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Define 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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Describe information theory:

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Processing data to produce information, and, in combination with knowledge and wisdom, using information to provide care. An example is putting the number 39 with celsius that combine to make temperature which is information and synthesized into knowledge= hypothermia, wisdom combines knowledge, values, and experience to make care decisions.

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Describe another theory involved in nursing informatics:

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Systems theory: interaction with a system will create something bigger and better than just the sum of the parts.

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What is the difference between an EMR and EHR?

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EMR is an electronic medical record. It has one provider, one entity, once hospital. -EHR: electronic health record is multiple organizations record. It is cumulative. Many EMR's and PHR's come together to make an EHR.

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What is a PHR?

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Personal health record: these can be on paper or on a website or even a usb drive. The patient controls their own health records with this and can add information.

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What are 3 benefits of a PHR?

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Can see results faster, can be a preventitive health complication tool, gets patients involved in their own healthcare, gives patients a piece of mind in knowing they can access.

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What are 3 limitations of a PHR?

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Privacy issues, knowledge about how to do it or what to put, the time it takes to keep it up to date.

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What is a smart card?

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A secure and portable way to carry PHR. Improves security, privacy, and can reduce health care fraud. They are compliant with government initiatives and are a secure access to emergency medical records.

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Name 3 core objectives of Stage 1 "meaningful use" requirements of the American Reinvestment and Recovery Act (ARRA)?

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Stage 1: -Maintain an allergy list -Record smoking status for patients 13 yeards or older -Record vital signs

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Name 3 core objectives of stage 2 of the "meaningful use" requirements of the American Reinvestment and Recovery Act (ARRA)?

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Stage 2: -Include clinical lab test results for HER -Preform medication reconciliation -Submit electronic data to immunization registries

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Describe how a clinical information system (EMR or EHR) contributes to patient safety.

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Improves legibility, supports safe medication practice (drug interaction/allergy), and improves nursing workflow; eliminated redundant documentation.

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Give an example of data about a specific quality indicator and describe how that data could b obtained from a clinical information system:

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Falls. On the clinical flowsheet in horizon there is a fall risk tab where risk of the patient is charted and a formula calculated the patients fall risk (high, moderate, or low fall risk)

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According to nursing researchers Staggers, Gassert, and Curran, what informatics competencies should be demonstrated by Beginning nurses:

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Has fundamental information management and computer technology skills, and uses existing information systems and available information to manage practice.

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"" According to nursing researchers, what informatics competencies should be demonstrated by experienced nurses:

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Has proficiency in a domain of interest (ex: public health, education, administration). Highly skilled in using information management and computer technology skills to support their major area of practice. Sees relationships among data elements and makes judgements based on trends and patterns within this data. And finally, uses current information systems but collaborated with the informatics nurse specialist to suggest improvement to systems.

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"" According to nursing researchers, what informatics competencies should be demonstrated by nursing informatics specialists:

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An RN with advanced preparation possessing additional knowledge and skills to information management and computer technology. -Focuses on information needs for the practice of nursing, which includes education, administration, research, and clinical practice. -Practice is built on the integration and application of information science, computer science, and nursing science. -Uses the tools of critical thinking, process skills, data management skills (including identifying, acquiring, preserving, retrieving, aggregating, analyzing, and transmitting data), systems development cycle, and computer skills.

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"" According to nursing researchers, what informatics competencies should be demonstrated by informatics innovators:

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-Educationally prepared to conduct informatics research and generate informatics theories. -Has a vision of what is possible and a keen sense of timing to make things happen. -Leads the advancement of informatics practice and research. -Functions with an ongoing, healthy skepticism of existing data management practices and is creative in developing solutions. -Possesses a sophisticated level of understanding and skills in information management and computer technology. -Understands the interdependence of systems, disciplines, and outcomes, and can finesse situation and maximize outcomes.

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Define the term computer fluency:

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Understanding how to use computers and the related computer concepts . This is not to be confused with computer literacy which is a temporary state.

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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 6 categories of QSEN:

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1.) patient centered care 2) teamwork and collaboration 3.) evidence based practice 4.) quality improvement 5.) safety 6.)informatics

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Name 3 nursing literature bibliographic databases:

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1.) CINAHL 2.) MedLINE 3.)Allied Health Source

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How do the Boolean operators affect a literature search:

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Increase and/or limit the amount of information retrieved. Using will broaden and or narrow the search.

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Define the term "research practice pay gap":

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Emerges when there are differences between clinical practice and the research on effectice clinical practice.

