Flash cards All
- Compare the super user and job-aid training approaches for information system training.
There are two major on-the-job training methods:
- Super user, a regular user of the system who has in-depth knowledge of the information system. Understands clinical areas and information system, any user may apply. Must take time away from clinical position.
- Job aides-learning tools at the workstation. Decreases need to memorize large amounts of information, decrease time for training. Access must be complete and up to date. User friendliness is key, all users must be given same information.
- Describe peer training and self-directed text-based courses used for information system training.
Two methods:
- Peer training: new users are trained by existing users. New users shadow peer. Adv: training is tailored directly to the function needed, proficiency can be easily tested. Dis: training may not be knowledgeable in principles of education, bad habits passed along. Tip: trainer should have knowledge of adult education, works better with lower level staff.
- Self directed text-based: self directed (self-paced) by use of provided materials. Usually in the form of workbooks, very little interaction with subject matter experts. Adv: works at own pace, proficiency easily tested, system does not need to be in place for training. Dis: motivation must be high. Tips: very structured material.
- Describe web-based and on-the-job training approaches to information systems.
- Web based training: delivers content directly to students via the internet.
- ADV: accessible from any PC that is connected, available 24hrs.
- DIS: expert web master needed, intranet must already be in place. Tips: online learner assessment is included.
- On-the-job: delivered to the student in person, usually at the work site.
- ADV: can be tailored to individual, learning applied immediately, proficiency tested by trainer.
- DIS: lower productivity, bad habits passed on, interruptions are bothersome. Tips: trainer should have adult education experience.
- Describe the role of support personnel who work with healthcare information systems.
Super user: employee with advanced knowledge about computers and is familiar with the work done at the department level.
Help desk: hospital must have 24hr information system help. PC specialists: BS in computer science assists with training and system setup.
- Describe the Logical Observation Identifiers Names and Codes (LOINC)
International Classification for Nursing Practice (ICNP)
Nursing Management Minimum Data Set (NMMDS) for classification systems.
LOINC: database terms primarily for lab results. 32,000 terms that include clinical information and codes for nursing observations.
ICNP: uniform terms for nursing data. Sponsored by the International Council of Nurses. Categories for diagnosis, interventions and outcomes.
NMMDS: dynamic collection of standardized terms related to nursing. Goal was to create terms that could be used by wide range of computer systems. Terms for describing context and environment, categories for personnel characteristics, financial resources and population data.
- Describe the informatics nurse responsibilities
- Teaching
- Security
- System effectiveness
- System works as designed
- Systems upgrade
- Finding new ways to use technology in nursing
- Compliance
- Project management
- Research in informatics
- Describe the Perioperative Nursing Data Set (PNDS)
SNOMED CT
Patient Care Data Set (PCDS).
PNDS: uniform terms for patient problems that may occur during an operation.
Systematized Nomenclature of Medicine Clinical Terms: 357,000 concepts defined and categorized, 957,000 descriptions, English, German and Spanish.
PCDS: data dictionary designed to provide standard clinical set of terms for inclusion in healthcare information systems, classification for problems, goals and orders.
- Describe the advantages and disadvantages of expert systems.
ADV:
- Consistency in decision making
- Central knowledge depository database can be larger than human experts can remember and information survives staffing changes
- Ability to review answers and generate reports
DIS:
- Software lacks common sense
- Logic is locked down lacks creativity
- Programming can be complex and is not adaptable,making it difficult to change
- Describe some of the roles that the informatics nurse plays.
- Developing informatics theories: what should be captured and how to analyze the data.
- Analyzing the information needs of the organization
- Help choose the computer system
- Customize the purchased computer system
- Design the system
- Test and upgrade systems
- Teach/training
- Describe the two primary data entry systems used in healthcare informatics:
Clinical Care Classification (CCC) system and the
Omaha System.
CCC: two major subsets of information: diagnosis and outcomes, interventions and actions. 21 care components that cover functional, physiological and psychological, compatible with ICD10.
Omaha: problem classification scheme (assessment), Intervention scheme and Problem rating scale which ranges from 1-5 similar to Likert scale, home care public health and community nursing.
- Outline three classification systems used in informatics:
NANDA-I (North American Nursing Diagnosis, Definitions and Classifications)
Nursing Interventions Classification (NIC)
Nursing Outcomes Classification (NOC) system.
