Nursing Informatics Exam 2|96 Questions with Verified Answers,100% CORRECT

Nursing Informatics Exam 2|96 Questions with Verified Answers CHAPTER 27: Evidence-Based Practice and Research - CORRECT ANSWER pg.542 Information technology (IT) and systems - CORRECT ANSWER Refer to technology that has the capacity to accumulate, retrieve, control, convey, or accept information by electronic means EBP is a systemic process requiring the following activities: - CORRECT ANSWER Asking a relevant, searchable question Systematically searching for evidence Critically examining the evidence Changing practice as needed Evaluating the effects of change and maintaining its practice Comparative effectiveness research (CER) - CORRECT ANSWER The direct comparison of healthcare interventions to determine which work the best as well as those that can afford the greatest benefits as well as harm Research - CORRECT ANSWER The systematic collection of information in order to increase universal knowledge Search filters - CORRECT ANSWER Collections of hundreds of search terms used to search and retrieve research on particular clinical topics or problems 5 major activities involved in producing a thorough and comprehensive review of research databases: - CORRECT ANSWER 1)Knowing how to make a comprehensive search of databases 2)Knowing how to select studies you want to include 3)Extracting relevant information from the research articles 4)Developing competency and skills in extracting relevant information; provide a complete analysis of findings 5)Structuring the results of the systematic review in a clear manner Conducting one's own review of the literature and database searches for EBP include: - CORRECT ANSWER Record the details of the search Maintain notes on each review Prepare a succinct summary of all the studies reviewed Research-based practice and EBP - CORRECT ANSWER RBP does not consider clinical expertise or patient preference while EBP uses expertise to translate evidence into an innovative practice change Primary databases for searching nursing literature: - CORRECT ANSWER CINAHL Medline PsychINFO Digital library - CORRECT ANSWER The purpose is to transform large volumes of data into information and knowledge Open access to materials that would otherwise be challenging to access Allow users to search or brows a particular research topic Data collection tool - CORRECT ANSWER Gather specific details of an intervention in an organized, systematic, and scientifically robust manner Ex. of online data-collection tools or measurement instruments: - CORRECT ANSWER Physical assessment form, a graphics record, or opinion quentionnaires Data analysis - CORRECT ANSWER The processing of death collected during the course of a study to identify trends and patterns of relationships Knowledge discovery in databases (KDD) - CORRECT ANSWER Identifies complex patterns and relationships in collected data Provides a powerful tool suitable for the analysis of large amounts of data Data mining - CORRECT ANSWER The use of database applications to look for previously hidden patterns Supports sifting through large volumes of data at rapid speeds in ways that were not previously possible due to size or speed limitations Quantitative research - CORRECT ANSWER Uses objective measurements to study structured questions Typically large numbers of subjects are used to obtain results to be considered statistically valid Ex: in- Qualitative research - CORRECT ANSWER Subjective individual interpretation Ex: meanings, concepts, definitions, characteristics, metaphors, symbols, and descriptions of things--in-depth interviews and focus groups Nurmetrics - CORRECT ANSWER Uses mathematical forms and statistics to test, estimate, and quantify nursing theories and solutions to problems Computational nursing - CORRECT ANSWER A branch of nurmetrics that uses models and simulation for the application of existing theory and numerical methods to new solutions for nursing problems and for the development of new computational methods One proposed use of nurmetrics and computational nursing is the formulation and testing of new models for healthcare delivery by using computers Computer Retrieval of Information on Scientific Projects (CRISP) - CORRECT ANSWER Lists the stat for each project: title, grant number, abstract, principle investigator, thesaurus terms, and key words American Recovery and Reinvestment Act of 2009 - CORRECT ANSWER Appropriate $1.1 billion for CER (comparative effectiveness research) Ultimate goal of CER - CORRECT ANSWER To improve healthcare quality for individual patients and populations as well as healthcare providers and other stakeholders with better information regarding risks and benefits of the various treatments options available to them Bibliography database manager (BDM) - CORRECT ANSWER Software that allows the researcher to maintain accurate and current references and properly forms in-text citations as well as the final reference list PHI - CORRECT ANSWER Protected health information CHAPTER 23&24 - CORRECT ANSWER Technology and Education Communication tools: - CORRECT ANSWER E-mail Instant messages Blogs Podcasts Threaded discussions CMS or LMS - CORRECT ANSWER Course/learning management systems HIS - CORRECT