
Evidence provides the means necessary to provide consistent, quality care technology helps remove barriers to information and evidence-based practice
EHR Essential Components
Evidence-based decision support, assessment findings, vital signs, demographic data
Semantic interoperability
Exchange of data where the meaning remains the same on both ends of the transaction.
Project Implementation Team Responsibilities
Execution of system changes, active involvement in user participation, knowledge of current workflows
informatics innovator
Expected to be educationally prepared to conduct informatics research and generate informatics theory and have advanced understanding and skills in information management and computer technology
Expert/Experienced Nurse
Expected to fully integrate informatics throughout the course of his/her practice, not just for basic data entry and retrieval. They also know how to pull trends out of data
one primarty benefit of EHR is a decrease in wait time for diagnostic testing
FALSE not primary
Order entry systems produce bar code labels for specimens and automatic reminders or alarms. True/ False
False
Information science
Focus on how to gather, process and transform information into knowledge. It also incorporates features from 5 other sciences -communication science -computer science -social science -library science -cognitive science
input devices
Hardware that allows the user to put data into the computer, such as the keyboard, mouse, track ball, touch screen, light pen, microphone, barcode reader, fax/modem card, joystick, and scanner.
Computer System
Hardware, Software, Data, Procedures, Users
TIGER Initiative (Technology Informatics Guiding Education Reform)
Formed in 2004 to advance nurses' competencies related to informatics. Primary objective was to develop a US nursing workforce capable of using electronic health records to improve the delivery of health care
Medicare
Former president George W. Bush required ______ providers to make their cost and quality data publicly available.
Vision
Future-oriented, high-level view of what an organization would like to become that provides direction for planning purposes
SNOMED Clinical Terms
Globally recognized, controlled healthcare vocabulary that provides a common language for electronic health records (EHRs)
Develop a training plan that allows for different learning methods of different staff members.
Good Samaritan General Hospital has just adopted a new informatics system. It needs to train its staff on the new system because it is dramatically different from the system it replaced. What must GSGH do to ensure that the training program successfully integrates the system into the institution? Warn the staff that if they do not become proficient in the system's operation, they will be fired. Hold a single, hour-long training session at the GSGH lecture hall and require all staff to attend. Develop a training plan that allows for different learning methods of different staff members. GSGH doesn't need to do any training because the new system is so easy to use.
Catastrophic Plans
Have lower premiums, protect against high out-of-pocket costs, and cover recommended preventive services without cost sharing—providing affordable individual coverage options for young adults and people for whom coverage would otherwise be unaffordable
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?
Health Information Technology for Economic and Clinical Health Act, HITECH.
Which law or regulation pertains to the privacy and security of healthcare related information
Health insurance portability and accountability act
Data security accuracy and integrity management are vital aspects of the informatics nurse role. How does an informatics nurse institute manual an automated procedures to manage data security accuracy and integrity?
Monitors patterns and exceptions
Using a computer system, a user must be comfortable in utilizing input and output devices. This definition identifies which concept
Human technology interface
HIPPA Compliant Codes
ICD, ABC, Common Procedural Terms
Needs to be Integrated
ICD-9, G-Codes, ICD-10, CPT, HCSPC
Standardized nursing terminology of nursing... DX, Actions And outcomes
ICNP
Which standardized nursing terminology is composed of nursing diagnoses, nursing actions, and nursing outcomes?
ICNP international classification for nuring practice
Demographics, Nursing/healthcare worker shortages, Excessive costs of healthcare services
Identify one of the driving factors in telehealthcare
Stage 1
Identify the stage: All three major ancillary clinical systems are installed.
Stage 4
Identify the stage: The Electronic Medication Administration Record application (eMAR) is implemented.
Stage 7
Identify the stage: The hospital no longer uses paper charts to deliver and manage patient care.
Stage 0
Identify the stage: The organization has not installed all of the three key ancillary department systems.
A local medical clinic is attempting to develop an electronic health record (EHR) system. Which challenges should the organization anticipate?
Identifying data needs for differing nursing practice specialties Implementing standardization of documentation across physician offices
EHR implementation challenges in a medical center with various specialties
Identifying the different data needs for each specialty practice
Telehealth can be provided to a wide range of patients,
Immobilized, live in difficult to reach places, debilitating diseases
EHR Information Includes
Immunization history, CT scan results, date of birth
FALSE
Implementing EHRs currently does not have a profitable return on investment.
Telemedicine
Improve pt outcomes by permitting pts to remain at home, allows pts to communicate w/ provider about blood glucose test or video conference w/ them directly to develop pt specific education opportunities, directed by doctors
FALSE
In the Internet age, telehealth has become more common than in-office visits.
evidence-based guidelines are used daily in the clinical field. What is one area of the electronic medical record in which evidence-based guidelines are found?
In the standing physicians order for a sepsis diagnosis
1970
In which era did the example of the computerized nursing care plans?
EBP Attributes
Increased job satisfaction, improved quality of care
A social convention about right and wrong human conduct that are so widely shared that they form a stable general agreement
Morals
Nursing Informatics
Integration of nursing science, computer science, and information science to manage and communicate data, information, knowledge, and wisdom into nursing practice.
In regards to a secure network, what gives employees confidence that the information they are reading is true?
Integrity
TRUE
Interactive conferencing is frequently used in telehealth.
FALSE
Interest in telehealth has stagnated since 1990.
Intranet/Extranet
Intranet - Private networks that cannot be accessed outside the organization Extranet - Network outside the organization that enables customers and suppliers access to the services.
Which strategy is useful when employee Lewins change model when considering a new health information system?
Involve employees in the decision making process of the new system
ICD-10 (International Classification of Diseases-10th Revision)
Is the international standard diagnostic classification for health-management purposes, and clinical use. The ICD diagnoses are used to classify mortality and morbidity data from inpatient and outpatient records. Also used for reimbursement.
Barrier to patient centered care
Is waiting until the end of the shift to chart patient assessments a barrier to patient centered care...Yes, chart in real time. Computer position can be a barrier if it is placed between the provider and the patient...pay attention to your patient.
What is an advantage of using the barcode medication administration within healthcare setting?
It allows for real time automated documentation of the administration of the patient's medication
What is important for a nurse informatics to know about change control?
It helps prioritize limited resources and ensure system standards are upheld
What is a major benefit of nursing informatics?
It improves communication among healthcare providers to improve patient care
ARRA provided up to $11 million for hospitals to build out their informatics capabilities.
It is 2009, and you are the informatics nurse specialist at Good Samaritan General Hospital. You have long wanted to expand the informatics potential of GSGH but have been unable to convince hospital administrators of the benefits. They think it will be too expensive to create. However, after the passage of ARRA, you are more optimistic that your vision of a more integrated and robust informatics system for GSGH can be realized. Why is this so? ARRA provided money for road projects that could make access to GSGH much easier for patients. ARRA gave e-signatures the same legal weight as handwritten signatures. ARRA created incentives for e-prescribing. ARRA provided up to $11 million for hospitals to build out their informatics capabilities.
What is a gap analysis in the electronic health record process?
It is a list of features and functions desired but not immediately available in the new system as identified
HIS Implementation Nursing
It is important to secure staff nurses active participation when implementing a health information system b/c the nurses knowledge of current patient care workflow may improve implementation decisions
A provider electronically orders bloodwork and laboratory. The provider must ensure the lab system can properly communicate with the provider system for the results to be usable. Which is the correct term that would be found in the systems?
Logical observation identifiers names and codes. LOINC
An admission nurse is awaiting notification of whether a patient being monitored by telehealth will be admitted to the hospital. The physician has already documented the admission orders in the digital medical record. Due to miscommunication, the admitting nurse did not access the digital medical record. There was a significant delay in the patient's admission, which led to decreased patient satisfaction with the admission process. How can the use of the digital health record improve this process?
It prevents the delay of tests and services. It allows for easy access to patient information.
What is clinical decision support?
It provides clinicians with suggested care information. It reminds busy clinicians of items easy to forget or overlooked.
A nurse manager identifies several advanced practice nurses at an ICU workstation responding to multiple patient alarms. She notices that the acuity of one patient drastically increases the demand for staff resources. How can workflow analysis impact practice in this situation?
It provides observation and documentation of what is happening in the current environment.
What is one way that technology acts as a change agent in the nursing process?
It reduces the time spent on documentation.
What is the intent of the 2003 health insurance portability and accountability act security rule?
It's sets the national standards to protect individuals electronic personal health information
Nurses as Knowledgeable workers
Knowledge as a product
name the type of connection needed to access the EHR when an internet connection is lost?
LAN local area network access
name the type of connectoin needed to access the EHR when an internet connection is lost?
LAN local area network access
Classify the mechanisms as either physical or logical security measures for protecting electronic information.
LOGICAL- Authentication Installing a firewall Automatic sign-off PHYSICAL- Placing computers, servers and routers in restricted Setting up surveillance
HIS Health information systems-Clinical Information systems
Laboaratory systems, Pharmacy systems, clinical documentation systems EX EHR
What are three types of clinical information systems? Choose 3 answers
Laboratory system Order entry system Monitoring system
3 types of Clinical info systems
Laboratory system, Order entry system, Monitoring system
HIS Examples
Laboratory system, pharmacy system, registration system
A nursing informatics specialist at a small, rural hospital implemented a clinical information system utilizing an electronic health record (EHR). She obtained input from nurses regarding selection of the specific EHR. She noted that some of the nurses had negative attitudes towards a change to the EHR, but she encouraged them to try the system and note its benefits. She implemented the system after all nurses were trained about the EHR. There were numerous complaints about the EHR, which the Nursing Informatics Specialist decided to ignore since the personnel were new to the system. Which barrier to implementing technology is present in the scenario?
Lack of continued support
Nursing Informatics Specialist decided to ignore the personnel/ Which barrier in implementing technology
Lack of continued support
Telehealth Issues
Lack of reimbursement, infrastructure, plug-play standard, license and liability issues, concerns r/t privacy confident.
HIPPA Provides
Legal protections for personal health info, set standards for electronic data interchange of claims data, named specific code sets for use in Medicare related transactions and priv
EMR (electronic medical record)
Legal record created in hospitals and ambulatory settings of a single encounter or visit that is the source of data for the electronic health record. Brings together diagnostic and treatment information for an individual in a specific healthcare setting.
EMR Provides
Legal record often restricted to a single visit of care, building block of EHR
These are the two greatest barriers to adoption of telehealth services by providers.
Licensing & Reimbursement
PHR (Personal Health Record)
Lifelong tool for managing health information, such as conditions, allergies, medications, past surgeries, and other relevant information
What are three types of networks are information exchanges?
Local area network Internet and wide area network
What are two items that exempt eligible clinicians from a merit based incentive payment system?
Low threshold provider who bills Medicare less than 90,000 yearly. 200 or fewer Medicare patient seen annually
Financial Systems are designed to do what
Manage the expenses and revenue of providing healthcare, report and track fiscal outcomes as they relate to organizational goals, help to determine the organizations strategic direction
Informatics support the quality reporting. What are two quality reporting characteristics informatics nurses practice?
Managing data, information, and knowledge. Developing tools and methods
TRUE
Many nurses feel that EHRs have decreased the quality of care.
Which of the following requires standardized nursing terminology to meet its criteria?
Meaningful Use
Telehealth (Store and Forward Technology)
Means of transferring data or images from one location to another, most often used for pathology reports and radiology images
Nursing informatics
Nursing informatics as a specialty does have its own National certification exam
Acquired of knowledge; descriptive research
Nursing informatics can facilitate all aspects of nursing especially in the __________ of _______________ and ________ _________ where we attempt to bridge the gap between what we know and what we do.
A nurse can increase their clinical knowledge by learning which component of computer Science
Nursing related blogs and forums [CDs and DVDs Research and learning networks
this type of health information system ensures the accuracy of physician orders
ORDER entry system
Which two tools are used to exchange a clinical workflow?
Observation and swim lane charts
interface engine example
On a client's admission, the client's demographic information is entered in the hospital registration system, and portions of these data are transmitted to the clinical data repository via the interface engine. When a laboratory order is entered into the order entry system, the appropriate client demographic information is retrieved from the clinical data repository and used by the order entry system. After the order is entered, the order information may be transmitted via the interface engine to the clinical data repository and the laboratory system. When testing is complete, the results are transferred via the interface engine from the laboratory system to the clinical data repository. At this point, they are available for retrieval using the order entry system or another clinical information system.
