ANCC nursing certification Exam 262 Questions with Verified Answers,100% CORRECT, Exams of Nursing

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ANCC nursing certification Exam 262 Questions with

Verified Answers

ANA definition of NI (2008) - CORRECT ANSWER Nursing informatics is a specialty that: A. integrates nursing science B. Computer science C. Information science to manage and communicate:

1. Data
2. Information
3. Knowledge and
4. Wisdom in nursing practice NI Supports: a. consumers b. patients c. nurses d. other providers in their decision-making in all roles and settings. This support is accomplished through: i. use of information structures ii. information processes iii. information technology What year did the ANA identify NI as a nursing specialty? - CORRECT ANSWER 1992 When was the first scope of practice statement for NI published? - CORRECT ANSWER 1994 ANA definition of NI - CORRECT ANSWER Specialty that integrates nursing science with multiple informative and analytical sciences to identify, define , manage and communicate data information, knowledge, and wisdoms in nursing practice What are the foundations of practice - CORRECT ANSWER A. Professional practice

B. Methodologies & Theories C. Rules, regulations, & requirements D. Interprofessional collaboration ANA definition of NI (2015) - CORRECT ANSWER NI is a specialty that integrates nursing science with multiple information and analytical sciences to: A. Identify B. Define C. Manage and D. Communicate data, information, knowledge, and wisdom in nursing practice NI supports:

1. Nurses
2. Consumers
3. Patients
4. Users
5. Interprofessional healthcare team
6. Other stakeholders in their decision-making roles and settings to achieve desired outcomes This support is accomplished through the use of: a. information structures, b. information processes, and c. information technology Tenents (beliefs) of Nursing Informatics - CORRECT ANSWER 1. A unique body of knowledge, preparation, and experience that aligns with the nursing profession.
7. Involves the synthesis of data & information into knowledge & wisdom
8. Supports decision-making of healthcare consumers, nurses, and other professionals achieve healthcare consumer safety and advocacy
9. Supports data analytics, including quality of care measures, to improve population health outcomes and global health
10. Promotes data integrity and the access and exchange of health data for all consumers of health information

6. Supports national and international agendas of interoperability and the efficient and effective transfer and delivery of data, information, and knowledge
7. Ensures that collaboration is an integral characteristic of practice
8. Interleaves user experience and computer-human interaction concepts throughout practice
9. Incorporates key ethical concerns of NI such as advocacy, privacy, and assurance of the confidentiality and security of data and information
10. Considers the impact of technological changes on patient safety, healthcare delivery, quality, reporting, and the nursing process
11. Leads in the design and promotion of useful, innovative information technologies that advance practice and achieve desired outcomes(Scope & Standards ) When was the ANA Standards of Practice for NI released? - CORRECT ANSWER 1995 When was the scope and standards of NI practice released combining both scope and standards of practice? - CORRECT ANSWER 2001 then updated in 2008 What are analytical sciences? - CORRECT ANSWER A listing of sciences that integrate with NI includes:
12. computer science
13. cognitive science
14. science of terminologies and taxonomies (including naming and coding conventions)
15. information management
16. library science
17. heuristics
18. archival science
19. mathematics

What are the NI competencies for all RNs? - CORRECT ANSWER TIGER-Technology informatics guiding education reform identified that all nurses in every role must be prepared to make HIT. TIGER formed an informatics competency collaborative which defines the competencies recommended for the NI discipline:

1. Basic computer skills
2. Information literacy
3. information management According to Staggers, Gassert, Curran 2002, what are the levels of informatics competencies? - CORRECT ANSWER 1. Beginning nurse
4. Experienced nurse
5. Informatics nurse specialist
6. Innovator Name some additional competencies - CORRECT ANSWER 1. Pierce, Tanner, & Pravikoff (2005) information literacy
7. Telehealth competencies (ATA, ICN)
8. Genetics & genomics competencies
9. National league for nursing
10. Amer Assoc of College of Nurses
11. Forecasting informatics competencies for nurses in the future of connected health IOS Press 2017 Name the types of roles - CORRECT ANSWER 1. Project manager
12. Decision support/outcomes
13. Educator
14. Product developer
15. Systems analyst
16. Consultant
17. Programmer
18. Advocate/policy developer
19. Web developer
20. CIO/CNIO
21. Entrepreneur
22. Researcher
23. Sales and Marketing
24. Consumer advocate

What are the functional areas: Informatics nurses - CORRECT ANSWER 1. Administration, leadership, & management

