Exam #4 Flashcards
What are Nursing Informatics?
The use of information and computer technology to support nursing practice
- helps you know how to find, evaluate, and use information effectively
- can be used for patient research
*know how to use it for your benefit
What is an EHR?
Electronic Health Record
- increasingly used to refer to a longitudinal (lifetime) record of all health care encounters for a patient
What is an EMR?
Electronic Medical Record
- The legal record that describes a single encounter or visit created in hospitals and outpatient settings
- source of data for the EHR
What is Clinical Decision Support?
CDSS
For improving the quality and safety of health care
- Automatic reminders about preventative practices
- Drug alerts for dosing and interactions
- Electronic resources for data interpretation and clinical decision making
What is alert fatigue?
You see so may alerts from the CDSS that you no longer take them seriously or ten to disregard them
What is a Computerized Provider Order Entry?
CPOE
Clinician with order writing authority sits at a computer to directly enter patient care orders
- Eliminates lost orders and illegible handwriting
- Prevents medical error
What does Information Communication do?
Interoperability of systems and linkages for exchange of data across disparate systems
What does Security do?
Provides better protections of confidential health information because of incorporated controls
The Health Insurance Portability and Accountability Act (HIPPA) provides?
Regulations to ensure privacy and security of patient
What is an Informatics Nurse specialist?
Education:
- 2 years of clinical practice
- successfully completion of the ANA Certification Examination in Nursing Informatics; 20 hours of CE informatics every 2 years
Responsibilities:
- Collects and analyze aggregate data
- Analyze available hardware and software
Role:
- manager, educator, Advocate for ethical issues
What should you look for when evaluating information?
Authority
- authority with regards to the topic, author, and authors credentials
- affiliation of the website is important
*do not trust .com (commercial enterprise)
Accuracy
- look for documentation and referencing
- compare information on the website with other sources
Usability
- is the site well designed, stable, and easy to use
- content should be error-free and readable by intended
Currency
- look for dates
- compare last update with current literature
Objectivity
- is the purpose of the website clear?
- is the information fact or opinion
What is theory?
A group of related concepts that explain existing phenomena and predict future events
What is the nursing metaparadigm?
- Person: recipients of nursing care; individuals, families, groups, communities
- Environment: within which the person exists; physical, social
- Health: illness continuum within which the person falls at the interaction with the nurse
- Nursing: actions, goals, rolls, functions
What is Grand Nursing Theories?
-Broadest scope and complex
- require further specification through research
- not specific
What is Mid-range Nursing Theories?
- Narrower in scope; offer an effective fridge between grand nursing theories and nursing practice
- is specific
What is Nursing Practice Theories?
- Use within a specific range of nursing situations. Nursing practice theories provide frameworks for interventions
- Used in the act of nursing
What is Florence Nightingale theory?
- She was the first nursing theorist
- Maintained by control of environment
- providing fresh air, worth, cleanliness, good diet, quiet, light, etc.
What is Betty Neuman theory?
- Views a patient as being an open system that is in constant energy exchange with the enviroment that the nurse must help cope with stressors
- person is an open system with internal and external stressors
What is Hildegard Peplau theory?
- focus on interpersonal relations between nurse, patient, and patient’s family
- identify the patients feelings as a predictor of positive outcomes related to health and wellness
What is Dorothea Orem theory?
- the goal of nursing is to help the patient perform self-care
- people who participate in self-care activities are more likely to improve their health outcomes
What is Sister Calista Roy Theory?
- person has mutual relationships with the word and God
What is Madeline Leninger theory?
- focus on cultural diversity
- Integrates patients cultural traditions, values and beliefs into care plans
What is Jean Watson Theory?
- understand the interrelationship between health, illness, and human behavior
- help persons attain a higher level of harmony within the mind-body-spirit
- Holistic outlook
What is Margaret Newman Theory?
- defines health as “expanding consciousness”, or increasing complexity
- the process of expanding consciousness
What is Merle Mishel Theory?
- stress-producing and capable of contributing to negative physical and/ or psychological outcomes
- uncertainty exists when client is unsure about diagnosed illness
What is Imogen King theory?
- nurse helps with goal attainment
- The nurse and patient mutually communicate, establish goals and take action to attain goals
What is nursing research?
Systematic inquiry or study conducted to generate new knowledge or to refine existing knowledge
What is the research process?
- Identify area of inquiry
- develop research question/hypothesis
- determine how study will be conducted
- conduct the study
- analyze results of the study
- address implications for nursing practice
What are research designs?
