Exam 3 Flashcards
What does nursing informatics do?
Integrates, nursing science, computer, science, information, science, information, technology to manage and communicate data, information, knowledge, and wisdom
Facilitates decision-making in all nursing roles
All allows nurses to deal with volumes of information on a daily basis
Requires all nurses to develop basic computer literacy and information management skills 
What is information systems?
Technology base system, that stores processes and manages information at individual and organizations
What are two major types of information systems?
Administrative or clinical
What do information systems do?
Provide an infrastructure for the organization
Requires thoughtful decision and input from the members of the organization
Requires resources for development, maintenance
What is information technology?
Combines computer technology with data and telecommunication technologies to provide solutions in the healthcare industry
Supports safe and quality patient care
Facilitates decision making all nursing roles
What is an electronic record?
Improves research quality management metrics data quality and access to data that support population health
What is an EMR?
Electronic medical record of a patient that is used by a single organization
What is an EHR?
Electronic health record used by more than one organization provides information throughout
What is a PHR?
Personal health record an electronic form of a patient’s medical record that the patient can take with him or send to a healthcare provider
What is a network in technical aspects of informatics?
Fundamental framework of an information system that allows electronic devices to transfer information between each other
What is the most common example of a network?
Internet
What is a intranet
A network within a healthcare organizations own network
What is data in technical aspects of informatics?
Collection of information, facts, or numbers
Gathered manage, analyze and interpreted to ensure effective operation of the unit as well as safe and effective delivery of nursing care
What is a database in the technical aspects of informatics?
Central place that stores data
Provide a key location for data to be stored and retrieved for analysis when needed
What is clinical data repository?
Database in which data from all information systems within an organization are kept in controlled
What is data mining?
Process of sorting through large data sets to identify information patterns in relationships that are previously unknown
Can be used to understand patient symptoms, predict diseases and identify possible interventions
What is interfaces used for?
To match data points from one system to the other system so data can be communicated between systems or sent to a main information system for collective use in analysis
What is real time processing?
Sending information as it’s gathered
What is batch processing?
Sending information with a delay to save system resources
What is decision support system?
Used to provide warnings or other decisions, support methods in order to help healthcare professionals become more aware of certain clinical information or utilize evidence space practices
When should rules and alerts be used?
On a limited basis, and focus on the most crucial patient care issues
What is a rule
Requires an action within the system to trigger or fire it
What is an alert?
A straightforward warning to implement precautions per institutional policies, which usually requires acknowledgment of the warning or reason for overriding it
What is machine learning or artificial intelligence?
Computer science theory that it uses statistical techniques to give a computer or artificial intelligence, the ability to progressively improve performance on a given task
What is standardized languages?
Allows for streamline sharing of information same terms are used by everyone to describe same condition
Important for effective data mining required for nursing documentation
How does informatics contribute to patient safety?
Patient safety is the most important directive for electronic health record
The use of evidence space cues within the information system, rules and alerts in reminders that decrease memory care contribute to improve patient outcomes
What is HIPAA’s privacy rule?
Designed to safeguard an individuals, health information
What is HIPAA security rule?
Establishes a set of national standards to protect electronic health information
What is HIPAA’s breach notification rule?
Requires all healthcare organizations to report any data breaches
What is the American recovery and reinvestment act of 2009 ARRA
Known as the HITECH ACT
Requirements include metrics to improve patient care, quality and public health
Provides incentives when metrics are met by both physician practices in hospitals to move forward, electronic documentation, and processes to improve patient care
Who are the regulatory bodies that review IT
Joint commission
Center for Medicare said Medicaid
US department of health and human services
What is the meaningful use program?
Center of Medicare and Medicaid services program that requires use of the electronic record to improve patient care and consists of three stages
What are the three stages of the CMS program?
Stage one data capture and sharing
Stage two advanced clinical processes
Stage three improved outcomes
What is a chief information officer?
Strategic planning for technology and computer systems in an organization
What is a chief medical information officer?
A physician who integrates the field of medicine and IT
What is a chief nursing information officer?
Integrates, nursing, and IT in charge of strategic planning for the information system
What is a project manager?
Responsible for planning, monitoring, and execution of an informatics project
What is a clinical systems educator?