Lewin's Change Model
One of several foundational theories for leading others through planned change; identifies three steps: * unfreezing * changing * refreezing
EHR Primary Benefit
One primary benefit of the EHR is a decreased wait time for diagnostic testing...FALSE
Web 2.0
Online tool that permits collaboration and sharing online, such as facebook, twitter; Provides education- wikis, web logs, virtual worlds, facebook
Premiums
Only allowed to vary based on age (within a 3:1 ratio for adults), tobacco use (within a 1.5:1 ratio and subject to wellness program requirements in the small group market), family size, and geography
Which procedures are essential to creating and maintaining a culture of safety during the medication administration cycle?
Performing double verification among nurses when administering high alert medications Barcode scanning the patient and the medication to ensure positive patient ID
EDI Electronic Data Interchange
Permits multiple systems to acquire and share data
Physical/Logical Means of Protecting Information
Physical - surveillance cameras, restricted areas, hard copy records being shredded Logical - firewall protection, biometrics, authentication, automatic sign off on computers
Unauthorized access to a server room is an example of this type of threat
Physical threat
Critical Pathways/Protocols Approach
Physician's orders are present for the multidisciplinary care team to observe and follow.
Single Risk Pools
Prevent insurers from using separate insurance pools within markets to get around market reforms and charge people with greater health problems higher premiums by increasing their premiums at higher rates
EHR Main Goal
Primary goal of EHR functionality in contrast to that of a health information system is promoting patient safety
Which theoretical framework emerged as a foundation for ethical decision making
Principalism
Which phase of implementation use a small groups of individuals to evaluate potential issues that may occur when making a new systems transition?
Pilot phase
Physical
Placing computers, servers and routers in restricted Setting up surveillance
The computer literate nurse with the use of nursing informatics will have the knowledge and as a result will have the _______________ and ____________ in nursing
Power and influence
Integration
Process by which two different information systems are able to exchange data in a way that is seamless to the end-user.
Informatics Innovator
Process of making enhancements or improvements..creative
Cross Monitoring
Process of monitoring the actions of other team members for the purpose of sharing the workload and reducing or avoiding errors
Guaranteed Renewal of Coverage
Prohibits issuers from refusing to renew coverage because an individual or employee becomes sick or has a preexisting condition
How can a nursing informatics cyst increase interoperability?
Promote the use of standard vocabulary for documentation and coding
operating systems
Provide an interface between the user or application program and the computer hardware. ex windows
ARRA
Provided funds to develop a national health care IT framework through the Department of Health and Human Services; addressed the need for an updated IT plan for the nation, a more integrated communication system across platforms and providers, and additional security measures
CPOE Computerized physician order entry
Provider process of enters orders in EHR
FALSE
Providers can assume that most patients know about the existence of, benefits of, and proper use of PHRs.
data warehouse
Provides a powerful method of managing and analyzing data
Nursing Process Approach
Provides discharge information and pertinent patient education materials and resources.
ARRA (American Recovery & Reinvestment Act
Provides funds for adoption of technology and provides the right for every individual to receive electronic copy of EHR
Mission
Purpose or reason for an organization's existence, representing the fundamental and unique aspirations that differentiate it from others
Which merit based incentive payment system category replaces the reporting program that assesses care provided to Medicare patients to ensure patients get the right care at the right time?
Quality
EHR Benefits
Reduces medication errors, improves provider documentation
Configurability
Refers to the extent that a given software product can be adapted or changed to meet a user's preference
Which health information system is used to collect and store client identification and demographic data that are verified and updated at the time of each visit?
Registration system
HIS Health information systems-Administrative Information system
Registration system ADT, Financial systems, scheduling systems
Clinical decision support
Reminders Recheck BP, able to look up PDR Physician drug record
What represents the greatest potential threat to data security?
Removable storage device
Cross Monitoring
Requires more than one, pop up allergy prior to ordering
Physical protection of patient information
Restricted access areas and surveillance cameras, shred pt info
What describes an administrative safeguards are electronic protected health information
Restricting access of all authorize users of the electronic health record according to their position within the healthcare system
What is one disadvantage of nurses frequently documenting in the free text notes section of the electronic health record rather than within designated flowsheets?
Running a report will not yield free text note data
strategic planning is driven by all of the following EXCEPT: A. SHORT TERM GOALS B. ORGANIZATION MISSION AND VALUES C. SERVICES OFFERED D. LONG TERM GOALS
SHORT TERM GOALS
Administrative Information System Examples
Scheduling system, financial system, admission, discharge and transfer (ADT) system
Ergonomics
Scientific study of work and space, including details that impact productivity and health
A nurse is creating a patient list in notes that there are symbols surrounding the patients name. Which action should the nurse complete to determine what the symbols indicate?
Select the legend
Instructor feedback, Debriefing, Interactive review of simulated episode by the team
Simulation episodes are concluded with
FALSE
Since a personal health record (PHR) contains complex health-related information, it is important that the PHR system be complex. Increasing the complexity of the PHR system will improve patient confidence of PHR.
TRUE
Some aspects of telehealth do not allow for proper medical aid.
Usability
Specific issues of human performance in achieving specific goals during computer interactions within a particular context
Strategic Planning
Strategic planning is not driven by short term goals as Strategic Planning is a LONG TERM GOAL
Nursing Process Approach
Streamlines documentation of assessments and patient-related data.
Examples of the Nursing Process Approach:
Streamlines documentation of assessments and patient-related data.Provides discharge information and pertinent patient education materials and resources.Provides medication information to help prevent medication errors or interactions.
HITECH (Health Information Technology for Economic and Clinical Health)
Strengthened HIPPA security and privacy protection, provides financial incentive for user of EHR
Knowledge Management
Structured process for the generation, storage, distribution, and application of both tacit knowledge (personal experience) and explicit knowledge (evidence)
Standardized Terminologies
Structured, controlled languages developed according to terminology guidelines and approved by an authoritative body
Who should a nurse informatics cyst exclude from participating in schedule meetings to discuss change control?
Subject matter expert's
What reduces and organize his terms for easier searches?
Taxonomic vocabularies
Informatics System Considerations
Technical Specifications - Downtime for Maintenance Response Time - Time it takes system to process request Architecture - Structure of system, open comm. each other Connectivity - Interface the system in multiple ways Testing - In different place than being used Compatibility - With other systems
(CCR) Continuity of Care Record
Technical informatics standard that provides a snapshot of a person's current health and healthcare to a provider who does not have access to that person's electronic health record
What is an output of system analysis?
Technical requirements
Data mining
Technique that looks for hidden patterns and relationships in large groups of data using software
TIGER
Technology Informatics Guiding Education Reform
FALSE
Telehealth is restricted mostly to conferences with patients.
TRUE
Telehealth solutions may not be available to all hospitals.
non-clinical telehealth
Telehealth utilized for necessary activities to enable the health care provider to provide patient care, but is NOT directly related to patient care. Examples: Research/data mining, Grand Rounds, staff education, expert consultation
False
Ten key steps were established to meet the 10-year vision of the TIGER initiative
Continuous
Term that best describes the life cycle of an information system
Project scope
Term that defines the size and details of a collaborative effort
Information
Term used to describe data that has been interpreted
Which mobile device feature me reside on a device indefinitely?
Text messages
FALSE
The American Nurses Association (ANA) has spoken in opposition to using EHRs in hospitals.
EHR
The EHR is a longitudinal electronic patient record of all health care encounters...carries with the patient (longitudinal)
The Health Information Technology for Economic & Clinical Health (HITECH) Act
The Health Information Technology for Economic & Clinical Health Act was enacted as part of the American Recovery and Reinvestment Act of 2009, promotes the adoption and meaningful use of health information technology
Model Privacy Notice
The Health and Human Services initiative, the ______, is an effort to uniformly address the privacy and security concerns consumers have had with PHRs since their inception.
Cost benefit
The Healthcare Information and Management Systems Society (HIMSS) notes that there is a higher ______ when an EHR is implemented comprehensively.
IN vs INS
The IN refers to the RN who works in the area of informatics. This individual has experience or an interest in the area but no formal informatics preparation The IN employs strategies that transform data into information and information into knowledge and ensures that information is disseminated at appropriate times for appropriate uses in the healthcare continuum. In contrast the INS has advanced, graduate education in nursing informatics or a related field and may hold ANCC certification. The INS needs to play an active role in research and theory development and in the design and testing of information systems and the human-computer interface; he or she also needs to help shape policy and serve as an advocate for the design and use of informatics to serve other healthcare professionals and the public INS may have responsibilities in administration, telehealth, education and professional development, compliance issues, and discovery in databases and analysis. The INS is prepared to assess work processes and subsequently design, select, implement, and evaluate data structures and suggested technology intended to improve productivity and contribute to the body of nursing knowledge
The key concepts of nurse, person, health and environment are known as
The Metaparadigm
Label the descriptions as belonging to the role of either the informatics nurse or the informatics nurse specialist.
The RN who works in the area of informatics - informatics nurse Has an interest or experience, but no formal training in informatics - informatics nurse Plays an active role in research and theory development = informatics nurse specialist Has advanced graduate training in nursing informatics = informatics nurse specialist Ensures that information is disseminated at appropriate times for appropriate uses - informatics nurse
Interoperability
The ability of two entities, human or machine, to exchange and predictably use data or information while retaining the original meaning of that data.
Interoperability
The ability of two entities, human or machine, to exchange and predictably use data or information while retaining the original meaning of the data
Interoperability
The ability of two or more systems to pass information between them and use the exchanged information
Technical interoperability
The ability to exchange the data from one point to another
information literacy
The ability to recognize when information is needed as well as the skills to find, evaluate and use needed information effectively
Meaningful use was signed into law in 2009 to provide a means for eligible providers, hospitals, and critical hospitals to use and communicate data to improve patient outcomes. What is the purpose of stage 1?
The allow the electronic health record to capture and share data
The foundation of knowledge model
The basis for which knowledge is used to meet the needs of the healthcare delivery system It is derived from its 3 key elements of knowledge acquisition, knowledge processing and knowledge dissemination
Computerized Physician Order Entry (CPOE)
The name used to describe the process by which the physician or provider enters orders electronically into the EHR
Which statement accurately represents the national quality forum?
The national quality forum is a non-profit membership based organization that works to improve healthcare through meaningful measurement
How does information literacy support the use of evidence-based-practice (EBP) in nursing?
The nurse can discern research findings that can be applied to practice Nurses must frequently consult resources including peers and general internet searches
Which statement describes a successful electronic health record?
The customers needs were met
Assignments
The delay in utilization of research findings can adversely affect
Strategic planning, long-range
The development of a comprehensive long range plan for guiding the activities and operations of an organization
Accessability, ubiquity, longevity, and reusability
The development of standardized terminologies in nursing informatics is driven by the following principles
A nurse is to administer insulin coverage in the electronic health record is preventing the nurse from completing the administration documentation. Why has this occurred?
The electronic health record requires the dose verification and sign off of another nurse
What is used to evaluate a health information system?
The electronic medical record adoption model
Semantic interoperability
The exchange of data in which the meaning remains the same on both ends of the transaction
What are two of the five rights of clinical decision support?
The right time in the workflow. The right person
Effectiveness research
The federal government has invested $1.1 billion in the ______ concept because it allows practitioners to quickly compare interventions and treatments to determine which is the best and most cost-effective methodology.
TRUE
The first instance of telehealth involved sending results over the telephone.
document deserved functions of an E H R
The first step in implementing an E H R into an organization is the vendor selection process. What other factor is included in this first step
E-Health
The focus on the provision of nursing for anyone or any organization, anytime, anywhere, through any networks and any devices. This statement is the definition of
Clinical knowledge
The future role of a nurse will be called
components of archetypes
The header has a unique code identifying the clinical concept defined as well as descriptive information such as author, version, and status. definition includes restrictions obtained from the information model. ontology section contains codes representing the meanings of nodes and constraints on text or terms, as well as linkages to terminologies such as SNOMED or LOINC. The Archetype Definition Language (ADL) is a formal language for the expression of archetypes.
