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NR 599 review study guide
General principles of Nursing Informatics
- Verbalize the importance of health information systems with clinical practice. - Have knowledge of types and clinical and administrative uses of health information systems. - Ensure confidentiality of protected patient health information. - Assure access control in the use of health information systems. - Informatics: Science and art of turning data into info. - Nursing Informatics ANS: The specialty that integrates nursing science with multiple information and analytical sciences to identify, define, manage, and communicate data, information, knowledge, and wisdom in nursing practice. o Nursing Informatics supports nurses, consumers, patients, the inter-professional healthcare team, and all other stakeholders in their decision making in all roles and settings to achieve desired outcomes. o 2 Levels NI practice: generalists and informatics-nurse specialists. Knowledge
- Awareness and understanding of a set of information and ways that information can be made useful to support specific task or arrive at a decision
- Information that’s synthesized so that relationships are identified and formalized.
- Processed information that helps to clarify or explain some portion in our environment or world that we can use a as basis for action or upon which we can act.
- Often affected by assumptions and central theories of a scientific discipline and is derived by discovering patterns of relationships between different clusters of information.
- Answers questions of “why” and “how”
- Data – uninterpreted items, often referred to as data elements. An example might be a person’s weight. Without additional data elements such as height, age, overall well- being it would be impossible to interpret the significance of an individual number.
- Information – a group of data elements that have been organized and processed
so that one can interpret the significance of the data elements. o For example, height, weight, age, and gender are data elements that can be used to calculate the BMI. The BMI can be used to determine if the individual is underweight, overweight, normal weight or obese.
- Knowledge - is built on a formalization of the relationships and interrelationships between data and information. A knowledge base makes it possible to understand that an individual may have a calculated BMI that is over 30 and not be obese.
- At this time, several automated decision support systems included a knowledge base and a set of rules for applying the knowledge base in a specific situation. o For example, the knowledge base may include the following information. A fever or elevated temperature often begins with a chill. At the beginning of the chill the patient’s temperature may be normal or even sub-normal but in 30 minutes it is likely the patient will have spiked a temp. A rule might read: if a patient complains of chills, then take the patient’s temperature and repeat in 30 minutes. Wisdom - Appropriate use of data, information, and knowledge in making decisions and implementing nursing actions. - Guides the nurse in recognizing the situation at hand based on patients’ values, nurse’s experience, and healthcare knowledge. - Implies a form of ethics, or knowing why certain things or procedures should or should not be implemented in healthcare practice. - Includes the ability to integrate data, information, and knowledge with professional values when managing specific human problems. - The use of knowledge and experience to heighten common sense and insight so as to exercise sound judgment in practical matters. - Thought to be the highest form of common sense, resulting from accumulated knowledge. - Ability to apply viable and valuable knowledge, experience, understanding, and insight while being prudent and sensible.
o Knowledge developers and generators: Changing and evolving knowledge based on the tasks at hand and the information available.
- With time, we begin to transform our experiences and applied knowledge into it highest form known as...wisdom. - Knowledge is a powerful tool and that nurses focus on information as a key building block of knowledge. Computer science
- Studies the theory underpinning information and computation and their implementation in computer systems.
- Looks at how the human mind works from an information processing perspective.
- Studies the theoretical foundations of information and computation and their implementation and application in computer systems.
- Study of storage/memory, conversion and transformation, and transfer or transmission of information in machines.
- Algorithms are detailed, unambiguous action sequences in the design, efficiency and application of computer systems, whereas practical implementation problems deal with the software and hardware.
- Facilitates the acquisition and manipulation of data and information by nurses, who can then synthesize these into evolving knowledge and wisdom base. Cognitive science - Study of thought, learning, and mental organization, which draws on aspects of psychology, linguistics, philosophy, and computer modeling. - Interdisciplinary field that studies the mind, intelligence, and behavior from an information processing perspective. Information science - Deals with the retrieval and management of information as well as human-computer interactions. - Studies the application and usage of information and knowledge in organizations and the interface or interaction between people.
- Concerned with the input, processing, output, and feedback of data and information through technology integration with a focus on comprehending the perspective of the stakeholders involved and then applying IT as needed. - An interdisciplinary, people-oriented field that explores and enhances the interchange of information to transform society, communication science, computer science, cognitive science, library science, and the social sciences. - Encompasses aspect of computer science, cognitive science, social science, communication science, and library science to deal with obtaining, gathering, organizing, manipulating, managing, storing, retrieving, recapturing, disposing of, distributing, and broadcasting information. - Studies everything that deals with information and can be defined as the study of ISs. - Enables the processing of information. - Links people and technology - Impacts information interfaces, influencing how people interact with information and subsequently develop and use knowledge. Standard Terminology (Week 1)
- Standardized terminologies (STs) contribute to the development of knowledge because they ensure that all professionals share the same understanding or meaning of a given concept, to clarify communication, facilitate research, and provide structure for decision support tools and EHRs.