2. Systems analysis & design
3. Compliance & integrity management
4. Consultation
5. Coordination, facilitation, & integration
6. Development
7. Educational & professional development
8. Genetics & genomics
9. Information management/operational architecture
10. Policy development & advocacy
11. Quality & performance improvement
12. Research & evaluation
13. Safety, security & environmental health What are the standards of nursing informatics Practice? - CORRECT ANSWER 1. Evaluates quality & effectiveness of NI practice
14. Performance appraisal
15. Maintains knowledge and NI competency-life-long learning
16. Contributes to the professional development of others
17. Bases decisions and actions on ethical principles
18. Collaborates with others
19. Contributes to the body of informatics research
20. 16 Standards are highlighted with measurement criteria What are the NI Standards of practice? - CORRECT ANSWER Standard 1: Assessment Standard 2: Diagnosis, Problems & Issues Identification Standard 3: Outcomes Identification Standard 4: PlanningStandard 5: Implementation Standard 6: Evaluation Standard 7: Ethics Standard 8: Education Standard 9: Evidence-Based Practice and Research Standard 10: Quality of Practice Standard 11: Communication

Standard 12: Leadership Standard 13: Collaboration Standard 14: Professional Practice Evaluation Standard 15: Resource Utilization Standard 16: Environmental HealthADOPIEEEEQCLCPRE What makes up EBP? - CORRECT ANSWER 1. Literature searches

2. Clinical practice guidelines
3. Clinical protocols Boolean search Definition of EBP - CORRECT ANSWER *A problem-solving approach to clinical decision-making within a healthcare organization *Integrates best available scientific evidence with best available experience *Uses research & non-research evidence (ethical or personal) Evidence-Based nursing practice is the process: - CORRECT ANSWER By which nurses make a clinical decision using:
4. The best available research evidence
5. Their clinical expertise
6. Patient preferences Formulating answerable clinical questions is the foundation of EBP. - CORRECT ANSWER 1. Start with the patient: clinical problems & questions arise out of patient care
7. Translate the clinical questions into a searchable question using PICOT
8. Decide on the best type of study to address the question
9. Perform a literature search in the appropriate sources What is the PICOT model to support EBP - CORRECT ANSWER P-Population/condition I-Intervention C-Comparison O-Outcome T-Time of study

What is the ACE Star Model of EBP (2004)? - CORRECT ANSWER 5 points of knowledge transformation:

1. Discovery
2. Summary
3. Translation
4. Integration
5. Evaluation NI support nurses, consumers, patients, interprofessional healthcare team, and stakeholders through the use of which three things? - CORRECT ANSWER 1. Information structures
6. Information processes
7. Information technology Name a Metastructure - CORRECT ANSWER DIK (Blum-1986)
8. Data 2, Information
9. Knowledge
10. WisdomDIKW (Graves & Corcoran-1989) What is Data? - CORRECT ANSWER Discrete entities that are described objectively with interpretation What is Information? - CORRECT ANSWER Data that have been:
11. Interpreted
12. Organized or
13. Structured What is Knowledge? - CORRECT ANSWER Information that is synthesized so that relationships are identified and formalized Focuses on what is known The appropriate use of knowledge involves? - CORRECT ANSWER Integration of empirical, ethical, personal, and aesthetic knowledge into actions What is Wisdom? - CORRECT ANSWER The appropriate use of knowledge to manage and solve human problems.

It consists of knowing when and how to apply knowledge to deal with complex problems or specific human needs Focuses on the appropriate application of that knowledge and an appreciation of the consequences of selected actions Relationship of Data, Information, Knowledge, and Wisdom Nelson 2002 - CORRECT ANSWER Data - naming, collecting, and organizing Information - Organizing and interpreting Knowledge - Interpreting, integrating, and understanding Wisdom - Understanding, applying and applying with compassion NI is concerned with - CORRECT ANSWER Creation Structure Storage Delivery Exchange Interoperability Reuse of nursing and clinical information along the continuum of care. What is the informatics nurse specialist often responsible for? - CORRECT ANSWER Implementing or coordinating projects involving multiple professions and specialties Support other RNs to best use data, information, knowledge, and technology NIs support through the use of: - CORRECT ANSWER Information structures Information processes Information technology NIs Foci - CORRECT ANSWER Information user, information recipients, exchange data, information, knowledge, and wisdom Design, structure, interpretation, and representation of data, information, knowledge, and wisdom

Design, develop, implement, and evaluate applications and technologies, ensuring their safety, quality, effectiveness, efficiency, and usability Standardized terminologies - CORRECT ANSWER Have become a significant vehicle for facilitating interoperability between different concepts, nomenclatures, and information systems What is the systems development life cycle (SDLC)? - CORRECT ANSWER Standardized approachProcess for developing information systems in a: - deliberate -structured -methodical manner What are the four phases of the SDLC? - CORRECT ANSWER 1. Planning2. Analysis3. Design, Develop, Customize4. Implementation, Evaluate, Maintain, Support What is a project life cycle? - CORRECT ANSWER 1. Initiating2. Planning3. Execution4. ClosingMay be used in conjunction with the SDLC What is the Planning phase of the SDLC? - CORRECT ANSWER It is a foundational, fundamental and often longest phase (sets the stage for the project)system requirementsfeasibility studyproject charterproject plan In the Planning phase of the SDLC, what are the system request components? - CORRECT ANSWER 1. Project sponsor2. Business need3. Business requirements4. Business value5. Special issues/considerations In the Planning phase of the SDLC, what are the feasibility analysis types? - CORRECT ANSWER 1. Technical, "can we build it?"2. Economic, "should we build it?"3. Operational, "if we build it, will they use it?" In the Planning phase of the SDLC, what are the elements of the project charter? - CORRECT ANSWER 1. Project champion2. Dates (start, milestones, end)3. Problems or opportunity statements (purpose/justification)4. Objectives (what we want to achieve)5. Key stakeholders6. Scope of the project7. Target benefit8. Budget