Analyses education needs of clinical staff who will utilize information systems
What is the data set?
Used to provide a standard set of data on a patient as well as standard definitions of data elements
What is coding
Process of taking the data in a patient file and applying an industry, standard medical code of data
Includes two basic types of coding systems ICD and CBT
What is data security?
Protect patient data from being lost changed, or held hostage by viruses or
Attacks
Done through use of unique usernames and passwords
What is an EMAR
Electronic medication administration record
Supports documentation of medications by providing a list of medication orders when they are due to be administered
What is CPOE
Computerized provider order entry
Allows providers to enter orders directly into a patient’s record
What is barcode medication administration?
Processing which clinicians use a barcode reader to verify patients identity and drug information immediately prior to giving medication to a patient
What is patient portals?
Web-based platforms that allow patients to access their health information
What is telehealth
Specialty in which electronic devices and telecommunication technologies are used to serve education and healthcare, to clinicians and patients
What is a super user?
Representatives from local nursing locations, who receive enhanced training to help with implementation, success, instability, overtime
What is conversion
Point when you switch from one system to another turn on a new application
What is implementation support?
Requires technical vendor, education, and support resources
What is maintenance?
Support of the application through enhancements to the systems throughout the rest of the systems lifecycle
What is system downtime?
Procedures in place to tell staff how they will get information on the system is down
Why is there continued nursing shortage?
There’s an increasingly complex healthcare, environment
Estimated 1,000,000+ RN reaching retirement between 2025 and 2030
Loss of knowledge and experience will result in negative consequences to patient safety and quality care

What is the new type of nursing shortage?
The shortage of knowledge, skill, expertise, and clinical judgment
What a nurse leaders and recruiters have to do while making hiring decisions
Carefully and seek and select the best person for the right position
Consider recruiting and hiring a balance of new and experience nurses
Provide adequate transition to practice programs to develop and retain experience nurses
Offer continuing education, up-to-date technology for advancement
 what should nurse leaders do in the interviewing process?
Prepare for interviewers by reviewing applicants information, résumé, and letters of reference
Keep the focus of interview on the rules and responsibilities, outlined and position description
What did nurse leaders role in orientation?
Be dedicated to providing a proper orientation for new staff to enhance retention
Bridge the gap between student nurse, and clinical, setting and world clinical setting
Select inappropriate preceptor, using the novice to expert model
Provide regular verbal in written feedback to build confidence and self-esteem
How can you become a preceptor?
Should have at least three years experience organized with good time management
How can a nurse leader retain nurses?
Examine strategies to retain experience nurses to avoid an adequate staffing and higher turnover
Provide strong leadership at unit level
Create, cultural, norms, and environment, that result in workforce safety
Provide meaningful recognition, mentoring, coaching, and professional development opportunities
What are some principles for INTRAprofessional team
Consist of nurses at various levels in the organization
Ensure patient care is continuous and reliable
Use tools effective for communication and active listening
Create authentic relationships in a learning environment and culture
Include all healthcare professionals, patient and his or her family
Collaborate communicate and integrate care
What is teamwork?
Involves integrating, the knowledge, expertise and experience of healthcare professionals
What are the core competencies of teamwork?
Values and ethics for interprofessional practice
Knowledge of others, rules, and responsibilities
Responsible, interprofessional, communication
Application of principles of team dynamics
What is collaboration?
Working jointly with others in mutual beneficial ways towards the a common goals
What are the five questions you ask when you’re considering building a team?
What are the tasks the team needs to accomplish
Is representation from various levels of the organization needed
Is geographical educational and interprofessional diversity needed
With skill mix is necessary for the team to succeeded
Are the same people on the team as usual or has new staff staff been encouraged to join
What is forming?
Initial stage in team development
Begin discussing goals
Members avoid controversial topics
Nurse leaders and managers help direct the team and explain the purpose
What is storming?
Team starts to work together
Member share their opinions resulting sometimes in intro group conflict
Nurse, leaders and managers assist with resolving conflict and Coach team members through conflict
What is norming?
Team overcomes resistance in progresses through the storming phase
Members give up individual goals and begin working as a team toward the common goal
Your leaders and managers step back and allow the team members to take responsibility
What is performing?