Plans that tell a researcher how data are to be collected, from whom data are to be collected, and how data will be analyze to answer specific research questions
What is quantitative and qualitative?
- Quantitative: quantity, has to be a #; deriving meaning from the statistical analysis of numbers
- Qualitative: descriptors; a method of research designed for discovery rather than for verification
What is phenomenology?
It is designed to provide an understanding of the patients “lived experience”
What is ethnography?
A method used to study phenomena from a cultural perspective
What is grounded theory?
A method designed to explore a social process and develop a theory
What is a nurses role in research?
- Read and critically appraise studies
- Use best research evidence in practice with guidance
- Assist with research problem identification and data collection
What is EBP?
Evidence-based practice
- used to deliver optimal healthcare through the integration of best current evidence, clinical expertise, and patient/family values
*based on patient values and expectations
What does PICOT stand for?
P: population, patient, problem
I: intervention or exposure
C: comparison
O: outcome
T: time
What is expectation of the Professional nurse?
Understands power and empowerment
What is emotional intelligence?
Emotional intelligence refers to the ability to use emotions effectively and is required by leaders/managers in order to enhance their success
*starts with your moral values
What is the difference between leaders and managers?
Leaders:
May not have or all authority but are still able to influence others
Managers:
Someone who has a title; have an appointed management position and a formal line or authority and accountability
*managers are not always considered a leader
What is a transactional leader and a transformational leader?
Transactional: focused on the day-to-day questions of the facility/unit
Transformational: Committed to organizational goals and clearly communicate vision and direction; empowers the work group to accomplish goals
What is a servant leader?
Putting others including employees, customers, and the community as the number one priority
What are Lewin’s stages of change?
- Unfreezing stage: change agent promotes problem identification and encourages awareness of the need for change
- Moving stage: change agent clarifies the need to change, explores alternatives, defines goals and objectives, plans the change and implements the change plan
- Refreezing stage: change agent integrates the change into the organization
What is delegation?
Transfer of responsibility for the performance of an activity from one individual to another while accountability for the outcome is retained
- RN delegator is responsible for:
— the act of delegation
— supervising the performance of the delegated task
— assessment and follow-up evaluation
- Delegatee is accountable for:
— his or her own actions
— accepting delegation within the parameters of training
— communicate information to the delegator
What are things a nurse cannot delegate?
- Initial assessment or any assessment that requires nursing knowledge
- determining a nursing diagnosis
- establishing nursing care goals
- development of a nursing care plan
- evaluation of patients progress
- health counseling or teaching
- activities that require specialized nursing knowledge or judgement
What is quality and quality improvement?
- Quality: the degree to which health services for individuals and populations increase the likelihood of desired health outcomes
- quality improvement: the use of data to monitor the outcomes of care processes, and uses improvement methods to design and test changes to continuously improve the quality
What are the principles of quality improvement?
- Customer defines quality
- Scientific approach: organizational support for all employees to develop knowledge and skills in the science of QI
What are the Institute of Medicine 6 guiding AIMS?
STEEEP
- Safe: Avoiding injuries to patients caused by the care intended to help them
- Timely: reducing waits and sometimes harmful delays for those receiving care
- Effective: providing services based on scientific knowledge to all who could benefit
- Efficient: avoiding waste of equipment, supplies, ideas, and energy
- Equitable: providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, etc.
- Patient-centered: providing care that is respectful of and responsive to individual patient preferences, needs, and values, ensuring that patient values guide all clinical decisions
What is the Joint Commission?
TJC
- one of the first accreditation agencies to embrace QI principles as an accreditation requirement in hospitals
- TJC accreditation: demonstrates that they have achieved a “gold seal of approval” in quality and safety standards
What is a flow chart?
Maps out what actually occurs in a work process
- includes steps and substeps and who does the work
What is a Pareto chart?
(Bar chart)
Reflects frequency at which events occur, or the effect events have on a process
What is a cause-and-effect diagram?
(Fishbone)
- lists potential causes arranged by category to show their effect on a problem
- helps determine potential causes of a problem
What is a run chart?
Graph of data points as they occur overtime
*sometimes referred to as time plots
What are the quality improvement methodologies?
PDSA
Plan: begin with planning the changes to a process that are to be implemented and tested
Do: carry out the plan and make the desired changes to the process
Study: review the impact and outcomes of the implemented changes
Act: determine if the changes can be implemented as is or if further cycles are necessary refinement
What is a Just Culture?
Recognizes errors as a system failure rather than individual failures and at the same time does not shrink from holding individuals accountable for their actions