Informatics Competencies (Week 2)
- Information Literacy: Refers to the use of digital technology to locate, navigate, manage, integrate, evaluate, create, and effectively communicate in a rapidly changing healthcare environment. The most important aspects of information literacy reflect information discovery, retrieval, and delivery as well as the ability to acquire, process, generate, and disseminate knowledge in ways that help those managing the knowledge reevaluate and rethink what an individual understands. o Ability to identify when information is needed as well as the skills to find, evaluate, and effectively use the same o Evaluation of online resources for quality o Able to search literature databases effectively
- Computer Literacy o Basic familiarity with computer uses and common applications o Ability to navigate hyperlinks o Able to set up and use a database to collect and retrieve information
- Clinical Information Management o Uses clinical decision making (CDS) and system safeguards to protect patients and protected health information (PHI) o Able to request and evaluate reports for the purpose of informed decision making o Participate in the selection, design, and evaluation of clinical information systems and patient-care technologies o Uses available technologies to appropriately and effectively communicate Health literacy (Week 2) - Degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. - Is dependent on individual and systemic factors: Communication skills of lay persons and professionals. - Is a major goal of Healthy People 2010
Meaningful Use (Week 3)
- The American Recovery and Reinvestment Act of 2009 specifies 3 main components of meaningful use: o Use of certified HER in a meaningful manner, such as e-prescribing o Use of certified HER tech. for electronic exchange of health info. to improve quality of health care o Use of certified HER tech. to submit clinical quality and other measures. - Defined by the use of certified EHR technology in a meaningful manner (for example electronic prescribing); ensuring that the certified EHR technology connects in a manner that provides for the electronic exchange of health information to improve the quality of care. - Developed as an incentive program to assure that EHRs are used according to standards that achieve quality, safety, and efficiency measures - Staged in 3 steps o Stage 1: baseline for electronic data capture and info sharing o Stage 2 & 3 continues to expand on this baseline and be developed through future rule making. Patient-centered Information Systems - EMRs, aggregate information systems, patient unique identifiers. - Aggregated data are used for the generation of routine reports and indicators, and for strategic planning and guidance within the health system. - Focused on collecting data and disseminating info related to direct care. - Most commonly types found in healthcare organizations: o Clinical documentation systems o Pharmacy info systems o Laboratory info systems o Radiology info systems.
o Reducing the incidence of medical error by improving the accuracy and clarity of medical records.
o Making the health information available, reducing duplication of tests, reducing delays in treatment, and patients well informed to take better decisions. o Reducing medical error by improving the accuracy and clarity of medical records Human-Technology Interface
- The study of interaction between human and technology. - With the evolution of technology and computer science, healthcare has been through many developments in respond to tech-world. - Human-Technology Interface in nursing defined as the application of computer technology to all fields of nursing. - It is hardware and software through which the user interacts with any technology (e.g., computers, patient monitors, and digital screens). - Indeed, the use and the development of technology in the clinical areas has become a necessity. Such technology has been already practiced in many nursing departments. o For example, the cardiac monitoring systems, defibrillators, electronic thermometers, intravenous pumps, Patient-controlled analgesia (PCA) pumps and many others hardware. - May present information using text, numbers, images, icons or sound. o Auditory, visual, or even tactile alarms may alert users to important information.
- Problems may include: o Nurses devise workarounds, such as removing armband from the patient o Major cause of as many as 87% of all patient monitoring incidents Health Information Technology - HIT has been promoted as a key strategy to achieve better care, affordable care, and healthy populations and communities.
o provide a framework for faculty and students of nursing at the associate, baccalaureate, master’s, and doctoral levels in the development of information literacy skills for evidence-based nursing practice o encourage the use of a common language for nursing faculty and librarians to discuss student information-seeking skills; o guide librarians and nursing faculty in creating learning activities that will support the growth of information literacy skills over the course of a program of nursing education and for lifelong learning; o provide administration and curriculum committees a shared understanding of student competencies and need; and o provide a framework for continuing education in the area of information literacy for the field of nursing practice and research
- Standard^ One:^ The^ information^ literate^ nurse^ determines^ the^ nature^ and^ extent^ of^ the information needed. o Defines and articulates the need for information. o Identifies a variety of types and formats of potential^ sources^ for^ information. o Has working knowledge of the literature in nursing-related fields and how it is produced. o Considers the costs and benefits of acquiring the needed information. o Re-evaluates the nature and extent of the^ information^ need.
- Standard Two: The information literate nurse accesses needed information effectively and efficiently. o Selects the most appropriate investigative methods or information retrieval systems for accessing the needed information. o Constructs and implements efficient and effectively designed search strategies. o Retrieves^ information online or in person^ using^ a^ variety^ of^ methods. o Refines the search strategy, if necessary o Extracts, records, and manages the in-formation and its sources.