ANSWER Hospital information systems 3 areas of competencies identified for competency-based training: - CORRECT ANSWER Nursing science Computer science Information science Didactic tools - CORRECT ANSWER Delivered via the the C/LMS and include Web resources (Weblinks, Weblogs, wikis, etc.) CRS - CORRECT ANSWER Classroom response systems VLE - CORRECT ANSWER Virtual learning environments Whenever a learner and a teacher do not meet face to face, but communicate "at a distance" to enable learning M-learning - CORRECT ANSWER Mobile learning Other instructional support... - CORRECT ANSWER Online literature searches Simulation Clickers Advantages of simulation - CORRECT ANSWER Standardized student learning opportunities Safe learning environment Unusual or high-risk clinical situations Mastery of skills Stimulate critical thinking and teamwork Disadvantages - CORRECT ANSWER Initial Cost Instructor training Distance education - CORRECT ANSWER Improve student access Meet student demands Extend geographic boundaries Remain viable Keep students on the cutting edge of technology Distance education can be synchronous or asynchronous - CORRECT ANSWER Synchronous = real time Asynchronous = delayed approach; learner reviews material at a convenient time VLE: Virtual learning environment - CORRECT ANSWER Instruction delivered outside the boundaries of the traditional classroom in which instructor and instructed do no meet face to face Virtual learning environment (VLE) - CORRECT ANSWER Any system that uses the Internet to assist the educator in developing, managing, and administering educational materials for students Facilitate learning Provide tracking capability Provide e-mail, chat, and discussion capability Blended learning Duke SON Second Life Virtual Patient Care Simulation Lab Available 24 hours a day and offers a safe learning environment Used to help develop procedural skills VLE advantages - CORRECT ANSWER Improved reading habits Convenience Reduced learning time Increased retention 24 hr access Consistent instruction in a safe environment Flexibility of faculty schedules VLE disadvantages - CORRECT ANSWER Reduced interaction with instructor and peers Lack of feedback Possibility for poor design and lack of intellectual stimulation 3 variables affecting the effectiveness of VLE - CORRECT ANSWER Quality of the software Environment of computer use Characteristics of the learner Course/Learning Management Systems - CORRECT ANSWER System that uses the Internet to assist in developing, managing, and administering educational materials for students Facilitate learning Provide tracking capability Provide e-mail, chat, and discussion capability Ex: Blackboard E-learning - CORRECT ANSWER Delivery of content and stimulation of learning primarily through the use of online telecommunication technologies such as blogs, podcasts, video, e-mail, bulletin board systems, electronic whiteboards, inter-relay chat, videoconferencing, and the World Wide Web (WWW) E-learning advantages - CORRECT ANSWER Convenience Flexibility Available anytime and anywhere there is an Internet connection Self-paced instruction May occur via mobile devices such as PDAs, iPods, or cellular phones Web-based instruction (WBI) - CORRECT ANSWER Uses attributes and resources of the World Wide Web (WWW) for educational purposes May be used to supplement traditional courses or as stand-alone instruction Benefits: self-paced learning, 24-hour availability, often prompt feedback, and interactivity Hospitals use this for annual education Videoteleconferencing - CORRECT ANSWER Skype GoToMeeting Microsoft 365 Print, audio, video, computer, tele- conference or the World Wide Web (WWW) to connect faculty and students located at 2 or more separate sites Web 2.0 - CORRECT ANSWER Uses web as a platform for collaboration to enrich user experience Facilitates online communication, learning, and collaboration Blogs, podcasts, wikis Wiki - CORRECT ANSWER A website that allows the easy creation and editing of any number of interlinked Web pages via a Web browser using a simplified markup language Podcasts - CORRECT ANSWER Internet based technology that allows distribution of audio or video content in MP3 file format via Real Simple Syndication (RSS) Content may be heard/viewed from any MP3 player anywhere, anytime Patients and the internet - CORRECT ANSWER Reliable information 24-hour access and convenience of the Internet Information about conditions, procedures, medications, providers Considerations for design/use of materials Readability level Ease of use Quality of content Patients and the internet (10 step scale)/E-patient access: - CORRECT ANSWER Level 1-Search for health information Level 2-Exchange email with family and friends Level 3-Seek guidance from online patient-helpers Level 4-Participate in online groups Level 5-Join with other online consumers to research their shared concerns Level 6-Use online medical guidance systems Level 7-Interact with volunteer online health professionals Level 8-Use the paid services of online medical advisors and consultants Level 9-Engage in electronic conversations with their local clinicians Level 10-Receive one way electronic messages from their clinicians Personal Digital Assistants (PDA) or