You are a nurse manager at a hospital. The informatics department at the hospital has established a no flash drive policy. In addition, all patient files must be saved on the secure O: drive. What would be an appropriate way to describe these changes to your staff?
The hospital is implementing a security program to prevent patient data for being compromised. The hospital is eliminating the need for flash drives to prevent the loss of sensitive data.
Why would the results of a patient report containing wait time data in the hospital emergency room be of interest to the hospital CEO?
The information is a piece of the puzzle needed when the CEOs determining patient satisfaction
Clinical Information Systems Examples of Effectiveness
The information retrieved can be used to foster research, improves nursing documentation compliance, It can improve clinician workflow
Data entry
The integrity of data can often be compromised if ________ is not correct.
Priority
The integrity of the patient's medical information must be taken into account with telehealth, making ______ a priority.
Automatic Sign-off
This security measure protects the healthcare provider if they leave the computer abruptly
What is an important legal consideration in the use of telehealth nursing?
The nurse is licensed in each state in which the remote clients are located.
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't you look it up? Which action should the nurse take?
The nurse should review the home medication section in the hospitals electronic health record to see if the information has been added and reviewed
CPOE (Computerized Provider Order Entry)
The prescribers' decisions to enter orders and immediately share the orders with appropriate health professionals who execute the orders and the departments that need to dispense, schedule, or immediately deliver services to patients
Integration
The process by which different information systems are able to exchange data in a fashion that is seamless to the end user.
Information Security
The protection of information from accidental or intentional misuse by persons inside or outside an organization
Physical Security
The protection of physical items, objects, or areas from unauthorized access and misuse. Measures include the placement of computers, file servers, routers, switches, and computers in restricted areas. Other examples include physical locks on devices
concern pt worsening heart condition. How does electronic heath record facilitate
The provider can see Chest Xray remotely/ provider has access to info being discussed
A nurse is working on a medical surgical unit and is concerned over a patient's worsening heart failure. The nurse calls the provider to discuss the assessments. How does the electronic medical record facilitate a collaborative discussion in this situation? Choose 2 answers
The provider can visualize the chest x-ray remotely. The provider has access to the data being discussed.
Mission
The purpose or reason for an organizations existence
Informatics
The science and art of turning data into information.
A patient is being transferred to a trauma hospital in the area. The current hospital uses a different electronic health record than the receiving hospital. Which process allows interoperability of the health information exchange between the two hospital systems?
The staff at the trauma hospital will obtain the patient's consolidated clinical document architecture via the electronic health record by the transferring hospital
Knowledge
The synthesis of information from several sources to produce a single concept or idea Ex. journal about BP
A computer program was implemented at a hospital that required nurses to wait until the patient arrived in the emergency room and was registered into the program before orders for critical time-sensitive treatment could be written. How could this program become a barrier to the nurses attempting to deliver patient-centered care?
The time spent waiting for the program to register the patient could delay critical care being delivered in a timely manner.
What is included in meaningful use stage three?
The use of electronic prescribing
nursing informatics
The use of information and computer technology to support all aspects of nursing practice, including direct delivery of care, administration, education, and research
Sees Flu Vac due b4 D/C to meet a clinical Pathway
To promote desired outcomes
FALSE
There are no downsides to quickly implementing an EHR system.
FALSE
There are three major smart technology solutions available.
Contract management systems
These are especially useful for large institutions with many different vendors and suppliers.
Risk management systems
These print out reports to help manage litigation and claims issues for institutions.
Registration systems
These track each patient's identifier, which is a code or a number
What is the main purpose of standardize nursing terminologies?
They allow uniformity an easier retrieval of nursing related data
How can clinical decision support tools lead to safer patient care?
They give timely information to nurses and other healthcare providers. They reduce waste of nurse's time looking through the medical record.
Standardized Terminologies important to nursing
They improve communication within the interdisciplinary team
What is the mission of the Health level seven organization?
To provide a comprehensive framework and related standards for the exchange, integration, sharing, and retrieval of electronic healthcare information.
What is the responsibility of a super user?
To support the system in a given unit and assist users with functionality and procedural issues
HITECH (Health Information Technology for Economic and Clinical Health)
This act improved patient confidentiality by increasing the penalty for HIPAA violations
Healthcare Facilities Accreditation Program (HFAP)
This agency accredits facilities related to health care delivery, including less-prevalent facilities such as primary stroke centers and mental health facilities.
National Committee for Quality Assurance (NCQA)
This agency accredits individual physicians, health plans, and medical groups. This is accomplished by examination of the Healthcare Effectiveness Data and Information Set (HEDIS) and the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey.
Healthcare Quality Association on Accreditation (HQAA)
This agency focuses its accreditation efforts on Durable Medical Equipment (DME)
Data Mining
This information management tool uses software to look for hidden patterns and relationships in large groups of data
Implementation team
This interdisciplinary team is tasked with selecting an organization's HIS
Systematized Nomenclature of Human and Veterinary Medicine Clinical Terms (SNOMED-CT)
This is a globally recognized controlled healthcare vocabulary that provides a common language for electronic health applications to exchange data
NANDA
This is a standardized nursing terminology used for nursing diagnosis
The Foundation of Knowledge Model
This is the basis for which knowledge is used to meet the needs of the healthcare delivery system. It is derived from its 3 key elements of knowledge acquisition, knowledge processing and knowledge dissemination
Strategic planning
This is the development of a comprehensive long range plan for the activities and operations of an organization
Knowledge of workflow
This is the primary reason nursing participation is essential on the implementation team.
information science
This science, originally a sub-discipline of computer science, supports the collection and management of information and applies technology to make information usable.
information systems
This system is comprised of the hardware and software that make up an organization's infrastructure.
Project Scope
This term defines the size and details of a collaboration effort
Open Access Initiative
This term refers to digital literature movement available to anyone free of charge, with internet access
Transitional research
This type of research is focused on the generation of more research
What is a goal of the health information exchange?
To allow insurance companies and providers to be able to share data
the facilities long term vision
To become a successful owner of an E H R in the healthcare organization it requires
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?
User dissatisfaction. Reduced productivity
Knowlege Managers
To capture and process collective expertise and distribute it where it can create the largest benefit and is what type of nursing role?
What is a goal of meaningful use?
To engage patients and families in their healthcare
What describes message format standards?
To ensure data is structured the same way for the two applications exchanging data
What is the importance of a nurse's active participation in electronic patient information?
To ensure patient information will be current and accessible to the healthcare team
What is the importance of a nurse's active participation in electronic patient info
To ensure pt info will be current and accessible to team
Nurses active participation in Electronic Information Importance
To ensure the information is current and accessible to the healthcare team
What is the focus of cognitive science in nursing informatics?
To explore the nature of knowledge and its components, development, and use
Human flexibility factor
To implement an E H R, requires a stretch in the organizations skills and capacity for change but which other factor must be overcome as well
What is a principle provision of the Health Information Technology for Economic and Clinical Health (HITECH) Act?
To improve healthcare quality by enhancing coordination of services among providers
Workflow changes in both the clinical area and physicians office
To incorporate a nationwide E H R the underlying infrastructure will require which of the following changes
A nurse is reviewing a patient's pneumonia vaccination status in the electronic medical record. The nurse determines the patient needs this vaccine before discharge to meet the requirements of a current clinical pathway. Why would the nurse use information systems in this manner?
To promote desired clinical outcomes
Clinical
Transmitting a chest x-ray to be read, mobile device to monitor patient, live video conferencing to check in with patient or caregiver to make sure dressing change is correct or administering medication.
Data that are interpreted, organized and structured are referred to as information
True
True/ False Health care providers should have a plan in place for potential violations of patient confidentiality.
True
True/ False Ideal nursing information systems include online databases, drug information, policies, and procedures.
True
True/ False PHRs improve patient outcomes through increasing patients' knowledge about their medical conditions.
True
True/ False Personal health records (PHRs) improve patient outcomes through communication between the provider and the patient.
True
True/False Nurses do not have to enter data at workstations when smart technology is utilized.
True
True/False Patients can see when tests or procedures are scheduled when they are in a SmartRoom.
True
True/False The Institute of Medicine (IOM), which sets the goals for undergraduate and graduate nursing education, has included informatics in its core learning modules.
True
True/False The Technology Informatics Guiding Education Reform Initiative (TIGER) calls for nursing education to keep up with rapidly changing technology and encourages nurses' active participation in the development of electronic records.
True
True/False `A Radio Frequency Identifier RFID is a type of technology that is used to identify and track supplies and medications within a healthcare environment
True
Wang (2003) 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.
True
Wisdom is the appropriate application of knowledge to a specific situation.
True
Blame-free environment
Type of environment that encourages interdisciplinary cooperation to reduce medical errors
HIPAA
Under the ______, patient health records are closely protected from distribution to anyone but the patient without the patient's permission.
What are common personal data access security threats in healthcare?
Unencrypted data Weak passwords
Scope Creep
Unexpected and uncontrolled growth of user expectations as a project progresses
FALSE
Unlike paper systems, electronic health records (EHRs) are not seriously affected by errors in data entry.
Confidentiality
Unspoken understanding that private information shared in a situation in which a relationship has been established for the purpose of treatment or delivery of services will remain protected
The ease of learning a computer application, and other issues of human performance is know as
Usability
A nurse receives a computerized alert of a critical lab value on her patient. This computerized alert informs the nurse that an action needs to be taken and provides suggestions for clinical intervention. Which technology did the nurse employ to achieve an enhanced safe practice environment?
Use of a clinical decision support tool
Teleconferencing
Use of computers, audio, & video equip. and high-grade dedicated telephone line, cable/sat connections to provide interactive communication between 2+ ppl at 2+ sites
Consumer Health Informatics (CHI)
Use of electronic information and communication to improve medical outcomes and health-care decision making from the patient/consumer perspective
Meaningful Use (MU)
Use of health information technology (HIT) legislated by ARRA of 2009 to collect specific data with the intent to improve care and populations health, engage patients, and ensure privacy and security, with financial incentive from Medicare and Medicaid
Telehealth
Use of technology to deliver health-related services and information, including telemedicine
Telehealth
Use of telecommunication technologies & computers to provide healthcare info & services to clients at another location - consumers are chronically ill, isolated, assisted living families - decrease er visits, decrease LOS, decrease Admissions, increased productivity for clinical
Patient safety issues
What drives healthcare to utilize technology today?
Information
What is a Nurse Knowledge workers primary resource?
Local Area Network (LAN) access
What is the type of connection is needed to access the EHR when an internet connection is lost
A.R.R.A. (American Recovery and Reinvestment Act of 2009)
What legislation prompted and funded the "Meaningful Use" of health information technology
Clinical Imnformationist
What other partner can be part of the healthcare team for providing nurses with timely clinical evidence into the clinical workflow?
Standardization of Data and Different data needs of each clinic
What potential challenge can occur when implementing an EHR in a medical center with various outpatient clinics
Explicit Knowledge Tacit Knowledge
What type of knowledge do nurses use to utilize the nursing process
Nursing informatics
What type of nursing analyzes and faciltates the Knowledge Worker to disseminate and reuse knowledge
RUGs C-3PO
Which codes do NOT need to be integrated? G-codes CPT RUGs ICD-9 ICD-10 HCSPC C-3PO
State Government
Which form of government (State or Federal) over sees the following? Health insurance Workers' compensation insurance Medicaid CHIP Reimbursement Rates
Federal Government
Which form of government (State or Federal) over sees the following? Medicare Social Security Disability Reimbursement Rates
Home Health industry
Which industry in healthcare can telehealth help with the nursing shortage?
Research utilization
Which is a subset of Evidence Based Practice?
Investigating current deficits and needs of the organization
Which item below does not play a role in system implementation
Perioperative nursing data set (PNDS)
Which nursing terminology contains a nursing diagnosis, interventions and outcomes specific to the perioperative experience
Perioperative nursing data set PNDS
Which nursing terminology contains nursing diagnosis, interventions, and outcomes specific to the perioperative experience
distance
Which of the following is NOT a challenge to using telehealth? legal issues safety and related standards distance patient privacy and confidentiality
Qualitative Research
Which type of research is not considered evidence based practice?
