Informatics – Flashcards
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Nursing Informatics
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A specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, knowledge and wisdom in nursing practice.
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What are the 3 sciences involved in Nursing Informatics?
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Nursing science, computer science, and information science
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Information Theory
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Processing data to produce information and, in combination with knowledge and wisdom, using information to provide care
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Describe another theory involved in Nursing Informatics
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a. Change Theory - unfreezing Ă moving Ă refreezing b. Systems Theory - interaction among parts c. Behaviorism - desired behaviors are reinforced d. Constructivism - reinterpret the world to fit new situations e. Adult learning - learn by doing, must know why they need to learn and value of learning
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Describe the differences between an EMR and an EHR
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EMR- medical record from one location/provider EX: Epic (St. Anthony) Ex: Kiddos (Children) Ex: Compass (Barnes) One provider EHR- mulitple provider records combined
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What is a PHR? Who is responsible for its maintenance?
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PHR- not official or correct and patient reported and can be merged to an EHR (Phone App, Flash drive, Smart Card Diary (Written)
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What are 3 benefits and 3 limitations of a PHR?
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a. Barriers- motivation- time - security -access- b. Benefits- visibility - unconscious- repeat yourself - involved in health - saves time
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What is the deadline for hospitals' compliance with the 'Meaningful Use' requirements of the American Reinvestment and Recovery Act (ARRA)?
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In 2015, penalty if unable to show meaningful use
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Describe how a clinical information system (EMR or EHR) contributes to patient safety.
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Improves legibility, Provides greater continuity of care, Supports safe medication practices, Improves nursing workflow; eliminates redundant documentation, Provides access to up-to-date, accurate data for informed decision-making, Decision support based on assessment data
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Give an example of data about a specific quality outcome measure that could be obtained from a clinical information system.
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Fall Preventions -Monitor how many patients fell out of bed
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According to nursing researchers Staggers, Gassert, and Curran, what informatics competencies should be demonstrated by:
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a. Beginning Nurses? Should process basic information management and computer technology. Access data, desktop software, & decision support. b. Experienced Nurses? Highly skilled in information systems to support their major area of practice. Make judgments on basic trends and patterns. c. Nursing Informatics Specialists? Meet the information needs of practicing nurses by integrating and applying information, computer science, and nursing science. d. Informatics Innovators? Conduct informatics research and generate informatics theory.
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Define the term 'computer fluency'
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Understanding computers and related systems. It includes a working vocabulary of computer and information system components, the fundamental principles of computer processing and a perspective for how non-technical people interact with technical people.
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What does the acronym QSEN mean?
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Quality and Safety Education for Nurses
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Name the 6 categories of QSEN.
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a. Patient-Centered Care b. Teamwork & Collaboration c. Evidence Based Practice d. Quality Improvement e. Safety f. Informatics
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Name 3 nursing literature bibliographic databases.
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a. Omid b. Medline c. PubMed
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How do the Boolean operators affect a literature search?
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a. "And" = search only records in which BOTH criteria are met b. "Or" = search returns any record with EITHER criteria c. "Not" = criteria returns records that do NOT have the designated criteria
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Define the 7 Levels of Evidence described in the Sewell & Thede textbook.
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a. Level 1 - evidence from a systematic review or meta-analysis of all relevant randomized controlled trials (RCTs) or evidence-based clinical practice guideline based on systematic review of RCTs. b. Level 2 - Evidence obtained from at least one well-designed RCT. c. Level 3 - Evidence obtained from well-designed controlled trails without randomization. d. Level 4 - Evidence from well-designed-case control and cohort studies. e. Level 5 - Evidence from systematic reviews of descriptive and qualitative studies. f. Level 6 - Evidence from single descriptive or qualitative study. g. Level 7 - Evidence from the opinion of authorities and/or reports of expert committees.
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Define the term 'research practice gap'.
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"Nurses must expedite closing the research practice gap in order to make dramatic, needed improvements to our healthcare delivery system." (Pg. 206 in the book)
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Name two factors that cause a research practice gap.
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a. Access to research b. Attitude c. Time d. Def: the discrepancy between research on effective clinical practice and direct care provided to patients
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Define the term 'seminal work'.
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Seminal work refers to work frequently cited by others or influences the opinions of others
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Provide a brief definition of 'just culture'.
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Just culture is the place that you work will not take serious action for making an error. Professionals do make mistakes, although if you make a reckless mistake you will be accountable.