NANDA-North American Diagnosis Association International: 167 classified diagnosis defined and characterized in this system.
NIC: 514 treatments performed by nurses, provides NANDA diagnosis, categorized into 44 specialties.
NOC-Nursing Outcomes Classification: 330 disease states that provide expected outcomes for patient, caregiver, family and community, includes definitions, indicators, measurement tools and references. Using these tools ensures terms are standardized and thus comparable across organizations, also compatible when published.
- Explain data mining.
- Electronically searching through large amounts of information to find relevant items.
- Associated rule mining-looks for patterns of data showing up repeatedly not random.
- Classification: data group membership such as number of sunny days in year.
- Clustering: organized data according to their similar characteristics into clusters.
- Mining is also called knowledge discovery. Results can be used to make predictions. Sample size needs to be considered, possible ethical considerations.
- Describe expert systems.
These systems are programmed with information that a human expert would use to handle a particular problem, in some cases provide a list of recommendations. The knowledge base is created by individuals that are asked to provide guidelines to solve very specific problems. Its tested to verify outcomes. They may use true/false or fuzzy logic which is generally not as accurate as true/false.
- Describe four types of data warehouses.
Data warehouses are separate entities to free up space and improve response times on servers.
- Offline operation databases-simple copies of operation system.
- Offline data warehouse-regular copy used in report-oriented system.
- Real-time warehouse-similar to offline data warehouse but updated realtime.
- Integrated-updated, processed and returns results to central system for use daily.
- Describe three major parts of data warehouse and storage of data.
- Infrastructure-refers to hardware and software used.
- Data-diagram representations of the structures that send and store information and how they relate.
- Process-how information gets from one place to another. Most warehouses use Codd rules of normalization which breaks it down into tables to show relations.
Two types of data design:
- Dimensional-breaks data into numerical facts that are easy to use and operate quickly but are hard to modify.
- Normalized-third normal form, they tend to be slow and difficult to use.
- Define EHR and its guidelines.
HIMSS defines EHR as “secure, real-time, point-of-care, patient-centric information resource for clinicians”. According to the model it should: manage information for long and short term, clinicians main resource when caring for patients, use evidence based planning for individual and community, QI, performance management, risk management, utilization review, resource planning, billing, clinical research since data is standardized and up to date.
- Define the term data retrieval and four important factors.
Accessed data that has been stored.
- Performance-speed and ability to process requests.
- Capacity-number of files and size of files.
- Security-protecting data.
- Cost-support personnel, software and hardware.
- Explain the term data management.
The storage, access and security of patient data that includes paper documents as well as x-rays that are handled by analyst, programmers and database admins.
- Describe the term automated documentation.
Charting by exception allows nurse to view normal values and change only those that the patient does not conform. Standardized nursing languages allow drop down menus that are free from ambiguity.
- Describe the factors necessary for information quality.
- Timeliness-available as needed.
- Precision-system dictionaries shall describe uniform wording and definitions.
- Accuracy-Error free as possible.
- Measurable-quantifiable so that comparisons can be made.
- Independently verifiable-information remains constant regardless of individual reporting it.
- Availability-access as needed and at the appropriate location.
- Outline some of the hazards related to storage on computer.
Safer on a computer than paper but hazards are:
- Environmental and physical.
- Control-keeping records from being erased, storing or altered.
- Planning-creating backup copies.
- Time restraints-archiving, how long to keep records.
- Transfer-salvage records that may become degraded.
- Maintenance-of system that reads and writes data.
- Describe the attributes that help to assure accuracy of information.
- Objective reporting-unbiased.
- Comprehensive-all information that is available to complete requests.
- Appropriateness-users are able to access information necessary for job.
- Unambiguous-data is clear.
- Reliable-data keyed in by different people is the same.
- Up to date-most recent data is listed first.
- Convenience-not difficult to find data.
- Describe supportive, scooped key, minimum-motion, and straight column keyboards.
- Supportive-support wrist but may cause fluid build up.
- Scooped key-puts keys closer together and allows an extra row.
- Minimum motion-light touch keyboard.
- Straight-lessons stress on left hand little effect on right.
- Outline the steps for human centered design.
- Define and understand the organizations requirements and individual requirements.
- Define and understand the logistics of how and where the system will be used.
- Break down tasks by priority, duration, frequency and probability of completion.