In the Planning phase of the SDLC, what is a project charter? - CORRECT ANSWER

1. Draws from system requests2. Created by project sponsor or initiator (often delegated to the project manager or informatics nurse)3. Formally authorizes the existence of a project4. Authorizes project manager to apply organizational resources In the Planning phase of the SDLC, what are the goals assessment? - CORRECT ANSWER 1. Return on investment (ROI)-ratio of expected financial gains divided by the total costs2. Cost-benefit analysis (CBA). Attempt to quantify tangible and intangible items3. Tangible-improve revenue, decrease staff needed4. Intangible- increase in patient satisfaction In the Planning phase of the SDLC, what are the tools used? - CORRECT ANSWER System Selection & Implementation: -customer site visit -surveys -RFI/RFP -Gap analysisSystem/Product Development -Stakeholders analysis -Market survey - Feasibility analysis -Assessment of competitors In the Planning phase of the SDLC, what is a GAP analysis template? - CORRECT ANSWER A visual tool that involves a comparison of actual performance & potential or desired performance. In the Planning phase of the SDLC, what is the informatics roles and skills? - CORRECT ANSWER System Selection & Implementation: -Project manager -SME - System analyst -Autor of artifacts: project charter system selection plan RFI/RFPSystem/Product Development -Market/user researcher -SME -Systems analyst -Author of artifacts product concepts scope document feasibility assessments other artifacts of planning -Respond to RFI/RFP In the Planning phase of the SDLC, what is an RFI? - CORRECT ANSWER Is it a request for informationA document that the organization sends to vendorsIndicates interest in gaining knowledge about the vendor's productLists (high level) the key features desired for the new systemVendor responds to RFI w/their products ability to meet these high-level requirements In the Planning phase of the SDLC, what is an RFP? - CORRECT ANSWER Request for proposalCreated by the project teamSent to selected vendors requesting greater and more detailed information about the features/functions desired for

the new systemResponse from vendor from an RFP are equally detailedSupports comparison of vendors In the Planning phase of the SDLC, what are outputs? - CORRECT ANSWER System Selection & Implementation -system request -feasibility assessment -charter - team formation proj governance structure/implement committee proj team(s) (actually implements the system) -gap analysis -timeline -workplan & resource requirementsSystems/Product Development -feasibility assessment -product scope document what it will and will no contain functionally -product concept document summary of customer needs proposed solution potential market use - In product development, the decision to "go" or "no go" is made in the planning phase In the Planning phase of the SDLC, what are typical teams and committees? - CORRECT ANSWER Systems Selection & Implementation: -Executive steering committee -Data governance committee -Information technology steering committee -Physician advisory committeeSystems/Product Development: -Project core group or build team(s) -Testing team -Change management/communication team -Training team -Support team In the Planning phase of the SDLC, what is the purpose of a project charter? - CORRECT ANSWER To formally authorize a project or a phase and document initial requirements which satisfy the stakeholder's needs & expectations. Categories of competencies with nursing informatics include? - CORRECT ANSWER

1. Basic computer skills2. Information management skills3. Information literacy skills The foundation of an organizations' strategic system planning begins with a review of the? - CORRECT ANSWER The organization's business mission In what phase of the SDLC are feasibility studies performed? - CORRECT ANSWER Planning phase The informatics nurse may recommend gap analysis in order to determine the? - CORRECT ANSWER Resources needed to move from the current state to a proposed state