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Discuss examples of barriers to a just culture; how can these barriers be reduced?
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a. Time consuming b. Cost c. Individual Slips d. People who make reckless errors e. Medicare/Medicaid/other mandatory reporting of errors f. Stuck in the mud/stick administration and/or managers
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How can informatics be used to monitor errors and support a just culture?
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a. Barcodes- help with support errors b. Familiar with technology c. Interventions
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What is BCMA and how does it contribute to patient safety?
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Barcode- scan the patient, is this the right patient, order, and medication.
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What are some of the limitations of BCMA?
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a. Errors in barcode on the medicine b. Cost c. Equipment malfunction d. Incorrect use of equipment
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If you were a nursing manager, what report data could help you monitor the use of BCMA technology on your nursing unit?
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a. Hooked to the patient record system because when it is scanned it will go to the document. (IS this happening 100% of the time) b. Does the staff like the system? Liking it will cause them to use it, rather than ignore it.
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Define telenursing and describe how it occurs.
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Use of technology to deliver care over a distance.
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Describe at least 2 examples of patient assessments that may be accomplished using telenursing.
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a. Hooked up to an ecectric spirometer connected to a computer b. Telecare nurses decide, direct, and coordinate care rather than provide it directly.
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What are some benefits and limitations of telenursing?
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a. Benefits: The nurse is always in contact with their patients. Beneficial to the elderly, allows in home care. b. Limitations: The nurse is not always physically with their patient, can break, less personal.
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What is the Leapfrog Group and how can a healthcare organization meet the CPOE criteria to be recognized by this group?
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Organization to help hospitals with their safety. You must score a certain score. Physicians enter the meds (75% electronically). Also, they must correct 50% of ordering errors.
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How can CPOE contribute to patient safety?
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a. Drug interactions b. Dosing errors c. Public reporting (competition)
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What are potential barriers to CPOE?
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a. Cost b. Physician resistance c. Missing data d. Unethical approach
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Define bioinformatics.
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Development and application of computational tools to acquire, store, organize, archive, analyze, and visualize biological data.
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How did the Human Genome Project utilize bioinformatics?
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a. 3.5 billion (info found on Small Group Topics) b. Mapped DNA
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Describe an example of data about a specific disease or condition that could be contained in a bioinformatics database.
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Polycystic Kidney Disease
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Name two examples of nursing or medical decision support.
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Prevention of adverse drug events -Allergies and Drugs Decision Support, DNR and Code Support
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What does the term 'alert fatigue' mean and how can it impact decision support systems?
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Growing apathetic and forget about the alerts
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What are the benefits and limitations of clinical decision support systems?
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a. Benefits- Real time patient info and patient piece of mind b. Limitations- Stop finding and too complex
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Name 4 ways a nurse can follow HIPAA guidelines for securing patient data.
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a. Don't share information in public areas (elevators, cafeterias, hallways, public restrooms) b. Don't share information with anyone not directly involved with the patient's care. c. Patient may not want family to know details of care. d. Don't look up friends, family, celebrities or other patients on other floors. e. Don't speak of the patients outside of the hospital to family, friends, neighbors, etc.
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What are 4 basic guidelines for quality documentation and reporting?
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Factual -Legal -Libel (written) and slander (spoken) Accurate and Complete Current Organized
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Name 5 types of patient data typically found in a hospital's clinical information system?
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a. Labs & Lab Results b. Vital Signs c. Orders d. Height/weight e. Demographics
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Define the legal term 'non-discoverable'.
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a. Outside sources cannot access this, especially in court/insurance company b. Cannot be used against a person in court
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How would an Incident Report become discoverable in court?
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If you added to the chart's documentation that you wrote an Incident Report
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Define the term 'professional negligence'.
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a. Failure to provide the standard of care resulting in injury to the patient b. Has to be injury, injury related.
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Define the term 'cyberchondriac' and discuss its positive attributes.
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-Indicates a person who has concerns about health and searches for health information on the web -Positive attributes: -Online info. influenced the discussions they had with their healthcare provider -Affected people's understanding of any health problems they had and improved their health management
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Name an example of a health numeracy skill.
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a. Deciding timing of medication dosages b. Def: ability of a consumer to interpret and act on all numerical info. such as graphical and probabilistic info. needed to make effective health care decisions
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Describe the components of the chart.
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a. Vital signs (blood pressure, statistical data) b. Biographical data (address, phone number, relatives) c. Labs d. Orders e. Weights, height, age, DOB