- Define key functions-logical and intuitive to user.
- Find common errors that may occur, optimize to process.
- Interfaces and workstations so they work for users.
- Test with actual users and then make adjustments.
- Three factors that contribute to software usability.
- Learnability-time it takes to learn and figure out.
- Memorability(efficiency)-time it takes to perform task w/o using instructions, intuitive design.
- Discovery-time taken to find feature.
- Explain the term usability when choosing software.
Useability is based on the user-centric design of the software. Measurements from focus groups, interviews, questionnaires. Balance between utility and usability.
- Outline the International Council of Nurses Code of Ethics for nurses in regards to practice and profession.
- Keep up to date with education.
- Look after ones own health.
- Dont take on more than reasonably handled.
- High standard of conduct.
- All new applications of tech are safe and dont compromise dignity.
- Put in place ethical standards in clinical, management, education and research.
- Describe the International Council of Nurses Code of Ethics for nurses in regards to coworkers.
- Cooperative and professional
- Patients are safe, deal with unprofessional conduct
- Dont delegate more than individual can handle
- Promote continuing education
- Keep communication open between departments
- Describe the framework for nursing informatics as defined by the American Nurses Association.
Standards:
- Assessment
- Diagnosis
- Identification of outcomes
- Planning implementation
- System planning
- Performance:QA, effective
- research
- ethics
- peer cooperation
- allocation of resources
- communication
- Describe the International Council of Nurses Code of Ethics in regards to patients.
- Best patient care.
- Patient rights, religion beliefs.
- Informed consent.
- Privacy.
- Community health.
- Describe the essential elements in the practice of nursing informatics.
- Focus on patient
- Keeping up to date
- Working environment
- Working with others
- Knowledge of data structures (hierchical, network, relational, object oriented)
- Knowledge of computer networking
- Knowledge of hardware
- Training skills
- BS Minor in computer science
- Benefits of wireless technology.
- Less chance of human error
- Less chance of information being seen by unauthorized personnel
- Time saving
- Decreased error from transcription
- More secure than paper
- No need to update files, saving time.
- Describe trend toward mHealth.
Trend will grow as cheaper and less expensive wireless becomes more wide spread. Devices include: diabetes monitors, IV delivery, fetal dopplers. Popular are digitized voice, third gen broadband, packet based transmission allowing patients to have real time control of medical conditions.
- Describe digital picture archiving and communication systems
PACS are becoming more feasible because of the decrease in cost of memory. PACS needs to be integrated into existing EHR. PACS can save time and resources and good investment for organizations.
- Describe computerized provider order entry systems.
- Real time and safest treatment possible
- Intuitive-resembles a paper record and can be personalized
- Secure
- Portable-accessible anywhere
- Improves billing and coding.
- Describe the Health Insurance Portability and Accountability Act.
Created in 1996.
- Rules regarding how electronic transactions are processed
- Unique identifier code for all providers, health plans and employers
- A way to keep information secure and private
- Granted certain rights for patients to view their own records
- Providers can keep PHI on their computer.
- Areas of concern related to computer systems used in healthcare outlined by JCAHO.
- Databases outside organization need to be secured
- PHI is secure
- Knowledge based systems should be developed to allow local expertise to be used in organization
- Link physician systems while protecting PHI
- Support QI programs
- Data integrity and security
- Same controls for current procedures for computer
- Assessment for future needs and growth.
- Describe role of the CIO, CPO, CehealthO
CIO-Hires information system staff, budgeting, design, and new systems.
CPO-Federal mandated position responsible for PHI, usually someone in another position.
Ehealth-Works with web to promote online interactive patient service.
- Describe the role of security officer for information systems.
- Responsible for assigning system access codes
- making sure passwords are updated and kept secret
- Physical security
- P&P.
- Describe the roles of:
Compliance
Planning and Recovery officers
Interface engineers
- Compliance-Making sure staff are following federal and accrediting requirements.
- Planning-keeping disaster and recovery plans up to date and integrated between departments
- Interface-Making sure information integrity is maintained when data is exchanged between systems.
- Describe the history of HIPAA
Enacted in 1996
- 2002-code sets to be identified
- 2003-Privacy standards are to be set
- 2004-Standards for employer identification are to be set
- 2005-Standards for system and data security to be set
- 2007-Standards for provider identification are to be set
- Standards to be set to ensure efficient monitoring to provide patient privacy.