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Name two factors that cause a research practice gap:

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Lack of time, lack of sufficient staff, and access to knowledge resources

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Define the term "Seminal work":

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Work frequently cited by others or influences the opinion of others

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Provide a brief definition of a "Just Culture":

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Reporting of error and near misses is supported without fear of retribution. It is nonpunitive. Fair environment, manages performance.

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Discuss examples of barriers to a Just Culture; how can these barriers be reduced?

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Barriers are employees who frequently make errors, employees intentionally cut corners knowing that there wouldn't be a punishment and also weak leaders. -How these barriers can be reduced is by educating employees and strong leaders.

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How can informatics be used to monitor errors and support a Just Culture:

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Computers could alert with abnormal, second set of eyes, look up what happened in previous encounters.

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What is BCMA and how does it contribute to patient safety?

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Bar Code Medication Administration is a system where patients have bar coded wrist bands. These bar codes must be scanned before administering medication. It is supposed to reduce errors when distributing meds. Tells what medication, dose, route, and time.

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What are some limitations of BCMA?

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Over reliance with technology, funds (its expensive), and emergency situations when time is crucial.

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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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Error rate and reasons for them, how many times a med was given, how long does it take to administer the meds and how many were given late, day/night errors/ weekend/weekday errors.

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Describe telenursing and describe how it occurs:

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use of telecommunication and information technology in the provision of nursing services, when there is a larger physical distance between patient and nurse or between any number of nursed.

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Describe at least two examples of patient assessments that may be accomplished using telenursing:

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Video chat: assess some symptoms, also the transmission of information such as in CPAP.

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What is the Leapfrog Group and how can a healthcare organization meet the CPOE (computerized physicial order entry) criteria to be recognized by this group?

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It is a large purchaser organization with focus on patient safety and value-promotes transparency through data collection and public reporting from hospitals (other classes). -Tool that allows hospitals to access their medication-safety related decision support -Uses questionaires to assess the standards.

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How can CPOE contribute to patient safety:

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Eliminates problems with handwriting, prevents patients form getting higher dose than indicated, prevents delays in medication getting to patient.

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What are potential barriers to CPOE:

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High cost, alert too much, not personable.

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Define bioinformatics:

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Biological data that uses technology.

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How did the Human Genome Project utilize bioinformatics?

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Genomic information (DNA & RNA) and linked it to disease via various technologies.

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Describe an example of data about a specific disease or conditions that could be contained in a bioinformatics database:

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Lupus. This is an autoimmune disorder that can be linked to genes and can be tested for using technology.

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Name two examples of nursing or medical decision support:

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Potential drug interactions, practicing safety and quality focus such as allergy, fall risk, meds.

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What does the term "Alert fatigue" mean and how can it impact decision support systems?

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Nurses becoming desensitized to alerts such as bed alarms or pop ups that they begin to ignore. This could result in error rates going up from missing important message when they are just clicking through.

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What are some benefits and limitations of clinical decision support systems?

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Benefits: unbiased evidence based second opinion, work load, checks and balance. -Limitations: not everyone has access to the same programs, and also standardized practice.

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Name 4 ways a nurse can follow HIPPA guidelines for securing patient data:

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1.) Frequently changing your password 2.)Not sharing your password w anyone 3.) Timely logging off 4.) Not sharing information about the patient in public areas where individual is not involved in that patient's care can hear.

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What are 4 basic guidelines for quality documentation and reporting?

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1.) Factual: descriptie information. Avoid vague terms (appears, seems, apparently) and also avoid opinions. 2.) Accurate and complete: use of exact measurements, use of accepted abbreviations, concise, clear, and easy to understand, spelling. 3.) Current: timely entries, record near bedside (point of care), electronic documentation, military time. 4.) Organized: logical order: assessment, interventions, client response.

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Name 5 types of patient data typically found in a hospital's clinical information system?

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1.) Admission Nursing History Form 2.) Flow sheet and graphic record 3.) Client Care Summary 4.) Standardized Care Plans 5.) Discharge Summary Form

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Define the terms "cyberchondriac" and "online diagnoser". Discuss the differences between them:

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-Cyberchondriac: a term that describes people who become distressed and frightened after repeated and excessive web searches for health info, it is an anxiety disorder and does not typify most consumer searches for health information. -Online Diagnoser: an individual who searched for online health info, it affects the individuals understanding of any health problem they had and improves their health management.

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Define the terms "health literacy" and "health numeracy". Name an example of each type of skill:

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-Health literacy: the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. Example: the ability to understand instructions on a medication bottle. -Health numeracy: the ability of a consumer to interpret and act on all numerical information such as graphical and probabilistic information needed to make effective health decision. Example: laboratory values and medication schedules.

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