When looking at potential products and gathering information, one of the first tools is often a: - CORRECT ANSWER Request for Information (FRI) What is the 2nd phase in the SDLC? - CORRECT ANSWER System Analysis During the Analysis phase of the SDLC, what are the main focus? - CORRECT ANSWER -Fact-finding phase-In-depth assessment and leads to the definition of the new system's requirements-Understanding the existing situation (the as-is system)-Identifying improvements-Define requirements for the new system (to- be system) During the Analysis phase of the SDLC, what are the major activities performed? - CORRECT ANSWER 1. Answers the question of: Who uses the system? What the system does Where and when the system will be used2. All deliverables are combined into the System Proposal -Requirements determination -Use case analysis -Process modeling -Data modelingPrimary Deliverable: SYSTEM PROPOSAL During the Analysis phase of the SDLC, what are the key deliverables? - CORRECT ANSWER 1. Gap analysis 2. Technical requirements for hardware, software, ^ networks3. Functional design document4. System proposal document During the Analysis phase of the SDLC, what are the goals for a system selection & implementation? - CORRECT ANSWER -Conduct a detailed assessment of gaps-gap analysis-and user needs (requirements) understanding the "must-have" functionality of the desired system-Conduct market survey to assess options/compare for selection-Develop FRI and RFP-Establish a system selection process including an objective decision-scoring methodology typically developed from the RFP scores based on functional requirements necessary elements scored higher than "nice-to-have"-Assess readiness for change During the Analysis phase of the SDLC, what are the goals for a systems/product development? - CORRECT ANSWER -Fully understand and prioritize gaps and needs in existing systems and products How will your development address those?-Understand the diagram-related workflows, data flows, and processes in order to effectively analyze-Document functional and technical requirements

Functional end-user requirements Technical: define programmer instructions- Outline future-state workflows, data flows, & processesOutline the impact on existing processes During the Analysis phase of the SDLC, what are the tools used in systems selection & implementation and systems/product development? - CORRECT ANSWER Qualitative analytical methods: -Interviews and focus groups with stakeholders -Observations, questionnaires -Artifact analysis (document examination)Quantitative analytical methods: -RFP and RFI scoring tools to quantify the best product to meet the need -Context diagrams (high-level data flow diagram/summary of the system) -Data flow diagrams (additional detail about each part of the business process) -Clinical workflow diagrams -Gap analysis*Current state assessment to determine "where we are now" During the Analysis phase of the SDLC, what are the roles and skills of the informatics nurse in the systems selection & implementation? - CORRECT ANSWER #NAME? During the Analysis phase of the SDLC, what are the roles and skills of the informatics nurse in the systems/product development? - CORRECT ANSWER #NAME? During the Analysis phase of the SDLC, what are the system analysis outputs of the systems selection & implementation? - CORRECT ANSWER -prioritizing end- user requirements-workflows (steps/process)-dataflows (information)-RFI/RFP- product demonstrations-reference call and site visits-product select scoring process-final recommendations-readiness assessment During the Analysis phase of the SDLC, what are the system analysis outputs of the systems/product development? - CORRECT ANSWER -report to stakeholders including interview results & end-user requirements-regulatory requirements related to the product you are developing-product scope documents-functional requirements-technical requirements (from which the product can be developed) and also for hardware, software, & networks During the Analysis phase of the SDLC, what are the system analysis outputs? - CORRECT ANSWER 1. The requirements analysis (or determination) is a major

output of this phase2. A detailed list of requirements that are supported by the other activities of the analysis phase 3. The system proposal combines much of the analysis output into a report. Key components of this report can include: a. requirements definition: simply lists the functional & non-functional requirements in an outline format b. use cases: define what the users or roles will be doing in the solution. Created considering the actor (someone who interacts with the system), the system (system function process) and goals or tasks to be fulfilled. c. process models d. data models During the Analysis phase of the SDLC, what are the system analysis Outputs Use Case examples? - CORRECT ANSWER 1. Information exchange to be solved electronicallyActors: PCP Ambulatory practice, MD specialty practiceSystem: EHR interfaceGoal: To improve care coordination and meet MU2 transition of care During the Analysis phase of the SDLC, what is a data flow diagram - CORRECT ANSWER A DFD shows the flow of the data through a system and the work or processing performed on the data as it moves through the system During the Analysis phase of the SDLC, what is an entity-relationship diagram? - CORRECT ANSWER -Shows relationships between entities. -Data modeling-data object and relationship between objects-graphically illustrates an information system's entities and the relationship between those entities In what stage of the SDLC are requirements lists developed? - CORRECT ANSWER System Analysis phase In the SDLC analysis phase, name non-functional requirements - CORRECT ANSWER 1. maintainability2. portability3. robustness The informatician is developing a diagram that shows the sequential steps of a process. What is the best choice for chart diagrams? - CORRECT ANSWER Flow Chart A data flow diagram shows graphically what? - CORRECT ANSWER How data flows into a system and from one process to another