- Describe the roles of analyst, liaisons and programmers.
Analyst-Primarily define the way clinical data is entered and processed by system
Liaison-Works between IT team and clinical staff.
Programmers-individuals that write code for system.
- Describe the role of network administrator and trainer.
- Network admin-have access to all areas of system therefore must be held to high standards of ethical accountability
- Manage current and design new system
- Help to organize hardware
- Trainer-teach staff how to use computer systems
- Discuss nursing theories Stages of clinical competence. developed by Patricia Benner.
Stages of clinical competence
- Novice-depends on rules and learned behavior
- Adv beg-has some experience
- Competent-2-3yrs experience can cope well given time for planning
- Proficient-looks at situations holistically, can adapt plans to changing needs
- Expert-wealth of experience, cares intuitively rather than rules, able to focus in on care needed.
- Discuss nursing theories Philosophy of human caring developed by Jean Watson.
Views the individual holistically. Has ten caritas:
- loving kindness and equanimity
- sustaining spiritual beliefs
- Cultivating personal spiritual practice
- Maintaining caring relationship
- Support both neg and pos feelings
- creative in caring
- Teaching withing patients frame of reference
- healing environment
- Basic human needs
- Being open to spiritual concepts of life and death
- Discuss information science: Information theory developed by Claude Shannon.
Shannon identified problems that required solutions. The essential factors in a system of communication include the source of power, the bandwidth, the noise, and the decoder/receiver.
- Signal-to-noise indicates the ratio between a signal’s magnitude and interfering “noise” magnitude.
- Channel capacity, which determines the amount of information that can be transmitted with the smallest rate of error.
- Entropy refers to the amount of energy, code, or bits, required to communicate or store one symbol in the communication process. The lower the entropy, the more efficient the process of communication.
- Discuss nursing theories: Florence Nightingale founder of modern nusing.
Created first training school. Set standards for sanitary conditions, nutrition and kindness.
- Discuss nursing theories: Nursing process theory developed by Ida Jean Orlando.
Published the Dynamic Nurse-Patient Relationship. Nursing process includes:
- Behaviour of the patient
- Nurses reaction
- Subsequent nursing actions needs may be different than what patient expresses.
- Discuss nursing theories: General theory of nursing developed by Dorothea Orem.
Actually three theories:
- Self-care
- Self-care deficit-nursing necessary to provide care
- Nursing systems-actions to meet patients self-care needs.
- Discuss nursing theories: Total-person systems model developed by Betty Neuman.
Concentric circles of physiological, psychological, sociocultural, spiritual, developmental provide defenses for individual. Model focuses on reactions to stress. Interventions include: Primary-preventive steps before stress develops. Secondary-prevent damage to central core and remove stressors. Tertiary-promote reconstitution and reduce energy needs support after secondary intervention.
- Four steps in evidence-based practice.
Steps include:
- Make diagnosis
- Research
- Apply research
- Evaluate outcome
- Discuss integrating the results of data analysis.
These data should be used for long-term strategic planning but also for identifying opportunities for performance improvement. It includes: Identifying issues for tracking, reviewing patterns and trends, process improvement, evaluating systems, monitor specific cases and outcomes.
- Discuss evidence-based practice: Strategies.
- Access to journals at POC
- Clinical understanding of how to interpret results of research
- Classes or on-site help should be available
- Discuss evidence-based practice: Steps to developing guidelines.
- Focus on the topic/methodology
- Evidence review
- Expert judgment
- Policy considerations
- Policy
- Review
- Discuss benchmarking: External benchmarking and internal trending.
- Analyzing outside data compared to organizations outcomes
- External data must be equivalent to internal data
- Internal is comparing departments within the organization. This can still be a problem since each area is different
- Discuss benchmarking: Xerox Corp 10-step model.
Moves through four phases: planning, analysis, integration and action. The steps:
- Identify targets
- Identify organization/providers to which to compare
- Collect data
- Evaluate current performance
- Project future performance
- Communicate findings and reach agreement
- Recommend changes based on benchmark data
- Develop action plan
- Implement actions and adjust according to monitoring
- Update benchmarks
- Explain data presentation: Scattergram.
Graphic display of one piece of data plotted on x and another on Y. A pattern may emerge with enough data. Example age and ER admissions. If the pattern is straight line there may be correlation between variables.