Team members understand their roles
Members except each other’s, individuals, idiosyncrasies and develop group norms
Nurse leaders and managers, focus energy on other projects
What is adjourning?
The final stage of team development is when the work of the team is completed
Members prepare emotionally to disband
Nurse, leaders and managers celebrate the team successes and provide recognition
What is the importance of creating synergy?
Combined strength of all members
Leads to outcomes that might not have been possible, if members worked alone
Foster, creativity, imagining intellectual networking
Requires members to value their own expertise, as well as others, expertise and be open minded
What is team leadership
Directing and coordinating the activities of team members, including assigning tasks, developing team, knowledge and motivating team members
What is mutual performance monitoring?
Developing common understandings of the team environment and applying appropriate task strategies
What is back up behavior?
Anticipating other team, members needed through an accurate understanding of their responsibilities
What is adaptability?
Adjusting strategies based on information, gathered from the environment through the use of back up behavior and relocation of team resources
What is team orientation?
Considering other team members behaviors during the group interaction in the belief of the importance of the team goals over the personal goals
What does mutual trust?
Believing that team members will perform their roles and protect the interest of their teammates
What is close loop communication
Exchanging information between a sender and a receiver
What are some characteristics of an effective team leader?
Positive impact on manager, staff, relationships, and team experiences
Enhances job certification in promote staff retention
Leads teams towards success
How does one manage generational differences?
Identify strategies to create cohesive partnerships among the different generations
Discourage stereotypes and judgmental attitudes about each generation
Acknowledge what each generation brings to the table
How does one manage cultural differences?
Engage in cultural, congruent practice
Develop recruitment and retention strategies to achieve a multicultural workforce for
Create a diverse workforce that reflects the population, it serves to improve nurse patient relationship and communication increase patient satisfaction improve outcomes
How does one managed gender differences?
Be sensitive to differences, be fair, varied, perceptions, and address any issues that arise appropriately
What is an appraising performance
Assess a new employee at the end of probation status
Provide recognition or constructive feedback
What are the key points of an effective performance appraisal
Enhances, employment development, and motivates staff to improve performance
Ensures feedback is based on facts
Provides employee feedback
Six. Input from the employee regarding plans for improvement.
What is self appraisal
Reflecting on one’s own personal actions and professional performance
May include feedback from patients in their families
What is a peer review?
Assessing monitoring, and making judgments about the quality of nursing care provided by a peer
Fosters accountability and support self regulation
What is constructive feedback?
Supports and motivates the employee to succeed and grow
Involves showing a respect and praising the employee for a job well done
What is 360° feedback
Is constructive nurse receives feedback from everyone around them
Provide specific opportunities for employee to use development plan
What is a corrective action
Progressive process used to improve poor performance, in which deficiencies and substandard performances, are addressed immediately to avoid escalation of behaviors
What must the nurse leaders and managers do while using a corrective action?
Explore the deficiencies and gather evidence to determine type of violation
Address, minor rule, infractions directly with the employee providing feedback for improvement
Address, major infractions with immediate termination
Encourage nurses who observe, questionable behavior, or practice to report these concerns
 what are the five questions of the care delivery model?
Who is responsible for making decisions about patient care
How long does that person’s decision remain in effect?
How is work distributed amongst staff by task or by patient?
How is patient care communication handled?
How is the whole unit managed?
What is the role of a nurse leader in manager in the caredelivery model
The participate and redesigning nursing care care delivery by focusing on patient centered care
Ensure Frontline nurses participate in decision-making
Serve as a change agent
Determine when new delivery models are appropriate
What is the care delivery model?
Organize and deliver nursing care and focus on structure process and outcomes
Balance, the needs of patience with competencies and available staff
Provide continuity of care
What is the traditional care delivery
Model total patient care
Coldest model of care
Responsibilities include complete, nursing care of patient plus other duties holistic care
Used in setting, such as critical care and hospice care
Communication is hierarchal charge. Nurse is responsible for making assignments, interfacing with physicians and shift reports
What is the traditional care delivery model, functional nursing?
Implemented as a means to accomplish patient care with the assistance help
Staff works side-by-side in assigned to complete specific tasks for a group of patients
Used in long-term care in ambulatory care
Viewed as efficient and cost-efficient, but results in fragment care
Communication is higher charge. Nurse is primarily responsible for assigning shift supervising tasks, interfacing with physicians and writing shift reports.