What phase comes after the planning and analysis phases of the SDLC? - CORRECT ANSWER System design, develop, customize In the SDLC design phase, what is determined? - CORRECT ANSWER 1. architecture and operation of the system with regard to processes, hardware, software, networking, data retrieval, archiving, and use, user interface, and so on.2. development user requirements are translated into new software solutions3. Implementation-vendor tools are customized to meet user needs. In the SDLC System Design phase, what is the primary deliverable? - CORRECT ANSWER 1. System specification document (architecture document, technical system blueprint) In the SDLC System Design phase, what are the key deliverables? - CORRECT ANSWER 1. Functional specifications2. Technical specifications3. Implementation Workplan regarding interfaces, testing, training, cut over and go-live. In the SDLC System Design phase, what are the major activities in system design? - CORRECT ANSWER 1. Transform business requirements identified during previous phases into detailed specifications covering all aspects of the system2. All deliverables from the Design phase are combined into the System Specification document In the SDLC System Design phase, Design versus Build? - CORRECT ANSWER In this phase, all the information form planning and analysis are used to create a document for the design.Design does not mean build-build is done in the implementation phase. In the SDLC System Design phase, what are the goals in System Selection & Implementation? - CORRECT ANSWER Customization of software, including data elements, documentation templates, & screen designWith commercial-off-the- shelf (COTS) products, customization/localization is the primary goals*End-user input & engagement for customization to meet (clinician) needs-extremely important in the design phase In the SDLC System Design phase, what are the goals in Systems/Product Development? - CORRECT ANSWER *Develop teams to write code that will

convert functional and technical specifications into software applicationsUSABILITY testing of prototypes and early product versions lead to system enhancementsStakeholder reviews to ensure that what is built matches the original vision & scopeUsability-easy to use, navigate, better adoption In the SDLC System Design phase, what are the tools used in the Systems Selection and Implementation? - CORRECT ANSWER Vendor system configuration, including databases, data dictionaries, documentation forms, flowsheets, security profiles, process redesign mapsChange management & end- user educational artifacts like stop-start-continueProject management tracking artifactsClinical & administrative committee review minutes & approval documentsProject management overarching during the design phase In the SDLC System Design phase, what are the tools used in Systems/Product Development? - CORRECT ANSWER Software programming codeProduct prototypesSoftware applications*Software development progress-tracking artifacts In the SDLC System Design phase, what are some of the design strategies (methods)? - CORRECT ANSWER Waterfall RAD-Rapid Application Development: IterativeRAD-Rapid Application Development: System PrototypingAgile In the SDLC System Design phase, what are the steps in the Waterfall development tool? - CORRECT ANSWER Planning Analysis Design Implementation SystemEach phase has to be completed before moving onto the next phase In the SDLC System Design phase, what are the steps of the Rapid Application Development (RAD) Iterative tool? - CORRECT ANSWER Planning Analysis Design Implement System Version I Analysis Design Implement System Version II and so onWorking system but keeps improving and adding enhancements. In the SDLC System Design phase, what are the steps of the Rapid Application Development (RAD): System Prototyping tool? - CORRECT ANSWER Planning Analysis Design Implementation System Prototype Implementation SystemAll are done at the same time

In the SDLC System Design phase, what are the steps of the Agile tool? - CORRECT ANSWER Planning Analysis Design System Implementation-Analysis, design, and implementation are all happening concurrently-Short period of time to a functioning product-Defined time frames (i.e. 4/5 weeks called sprints/scrum- Time boxing-working on chunks of the product In the SDLC System DESIGN phase, what are informatics roles and skills of the system selection and implementation? - CORRECT ANSWER 1. Participant on system configuration teams; like clinical documentation, CPOE, clinical decision support/CDS, and other2. Process redesign analyst3. Change manager4. The developer of training materials In the SDLC System DESIGN phase, what are informatics roles and skills of the system product development? - CORRECT ANSWER 1. SME resource for developers2. Developer3. Usability Tester4. Development manager In the SDLC System DESIGN phase, what are informatics roles and skills of other functions and proficiencies in line with clinical informatics contributions? - CORRECT ANSWER 1. Ensuring systems have an appropriate display of patient- level data for clinical decision making. 2. Designing reports identifying trends to align with quality measures initiatives.3. Translating user requirements into informatics solutions a. bridge communication divides between technical experts and clinical end-users.4. Customizing vendor data elements and forms to meet needs.5. Workflow considerations and interfaces with respect to retrofitting legacy systems with newer technology. In the SDLC System DESIGN phase, during the design, develop, customize phase, what are the OUTPUTS of systems selection and implementation? - CORRECT ANSWER 1. Vendor system configuration documents; like database dictionary, documentation forms, flowsheets, security profiles, process redesign maps, and other artifacts2. Change management and end-user artifacts3. Clinical committee reviews and approvals4. Project management tracking artifacts In the SDLC System DESIGN phase, during the design, develop, customize phase, what are the OUTPUTS of systems/product development? - CORRECT ANSWER 1. Software/programming code2. Product prototypes3. Software applications4. Software development documentation-including tracking of progress and artifacts

In the SDLC System DESIGN phase, during the design, develop, customize phase, what are the aspects of PROJECT MANAGEMENT? - CORRECT ANSWER 1. Project management is an essential tool of the design phase of the SDLC because it is required to keep implementation and development projects: a. on time, b. within the scope and c. on budget. 2. PMBOK = Project Management Body of Knowledge a. The entire collection of processes, terminologies, and guidelines that are accepted as standards within the project management industry. In the SDLC System DESIGN phase, what are some project management artifacts?