You consider whether the telehealth nurses from other institutions with which you partner are licensed in your state.
You are a nurse at Good Samaritan General Hospital. You have taken a particular interest in developing telehealth solutions for GSGH. However, you are aware of several concerns that practitioners and patients may have with adopting telehealth throughout the GSGH system. Which of the following is a concern that you must address prior to adopting the technology? There are no real concerns with telehealth because the benefits are so great. You consider whether the patient is able to receive a consultation from world-class experts. You consider whether your nurses are able to partner with other nurses to provide better overall patient care. You consider whether the telehealth nurses from other institutions with which you partner are licensed in your state.
Turn off your friend's workstation and let her know about her mistake.
You are a nurse in the emergency department at Good Samaritan General Hospital. One night at work, your neighbor arrives in the emergency department by ambulance. Your friend is assigned to care for him. This neighbor has been causing strife in your neighborhood. He does not like the neighborhood children. In fact, he cursed your own children for walking too close to his property line. You know that he and his wife have been having foreclosure problems and that he has been in and out of the hospital frequently for vague complaints. When you and your friend go on break, your friend forgets to sign off her work station. You walk by and read that your neighbor is indeed sick and is diagnosed with Münchausen by proxy. You want to tell your neighbors that the neighbor's wife is making him sick. What, if anything, can you do with this information? Tell your neighbors everything. He was your friend's patient, not yours. Tell your spouse/significant other so you can share a good laugh. Turn off your friend's workstation and let her know about her mistake. Write an anonymous letter to the neighbor telling him to stop being mean or the police will be told about his wife's actions.
Perform a risk analysis of the potential security threats.
You are a nurse informatics professional at Good Samaritan General Hospital. During the course of your time at GSGH, you have noticed that, although GSGH has avoided any formal HIPAA sanctions, GSGH has been lucky. That is because your predecessor never formally adopted an accountability structure at the administrative level to ensure data security. As a result, there is no clear hierarchy of who receives confidential and private information and who does not. What is the first step you should take to develop a good security management process to ensure better administrative safeguards over HIPAA-protected material? Perform a risk analysis of the potential security threats. Conduct rigorous risk management. Develop a solid sanction policy. Perform an information system activity review.
You may notate the disclosure in Jerry's electronic chart and discuss it with his physician.
You are a nurse on an intensive care unit at Good Samaritan General Hospital. During the course of your time on the unit, you have come to know a patient named Jerry and his family very well. He had a type of flesh-eating disease that has taken months to treat. None of Jerry's caregivers have been able to figure out how Jerry acquired the disease. Jerry's wife, Barb, is an excellent caregiver and always wants to review Jerry's chart (although Jerry has not granted permission for this). One day, while you are in Jerry's room discussing his disease, he discloses to you that he fears he acquired the flesh-eating disease while with a prostitute during a business trip out of the country. He tells you not to tell anyone because he doesn't want his wife to find out. To whom would you be able to disclose the information Jerry just gave you? No one. You must never reveal Jerry's secret. You may tell any of the nurses at the nurses' station because they are also bound to confidentiality. You may notate the disclosure in Jerry's electronic chart and discuss it with his physician. You may discuss the disclosure with his doctor, but you may not notate it because his wife could see the record and he specifically asked you not to disclose it to his wife.
a laboratory system
You are a nurse on the psychiatric unit at Good Samaritan General Hospital. During the course of your shift, you draw a specimen and send it to the lab as ordered. The attending physician then orders additional lab tests. You request the additional laboratory tests to be performed on the patient's specimen that has already been drawn and sent for the initial tests, as ordered by the attending physician. You do this by calling down to the lab. However, when the results come back, it is clear to you that the incorrect tests were run. Apparently, the lab had misheard your request. Which of these informatics solutions would prevent this from happening in the future? a pharmacy dispensing system a monitoring system a laboratory system a radiology system
Connect with the Albany facility so that MGH emergency department nurses and physicians can consult with Albany's staff through the videoconference suite.
You are a nurse working in the emergency department at Mountainside General Hospital, which is located deep in the Catskill Mountains of upstate New York. A psychiatric patient arrives in the emergency department and starts threatening people. MGH does not have a psychiatrist on staff. However, there is a psychiatric institute in Albany. You suggest establishing a relationship with the facility in Albany for telehealth consults. Your supervisor compliments your initiative and asks you to help the facility develop a telehealth solution that enables MGH to consult with the Albany facility. MGH recently had a videoconferencing suite installed in the emergency department. Which of the following telehealth options should you adopt, as requested by your supervisor? Establish a relationship with a transport company to transport patients to the Albany facility. Arrange for a direct telephone connection to the transportation company to be installed at the nurses' station. Have a specialist at Albany give out her phone number to all the MGH nurses. Connect with the Albany facility so that MGH emergency department nurses and physicians can consult with Albany's staff through the videoconference suite. Recommend that MGH have police on duty to take psychiatric patients to a group home.
Conduct a needs assessment to determine the qualities you need in the informatics system.
You are a nursing informatics director at Good Samaritan General Hospital. The GSGH CEO has tasked you with developing a comprehensive informatics system for all units at GSGH. What is the first step you should take to effectively adopt and implement the new system? Put out a request for information (RFI) from two dozen manufacturers. Put out a request for proposal (RFP) to several manufacturers. Conduct a needs assessment to determine the qualities you need in the informatics system. Put out a request for quote (RFQ) to several manufacturers.
what challenge might an organization face when trying to implement a health information system throughout their various specialty clinics?
identifying the difference data needed for each specialty practice
Test the system with a few nurses first to demonstrate how easy it is to learn and then evaluate whether it requires changes to make it more user friendly.
You are a nursing informatics director at Good Samaritan Hospital. The current documentation system is old and causing huge problems for the floor nurses. You notice that productivity and error rates are unacceptable and decide to switch to a better, more efficient system. You decide to adapt an informatics system, NURSE-EX, that has demonstrated the ability to reduce medical errors by 50% and increase efficiency by 75% over older systems like yours. However, it will represent a major change in format and habit for the nurses, many of whom have been at Good Samaritan for 15 or more years. You know that you must demonstrate the user friendliness of the system to the staff to make them more likely to adopt the new system. What would be the best way to ensure that NURSE-EX is the most user-friendly system possible for your nursing staff? Adopt the system and support staff with the growing pains. Test it out yourself to see how easy it is for you to operate. Show the staff the research showing how great NURSE-EX is. Test the system with a few nurses first to demonstrate how easy it is to learn and then evaluate whether it requires changes to make it more user friendly.
Patients may be uncomfortable with outsourced providers whom they have never met monitoring their health.
You are a nursing informatics professional at Good Samaritan General Hospital. You are establishing a new telehealth solution for your recently released cardiac patients. It will enable cardiologists to monitor their younger patients at home and answer their questions at no cost to patients. However, GSGH's CEO does not like having to pay the hospital-affiliated cardiologists the money it would cost to provide consultations, saying, "They will be able to do this by just turning on their Internet-connected computer anywhere in the world." He tells you to instead "farm out the follow-up with a telehealth firm in another country that can do the monitoring at half of the cost to GSGH." Barely one month after implementing the system, patients begin rejecting the technology en masse, and only a handful of patients decide to take advantage of the monitoring system. Why would this be? Patients do not like having doctors monitoring them in the comfort of their homes. Younger patients are fearful of technology and slow to adopt it. Patients may be uncomfortable with outsourced providers whom they have never met monitoring their health. Patients don't like paying extra for the service.
I wish I could spend more time with patients and less time entering data.
You are a nursing informatics specialist at Big Canyon Community Health Center. BCCHC has adopted a new informatics system that has replaced the old paper system. One of the veteran nurses, Giancarlo, had been an expert in the old paper system. With the new system, the sheer number of screens through which Giancarlo must navigate has doubled his documentation time. This means he is unable to spend as much time with patients. Which of the following would be a comment you would expect to hear from Giancarlo concerning the new informatics system? I hate the computer second-guessing me all the time. I wish I could spend more time with patients and less time entering data. I don't like having all the patient information right at my fingertips. I like the organization of the system.
Establish appropriate uses for mobile access and procedures for session termination (time-out) on inactive portable or remote devices.
You are a nursing informatics specialist at Good Samaritan General Hospital. The informatics director has decided to allow mobile devices to utilize the GSGH informatics system. You think this was a great idea because you are now able to monitor systems and security from your iPhone instead of from your office. As a result, you can go out on the floor and talk with staff to find out how the systems are working and develop better fixes more quickly. However, you have noticed that there have been nurses who make changes to their charts once they get home. There are many more people accessing the information offsite than there used to be. You are concerned that some private or confidential information could be compromised. Sure enough, six months after the new remote access was adopted, the informatics director tells you that a man named S.D. who was being treated for a psychiatric condition has been fired because the man's employer, Best Corporate Investigation Solutions, does not want someone with psychiatric problems working closely with clients. Apparently, the head of Best Corporation's wife is a nurse at GSGH and he saw her computer screen, which she left while updating S.D.'s chart at home. How could GSGH avoid this situation in the future while maintaining its commitment to greater flexibility of access? Fire the nurse for her negligent act. Abandon the program of allowing mobile or offsite access to the system. Tell the staff not to chart or edit documentation from home. Establish appropriate uses for mobile access and procedures for session termination (time-out) on inactive portable or remote devices.
The idea of remotely treating and caring for patients through technology is more than 100 years old.
You are a nursing informatics specialist at Good Samaritan General Hospital. You have been chosen to present at a conference on telehealth because GSGH is progressive in its use of telehealth. During the first session at the conference, a participant stands up and asks if telehealth is an outgrowth of only the last 25 years, since the Digital Revolution. You know this is false. Which of the following statements should you use to explain the evolution of telehealth? The Digital Revolution didn't really begin until 2001. The idea of remotely treating and caring for patients through technology is more than 100 years old. The participant is correct—telehealth is an outgrowth of only the last 25 years, since the Digital Revolution. Digitalization had nothing to do with the proliferation of telehealth during the last 25 years.
-The American Recovery and Reinvestment Act of 2009 requires institutions to meet certain standards of electronic record adoption by 2014.
You are a nursing informatics specialist at Good Samaritan General Hospital. You have been recently hired because GSGH has been classified by the Healthcare Information and Management Systems Society (HIMSS) at Stage 0 of its EMR development. The hospital's longtime CEO decides he wants to kick-start the hospital's conversion to electronic records. GSGH has arranged for you to give a presentation to the board about the origins, development, and future of EHRs and EMRs. You are not given much time to present the information, so you have to clarify the EHR's development into the most succinct description possible. Which part of the EHR timeline must you include if you are to give a full assessment of its development? -The American Recovery and Reinvestment Act of 2009 requires institutions to meet certain standards of electronic record adoption by 2014. -The development of EHRs can be traced back to a report from 2000. -The first electronic medical records were created by the government, not by individual institutions. -Take your time developing your electronic records conversion. Time doesn't matter.
It created a national policy framework for the development of a national informatics system.
You are a staff nurse and a member of the informatics committee at Good Samaritan General Hospital. The GSGH director of informatics has asked you to briefly outline the impact of the American Recovery and Reinvestment Act on informatics for your unit. Which of the following aspects of ARRA that impacts informatics is the focus of your report? It created financial incentives for e-prescribing, cementing e-prescribing as the prescription method of the future. It provided the legal and ethical framework for the exchange of electronic health care information. It gave e-signatures the same weight of law as handwritten signatures. It created a national policy framework for the development of a national informatics system.
Work with staff and colleagues to determine where telehealth systems would make the most sense to develop immediately and where they would need more time to develop.
You are a staff nurse at Good Samaritan General Hospital and chair the facility's nursing quality council. The hospital's new CEO has decided to radically update the telehealth capability at GSGH. He has asked you to work closely with the informatics director to implement more telehealth solutions throughout the system. Since GSGH does not currently use telehealth, you have a clean slate to implement telehealth where it makes most sense. The CEO has given you the green light to implement any and all systems you deem appropriate for GSGH. How should you and the informatics director approach the implementation of these systems? Look at a catalog from a telehealth systems company and adopt all its solutions throughout GSGH. Work with staff and colleagues to determine where telehealth systems would make the most sense to develop immediately and where they would need more time to develop. Buy a wireless router so your staff can access the Internet remotely. Ask the CEO where he wants to put telehealth solutions, then adopt those solutions without staff or colleague input.