Smart Phones - CORRECT ANSWER Nurses: Used at POC to ensure delivery of safe care Reference tools Calculators Patients: Medical diaries or logs Reminder messages for medications Web access to physician Social media - CORRECT ANSWER Nurses: HIPAA Professional boundaries Job implications Advantage: up to date on organization events, inspiring stories Patients: Support groups Social networking Disadvantage: questionable content posted, anxiety generation, confidentiality issues E-patients - CORRECT ANSWER Individuals who assume access to healthcare information 24/7 and expect to be a partner in healthcare decision making CHI - CORRECT ANSWER Consumer health informatics Studies from a patient/consumer perspective the use of electronic information and communication to improve medical outcomes and the healthcare decision-making process Health literacy - CORRECT ANSWER The ability to obtain, process, and understand basic health information needed to make appropriate health decisions They must have competency in: Visual literacy Computer literacy Information literacy PHR - CORRECT ANSWER Personal health records These are consumer-selected tools (ex: smart phone apps) Difference between EMR and PHR - CORRECT ANSWER EMRs are owned, managed, and maintained by the provider while the consumer manages information in the PHR Consumers don't have permission to enter information in the EMR, but might be the major contributor to their PHR Home telemedicine - CORRECT ANSWER Encompasses a number of different tools that can be utilized by consumers to self-monitor and self-manage health conditions Informatics specialists as designers need to... - CORRECT ANSWER Make the site easy for the public to access with understandable content Interrelate and integrate existing resources extending from consumer health resources to clinical and scientific resources Create an informatics knowledge base to sustain the project eHI - CORRECT ANSWER e-Health Initiative Developed by a group of stakeholders dedicated to promoting the use of information technology as a means of improving the quality, safety, and efficiency of managing and improving healthcare delivery CHAPTER 14&16 - CORRECT ANSWER Electronic health record and Personal health record SNOMED-CT - CORRECT ANSWER Systemized Nomenclature of Medicine Clinical Terms Was chosen as the common language required by 2015 for certified EHRs NANDA - CORRECT ANSWER North American Nursing Diagnosis Association NIC - CORRECT ANSWER Nursing Interventions Classification NOC - CORRECT ANSWER Nursing Outcomes classification ICD - CORRECT ANSWER International classification of diseases Electronic medical record (EMR) - CORRECT ANSWER Long referred to single episode of treatment Comprised of structured and unstructured data Components include: Clinical messaging and email Results reporting Data repository Decision support Clinical documentation Order entry Structured data - CORRECT ANSWER Have predefined format (discrete data) examples assessments, vital signs, intake and output—could be easily put into a report Data that follow a predefined format and are often presented as discrete data elements Unstructured data - CORRECT ANSWER Data that doesn't follow any particular format and is often provided as text report such as consultation findings, nurses notes, operative reports—hard to identify trends EMR components - CORRECT ANSWER The EMR is the source of data for the EHR Results reporting Data repository = where the documentation/source of data lives and can be easily retrieved when needed Decision support Clinical messaging and e-mail = clinicians can communicate each other Documentation = if it's not documented, it's not done Order entry = orders simultaneously go to the right departments EHR attributes - CORRECT ANSWER Secure, reliable access where and when needed Records and manages episodic and longitudinal information Assists with planning and delivery of evidence-based care Supports : Clinical research Public health reporting Population health initiatives Captures data for: Quality improvement Utilization review Risk management Resource planning Performance management Reimbursement ICD-10 Levels of Automation of EMR - CORRECT ANSWER 0—Not all ancillary systems operational = has purchased the system and it just getting started 1—Major ancillary clinical systems up = major insullary (supporting department) systems are up ; ex: radiology, the laboratory, pharmacy 2—Major ancillary clinical systems + CDR (clinical data repository) = big data warehouse to review is up; allows physician to retrieve and review results 3—Some documentation and retrieval (vital signs, flow sheets); x-rays and other diagnostic things; nurses' notes, care plans, and/or electronic medical administration records may be present and are integrated with the CDR for at least one hospital service 4—CPOE, support for evidence-based practice = doctors, NPs, etc., are placing their own orders in the computers 5—BCMA + identification technology + CPOE = bar coding and CPOE; when the order puts the medication order in the system, there is that checking and scanning of patient and medication—huge for safety; at least one service area has the closed loop medication administration process where barcode medication