Chapter IX Flashcards
data-to-knowledge continuum is represented within what 2 constructs
client and outcome
captures the intrinsic complexity of the healthcare-centered technology decision-making process
Informatics Research Organizing Model
SRO model’s 4 construct
client, intervention, context, and outcome
corresponds to nursing (in the
nursing metaparadigm) and describes the nursing informatics solution in terms of the content, structure, and flow of the information, as well as the technology used.
Nursing informatics intervention
Developing organizational policies and standards
being an advocate for consumers, hospital units, and the institution as a
whole; also helping shape policies and standards at the state, national and
organizational level.
Policy development and advocacy
President of General Motors in the 1920s.
Initiated the planned obsolence movement which
started in the automobile industry
Alfred P. Sloan
addresses HIT decision-making from an organizational perspective but a nursing-centric analysis of the process reveals further complexity coming from the dynamics of the physician-dominated HIT discussions
IRO
make sure the tools and procedures being implemented will be userfriendly and practical for the rest of the staff.
The nurse guides design of technology that is nurse-friendly, supportive
of nursing work, accessible and mobile (
Data integration
e.g. NI might prepare training for a team of medical-surgical nurses on the use of a new electronic medication dispensing system. After the training,
NI then serve as their point of contact for any questions or concerns that come up as the system is put in place.
Educational and professional development
occurs when the consumer makes some
value judgement regarding its continued consumption, often following a comparison with other available products.
Relative obsolescence
align technologies and systems under consideration with organizational
objectives.
Systems integration
the information, knowledge, decisions,
and actions that emerge from the data to improve cost, quality, safety, and satisfaction outcomes
Outcomes
identifiable in the SRO model’s 4 constructs
(client, intervention, context, and outcome)
nursing metaparadigm
what are included in client construct
data or information, client or discipline behaviors or characteristics
- Analyzing clinical statistics
using data to synthesize knowledge, inform decision support, and
manage outcomes as well as taxonomies.
NI command highly specialized knowledge from three distinct disciplines:
Analysis
In SDLC, it is sometimes considered the sixth phase, is
represented at occurring throughout
evaluation
a direct reporting structure to the technology expert offers the most efficient and
effective pathway to this highly specialized knowledge =
Nurse Informaticist
shown by the outer ring, represents the 4 constructs
Systems Research Organizing (SRO) Model
Staff training, Troubleshooting, Escalating issues as needed
systems implementation
focus the training of new technology on how it will improve their ability
to care for patients
User training
what are included in outcome constructs
information, knowledge, decisions and actions to improve cost, quality, safety, and satisfaction
what is shown as occurring at each stage of the lifecycle.
evaluation
foundation for these studies
as manufacturing firms have been capable of
engineering their products to fail after a determined
period of time,
Durability
is composed of the data and information
collected from clients, as well as client behaviors and
characteristics.
client construct
Technology’s Life Cycle
planning to procurement to deployment to management to support
and disposition, only to cycle back to planning.
2 component models of Informatics Research Organizing Model
Systems Development Life Cycle (SDLC
Systems Research Organizing (SRO) Model
phases in SDLC
plan, analyze, design, implement, maintain
act as a point of communication between clinical nurses and IT staff
Serving as a liaison/translator between staff and information technology
experts
report feedback on new systems and technology directly from the staff
who are using it each day
Patient care coordination, facilitation, and integration
Roles of Nurse Informaticist:
Leadership, including management and administration
Analysis
Integrity and compliance management
Consultation
Patient care coordination, facilitation, and integration
Data integration
Educational and professional development
Policy development and advocacy
Research and evaluation
Systems integration
Process and workflow design
Clinical transformation
Information technology security
Clinical champion
User training
what are included in context construct
cultural, economic, social, physical
e.g. NI identify the key areas where studies tell problems arise: inadequate
discharge education, a patient doesn’t have support at home, poor
hearing or sight, or being on multiple medications. NI take those variables
and identify how and where in the system NI should alert a nurse that this
is a possible red flag and give her the elements of a plan to decrease the
risk for a readmit.