What is the traditional care delivery model team nursing?
Total care is delivered by license and unlicensed personnel under direction of team leader
Communication is hierarchal charge. Nurse is responsible for related tasks directly.
Used in MedSurg units
What must the team leader do in a team nursing delivery motto?
Assigned duties to team members based on licensure education, ability and competencies
Supervise care provided and provide more complex care
Interface with physicians and provide shift reports to the oncoming team leader
What is traditional care delivery models, primary nursing?
Primary nurse is not available an associate nurse carries for the same group of patients, following the plan of care developed by the primary
Decisions occur at the bedside with patient and family
Used in home health
Communication is lateral with the primary nurse, being responsible for direct care, interfacing with physicians and other members of the healthcare team
What is the nontraditional model of partnership models
Goal is to decrease the cost of nursing care while increasing productivity
Communication is lateral and RN coordinate and provide care and remain accountable for all patients
What are some examples of partnership models?
Partnership in practice (PIP)
RN hires and works with UAP as partners on the same schedule
Partnership to improve patient care (PIPC) same as PIP, except RNs are not involved in hiring
Nurse extender model
Same as PIP, except RNs are not involved in hiring
What is the contemporary model of professional nurse practice model?
Requires higher orientation ratios with RN, having greater autonomy and control over practice
Identified as core feature of magnet hospitals
Higher rates of patient satisfaction, lower rates of nurse, burnout, and safer work environments
Includes interprofessional and interprofessional communication in the RN controls the delivery of nursing care
 what is the contemporary models of differentiated nursing practice model?
Kara is differentiated based on the level of education competency and clinical expertise of RNs
Recognizes that all nurses, regardless of education are needed to provide high-quality comprehensive care to patient patients in all settings
What are the goals of a differentiated nurse practice model
Optimal, nursing care matching patients needs with nurses competencies
Effective in efficient use of scarce nursing resources
Equitable compensation, and increased career satisfaction among nurses
In contemporary models, what is the clinical nurse leader model
Goal is to improve the quality of patient care across the continuum and engage. Highly skilled clinicians in outcome base practice and quality improvement.
What does the CNL clinical nurse leader model do?
Design implement and evaluate patient care by coordinating delegating and supervising the care provided by an interprofessional team
Is a provider and coordinator of care and Foster interprofessional and intraprofessional communication
In contemporary models, what is the patient and family centered care model
Places and emphasis on collaborating and planning care with patients and their families of all ages, at all levels of care, and in all healthcare settings
Based on foundational concepts, dignity and respect, information, sharing, participation, and collaboration
In the patient and family centered care, model, nurses
Initially, and promote a self healing environment
Effectively communicate with patients and their families
Provide all necessary information for patient to make an informed health decision
What are the guidelines for prioritizing nursing care?
1.) life-threatening problems, or those that could result in harm to the patient if left untreated
2.) actual problems and needs before potential problems or risks
3.) acute problems before chronic problems.
4.) problems identified as important to the patient.
What is the average daily census?
Average total number of patients when census is taken at midnight over a given period of time, such as weekly monthly or yearly
 what is staffing mix?
Refers to the appropriate numbers of RNLPN in UA Pc needed needed on a unit
What is patient acuity?
Represents how patients are categorized according to an assessment of their nursing care needs
What is skill mix?
Refers to the vary, level of education, licensure, certifications, and experience of the staff
What is an RN scope of practice?
Licensed personnel, who have completed a specific course of study at a state approved school of nursing and passed NCLEX
Fairly consistent nationally and globally includes all aspects of nursing process
What are the responsibilities of an RN
Assessments, diagnosis, planning, intervention and evaluation
Patient teaching discharge planning in evaluating monitoring changes in patient status
Assignment, supervision, and delegation
What is an LPN/LVN
Licensed personnel, who have completed a specific course of study at a state, approved, practical or vocational nursing school and passes the NCLEX
What are the responsibilities of an LPN
Is responsible for physical care, taking vitals and administering medication
Always works under the direction or supervision of an RN advanced practice, RN, physician, or other healthcare providers designated by state
What is a UAP scope of practice?