You instituted a new system that forces providers to compare the medication with the medication that was ordered for the patient and effectively resolve any discrepancies.
You are a staff nurse at Good Samaritan General Hospital, and you sit on the hospital's quality committee. GSGH is preparing for the next Joint Commission visit. When The Joint Commission last came to GSGH six months ago, the visitors had several concerns, including the informatics system's failure to effectively manage medications. GSGH has since instituted a new system to resolve medication discrepancies. You are confident that this time The Joint Commission will not find fault with GSGH's informatics system. Why is this? You instituted a new system that forces providers to compare the medication with the medication that was ordered for the patient and effectively resolve any discrepancies. The Joint Commission does not voice the same concerns twice. GSGH hired a new informatics director. GSGH instituted a new procedure to deal with power outages.
Allowing mobile devices to access the informatics system could increase the potential for HIPAA violations.
You are a staff nurse at Good Samaritan General Hospital. The hospital's administration is seeking staff input about allowing staff and physicians to utilize the hospital's informatics system using mobile storage and communications devices. The system is currently only available through workstations at nursing stations and in the patients' rooms. Administration asks you for any concerns you may have. What is the concern you must raise prior to implementing any remote access? The system may need to be compatible with iPhones. Accessing the informatics system through mobile devices poses very little risk. Allowing mobile devices to access the informatics system could increase the potential for HIPAA violations. Because mobile devices are always changing, updates will be needed so frequently that allowing them to access the system is not worth the time and effort.
a registration system
You are a staff nurse on the Quality Committee at Good Samaritan General Hospital. You have long wondered why the medical error rate at GSGH is alarmingly high. Despite the fact that a state-of-the-art informatics system for documentation, labs, and pharmacy is in place, GSGH continues to have trouble administering the correct medication to its patients. Upon closer examination, you discover that the information entered at the bedside by the nurses and the other providers is correct. The issue is that the patients are incorrectly identified upon their initial intake at GSGH, which is initially done by hand and later copied into the informatics system by nurses on the units. What solution would you recommend to your director of informatics institute to minimize these errors? a registration system a contractual system a decision support system a financial system
the administrative, physical, and technical safeguards within the informatics system
You are a staff nurse on the informatics committee at Good Samaritan General Hospital. The committee has been charged with ensuring that the hospital's new informatics system complies with the security standards required under HIPAA. What portions of the system should the committee examine? the administrative, physical, and technical safeguards within the informatics system the ergonomics of the workstations the age and condition of the hardware at workstations the speed of the system processors
GSGH should consider whether ancillary hospital departments and outside providers will be able to access the patient data obtained and recorded on the nursing unit.
You are a staff nurse on the psychiatry unit at Good Samaritan General Hospital. GSGH has adopted a new EMR/EHR system, and you will be a superuser. You are frequently involved in new unit initiatives and often help train staff. As a superuser, you will be helping train the staff on your unit. Prior to implementation, the unit manager, Jenny Basil, has asked for your input about the system's implementation. She wants to know what you feel GSGH must consider prior to the system's implementation. Which of the following considerations should you tell Jenny you want GSGH to address prior to the implementation of this EMR/EHR system? GSGH should consider whether ancillary hospital departments and outside providers will be able to access the patient data obtained and recorded on the nursing unit. You provide no input. Jenny is the unit manager and knows what is best. You're sure she has thought of everything. GSGH should consider whether the staff members will still be able to use the paper system if they want. GSGH should consider whether the system is from the same vendor that provides the unit's patient care supplies.
heath information system
a group of systems used within a hospital or enterprise that support and enhance healthcare. The HIS comprises two major types of information systems: clinical information systems and administrative information systems
Health information system
a group of systems used within a hospital that support and enhance healthcare
It would track the locations of the reports and synthesize the data you collected about the incidents.
You are an ER nurse in a quiet suburban community that hasn't had many public health crises during your 10-year career. It is Christmas, and you have been asked to be on duty during the holiday. All other staff members are out on holiday. At 10:00 a.m., you receive a phone call from a family with symptoms of hemorrhagic fever. Within minutes, you receive another call from another family across town that has similar symptoms. Within an hour, you have five reports of families or individuals with symptoms of hemorrhagic fever throughout town. How would your hospital's informatics system help you cope with these reports and begin problem solving? It would track the locations of the reports and synthesize the data you collected about the incidents. It would automatically contact and conduct detailed interviews and full assessments of the victims. It would allow you to contact each patient and determine how well he or she is doing. It would contact other employees to come in to the hospital and help.
cConduct a needs assessment of the hospital and then institute a clear, realistic timeline to adopt and implement a system based on that assessment.
You are an informatics nurse at Nation's General Hospital, a 1,000-bed facility in a major city. NGH has been an early adopter of informatics tools, having created a fully integrated computer system that links each patient's electronic health record with every necessary system at the hospital. In addition, the hospital's systems have been interoperable for five years. The hospital has an opportunity to leverage its successful adoption of informatics systems into an additional revenue stream. NGH has agreed to help Rural Community Health Center, a 250-bed hospital located 50 miles east of NGH, to develop a fully functional informatics system. Rural has a pure paper-based system—the same system it has had in place since its founding in 1952. NGH has sent you to help Rural become EHR compliant in time to meet the mandate. What is the most important thing to tell Rural about developing and acquiring a new informatics system? Advise Rural to choose a system as quickly as it can to ensure it meets the mandate. Assure Rural that the government will give extensions on the mandate to small community hospitals. Conduct a needs assessment of the hospital and then institute a clear, realistic timeline to adopt and implement a system based on that assessment. Offer to give Rural access to NGH's system so it can quickly adopt it.
Identify the scale for the project so you can adopt the system that best fulfills that scale.
You are staff nurse and are working with the nursing informatics director at Good Samaritan General Hospital to develop a new, nursing-friendly informatics system for bedside documentation. This project is in response to what most staff at GSGH know about the antiquated documentation systems in the GSGH's region. These documentation systems allow nurses to document at only two workstations on a unit, which means they have to document twice: once on paper at the bedside and again and by retyping the information into a workstation when one is available. What is the first step you should take in approaching creation of an informatics solution for GSGH nurses? Identify the scale for the project so you can adopt the system that best fulfills that scale. Find the best solution for the informatics problem described. Hold training sessions so the staff will be more likely to adopt your solution. Re-examine the solution to ensure it will work well over time.
a pharmacy dispensing system
You are the director of nursing informatics at Good Samaritan General Hospital. You were recently hired to update GSGH's informatics technology. The hospital currently uses one informatics system for all its functions, none of which the system handles particularly well. The system was constructed by a computer-literate physician who developed it on his own. Providers and patients are frustrated with the system, and the hospital CEO has asked you to apply your expertise to this problem. Complicating matters is the fact that the GSGH's medication error rate is the highest in the state by a wide margin. Which of the following clinical information systems should you implement first to address the GSGH's immediate concern? a long-term health information system an improved monitoring system an ambulatory care system a pharmacy dispensing system
Accreditation Commission for Health Care
You are the informatics director of a small community hospital in rural Wyoming. In your role, you work closely with other administrators. The facility's budget does not permit much flexibility to pay for accreditation. However, the hospital needs to be accredited to receive reimbursement payments for services. The Joint Commission will be too expensive for the facility. What is your best option for accreditation? Accreditation Commission for Health Care Commission on Accreditation of Healthcare Management Education Community Health Accreditation Program Accreditation Program of America
I like the old system better because I was used to it.
You are the nursing informatics director at Good Samaritan General Hospital. Good Samaritan has just adopted a new, smart technology documentation system. It enables nurses and other providers to document a patient's vital signs and other tasks right at the bedside. It also enables patients to play video games, watch TV, and check email. Good Samaritan's nurses now have much more time to provide patient care, and the system has had no glitches since its introduction. After three months of using the new system, you send out a staff questionnaire to gather their thoughts about new system. What is the chief complaint you would expect about the new system? I am bored now that I have more free time. I like the old system better because I was used to it. I don't like knowing what my tasks are for each patient. I wish I could spend hours in front of a computer screen entering data again.
Nursing information systems
______ assist nurses in providing high-quality patient care by giving them access to pertinent patient care information and providing the opportunity to document patient assessments, care provided, procedures performed, and medications given. Data can be collected and stored electronically and is available to other members of the multidisciplinary team.
Knowledge management
______ seeks to improve the quality of care an organization provides through knowledge and educational information storage.
Information management
______ seeks to provide safe patient care through managing patient-related information to ensure that it contains the latest data, is correct, and is readily available to providers.
Systematic review
___________ ____________ combine reviews from multiple primary investigations in order to obtain consensus on a specific area of research
data
a collection of numbers, characters, or facts that are gathered according to some perceived need for analysis
personal health record (PHR)
a private, secure application through which an individual may access, manage and share his or her health information. The PHR can include information that is entered by the consumer and/or data from other sources such as pharmacies, labs, and health care providers. The PHR may or may not include information from the electronic health record (EHR) that is maintained by the health care provider and is not synonymous with the EHR. PHR sponsors include vendors who may or may not charge a fee, health care organizations such as hospitals, health insurance companies, or employers.
Which function is performed within an electronic health record system? a. Bar scanning medications and patients b. Verifying the accuracy of laboratory data c. Determining availability of generic drug substitutes d. Automating prescriptions based on patient profiles
a. Bar scanning medications and patients
Which national trend is related to nursing informatics? a. Barcode scanning for medication administration b. Blogging with other nurses about latest treatments c. Texting another nurse in a patient's room to come help d. Taking pictures with smartphones of patients' wounds
a. Barcode scanning for medication administration
Uses information systems to manage patients a. Beginning Nurse b. Experienced Nurse c. Informatics Innovator d. Informatics Nurse Specialist
a. Beginning Nurse
How does meaningful use of electronic health records (EHR) relate to quality patient care? *Choose 2 answers* a. Computerization of prescriber order entry (CPOE) b. Decreasing the storage of medical files c. Maintenance of active patient medication lists d. Fosters segregation of care
a. Computerization of prescriber order entry (CPOE) c. Maintenance of active patient medication lists
What are some benefits of using an electronic health record (EHR) system in an ambulatory care clinic? *Choose 4 answers* a. Decrease medication errors b. Increase clinic reimbursement c. Improve provider documentation d. Increase delivery of guideline based care e. Less complicated patient treatment regimens
a. Decrease medication errors b. Increase clinic reimbursement c. Improve provider documentation d. Increase delivery of guideline based care
Which example is a telehealth non-clinical application? a. Distant patient education via computer b. Monitoring maternal contractions remotely c. Utilizing live video feed for remote assessment d. Transmitting a radiology image for assessment
a. Distant patient education via computer
How is information related to data? a. Information is data that have been interpreted b. Information forms the base for accurate data collection c. Data provide an explanation of information d. Data is constructed through information synthesis
a. Information is data that have been interpreted
A nurse documents care of a patient with a decubitus ulcer in the electronic health record. Which term describes the electronic health record in this situation? a. Information system b. Information science c. Information technology d. Information processing
a. Information system
In regards to a secure network, what gives employees confidence that the information they are reading is true? a. Integrity b. Availability c. Accessibility d. Confidentiality
a. Integrity
An admission nurse is awaiting notification of whether a patient being monitored by telehealth will be admitted to the hospital. The physician has already documented the admission orders in the digital medical record. Due to miscommunication, the admitting nurse did not access the digital medical record. There was a significant delay in the patient's admission, which led to decreased patient satisfaction with the admission process. How can the use of the digital health record improve this process? *Choose 2 answers* a. It prevents the delay of tests and services. b. It allows for easy access to patient information. c. Information is recorded and stored in brief episodes. d. The nurse no longer needs to obtain an admission order.
a. It prevents the delay of tests and services. b. It allows for easy access to patient information.