• CORRECT ANSWER 1. Gantt chart2. PERT - Program Evaluation and Review Technique3. CDS - Clinical Decision Support In the SDLC System DESIGN phase, what is the Gantt chart in the project management artifacts? - CORRECT ANSWER At a glance...the Gantt chart lest you see:1. What are the various activities2. When each activity begins and ends3. How long each activity is scheduled to last4. Where and by how much activities overlap5. Start and end date of the entire projectalso considered a bar chart In the SDLC System DESIGN phase, what is PERT chart in the project management artifacts? - CORRECT ANSWER Program Evaluation and Review Technique1. PERT diagrams show precedence, activities that must be completed before the next activities may be started2. It illustrates the dependencies and flow of project events and milestones3. Once a diagram is drawn, it is possible to identify the CRITICAL PATH, the longest path/duration through the activities4. Monitoring critical path will identify shortest time to complete the project. PERT Diagram - CORRECT ANSWER 1. Circles mark the beginning and ends of tasks to be done in the project (aka NODES)2. Arrows are the tasks themsevles. They are identified by letters. The actual names of tasks could be used instead of letters. The lengths of the arrows do not relate to their length in time3. Numbers after the task names are the durations of the task. The time interval may be anything from picoseconds to years. Critical path-longest # of days the shortest amount of time without missing any tasks In the SDLC System DESIGN phase, what is CDS? - CORRECT ANSWER Clinical Decision Support1. CDS tools - like Best Practice Alerts (BPA) provide clinicians,

staff, patients, and other individuals with knowledge and person-specific information, intelligently filtered at appropriate times, to enhance health and healthcare.2. Variety of decision-making enhancing tools beyond simply alerts: a. Computerized alerts/reminders to providers/patient b. Focused patient data reports and summaries c. Contextually relevant reference information d. Clinical guidelines e. Condition-specific order sets f. Documentation templates g. Diagnostic support - like PACS h. Reflex orders What are the 5 rights of CDS? - CORRECT ANSWER 1. The right information2. To the right person3. In the right intervention format4. Through the right channel5. At the right time in workflow In the SDLC System DESIGN phase, what are some CDS considerations? - CORRECT ANSWER 1. CDS can be an extremely effective tool to save time and reduce errors, but alerting algorithms must be carefully designed to avoid unintended consequences -like alert fatigue.2. Ultimately, such nuisance alerts interrupt workflow and distract from patient care, leading to the routine override of alerts by users In CDS, what are soft stops and hard stops? - CORRECT ANSWER Soft stops: moving forward is permitted as long as an active acknowledgment reason is enteredHard stops: No override accepted. Cannot place an order without first performing the reason for the hard-stop (i.e. have to record allergies before can order medication) What are some considerations for systems design disability accommodations? - CORRECT ANSWER Patients who are disabledEmployees who are disabled*During the design phase, both developers and implementers are required (by law) to consider ADA requirements *The regulations define "physical or mental impairment" as any physiological disorder or condition and also cover any mental or psychological disorder Examples: Deaf/hearing impaired, blindness/low vision, missing limbs, epilepsy, cerebral palsy, schizophrenia, bipolar disorder, PTSD In System Design-What is a database management system (DBMS)? - CORRECT ANSWER Def: Tool for information storage and retrieval It is a program or a collection of programs through which the user interacts with a databaseInteract

w/a DBMS directly: User--DBMS--DatabaseInteract w/program (JAVA, C++) which interacts w/DBMS User--program--DBMS--DatabaseIMP: In either case, it is only the DBMS which accesses the database System Design: What are some types of databases? - CORRECT ANSWER 1. Legacy (older technology) A. Hierarchical: "tree" structure (folders on a computer). Just as a file on a computer sits in one folder, every record in the db has one "parent" a. One-to-One and One-to-Many B. Network: Handles many relationships b. One- to-One; One-to-Many; Many-to-Many C. Relational (popular): collections of tables c. each has a primary key (a field whose value is diff for every row of the table) cc. Tables are r/t ea other by the placement of primary from one table into the r/t as a foreign key. Systems Design-Relational databases primary vs. foreign key - CORRECT ANSWER Patient ID is the primary key of the patient in the Patient Table*Patient ID is the foreign key of the encounter in the Encounter TableDatabase-spreadsheet organized in rows and columns Designed to add, retrieve, and manipulate data Use Query or SQL to obtain info form relational db System Design-What is database design and modeling? - CORRECT ANSWER *Logical database design-look at the logical relationships among objects. a. conceptual, abstract design b. involves arranging data into a series of logical relationships called entities and attributes c. can be displayed with an ERD (entity relationship diagram) or a logical ERD aka a logical data model System Design-what are key terms in database modeling? - CORRECT ANSWER Entity: (N) definable, real-world thing or concept w/in a system. a. in a relational db, maps to a table (Entity=table) b. real life thing, person, name Attribute: component of an entity and helps define the uniqueness of the entity. a. in a relational db, maps to a column (property, characteristic (Attribute=column)Relationship: relationship between 2 entities signifies that the 2 entities are associated w/each other somehowUnique Identifier: any identifier which is guaranteed to be unique among all identifiers used for those objects. a. Classic example is SSN System Design-DB design & modeling: What is the physical db design? - CORRECT ANSWER Physical DB design: convert the data gathered during the logical design