- Explain data presentation: Balanced scorecard.
Performance measures that include: financials, customers, clinical outcomes, education/learning, community, growth.
- Explain data analysis: Chi-square test and t test.
- Chi-square-is a method of comparing rates or ratios. The chi-square test is a means by which to establish if a variance in categorical data (as opposed to numerical data) is of statistical significance. Lets you know whether two groups have significantly different opinions, which makes it a very useful statistic for survey research. Rates of infection compared between two surgical procedures.
- T test-The t test is used to analyze data to determine if there is a statistically
significant difference in the means of both groups. The t test examines two sets of data that are similar, such as the average number of miles walked each week by women over 65 who have breast cancer
as compared to women over 65 who do not have breast cancer.
- Explain data analysis: Regression analysis.
Regression analysis is used when two or more variables are thought to be systematically connected by
a linear relationship. Like temp and drying time. Used to evaluate the data sets found in scattergrams. The correlation coefficient range from 1 to -1. -1 indicates as one variable increases the other decreases. 1 indicates that both variables increase or decrease. 0 indicates no relationship.
- Explain definitions used in data analysis.
- Sensitivity-data includes all positive cases, taking into account all variables decreasing false-negatives.
- Specificity-data only include those specific to measurement.
- Stratification-data are classified by subsets, taking variables into consideration.
- Recordability-ability to collect necessary data.
- Reliability-reproducible.
- Usability-collection tool should be easy to use.
- Validity-results have predictive value.
- Explain data analysis: Knowledge discovery in database and data mining.
Knowledge discovery in database (KDD)-method to identify patterns in large amounts of data. Perturbation (a deviation of a system, moving object, or process from its regular or normal state of path, caused by an outside influence) may be used to hide names while still accessing the useful data. Data mining-analysis of large amounts of data for hidden patterns. Steps include:
- Anomalies
- Identifying relationships
- Clustering
- Classifying
- Regressing and summarizing
- Explain data analysis: Measures of distribution such as range, variance and standard deviation.
- Range-highest to lowest number. Interquartile denotes the range between the 25th and 75th percentile.
- Variance-measures the distribution spread around an average value.
- Standard deviation-shows the dispersion of data above and below the mean. In normal distribution 68% are within 1 standard deviation, 95% 2 and 99.7% 3.
- Explain data analysis: Measures of averages such as mean, median and mode.
- Mean-actual average
- Median-middle of data
- Mode-most frequently occurring number.
- Explain data aggregation.
Collection and summation of data for further use such as for statistical analysis.
- Discuss data representation: Unicode standard coding scheme.
Provides a specific numerical value to represent text for most languages allowing ease of use across platforms. Approximately 110,000 characters.
- Discuss data representation: Hexadecimal coding system.
Representation of decimal numbers in format that uses fewer characters than binary. 1-9 and A-F.
- Discuss data representation: Binary code.
Base 2 0’s and 1’s to represent values. 8Bits = 1byte.
- Discuss types of health care-related data: Medical/clinical, knowledge-based, comparison and aggregate data.
Medical/clinical-patient specific. Knowledge-based-staff has been given access to information to make good practice care. Comparison-benchmarked data for best practice. Aggregate-data not included in clinical record, financials, demographic, etc.
- List the major steps used in strategic planning.
- Mission statement
- Determine goals
- Create strategy
- Identify solutions
- Select action
- Implement
- Evaluate
- List important questions that should be asked when performing strategic planning for information systems.
- OS open or closed, can programmers access
- What tech is the system built
- Is the user interface friendly
- Does it comply with current standards
- How easy it is it to create reports from raw data
- How is system performance measured
- Can users customize views
- How many users can it support
- Is it upgradeable
- Will system decrease paper use
- Timeline for implementation.
- Define the term management science.
The study of business decision making using various analytical methods.
- Explain the way goals are set in an organization.
Goals are based on the needs assessment. Either long or short term.
- Define the term computer science.
The study of information manipulation to solve problems.
- Explain the factors that are important for information systems in the accreditation process.
- Measures to protect PHI
- Training for users that encourages standard data entry
- Information should be available on computer and print form.
- Explain the National Institutes of Health (NIH) push for standards in information storage, creation, analysis and retrieval.