Unlicensed personnel specifically trained to function in an assistive role to RN, and may or may not be regulated by state Board of nursing
What is the responsibility of a UAP?
Daily living hygiene and physical care
Performs task delegated by RN
To determine adequate staffing levels nurse leaders and management must recognize
Unique patient care settings
Patient, Flo admissions, discharges, and transfers
Patient acuity
Skills, education, and experience of staff
What is the patient classification system?
Patients are grouped according to acuity of illness in complexity of nursing activities necessary to care for patients
What are the cons of patient classification system?
Lack of standardization lack of credibility among nurse, leaders and managers, and no considerations of patient Flo, very subjective as the leader determines what group each patient falls into
What is ANA’s principle for safe staffing
Focuses on, addressing the complexities of nursing staffing decisions, and applies them to all of nursing staffing in all types of healthcare settings
What are the five categories of ANA principle for Steve staffing?
Characteristics and considerations of the healthcare consumer
Characteristics and considerations of RNs and other interprofessional team, members and staff
Context of the entire organization in which the nursing services are delivered
Overall practice environment that influences delivery of care
Evaluation of staffing plans
What is a staffing plan?
Describes the number and type of nursing staff needed to shift to shift and day-to-day
When developing a staffing, plan, nurse leaders and managers must or should consider
Regulatory requirements, including federal and state legislation
Guidelines from accredited agencies, such as joint commission
Standards of practice like the ANA scope and standards of practice
Beares novice to expert model
What is the Benners novice to expert model?
Takes into account, the test, competencies and outcomes. RN can be expected to acquire.
What are the five stages of the benners novice to expert model
 stage, one novice have no experience of situations in which they are expected to perform
Stage two advanced beginner can demonstrate marginally, acceptable performances of tasks
Stage three competent, have two or three years of experience, and can establish a plan of care
Stage four proficient have three or more years of experience, and can perceive the situation as a whole
Stage five expert operate from a deep understanding of a total situation
In evaluating staffing, effectiveness, nurse leaders, and managers must
Evaluate daily weekly and monthly
Consider elements such as patient acuity trend staffing, overtime staffing mix patient satisfaction and patient outcomes
Use variance reports to evaluate staffing effectiveness by comparing plan staffing to budgeting staffing
Investigate staffing concerns identified by nursing staff, and immediately on any issues that could negatively impact patient or nurse outcomes
What is an unhealthy work environment?
Create stress among nurses and contributes to adverse events
Lax, ability, respect, and courtesy, and intern breeds in effective interpersonal relationships
What is a healthy work environment?
Leads to work satisfaction, increase retention, effective organizational performance, and improve patient outcomes
Supports meaningful work joy in the workplace and safer patient care delivery
Enhances, nurse, recruitment and retention
What is the American nurse association developed the nurses bill of rights in 2001 which
Helps nurses to improve their work environment and ensure their ability to provide safe quality. Patient care.
Outlines workplace expectations for professional nursing practice across the United States
Is a statement of professional rights and not illegal document
What are the six standards for establishing sustaining, healthy work environments in 2005 written by the American Association of colleges of nurses
Skills communication
True collaboration Oar
Effective decision-making
Appropriate staffing
Meaningful recognition
Authentic leadership
The American organization for nursing leadership develop the ANL guiding principles mitigating violence in the workplace in 2014, which included
Recognizing that violence can, and does happen anywhere
Healthy work environments promote positive patient outcomes
Everyone in the organization is accountable for upholding foundation behavior standards
Addressing workplace violence may increase the effectiveness of nurse practice and patient care
What is workplace safety?
A workplace free from risks of both physical and physiological harm
Patient safety and nurse safety link
What are dangers of unsafe, patient handling and mobility
Increase risk of musculoskeletal disorders on a daily basis, due to lifting, transferring and repositioning patients
What are barriers to safe patient handling
Lack of no lift policy adequate lifting equipment in adequate space on patient’s care units
Lack of equipment, decreased staffing levels in the architecture of the environment
Nurses who do not report their injuries
How does one ensure safe, patient handling and mobility
Implementation of safe, patient handling, and mobility programs
Establishment of policies to prevent nurses and patient injuries across the
Care
Attainment of knowledge, skills and attitudes create best environment that focuses on minimizing risk of harm to work force
What are the benefits of safe patient handling programs?