phase into a description of the physical dbYou translate the expected SCHEMAS (collection of db objects including tables, views, indexes, and synonyms) into actual db structuresCan be displayed with an ERD (entity relationship diagram)...in this case physical ERD - a physical data modelMore defined-actual design of db objects such as tables/columns are createdBlueprint of relational DB System Design-DB design & modeling: Logical vs. physical design - CORRECT ANSWER Logical PhysicalEntity map--------- TableRelationship map--------- Foreign KeyAttribute map----------ColumnUnique Identifier map----------Primary Key***db NORMALIZATION is process used to organize a db into tables & columns. A normalized logical data model can be translated into a physical db that is organized corectly. System Desing-What is Normalization? - CORRECT ANSWER *db NORMALIZATION is a process used to organize a db into tables & columns. A normalized logical data model can be translated into a physical db that is organized correctly. Improves data integrity-organizes data correctlyDecreased redundancyEstablishes relationship between tables System Design-What is discrete data? - CORRECT ANSWER Discrete data is: 1. counted 2. finite numbers-that have integer (whole) values 3. collected discretely & stored in a db table at the lowest level of granularity 4. supports subsequent analysis & care improvement efforts 5. DISCRETE DATA CAN BE QUERIED & COUNTED System Design-what is discrete data graphical representation? - CORRECT ANSWER Column chart=verticalBar chart=horizontalPie chart=circleNote: the length or height of the bar is equal to the qty w/in that category of data System Design-what is continuous data? - CORRECT ANSWER Continuous data is:

1. data that is measured (body temp 98.6) 2. data that is infinitely divisible (Height (180.34cm) 3. represents measurable quantities but are not restricted to certain specified values (wt in lbs of dog) 4. only limiting factor is degree of accuracy with which it can be measured (amt of rain, inches, that falls in a randomly selected storm 5. Measured NOT COUNTED Note: can take on any number, (ie speed of a car), infinitely divisible

System Design-continuous data graphical representation? - CORRECT ANSWER Histogram: For analysis, continuous data are often converted to a range that acts as a category like 16-24, 25-34, 35-44....called "bins"Histograms refer to a graphical representation; that displays data by way of bars to show the FREQUENCY of numerical data System Design-why are standard terminologies needed? - CORRECT ANSWER Standard terminology provides a foundation for interoperability by improving the effectiveness of information exchange aka common languageData must be collected-discretely and maintained in a standardized format, using uniform definitions a. in order to link data w/in an EHR system or share health information btwn systems System Design-what are standard terminologies? - CORRECT ANSWER 1. Interface Terminology: uses common terms that nurses use; thus, supports a user-friendly structured data entry interface (NANDA, NIC, NOC, LOINC, PNDS, CCC, OMAHA, ICNP, SNOMED-CT)2. Reference Terminology: acts as a common reference point that can cross-map between interface terminologies. Enable storage, retrieval, and analysis of clinical data (UMLS, ICNP, SNOMED-CT)Note: ICNP and SNOMED- CT can both interface & reference terminologies System Design-What are the ANA recognized nursing terminologies and data element sets? - CORRECT ANSWER Nursing Developed Terminologies: 1. CCC (clinical care classification system) 2. ICNP (Intl classification for nursing practice)

3. NANDA (No Am nursing dx assoc) 4. NANDA Intl 5. NOC (nursing outcomes classification) 6. Omaha system System Design-What are the ANA recognized multidisciplinary terminologies? - CORRECT ANSWER 1. LOINC (logical observation identifiers, names & codes)2. SNOMED-CT (systematic nomenclature of medicine clinical terms) Systems Design-ANA recognized data element sets - CORRECT ANSWER How do we know what elements to capture? 1. Nursing Minimum Data Set (NMDS): identifies common and core data elements to be collected for all patients receiving nursing care (clinical data elements( Note: These elements are collected by interface terminologies.