Standard is called ISCAR: information storage, creation, analysis, retrieval. The point is to make data more comparable reviewable and verifiable
- Outline the factors that JCAHO has identified as important to patient information security.
- Information available in 24hrs in best format for user
- Orders entered as quickly as possible
- Test results quickly
- Systems in place to help eliminate errors
- Communication methods reviewed for efficiency
- Clinical and non-clinical should talk
- Records customizable
- Creation of reports by users
- Ability to compare organizations
- Define the steps for workgroup formation.
ADV: increased creativity and insight.
DIS: fail because of personal conflicts.
- Forming
- Storming
- Norming
- Performing
- Explain the term systems theory.
The system is not just a grouping of individual parts but an entity itself. Natural and designed. Embedded and entangled. Important factor is the complexity.
- Describe the advantages of telehealth.
Allow virtual house calls. Consults by monitoring patient status during a surgery.
- Discuss regional health improvement plans.
Developed to improve delivery of health care.
Cover all aspects of health care including:
- risk
- diagnosis
- treatment
- disability
- social mental factors as well as delivery including hospital and clinics and individual practitioners
Working to improve care will reduced costs.
- Discuss implications of health care reform.
- Initiatives to change from paper to electronic
- Increasing number of people covered on plans
- Increasing demands on health care providers
- Emphasis on data analysis to improve care while decreasing costs
- Increasing literacy is necessary so they better understand their options.
- Discuss the personal health records: patient use.
Encouraging patients to participate in their own health care. Allowing them to enter some of their own data, b/p, history blood sugars.
Delegation-allowing assignment of others to allow access and still restrict certain areas like sexual and treatment history.
Messaging-allowing the sending of secure messages.
- Discuss health information exchanges and regional health information organizations.
- HIE have been developed to allow transfer of PHI between providers in an area or region, to save costs and speeding access
- Grants are allowed from the National Coordinator of Health Information Technology to establish RHIO to facilitate HIEs
- The RHIO is a neutral organization with basic function of allowing data to be effectively and securely exchanged across local state and regional HIEs
- Types of personal health records.
- Paper
- Non-tethered- not connected to particular system
- Tethered-tied to a particular system secure patient portal is provided
- Networked-data derived from multiple sources allowing more flexibility.
- Disuss applying current research findings to practice: Model of integration.
Integration of data analysis and research for performance improvement or best practice guidelines depending on the model of integration:
- Organizational-teams report to one individual
- Functional/coordinated-risk and quality management are not integrated they draw from same data source
- Functional/integrated-staff to specialties with cross-training, a case management approach so that the patient can be followed through the system.
- Discuss the personal health records: elements.
- Individual has the ability to control PHR
- Information is comprehensive, pts lifetime
- Information from health care providers
- Easily accessed at any time any location
- Secure and only accessed with proper auth
- Discloses who, when entered data
- Exchanges information with different providers
- Should deliver care cost-effective and efficiently
- Explain issues related to instructing and advising staff on changes in policies, procedures or working standards.
- Policies-updated after period of discussion with admin and staff, staff alerted during meetings or notices.
- Procedures-changed to improve efficiency or safety, communicated in workshops with demonstrations
- Working standards-changed because of regulatory or accrediting discussed in workshops, handouts so implications understood.
- Explain a review of informatics policies and procedures.
Review done in response to surveillance/evaluation
- Acheivement of goals-may need to set new goals
- Analysis of variances and assessing risk factors
- Staff input-meetings and questionnaires regarding compliance, knowledge and training
- Training review-ongoing and coupled with clear expectations of compliance.
- Discuss interpersonal communication skills: Team building.
- Initial interactions-define roles, develop relationships, determining comfort of group
- Power issues-determine who controls meeting, alliances form
- Organizing-team begins to work together, gaining respect working toward common goal
- Team identifications-interactions become less formal, more willing to help each other to achieve goals.
- Excellence-good leadership, committed team members, clear goals, high standards, external recognition, shared commitment to the process.
- Discuss development of policies.
Based on best practice, conform to state, federal and accreditation regulations and guidelines. Use of computer equipment may be more specific.
- Discuss the project scope and project plan.
Project scope-the goals of the information system project, outlining both the content and complexity. Alternate solutions should be identified.