Research and evaluation
nursing metaparadigm
patient, nursing, context, and health
Most nurse executives view technology-related decision-making as an episodic responsibility that takes place once every ***, the timeframe when major HIT systems are replaced
seven to 10 years
Two Perspectives Of Nursing Informatics staff:
• content structure
• information flow
delineates the actual steps of clinical practice as they occur during patient care
Process mapping
Durability, designed failure process that is
dealt with in **
value engineering’
e.g., NI work with the delivery-of-care team – the chief nursing officer,
chief medical officer and quality leadership – who might give NI a directive
based on improving patient safety by decreasing readmissions.
Clinical transformation
three distinct disciplines in analysis
clinical nursing, information technology, and research
common conceptual basis for nursing and health informatics consists of a triad:
data, information, knowledge
e.g. When a client wants a specific functionality or workflow, NI can take
it and go to the application builders and speak their language to explain
what the clinical folks are looking for. If technical people have issues, NI
can go back to the clinical folks and try to find the resolution that will
technically work.
Patient care coordination, facilitation, and integration
- a process model which is represented by the center ring as 5 distinct phases.
Systems Development Life Cycle (SDLC)
“to create demand for the new
value and, so to speak, create a certain amount of
dissatisfaction with past models as compared with
the new one
providers’ planned obsolescence
Information and communication technologies to address interprofessional work flow needs across all care venues
Process and workflow design
helping make sure organizations are meeting all the national laws and
standards such as HIPAA, FDA, Joint Commission, etc.
selecting and preparing new technology, as well as training and
supporting the nursing staff on the how to use it
Tracking the success of quality initiatives
Integrity and compliance management
Evaluating the success of implementation; revising as needed
Researching different informatics topics that affect health care providers
as well as patients
Research and evaluation
serving both internally or externally as a resource
As a trusted advisor to the nurse executive, the NI serves a “translator” of
technology capabilities, options, and alternatives to the nurse executive
Nurses spearhead the selection, development, implementation, evaluation and modification of the electronic medical record (EMR) and other technologies such as bar coding of medications, blood transfusions and laboratory specimens.
Consultation
must be properly trained to recognize, assess, and report cybersecurity
threats within their organization as part of the informatics and healthcare
technologies curriculum
competency in maintaining the security ofsensitive data related to patient
information and the care nurses provide
Information technology security
occurs when a product has physically
deteriorated to the point at which it does not provide the consumer with the functionality for which it was being consumed
Absolute obsolescence
contributing to the design and build of different EHR functions by building
a workflow that augments what the technology can do
must be knowledgeable on how to structure, create and drive these systems so they remove what’s redundant, and incorporate what’s important and how it all aligns.
NI makes a huge difference in an IT project, because they are be able to translate and talk to leadership to bring them on board before any initiative.
Clinical champion
largest “user group” in most healthcare organizations; feels the impact of technology decisions faster and more often than other user populations
in the healthcare organization
nurses
NIs use this rich, interdisciplinary perspective to analyze patient care and
outcome data, creating new knowledge that advances the clinical practice
of nursing
Analysis
term used when a
technical product or service is no longer needed or wanted
even though it could still be in working order.
Technological obsolescence generally occurs when a new
product has been created to replace an older version.
Technological Obsolescence
a process model that interacts with all 4 concepts in the SRO model.
SDLC
Adding an outcome orientation to those decisions layer impacts what:
cost, quality, safety, and satisfaction
what are included in NI intervention construct
content, structure, and flow of information; technology characteristics
in the adapted SRO, “system” was changed to “**”
because the entire model was viewed as the relevant
“system.”
context
either directly with clinical informatics departments or in combination
with other functional areas such as serving as project managers.
Assisting in the transition from one system’s technology to another
Leadership, including management and administration
Nursing-centric technology decisions emerge from a setting that includes:
• cultural
• economic
• social
• physical requirements
spans the mechanical arrangement of information, forms, and triggers to document nursing practice.
Workflow design
at the center of this advancement as the professionals with the greatest amount of direct patient care.
nurses
defined as the cultural, economic, and social
environment in which the intervention occurs.
Context
focus the training of new technology on how it will improve clinical nurses’ ability to care for patients
ranges from teaching the end-user to use a device or application to educating the next generation of nurses and the general public
Educational and professional development