System Design-What are vocabulary standards? - CORRECT ANSWER Def: common clinical vocabulary standards can include: 1. CPT-(current procedural terminology) formal classification of dx & therapeutic procedures performed by MDs and other HCP (AMA) 2. HCPCS-(health care procedure code set) collection of standardized codes that represent medical procedures, supplies, products, & services (CMS) 3. ICD-10 (Intl statistical classification of dx: a dx classification vocabulary standard (WHO) 4. ISO-639 (Intl organization standardization standard 639). set of standards used to classify languages What is the term used to describe what data is stored in the database and the relationships among the data? - CORRECT ANSWER Logical The EHR alert for a serious potential error requiring a specific action before proceeding is called a? - CORRECT ANSWER Hard stop When choosing to display the effects of antibiotic A and antibiotic B on bacterial growth, you might use a? - CORRECT ANSWER Bar chart ICNP, PNDS, ABC, and NIC are known as? - CORRECT ANSWER ANA recognized terminologies SDLC-Testing Goals for systems selection & implementation and systems/product development - CORRECT ANSWER IMP testing is an activity or stage of the Implementation phase1. validates that the system works as intended (designed)2. ensures elements are ready for end-users in a live environment: a. components, features, interfaces, devices, reports, screens, and user interfaces3. Answers these questions: a. does the system work? b. are the interfaces valid? c. Is it ready for use? d. Is the system easy to navigate? e. does it contain the appropriate language or reference tables? f. Is it efficient and intuitive to use? SDLC-System Testing tools (part of the implementation phase) systems selection & implementation and systems/product development - CORRECT ANSWER Develop/build Test Train ProductionBox testing types (software testing methods): a. Black box testing: testing as a user-internals not known b. White box testing: testing as a developer. Internals are fully known. focuses more on program code

SDLC-System Testing tools (part of the implementation phase) systems selection & implementation and systems/product development-functional testing: - CORRECT ANSWER Def: functional testing describes what the product does1. Unit testing (ie place an order to ensure charge drops)2. Acceptance testing (user acceptance) a. alpha testing: developers pre-release b. beta testing: testing by customers to give feedback3. System testing (testing complete system& interfaces)4. Interface testing (integration testing to expose faults5. Regression testing (code/pkg upgrades, makes sure works after pkg upgrade loaded SDLC-System Testing tools (part of the implementation phase) systems selection & implementation and systems/product development-NON-functional testing: - CORRECT ANSWER Def: Non-functional testing describes how good the product works1. Load testing (performance testing, threshold where you think it will break)2. Volume testing (focuses primarily on db, performance testing, throughput time, how many users can access db at same time)3. Stress testing (run system above threshold to see what happens-try to make system crash)4. Usability testing (heuristics, how easily is the system able to be used, how well the system works) SDLC-System Testing tools (part of the implementation phase) systems selection & implementation and systems/product development-Heuristics - CORRECT ANSWER Def: Heuristics are important concepts associated with usability testing- can serve as a guide1. Non-functional testing--usability testing--heuristics2. Heuristics are "rules of thumb" to consider when designing usable hc information systems3. General principles that seem to describe common properties of usable interfaces4. How things are discovered or learned by humans5. ex: apple has put a lot of work into usability...if you can operate a cell phone...you can operate an iPad or macbook etc. SDLC-System Testing tools (part of the implementation phase) systems selection & implementation and systems/product development-Informatics roles and skills

• CORRECT ANSWER 1. Developing & executing testing plans, including scripts2. Validating data integration across disparate systems3. Assessing end-user acceptance & system performance (effectiveness)4. Identifying & resolving issues with problem-solving & technical skills.

SDLC-System Testing tools (part of the implementation phase) systems selection & implementation and systems/product development-Outputs - CORRECT ANSWER 1. Testing results are the primary outputs2. At a minimum, this includes the unit and integration of functional testing & load and volume non-functional testing.goal of testing is to break the system When interfacing a new cardiac monitoring system with the EHR, the most critical testing is? - CORRECT ANSWER System integration testing What is the ideal time that user-acceptance testing should be completed? - CORRECT ANSWER During alpha or beta testing before the release When should we run regression tests? - CORRECT ANSWER After the software has changed andWhen the environment has changed What is the area that addresses how easy something is to use, understand, and recognize? - CORRECT ANSWER Usability SDLC-What phase does testing occur in? - CORRECT ANSWER Implementation phase SDLC-What is the focus of the Implement, Evaluate, Maintain, and Support phase?

• CORRECT ANSWER Implementation is the final stage when the system is brought into live use.System is customized, tested, installed, evaluate outcomes, key performance indicatorsFocus: System is builtFocus: System is put into operationFocus: System is maintained and supportedBy this phase there is vestment: money, time, resources SDLC-What are the major activities of the system implementation? - CORRECT ANSWER *Deploying the new system in its target environment and turning the system over to maintenance and supportPrimary Deliverable: Fully installed system in productionKey deliverables: 1. User documentation (communication & training plans) 2. Operational documentation (data conversion plan, cutover plan, downtime plan, support plans)To make transition as painless as possible-training