Project plan should include:
- Objectives of the project and characteristics
- Requirements
- Acceptance criteria
- Limitations, boundries and contraints
- Assumptions
- Premilinary timetable and schedule taking into consideration skill levels of assigned staff
- Risks and methods to attenuate
- Initial work breakdown
- Discuss communication skills needed for leading intra- and interdisciplinary teams
- Open communication, encourage participation
- Avoid interrupting or interpreting
- Avoid jumping to conclusions
- Active listening, asking questions for clarification
- Respect opinions of others
- Facts not feelings
- Clarification to avoid misunderstanding
- Keeping unsolicited opinions to a minimum.
- Discuss the legal implications: Privacy and security rules.
Privacy-applies to electronic, paper and verbal communications, billing.
Security-applies to:
- electronic
- admin
- physical
- technical along with P&P. Auth users only, unique identifiers, auto logoff, encryption, data not altered or destroyed, secure transmissions
- Break-the-glass procedures.
- Discuss legal implications: Proprietary data.
Monitor proprietary software associated with patient lists, copyright, financials and other details about the organization need to sign nondisclosure agreement.
- Discuss legal implications: Patient data misuse.
- Identity theft
- Unauthorized access
- Privacy violations
- Security breaches.
- Discuss legal implications: Liability.
- Delay between data entered and acted upon
- Errors of data entry due to improper training
- Interface engine errors causing data errors
- Delay in response to emails.
- Discuss legal implications: Malpractice and negligence.
Negligence care is below established standards leading to malpractice.
- Discuss methods to promote an environment for ethical decision-making and patient advocacy.
Clear P&P should be defined for dealing with conflicts, ethics committee and training for staff.
- Discuss the synergy model: Advocacy and moral agency.
Advocacy-working in best interest of patient/stakeholders.
Agency-recognition of issues and acting on them.
Moral agency-recognize needs and take action to influence outcome.
- Discuss issues related to the fair distribution of health information access.
Allowing access to EHR data as well as journals while maintaining privacy and giving training on use of products. Telehealth for those that dont have access.
- Advanced practice nursing: Discuss ethical principles in practice.
- Treats individuals with respect
- Primary commitment is to individual
- Advocacy
- Responsible for own care practice and delegation
- Respect for own competence
- Environment is conducive to good care
- Improved education opportunities
- Collaborates with others
- Promotes profession.
- Discuss the International Medical Informatics Association code of Ethics.
Part 1 begins with a set of fundamental ethical principles and a brief list of general principles of informatic ethics
that apply to electronic gathering, processing, storing, communicating, using, manipulating and accessing of health information in general. These general principles of informatic ethics are high-level principles and provide general guidance.
Part 2 This part lays out a detailed set of ethical rules of behaviour for HIPs. They are more specific than the general principles of informatic ethics, and offer more particular guidance.
- right to privacy
- Open process of data collection pt informed
- Security
- Right to access personal data
- legitimate infringement for greater good of society
- Infringement of right to privacy
- Accountability of infringement
- Discuss the American Nurses Association definition scope and functional areas of the informatics nurse specialist.
INS has completed graduate or certification. Functions include:
- Providing tools for standardized documentation
- Managing information
- Re-engineering information processes and promoting standardization
- Participation in research
- Analyzing data
- Providing nursing management
- Consultant in informatics
- Promoting/providing professional development
- Advocate for staff/pt.
- Ensuring implementation of EHR and CPOE
- Support for applications.
- Discuss clinical flow chart.
Often used to analyze quality improvement. Typically uses the following symbols:parallelogram, arrow, diamond and circle. Flow top to bottom, left to right.
- Discuss data flow diagram.
Shows data flow in a system from one process to another. A simplified flow chart with four symbols:square, rounded triangle, arrow,three sided open rectangle.
- Control chart
Has mean line and an upper and lower control limits that are nomally 2-3 standard deviations from the mean.
- Run chart
A line graph showing outcomes over time, like infections. Has a median line which allows a “run” on one side of the median line. Either 6 points in same direction or 8 on one side of the median need investigation.
- Trending analysis.
Applied to run chart or control chart. Run-7 or more consecutive data points above or below the median.
- Trend-7 or more consecutive data points either ascending or descending with 21 or more points, or 6 with less than 21 points
- Cycle-An up and down sawtooth pattern
- Astronomical- points unrelated to other points indicate sentinel or special cause variation
Whats the difference between hub, bridge, switch and router.