Which informatics tools are commonly used for collecting and analyzing patient data? *Choose 2 answers* a. PDAs b. YouTube c. Nursing textbooks d. Bedside computers
a. PDAs d. Bedside computers
A nurse is administering a new medication to a patient who has never taken this medication in the past. The patient is already taking seven different medications at this time. Which nursing intervention should the nurse do before administering this medication? a. Review the drug-to-drug, drug-allergy check in electronic health record b. Assess the patient's own knowledge about the medication c. Go over common side effects about this medication with the patient d. Notify the pharmacist that the patient has not had this medication in the past
a. Review the drug-to-drug, drug-allergy check in electronic health record
How does information literacy support the use of evidence-based-practice (EBP) in nursing? Choose 2 answers a. The nurse can discern research findings that can be applied to practice b. Nurses consistently role-model this behavior in their practice environment c. Nurses are comfortable in performing data base searches d. Nurses must frequently consult resources including peers and general internet searches
a. The nurse can discern research findings that can be applied to practice d. Nurses must frequently consult resources including peers and general internet searches
What are two common characteristics of telehealth? *Choose 2 answers* a. The use of video streaming technology b. Hands-on assessments performed remotely c. The need for specialized computer knowledge d. Transmission of biological data from a remote location
a. The use of video streaming technology d. Transmission of biological data from a remote location
What are common personal data access security threats in healthcare? *Choose 2 answers* a. Unencrypted data b. Weak passwords c. Digital charting template d. Electronic physician orders
a. Unencrypted data b. Weak passwords
A nurse manager views patient data collected over the last three months of hospital admissions. Trends show that nosocomial infections have increased on the geriatric unit. Which actions can patient data facilitate quality improvement in the future? *Choose 2 answers* a. Using the data to implement evidence-based practice procedures b. Using the data to remove hand sanitizers in low risk patient rooms c. Using the data to monitor infection trends d. Using the data to increase stock of gowns and masks for other hospital units
a. Using the data to implement evidence-based practice procedures c. Using the data to monitor infection trends
What are the essential components of an electronic health record? Choose 3 answers a. Vital signs b. Lab results c. Demographics d. Name of workplace e. Cost of procedures f. Expected discharge date
a. Vital signs b. Lab results c. Demographics
Which healthcare information system is depicted? *Clinical documentation system* a. clinical information systems b. administrative information systems
a. clinical information systems
Which healthcare information system is depicted? *Radiology information system* a. clinical information systems b. administrative information systems
a. clinical information systems
Determine if the mechanism is *physical* or *logical* security measures for protecting electronic information. *Placing computers, servers and routers in restricted* a. physical b. logical
a. physical
Determine if the mechanism is *physical* or *logical* security measures for protecting electronic information. *Setting up surveillance* a. physical b. logical
a. physical
What is the most effective and appropriate telecommunication strategy for the situation listed. A family member is unsure what to do for a home hospice patient who is restless and agitated during the night. a. real-time remote monitoring b. online classroom c. teleconsultants d. telephony
a. real-time remote monitoring
What is the most effective and appropriate telecommunication strategy for the situation listed. An elderly homebound patient is concerned about the palpitations she is feeling. a. real-time remote monitoring b. online classroom c. teleconsultants d. telephony
a. real-time remote monitoring
Technical Interoperability
ability to exchange data from one point to another
the development of standardized terminologies in nursing informatics is driven by the following principles:
accessibility ubiquity longevity and reusability
health informatio system
administrative information side and critical info
health information system
administrative information side and critical info
a registration system is also commonly referred to as which of the following
admission discharge transfer ADT system
user interface
allows humans and technologies to cooperatively perform tasks with specific goals. User interface actions are often displayed as data or information, sound, or other observable or detectable elements related to specific characteristics of embedded software and respective hardware. For instance, a provider requests data about a patient's previous encounter. The result, an interface action, is intimately related to the applications software and hardware characteristics such as the elegance of the program, the complexity of the system, and speed of system and network.
requirements for interface engine management
an analyst who can identify initial and ongoing interface specifications, coordinate any changes that will impact interfaces, maintain a database for translation tables, and ascertain that data integrity is intact for all data to be sent through the interface engine.
A nurse is working on a medical surgical unit and is concerned over a patient's worsening heart failure. The nurse calls the provider to discuss the assessments. How does the electronic medical record facilitate a collaborative discussion in this situation? Choose 2 answers a. The provider can enter new orders remotely. b. The provider can visualize the chest x-ray remotely. c. The provider has access to the data being discussed. d. The primary care past medical record can be reviewed.
b. The provider can visualize the chest x-ray remotely. c. The provider has access to the data being discussed.
How can clinical decision support tools lead to safer patient care? *Choose 2 answers* a. They provide more human resources to assist with patient care. b. They give timely information to nurses and other healthcare providers. c. They give nurses access to information they would not normally have. d. They reduce waste of nurse's time looking through the medical record.
b. They give timely information to nurses and other healthcare providers. d. They reduce waste of nurse's time looking through the medical record.
Which healthcare information system is depicted? *Admission, discharge, and transfer system* a. clinical information systems b. administrative information systems
b. administrative information systems
Which healthcare information system is depicted? *Financial system* a. clinical information systems b. administrative information systems
b. administrative information systems
Which healthcare information system is depicted? *Scheduling system* a. clinical information systems b. administrative information systems
b. administrative information systems
Determine if the mechanism is *physical* or *logical* security measures for protecting electronic information. *Authentication* a. physical b. logical
b. logical
Determine if the mechanism is *physical* or *logical* security measures for protecting electronic information. *Automatic sign-off* a. physical b. logical
b. logical
Determine if the mechanism is *physical* or *logical* security measures for protecting electronic information. *Installing a firewall* a. physical b. logical
b. logical
What is the most effective and appropriate telecommunication strategy for the situation listed. A nurse is struggling to work full-time in a hospital setting time while completing her Masters. a. real-time remote monitoring b. online classroom c. teleconsultants d. telephony
b. online classroom
what is the function of EHR?
barcode medication administraction
what is the function of EHR?
barcode medication administration
Which 2 items could the RN use to access a pts medications from a med administration system such as a pyxis?
barcoded ID card employee badge finger print (biometrics)
which 2 items could the RN use to access a pts medications from a med administration system such as a pyxis?
barcoded ID card employee badge finger print (biometrics)
Foundation of Knowledge Model
basis for which knowledge is used to meet the needs of healthcare deliver system. derived from 3 key elements of KNOWLEDGE AQUISITION KNOWLEDGE PROCESSING KNOWLEDGE DISSEMINATION
Foundation of Knowledge Model
basis for which knowledge is used to meet the needs of healthcare delivery system. derived from 3 key elements of **KNOWLEDGE AQUISITION **KNOWLEDGE PROCESSING **KNOWLEDGE DISSEMINATION
What is NOT a national trend related to nursing informatics?
blogging as a means to give report
how can using simulation technology with your pts improve overall outcomes?
by allowing them hands on practice and immediate feedback of the skill being learned.
What is a prominent socioeconomic factor driving telehealth medicine? a. An aging urban population b. Advanced computer technologies c. An increase in chronic disease conditions d. An increase in rural access to healthcare
c. An increase in chronic disease conditions
A a student is behind on morning medication administration. The instructor is pressuring the student to pass quickly without any errors. One of the clients assigned to the student's care asks for pain medication. Which nursing intervention is questionable? a. Call the charge nurse for assistance b. Double check dose of pain medication with another nurse c. Computer scan the meds and come back later to administer them d. Use a PDA to look up rate of infusion for intravenous pain medication
c. Computer scan the meds and come back later to administer them
Which of the following uses database applications to sift through large amounts of data and looks for previously hidden trends? a. Evidence-Based Practice b. Quantitative Analysis c. Data Mining d. Digital Library
c. Data Mining
A patient is in the ICU after a motorcycle accident. The patient sustained multiple contusions and fractures. Various digital monitoring devices are being used to track the patient's vital signs, pulse oximetry, and cardiac rhythm. How can the appropriate use of these technologies impact this patient's outcome? *Choose 2 answers* a. Prevention of infection b. Improved wound healing c. Decreased recovery time d. Timely treatment of potential complications
c. Decreased recovery time d. Timely treatment of potential complications
what challenge might an organization face when trying to implement a health information system throughout their various specialty clinics?
identifying the different data needed for each specialty practice
A nurse uses an internet blog to give a patient shift report to a nurse coming on to the next shift. Why is this nursing action a problem? *Choose 2 answers* a. Blog information is not always reliable b. The blog is a private place to give nursing reports c. Giving a nursing report via a blog does not meet HIPAA requirements d. Healthcare information discussed on the blog violates a patient's privacy
c. Giving a nursing report via a blog does not meet HIPAA requirements d. Healthcare information discussed on the blog violates a patient's privacy
Which standardized nursing terminology is composed of nursing diagnoses, nursing actions, and nursing outcomes? a. NIC b. NOC c. ICNP d. NANDA
c. ICNP international classification for nuring practice
A local medical clinic is attempting to develop an electronic health record (EHR) system. Which challenges should the organization anticipate? *Choose 2 answers* a. Ensuring Internet access when documenting in the EHR b. Preparing for increased utilization of patient care services c. Identifying data needs for differing nursing practice specialties d. Implementing standardization of documentation across physician offices
c. Identifying data needs for differing nursing practice specialties d. Implementing standardization of documentation across physician offices
Generates informatics theory a. Beginning Nurse b. Experienced Nurse c. Informatics Innovator d. Informatics Nurse Specialist
c. Informatics Innovator
Which procedures are essential to creating and maintaining a culture of safety during the medication administration cycle? *Choose 2 answers* a. Pulling all medications from the dispensing cabinet for your assigned patients at one time b. Situational awareness c. Performing double verification among nurses when administering high alert medications d. Barcode scanning the patient and the medication to ensure positive patient ID
c. Performing double verification among nurses when administering high alert medications d. Barcode scanning the patient and the medication to ensure positive patient ID
A nurse learns that a colleague has accessed electronically stored health information of a patient that the colleague is not involved in treating. What should the nurse do? a. Disregard the incident b. Confront the colleague c. Report the colleague to their employer d. Report the incident to a hospital security guard
c. Report the colleague to their employer
What is a principle provision of the Health Information Technology for Economic and Clinical Health (HITECH) Act? a. To secure patient confidentiality and security of patient records b. To create a universal single-payer healthcare system in the United States c. To improve healthcare quality by enhancing coordination of services among providers d. To decrease the number of uninsured Americans and reducing the overall costs of healthcare
c. To improve healthcare quality by enhancing coordination of services among providers
A nurse is reviewing a patient's pneumonia vaccination status in the electronic medical record. The nurse determines the patient needs this vaccine before discharge to meet the requirements of a current clinical pathway. Why would the nurse use information systems in this manner? a. To ensure cost effectiveness b. To control communicable disease c. To promote desired clinical outcomes d. To meet requirements of the nurse practice act
c. To promote desired clinical outcomes
A nurse receives a computerized alert of a critical lab value on her patient. This computerized alert informs the nurse that an action needs to be taken and provides suggestions for clinical intervention. Which technology did the nurse employ to achieve an enhanced safe practice environment? a. Use of clinical guidelines b. Use of a clinical information system c. Use of a clinical decision support tool d. Use of a clinical documentation system
c. Use of a clinical decision support tool
Which type of technology offers support during the medication administration cycle? a. Online chats during nursing conference sessions b. Virtual reality exercise involving anchoring a urinary catheter c. Viewing of the digital health record during a home health visit d. Watching a webcast regarding pathophysiology of renal failure
c. Viewing of the digital health record during a home health visit
What is the most effective and appropriate telecommunication strategy for the situation listed. A cardiologist with a rural office practice has no one to cover his patients when he is away. a. real-time remote monitoring b. online classroom c. teleconsultants d. telephony
c. teleconsultants
TIGER Initiative (Technology Informatics Guiding Education Reform)
called for the redesign of nursing education to keep up with rapid changes in technology, active participation by nurses in the design of informatics tools, and increased visibility by nurses in the national health IT agenda. It organized teams to work toward the common goals; obtained additional funding; developed work plans and outcomes for each team; and identified informatics competencies for all levels of nursing personnel, including nursing assistants.