administration or other identification technology is in place and integrated 6—Physician documentation, DS, alerts, PACS = at least one service is using physician documentation; can pull up radiology reports on the PACS computer 7—Fully electronic paperless environment Know page 277 Meaningful use - CORRECT ANSWER Federal incentives allocated for facilities that can demonstrate they are "meaningfully using" certified EMR technology to improve patient care. Medicare and Medicaid EMR incentive programs are staged in three steps with increasing requirements for each stage. CMS has defined core objectives that measure the impact of an EMR EPR - CORRECT ANSWER Electronic patient record Not necessarily a lifetime record, that focuses on relevant information for the current episode of care CPR - CORRECT ANSWER Computerized patient record Comprehensive lifetime record that includes all information from all specialties Unlike the EMR, the EHR... - CORRECT ANSWER Provides interactive patient access as well as the ability for the patient to append information CCD - CORRECT ANSWER Continuity of care document Intended to improve the continuity of care when clients move between various points of care It is a snapshot of patient status, rather than a comprehensive report Meaningful use of the EHR - CORRECT ANSWER Patient engagement Reducing racial disparities Improved efficiency Increased safety Coordination of care Measures to improve population health Stage 1 Focuses on electronic capture and sharing of information: record demographic info CPOE drug-drug, allergy interaction checker med list vital signs, BMI, smoking status Stage 2: must meet 5 of the requirements HIT use at POC for quality improvement lab results as structured data med. Reconciliation submit electronic data to immunization registries Stage 3 Improved outcomes and population health Not yet defined Benefits of the EHR - CORRECT ANSWER Improved data integrity Increased productivity Improved quality of care Increased satisfaction for caregivers Benefits exist for many groups: Nursing Healthcare providers Healthcare enterprise Consumers Payer Nursing benefits - CORRECT ANSWER Facilitates comparison of data from previous events-example weights, supports ongoing record of patient's education such as trach teaching, improves documentation, provides prompts to ensure administration and documentation of medications and treatements Healthcare providers benefits - CORRECT ANSWER Improved eligibility for reimbursement, simultaneous record access, early warning of changes in patient status, increased efficiencies in workflow Healthcare enterprise - CORRECT ANSWER Improved record security, strengthened communication, fewer lost records, decreased need for x-ray film, enhanced compliance with regulatory requirements Better record security Instant notice of eligibility/procedure authorization Decreased need for record storage, x-ray film, filing Faster turnaround for accounts Decreased length of stay Consumers - CORRECT ANSWER Decreased wait time for treatment, increased medication safety, alerts and reminders for appointments Decreased wait time for treatment Increased access/control over health information Increase ability to ask informed questions Increased responsibility for own care Alerts and reminders for appointments and scheduled tests Increased satisfaction and understanding of choices Payer - CORRECT ANSWER Supports pay for performance, accurate billing Benefits of the EHR continued - CORRECT ANSWER Increases data integrity and quality Increases productivity Increases satisfaction for caregivers Decreases redundant data collection Allows data comparison from prior visits Ongoing record Supports decision support Better/faster data access Supports research Improved documentation Prompts to ensure administration of treatments and medications Supports trending Supports automation of critical pathways = the expected course of treatment Improved efficiency EHR current status - CORRECT ANSWER No country has an operational EHR. Bush called for adoption of the EHR by 2014. Departments of Defense, Health and Human Services, Veterans Administration, and Centers for Medicare and Medicaid Services mandated the EHR for their facilities and operations Personal health record (PHR) - CORRECT ANSWER Private, secure application which an individual may access, manage and share his or her health information Evolving definition of a PHR Different from an EHR Driven by consumers Multiple sources of health information and services PHRs - CORRECT ANSWER Standalone systems are not tied to any healthcare system. Security is a big threat here. You as a patient have to enter in all the data, so they're not very popular Google Health PHR (discontinued in 2012) Microsoft Health Vault Tethered systems are tied into a healthcare system. My HealtheVet PHR from the VA PHR combined within EHR - CORRECT ANSWER Shared medical record with patient: Lab and test results Medication lists Appointment After-visit summaries Visit notes Patient clinical reminders Data integrity - CORRECT ANSWER Can be compromised in three ways: incorrect entry, data tampering, and system failure IOM - CORRECT ANSWER Institute of medicine INS - CORRECT ANSWER Informatics nurse specialist