- Standard Three: The information literate nurse critically evaluates the procured information and its sources, and, as a result, decides whether or not to modify the initial query and/or seek additional sources and whether to develop a new research process. o Summarizes^ the main ideas to be extracted^ from^ the^ information^ gathered. o Selects information by articulating and applying criteria for evaluating both the in- formation and its sources. o Synthesizes main ideas to construct new^ concepts. o Compares new knowledge with prior knowledge to determine the value added, contradictions, or (^) other unique characteristics of the information. o Validates understanding and interpretation of the information through discourse with other individuals, subject-area experts, and/or practitioners o Determines whether the initial query should be revised. o Evaluates the procured information and the entire process.
- Standard^ Four:^ The^ information^ literate^ nurse,^ individually^ or^ as^ a^ member^ of^ a^ group, uses information effectively to accomplish a specific purpose. o Applies new and prior information to the planning and creation of a particular product. o Revises the development process for the product. o Communicates the product effectively to^ others.
- Standard Five : The information literate nurse understands many of the economic, legal, and social issues surrounding the use of information and accesses and uses information ethically and legally. o Understands many of the ethical, legal, and socio-economic issues surrounding information and information technology. o Follows^ laws, regulations, institutional policies,^ and^ etiquette^ related^ to^ the access and use of information resources. o Acknowledges the use of information sources in communicating the product or performance. HITECH Act
o Culture: A respectful, open system that leverages technology and informatics
across multiple disciplines Review Questions found online:
- The nurse understands that nursing informatics is recognized as a specialty area of practice by which statement? o Research priorities for nursing informatics include the development of a standard nursing language and the development of databases for clinical information.
- Which statement by the nurse verifies that the nurse is "information literate"? o "I understand how to search for a website and evaluate its usefulness for health care needs."
- What is information? o data that can be interpreted. Example: patient’s temperature. Grouping of data process into meaningful structured form.
- The nurse gathers much data when caring for clients. Which is an example of the higher-level "information" useful in caring for clients? o After receiving Rocephin (ceftriaxone sodium) 1.0 gram IV yesterday, the client reported feeling better today.
- Which statement best distinguishes the difference between information literacy and computer literacy? o Information literacy forms the basis for ongoing learning whereas computer literacy refers to a familiarity with the use of personal computers
- Which statement indicates the appropriate level of informatics competencies to the correct nurse? o A nurse informatics specialist extrapolates data to develop best practice model for indwelling catheter care.
- What is Quality Information? o Information that is timeliness, precision, accuracy, numerically quantifiable, easily available, unbiased, clear and reliable
- Definition of Nursing Informatics by ANA: o Specialty that integrates nursing science, computer science to manage and communicate data , info and knowledge in nursing practice
- What are the functions of computers in Nursing Practice? o Record information, provide access to other departments, manage schedules
- What is Telehealth? o Uses technology to access, diagnose, and treat at a distance ▪ Examples of Telehealth devices: BP, pulse oximeters, scales, video monitors
- What is biometric technology? o Using human characteristics to authenticate or grant access to data or information
- How do human resources use computers? o Employee database, administration services
- How do medical records management use computers?
- What is the definition of information technology? o hardware and software facilitates storage retrieval, communication, and management of information
- What is the definition of computer literacy? o knowledge and understanding of computers with effective use
- How do you identify problems? o Locate current literature and related concepts
- What is the 3 things needed when looking for information online? o Define Purpose: Why are you doing the search? Why do you need this information? o Define Focus: Basic information for you, lay oriented for your patients, professionally orientated for you colleagues o Define Approach: Broad and general with information that can be quickly accessed
- Edu: education org: nonprofit organization com: commercial enterprise net: internet provider
gov: governmental body mil: military
- A disadvantage to the utilization of the electronic medical record (EMR) includes which of the following? o The intensive training in the beginning needed to prepare staff members to use the EMR
- Which action indicates the nurse is functioning as a knowledge worker? o The nurse auscultates diminished breath sounds in a postoperative client the morning after abdominal surgery and encourages the client to turn, cough, and deep breathe every hour instead of every two hours.
- A nurse manager wishes to hire a new nurse who has just graduated from nursing school. At the beginning level of informatics competencies, the nurse should be able to do which of the following? o Input vital signs and intake and output data in the electronic medical record.
- In which way does medical informatics overlap with nursing informatics? o Medical and nursing informatics focus on the areas of information retrieval.
- Health care consumers have all the information and tools to make health care choices because they can easily compare quality and cost of care. Which of the following is correct? o The statement is false because the tool has not been developed.
- The role of the informatics nurse does not include assessing the usability of devices for health care consumers. This statement is false because of which of the following reasons? o The development of policy regarding usability is an important part of the informatics nurse's role.
- Over the next few years, nursing informatics and other health informatics disciplines will crisscross, resulting in more interdisciplinary projects. This statement is true because of which of the following reasons? o Nurse informatics specialists will work collaboratively with other disciplines to develop user- friendly systems.