clinical practice guidelines
can access to see how to do a procedure, treat a condition, clinical decision support by helping guide better care of a pt
clinical prative guidelines;
can access to see how to do a procedure, treat a condition, clinical decision support by helping guide better care of a pt
clinical practice guidelines
can allow for creation of nursing policies, they are also ex of clinical decision support tool.
which is NOT an example of an administrative information sytem?
clinical documentation system
clinical decision support
clinicians with knowledge or specific information that is intelligently filtered, or presented at appropriate times, to enhance health and healthcare ools may include clinical practice guidelines, alerts and reminders, order sets, patient data reports and dashboards, diagnostic support, workflow tools, and financial applications. CDS is effective in all phases of the clinical process. CPOE with CDS has been shown to decrease medication errors by as much as 80%
why is it important that departments collaborate with on another when selecting information system?
collaboration leads to knowledge sharing
why is it important that departments collaborate with one another when selecting an information system?
collaboration leads to knowledge sharing
network
combines hardware and software to connect multiple computers in different locations
Local Area Network (LAN)
connects few computers printers or other peripherals that can be operated over large geographical areas. files are stores in a computer or server for one to access remotely even if the internet is unstable you can still have access to the EHR
perioperative nursing data set
contains nursing diagnoses, interventions, & outcomes specific to perioperative experiences.
which term is best applied when describing the lift cycle of an information system?
continuous
which is NOT an essential component of EHR?
cost of procedures
benefits for organizations using standardized vocabs
cost savings, decision-support rules, outcomes measurement, and the ability to use the data for data mining
The intent of HIPAA was to
curtail healthcare fraud and abuse and enforce standards for health information guarantee the security and privacy of health information assure health insurance portability for employed persons
During a crisis, a nurse manager is looking for the written, hospital-wide procedural policy. The nurse is unable to locate it. What can the nurse manager use to solve this issue? a. Change agents b. Nursing process c. Point of care charting d. Decision support tools
d. Decision support tools
Focuses on nursing's information needs a. Beginning Nurse b. Experienced Nurse c. Informatics Innovator d. Informatics Nurse Specialist
d. Informatics Nurse Specialist
information science?
this is the focus on how to gather, process and transform information into knowledge. Incorporates features from 5 other sciences: - communication science -computer science -social science -library science cognitive science
Which statement represents one of the principle provisions of the Health Information Portability and Accountability Act (HIPAA) related to information security? a. A nurse may share information about a high profile patient with another nurse. b. A patient electronic health record can be sent to another hospital without consent. c. Patients are not allowed to obtain a complete copy of their own electronic health records. d. Nurses should notify a supervisor immediately when observing a breach of patient confidentiality.
d. Nurses should notify a supervisor immediately when observing a breach of patient confidentiality.
What is a function of a clinical decision support tool? a. Intersecting of computer, information, and nursing science b. Educating by research generated evidence of best practices c. Creating new understandings generated in research into practice d. Providing clinicians with knowledge and person-specific information
d. Providing clinicians with knowledge and person-specific information
Which health information system is used to collect and store client identification and demographic data that are verified and updated at the time of each visit? a. Scheduling system b. Risk Management system c. Expert system d. Registration system
d. Registration system
What is an important legal consideration in the use of telehealth nursing? a. The nurse is aware of computer software programming. b. The nurse has the data available to monitor the patient for changes. c. The nurse is competent in aspects of technical support of the program. d. The nurse is licensed in each state in which the remote clients are located.
d. The nurse is licensed in each state in which the remote clients are located.
A computer program was implemented at a hospital that required nurses to wait until the patient arrived in the emergency room and was registered into the program before orders for critical time-sensitive treatment could be written. How could this program become a barrier to the nurses attempting to deliver patient-centered care? a. The computer program could intimidate the nurses and cause them to shy away from the patients. b. The time spent waiting for the program to register the patient could allow the nurses to restock patient rooms. c. The computer program could interest the nurses more than the patients do, thus entertaining the nurses away from their focus on the patient. d. The time spent waiting for the program to register the patient could delay critical care being delivered in a timely manner.
d. The time spent waiting for the program to register the patient could delay critical care being delivered in a timely manner.
What is the importance of a nurse's active participation in electronic patient information? a. To identify the roles and titles of nurses across the continuum of care b. To anticipate the educational and professional needs of nurses and staff c. To provide replicate information across the system for the healthcare team d. To ensure patient information will be current and accessible to the healthcare team
d. To ensure patient information will be current and accessible to the healthcare team
information
data that has been interpreted
what is information?
data that has been interpreted
information
data that have been interpreted
strategic planning process
define the corporate vision and mission specify achievable goals and objectives et policy guidelines determine products, services, and markets
Project scope
defines the size and details of a collaborative effort
Project scope?
defines the size and details of a collaborative effort
project scope
defines the size and details of an effort
which is NOT an example of a health information system?
departmental system
financial systems
designed to manage the expenses and revenue of providing healthcare, report and track fiscal outcomes as they relate to organizational goals, and help to determine the organization's strategic direction
beginner level nurse
developing and using skills that rely upon the ability to retrieve and enter data in an electronic format that is relevant to patient care, the analysis and interpretation of information as part of planning care, the use of informatics applications designed for nursing practice, and the implementation of policies relevant to information basic understanding of informatics systems and be able to use them effectively
informatics nursing standards (ANA)
differentiated practice (focuses on data, info, knowledge) targets areas for research represented by organizational groups (AMIA and IMIA) formal education (graduate programs in NI) credentialed by exam and special criteria
The meaningful use of an EHR includes
efficiency safety coordination.
benefits of expanding usability in technology
improvements in patient safety, the number of errors, data entry, information displays, and information interpretation, and contribute to sound decision making decreases in the time to complete tasks, user disruptions, training time, software rewrites, burden on support staff, and user frustration allows for informatics to ID issues with technology usability methods address why users are having those problems
nurse benefit for standardized terminology
enhanced efficiency, accuracy, and effectiveness, resulting in a significant improvement in patient care
benefits of standardized terminologies
ensures compliance with standards coming forth for Meaningful Use, quality measures, and interoperability Terminology facilitates the monitoring of trends and problems of the health of populations, developing clinical decision support, and expanding our knowledge of diseases and treatments and outcomes through research and clinical data mining.
process interoperability
ensures that the processes that coordinate the work are working together.
which ONE example is an essential component of the EHR?
evidenced based decision support
_________ nurses know how to pull trends out of data
experienced
Data
facts and statistics collected together for reference or analysis. Once you take data, analyze and interpret it becomes information. *Examples* --Pts height --weight --codestatus --DOB
The majority of radiologists use film to examine and interpret results from tests. True/ False
false
True/ False Nursing informatics can only be used to support learning in the academic setting.
false
True/ False The Institute of Medicine (IOM), which sets the goals for undergraduate and graduate nursing education, has included informatics in its core learning modules.
false
international classification of diseases
focuses more on billing codes
nursing intervention classification NIC
focuses on intervention terminologies specific to different types of nursing interventions.
Nursing OUTcomes classification NOC
focuses on nursing outcomes
Tailored
focuses specifically on individuals based on their specific conditions, typically gleaned from EHRs or PHRs
needs assessment phase:
gap analysis, determine needs/wants in an information system
Targeted
geared toward people who are a subset of the general population, such as having men undergo routine prostate exams after age 40
Personalized
gives information about specific conditions the consumer has been diagnosed with such as how to treat type 2 diabetes
information science
this is the focus on how to gather, process and transform information into knowledge. Incorporates features from 5 other sciences: - communication science - computer science - social science - library science - cognitive science
system implementation phase
go live planning. training staff. analyst starts building screens and templates according to organization and its policies
information security
greatest risks to data security are authorized personnel getting access to the equipment and removable storage devices
information security
greatest risks to data security are authroized personnel getting access to the equipment and removable storage devices
health information systems
group of systems and the goal is to enhance healthcare organization
Experienced level nurse
has the expertise to serve as a content expert in system design, to see relationships among data elements, to execute judgments based on observed data patterns, to safeguard access to quality of information, and to participate in efforts to improve information management and communication
Bioinformatics tools
help biomedical informaticists and healthcare personnel tackle the analysis of large data sets
ergonomics
human performance as it relates to the physical characteristics of tools, systems, and machines ex nurses complaining that a workstation on wheels is too bulky, heavy, and not convenient to take into a patient room
how is info related to data
info is data interpreted
logical protecting pt infomration
installing firewall protection use of biometrics(fingerprints/scanning eye) authentication(password) automatic sign off.
logical protecting pt information
installing firewall protection use of biometrics(fingerprints/scanning eye) authentication(password) automatic sign off.
Request for Quote (RFQ)
instead of FRI,, a statement of need that focuses upon pricing, service levels, and contract terms
human factors
interactions between humans and tools of all kind ex evaluation of how work is performed within the layout of a hospital room in an intensive care uni
The Computer-Based Patient Record Institute (CPRI)
is a group of private interests seeking to promote EHR development.
Scheduling systems
these link with other systems in the institution to provide a seamless handoff of information.
Standardized terminology
is essential for successful development and implementation of an EHR. Terminology is required to represent, communicate, exchange, manage, and report data, information, and knowledge. It enables safe, patient-centric, high-quality healthcare that optimizes data collection for the measurement of patient outcomes. EHRs can no longer be developed or implemented without standardized terminologies
informatics nurse specialist
is the innovator who sees the broad vision of what is possible and how it may be attained educational preparation for the INS that enables him or her to conduct informatics research and generate informatics theory. This preparation and expertise makes the INS well suited to work in a variety of areas and functional roles including project management and administration.
clinical information systems are effective for all of the following reasons except:
it replaces the need for unit training
experienced nurses
know how to pull pull trends out of data
Experienced nurse
know how to pull trends out of data
knowledge management
knowledge management enables a more robust, system-wide accumulation of knowledge and information for the health care system.
clinical system
lab, pharmacy, clinical documentation EHR
strategic planning
led me upper management + CEO+ CSO (oversee plan) and CIO (manage and see the goal of IT in meeting goals)
what is NOT an emerging trend in healthcare?
less consumer accountability
financial systems are designed to do what?
manage the expenses and revenue of providing healthcare, report and track fiscal outcomes as they relate to organizational goals and help to determine the organizations strategic direction
why are standardized terminologies important to nursing?
they improve communication among interdisciplinary teams
remote clinical monitoring
monitoring glucose levels, weight, general well-being, and cardiac rhythms, to checking pace maker function, to determining whether the refrigerator was opened
ARRA American Recovery and Reinvestment Act
necessitated that healthcare providers comply with mandated reporting requirements that were structured to provide information deemed critical to improve the overall quality of care. Compliance with reporting requirements were tied to the adoption and use of EHR systems certified as capable of collecting and sharing the specified data. Financial incentives were designated for providers that met mandatory reporting requirements. Under HIPAA, every person has the right to examine and obtain a copy of protected information. Typically, requested copies have been in paper form. Under ARRA, every person now has the right to have an electronic copy of an EHR and to have a copy directly transmitted to any designated entity
ethical and legal factors of telehealth
need for telehealth nurses to keep extensive documentaion also have to be licensed in every state they practice telehealth
During which phase of the information system life cycle should the "Musts" and "Wants" be determined?
needs assessment
life cycle of implementing HIT
needs assessment: ID the gap between an organization's current state and the overall needs of the organization with consideration to the strategic plan system selection implementation the implementation stage should involve the formation of an implementation committee, including a project leader first task of the committee is to develop a timeline for the installation of the new system WBS maintenance
How does information literacy support EBP in nursing
nurse can use research and apply/ consult resources, peers and internet
nonclinical applications of telehealth
nurse is doing research with online database. administrative team is holdingmeetin with live video confernec not using pt purposes
knowledge workers
nurses in this type of role are continuous learners, use technology to support and inform nursing practice and generate knowledge as a product
Knowledge works
nurses in this type of role are continuous learners, use technology to support and inform nursing practice and generate knowledge as a product?