Reduction of workplace injuries
Improvement in the quality of care for safety of patience
Reduction of work related healthcare cost
Increases in worker satisfaction and healthcare savings
What are the different types of nursing fatigue?
Physiological or reduce physical capacity
Objective or reduce productivity
Subjective or weary, or unmotivated feeling
What are the dangers of nurse fatigue?
 physical injuries to staff and patients
Nurses who have irritability, reduced motivation, inability to stay focused, diminished reaction time and ineffective, communication skills
What are some causes of nursing fatigue?
Extended shifts of more than 12.5 hours results in higher chance to make errors slow reaction time lapses of attention and compromise problem sol
Lack of rest breaks during work hours, not mandated by federal regulations
How does a nurse leader in manager reduce nursing fatigue?
Foster worklife balance amongst staff
Create and sustain a healthy work environment that promotes healthy work schedules
Develop policies that support evidence base recommendations for dealing with nurse fatigue
What is non-physical workplace violence
Emotional abuse, intimidation put down harassment, humiliation humor at the expense, a colleague, bullying and civility
What is the definition of bullying and incivility
Bullying is undermining, degrading others through use of hostile remarks, verbal attack threats in civility, is showing distain or disrespect for others through gossiping spreading rumors
What is nurse to nurse violence?
Physical or non-physical violence between nurses who have a workplace relationship
What is lateral/horizontal violence
Bullying or instability between two or more nurses at the same level
What is vertical violence?
Bullying or inability between a nurse, subordinate and someone at higher level
What is third-party violence?
Violence that is witnessed directly or indirectly by others
What is nurse to patient violence?
Violence towards those in a nurse care, resulting in violation of nurses code of ethics examples, hitting a patient or using restraints without an order, refusing to administer pain medication at a timely basis
What is patient to nurse violence?
A patient or family member being violent towards the nurse
Patient hitting or biting nurse can be due to acute disease, states alcohol and intoxication emotional states
What is organizational violence?
Affects the entire healthcare organization and occurs as a result of a changing work environment
Example, excessive, workloads, unsafe, working conditions
What is external violence?
Perpetrated by outside persons entering the workplace, or when nurses are going to, and from the workplace, usually random perpetrator with criminal intent
What is sexual harassment?
Inappropriate behavior, including sexually based language or unwanted, sexual, advances or contact
What is mass trauma or natural disaster, workplace violence
Includes biochemical attacks or terrorist attacks and natural disasters can be extremely stressful for and have a potential for serious health and mental health issues for staff
What are individual factors contributing to workplace violence?
A lack of interpersonal coping or conflict management skills in person
What is systemic factors contributing to workplace violence?
Include increase, productivity, demands cost containment stress from fear of ligation and inadequate information between organization and leadership
What is the expectation for nurses when it comes to workplace violence?
To remain silent about it
What are some risk factors for workplace violence?
Age and experience, younger and less experienced
Females
Degree of accessibility nurses in the emergency room
What are some reasons for under reporting workplace violence?
Lack of knowledge, time and administrative support
Fear of repercussion for reporting it
Lack of hospital administrators to follow up on report
Unhealthy work environment that breeds frequency and character of workplace violence
What are consequences of workplace violence on the organization?
Creates a culture of fear and diminish staff morale
Impact patient, safety, and job satisfaction
Results and disrupted work relationships, miscommunication, and unhealthy work environment
Results in negative outcomes
What are the consequences of workplace violence on the individual?
May result in physical effects, such as frequent headaches, and decreased energy
Results in physiological effect, such as stress, anxiety, depression, and frustration
What are some strategies to prevent workplace violence?
Increase awareness by providing information
Model and promote positivity and professional behaviors
Support, zero tolerance programs and policies
Encourage open communication biased
Deal directly with all reported incidents
What is a security plan?
A formalize plan of action for addressing a security breach
All healthcare facilities must have security plans in place
What is an emergency response plan
A formalize plan of action in the event of a disaster
What is an internal disaster?
Those occurring within the facility that can jeopardize the safety of patients staff and visitors
Example, fire bomb, threat, active shooter
What is an external disaster?
Those events occurring outside the organization involving mass casualties that can overload the facility
Ex bus accident, chemical spill explosion