Why is it important to secure staff nurses' active participation when implementing a health information system?
nurses knowledge of current pt care workflow may improve implementation decisions.
why is it important to secure staff nurses active participation when implementing a health information system?
nurses knowledge of current pt care workflow may improve implementation decisions.
why is nursing informatics important
nursing informatics, through the use of computers can facilitate and speed information sharing in all practice areas. For this to be most effective, nurses must have a basic understanding of informatics.
HL7 health level 7
this acronym is used to refer a standard of interoperability and the exchange of clinical data
TELE health store and forward technology
pathology reports or radiology images, accesses for care disability,
which nursing terminology contains nursing diagnoses, interventions, outcomes specific perioperative experiences?
perioperative nursing data set
which of the following is NOT a responsibiltity of the project implementation team?
present system design to the managment
Maintenance phase:
problem solving any debugging. files backed up routinely and install any system upgrades. make sure its working as intended
Maintence phase:
problem solving any debugging. files backed up routinely and install any system upgrades. make sure its working as intended
CPOE
process by which physician/provider enter orders electronically into system
what is the primary goal of EHR functionality in contrast to that of a health information system?
promotes pt safety
what is the primary goal of EHR functionality in contrast to that of a health information system?
promotes pt saftey
goals of HC info system security
protection of client confidentiality and information integrity and the timely availability of information when it is needed.
provider nurse benefit for standardized vocabs
provide access to complete and accurate healthcare data. Lack of complete and accurate data is currently a frustration to providers who want to give the best patient care. This frustration occurs when important clinical information for the patient is unavailable at the point of care. These systems will provide access to medical records that will gain better control over healthcare information quickly and when the information is needed most, at the point of care.
comparative effective research
provides evidence on the efficacy, benefits, and harms of treatment options so as to better inform healthcare decisions easier with meaningful use requirements and subsequent data collection
HITECH Act 2009
provides financial incentives for the adoption of EHRs with corresponding Meaningful Use criteria proposed by the Centers for Medicare & Medicaid Services that mandate CPOE use The HITECH Act provided additional funding for informatics education and training. These included: • The establishment of Regional Extension Centers to provide information and assistance to providers striving to become meaningful users of EHRs • Monies for institutions of higher education (or consortia) to support curriculum development in HIT • Efforts to create or expand intense, nondegree Community College programs designed to be completed in 6 months or less • A component of the Health IT Workforce Program designed to rapidly prepare persons to serve in designated HIT professional roles • The establishment and initial administration of a set of health IT competency examinations
interface engine software
provides the ability to transfer information from the sending system to one or many receiving systems and allows users of different information systems to access and exchange information both in real-time and batch processing. Real-time processing occurs immediately, or with only a slight delay, whereas batch processing typically occurs once daily batch processing was very common in the past, current use is primarily limited to transactions that are less time critical, such as processing charges for procedures, supplies, and special equipment
how does the EHR help pts receive quality care when going from one facility to another?
providing continuity of care, interoperability.
a benefit of EHR is that it can provide pt support. what is an example of pt support
pt education material such as reducing sodium intake
a benifit of HER is that it can provie pt support. which is an example of pt support
pt education material such as reducing sodium intake
HIIPA
pts have ownership rights to their health record and have correction rights
the mission
purpose or reason for a organizations existence. fundamental and unique aspirations. who they are. what they do. meaningful measurable criteria.
Mission
purpose or reason for an organization existence
Mission?
purpose or reason for an organization existence
ORDER entry system
this type of health information system ensures the accuracy of physician orders
reference terminology
reference terminology consists of a set of concepts with definitional relationships. A reference terminology is frequently an ontology and can therefore be used to support data aggregation, disaggregation, and retrieval. A reference terminology is necessary to analyze data, develop evidence-based practice, and improve the quality of care. A reference terminology is used to retrieve data across healthcare settings, domains, and specialties, in a standardized manner
administrative systems
registration systems scheduling systems contract management systems financial systems risk management systems decision support systems expert systems
administrative system
registration systems. admission, discharge, transfer, financial and billing, scheduling
project manager
responsible for the success of a project by management planning and enactment of a project
Informatics
science and art of turning data into information
Knowledge Management:
seeks to improve the quality of care an organization provides through knowledge and educational information storage.
Information Management:
seeks to provide safe patient care through managing patient-related information to ensure that it contains the latest data, is correct, and is readily available to providers.
project management
set of practices intended to raise the liklihood a project will succeed
what patient infomation would a nurse NOT retrieve from the HER?
spouses medical history
what patient information would a nurse NOT retrieve from the EHR?
spouses medical history
what potential challenge can occur when implementing an EHR throughout a medical center with various outpt clinics?
standardization of data/different data needs for each outpatient clinic
what potential challenge can occur when implementing an HER throughout a medical center with various outpt clinic?
standardization of data/different data needs for each outpatient clinic
INCP:
standardizing nursing terminology of nursing diagnoses, actions and outcomes
how is effective security achieved
starts with a thorough assessment of assets and risks, as well as necessary resources, a well-crafted security plan and policy, and a supportive organizational culture and structure. Administrative support is essential to this effort. In addition to being secure, systems must still be easily accessible for legitimate users.
data management
storage retrieval exchange cleansing disposal
telehealth
store and forward technology. form of transferring data or images from one location to another. test performed in one area and then transfer results or image to another area to be read or interpreted (chest xray, pathology reports, radiology)
nurse information systems
supports the use and documentation of nursing processes and activities, and provides tools for managing the delivery of nursing care. An effective nursing information system must accomplish two goals: • Support the way that nurses function, allowing them to view data, collect necessary information, provide quality client care, and document the client's condition and the care that was given. • Support and enhance nursing practice through improved access to information and tools such as online literature databases, drug information, and hospital policy and procedure guidelines.
physically protecting pt information
surveillance cameras use of restricted area shredding paper material
which is NOT a phase of the information system life cycle?
system evaluation
characteristics of clinical decision support?
takes your pt specific data or information and analzyes it or compares it againist specific rule and then it provides some type of recommendations. provided prompt, alert, reminider, helping build care plan saying a pt may be septic based on such value.
non clinical
telehealth nurse is doing research with online database. Administrative team is holding meeting with live video conference... not using for patient purposes.
Electronic Medical Record (EMR)
the "legal record created in hospitals and ambulatory environments that is the source of data for the EHR
interoperability
the ability of two entities, whether those are human or machine, to exchange and predictably use data or information while retaining the original meaning of that data
EMR vs EHR
the ability to exchange information outside of a single healthcare delivery system in EHR EHR may be owned by the patient or stakeholder although recent developments favor a more consumer-centric approach EHR provides interactive patient access as well as the ability for the patient to append information EHR relies upon the presence of fully operational EMRs, interoperability, a national health information network
information literacy
the ability to recognize when information is needed as well as the skills to find, evaluate and use needed information effectively
information literacy?
the ability to recongnize when information is needed as well as the skills to find, evaluate and use needed infomration effectively
What is computational biology?
the actual process of analyzing and interpreting data
knowledge management
the creation of systems that enable organizations to tap into the knowledge, experiences, and creativity of their staff to improve their performance a structured process for the generation, storage, distribution, and application of both tacit knowledge (personal experience) and explicit knowledge (evidence) in organizations
strategic planning?
the development of a comprehensive long range plan for guiding the activites and operations of an organization
strategic planning
the development of a comprehensive long range plan for guiding the activities and operations of an organization
Nurses need to be familiar with
the goals and purposes of the HITECH Act of 2009 the Medicare and Medicaid HIT provisions of the law the Health Insurance Portability and Accountability Act (HIPAA) of 1996 The concepts of 'meaningful use' and 'certified EHR technology'
RFI (request for information)
the initial contact with vendors. An RFI is a letter or brief document sent to vendors that explains the institution's plans for purchasing and installing an information system. The purpose of the RFI is to obtain essential information about the vendor and its systems to eliminate those vendors that cannot meet the organization's basic requirements
information technology
the management and processing of information with the assistance of computers.
Data gatherer
the nurse completes a patient assessment and records the patient's vital signs" blood pressure 186/102, apical pulse; 84, respiratory rate: 20.
Knowledge user
the nurse notes that the patient's prior systolic blood pressure ranged from 138 to 159, and the diastolic ranged from 79 to 91. She further assesses the patient and notifies the physician.
Information user
the nurse recently read a journal article about blood pressure monitoring. The article contained information about nursing assessments and average variations in blood pressure readings.
hardware
the physical parts of a computer
mapping
the process in which terms defined in one system are associated with comparable terms in another system. The major impact of using interface engines is that mappings for multiple receiving systems can be built for each sending system.
data mining
the process of analyzing healthcare data from different perspectives and summarizing it into useful information that can be used to improve patient safety and quality of care and cut costs Data mining uses software to find relationships within datasets.Data mining can, for example, discover whether certain demographic groups are more prevalent for specific ailments than other groups
strategic planning
the process of developing and maintaining a strategic fit between the organization's goals and capabilities and its changing marketing opportunities
nursing informatics
the use of information and computer technology to support all aspects of nursing practice, including direct delivery of care, administration, education, and research
nursing informatics
the use of technology and information to help support all aspects of nursing practice
nursing informatics?
the use of technology and information to help support all aspects of nursing practice
benefits of integration
• Allows instant access to applications and data • Improves data integrity with single entry of data • Decreases labor costs with single entry of data • Facilitates the formulation of a more accurate, complete client record • Facilitates information tracking for accurate cost determinations
applications of NI in administration
• Automated staff scheduling • Online bidding for unfilled shifts • E-mail for improved communication • Cost analysis and finding trends for budget purposes • Quality assurance and outcomes analysis • Patient tracking and placement for case management
ANA beginner nurse competencies
• Basic computer literacy, including the ability to use basic desktop applications and electronic communication • The ability to use IT to support clinical and administrative processes, which presumes information literacy to support evidence-based practice • The ability to access data and perform documentation via computerized patient records • The ability to support patient safety initiatives via the use of IT • Recognition of the role of informatics in nursing
consumer applications for HIT
• Communication with healthcare providers via e-mail and instant messaging • Remote monitoring and other telehealth services • Support groups • Online scheduling
applications of NI in research
• Computerized literature searching • The adoption of standardized language related to nursing terms • The ability to find trends in aggregate data, which is data derived from large population groups • Use of the Internet for obtaining data collection tools and conducting research • Collaboration with other nurse researchers
ANA genomic focused care competences RN
• Demonstrate knowledge of the relationship of genetics and genomics to health, prevention, screening, and monitoring • Identify clients who may benefit from genetic information and services and provide appropriate, accurate information • Make referrals as needed • Provide appropriate services • Evaluate the effectiveness of current technology and interventions
benefits of interface engines
• Improves timeliness and availability of critical administrative and clinical data • Decreases integration costs by providing an alternative to customized point-to-point interface application programming • Improves data quality because of data mapping and consistent use of terms • Allows clients to select the best system for their needs • Preserves institutional investment in existing systems • Simplifies the administration of healthcare data processing • Simplifies systems integration efforts • Shortens the time required for integration • Improves management of care, the financial tracking of care rendered, and efficacy of treatment
applications of NI in education
• Online completion of mandatory education requirements • Online course registration and scheduling • Computerized student tracking, testing, and grade management • Course delivery and support for Web-based education • Remote access to library and Internet resources • Teleconferencing and Webcast capability • Presentation software for preparing slides and handouts • Online test administration • Communication with students
meaningful use priorities
• Patient engagement • Reducing racial disparities • Improved efficiency • Increased safety • Coordination of care • Measures to improve population health
ANA experienced nurse competencies
• Proficiency in his or her area of specialization and the use of IT and computers to support that area of practice including quality improvement and other related activities • Knowledge representation methodologies for evidence-based practice • The ability to use information systems and work with informatics specialists to enact system improvements • Proficiency in using evidence-based databases • The promotion of innovative applications of technology in healthcare more fully integrate informatics throughout the course of his or her practice, not just for basic data entry and retrieval
informatics nurse
• Proficiency with informatics applications to support all areas of nursing practice including quality improvement activities, research, project management, system design, development, analysis, implementation, support, maintenance, and evaluation • Fiscal management • Integration of multidisciplinary language/standards of practice • Skills in critical thinking, data management and processing, decision making, and system development, and computer skills • Identification and provision of data for decision making
