Information Management In The Occupational Health Setting Flashcards
ANA definition of nursing informatics
Nursing informatics facilitates the integration of data, information and knowledge to support patients, nurses and other providers in their decision-making in all roles and settings
Nursing informatics support is accomplished through the use of:
- Information structures
- Information processes
- Information technology
Two components of nursing informatics
- Management components
2. Processing components
Management component
The functional ability to collect, aggregate, organize, move, and represent information in an economical, efficient way that is useful to the users of the system
Processing component
Refers to the transformation of data into information and of information into knowledge
Factors that necessitate more efficient management of information
- Increase in health related legislation
- Rapid emergence of new health issues require immediate action
- Changing demographic of client populations
- The more global nature of business, resulting in widely dispersed workers and customers
- An expectation that the occupational and environmental health nurse will work collaboratively as part of a multidisciplinary team
- A need to justify occupational health services as a worthwhile expenditure
- The need to operate occupational health programs and services as a business
Examples of health-related legislation requirements related to informatics
- Protection of information
- Extensive record keeping
- Tracking
- Reporting
- Documentation
Changes in demographics of client populations that necessitate more efficient management of information
- Older workers
- More mobile workers
- Working from home
- Caring for family members
- Working multiple jobs
- Sharing jobs
- Engaging in activities that may compound effects of work on health
Nursing informatics principles can be applied to the following activities in occupational and environmental health nursing
- Assessing needs of workers for services,education, and surveillance
- Developing interventions
- Evaluating services to ensure quality of care and outcomes
- Disseminating information
- Ensuring compliance with regulations and legislation
- Conducting research
- Accessing and using information from expert sources
Information management systems can be applied to these aspects of the occupational health service
- Budgets
- Selecting, training and managing the performance and professional development of staff
- Overseeing the physical plant
- Anticipating, acquiring and managing resources
- Producing and presenting reports
- Developing Ann implementing policies
- Developing. And implementing protocols and standards of practice
Occupational health information management systems
Computerized programs that provide a mechanism to collect, assess and use large amounts of information from many different sources in a single repository
Types of occupational health information management systems
- Client centered systems
- Site management systems
- Combination of both types of system
Client centered systems
Facilitate the development of an electronic medical record that tracks health experiences of an individual from placement through the period of employment and for the period of retention as required by OSHA
Information maintained in a client centered system includes the following:
- Pre placement health evaluations
- On the job injury treatment documentation
- Clinic visit notes
- Work restriction management records
- Disability case management notes
- Exposure documentation
- Participation in workplace surveillance programs
- Assignment and fitting of personal protective equipment
- Examination and test results
Site management systems
Enable the occupational health professional to document activities related to physical work environment, a corporation or some geographic region
Examples of data captured by a site management system
- Industrial hygiene sampling activities and results over time
- Exposures and actions taken
- OSHA record keeping
- Equipment calibration and maintenance records
- Vendor, supplier and community provider lists
- Motor vehicle accident records
Combination systems
- Usually modular in design
- Can be tailored to the specific needs of the organization
Combination systems enable occupational health professionals to…
Select, purchase and implement those functions that are most applicable to their specific needs
What type of system is increasingly preferred?
Combination systems because of the expanding role of the occupational and environmental health nurse
Group that described the essential characteristics of effective health information systems
American Nurses Association Task Force on Nursing Information Systems
Essential characteristics of effective health information systems
- Be flexible to meet changing requirements
- Be comparable and able to integrate with other internal and external systems
- Have a simple, logical approach to language and codes
- Support the work of the nurse without increasing effort
- Provide useful outputs
- Be cost efficient and cost beneficial to the organization and the user
- Ensure sustained performance with minimal downtime and ensure that data are easily recovered in the event of system failure
- Ensure system security
- Ensure data integrity
- Ensure confidentiality of sensitive information recorded by a health professional
Example of an information system being flexible to meet changing requirements
Incorporating new functionality to help track workers in a new exposure group
Internal/external systems that the occupational health information systems should be compatible with
- Personnel
2. Human resources
Ways a health information system can support the work of the nurse without increasing the effort
Eliminating double entry of the same data
Examples of useful outputs from a health information system
- Reports
- Letters
- Notices
Other characteristics important to include in systems
- Standardized vocabulary and coding system
2. Drop down lists
What do drop down lists force among users?
Consistency among users and avoid errors in data entry
Drop down lists
- a field that contains a list of selectable options
- user can select an entry from the list by clicking the down arrow to the right of the field and highlighting the selection
Selection of an occupational health information system must be…..
A well organized thoughtful process that involves the input of any individual or group who will be using, interfacing with or supporting the system
Typical team members participating in the selection process may include the following:
- Occupational and environmental health nurses
- Occupational physicians
- Industrial hygienists
- Safety professionals
- Employee assistant personnel
- Management representative
- Person assigned from corporate information systems department
- Representatives from the human resources or personnel department
Steps for health information systems selection team
- Identify and define the information needs of users, other departments and the company
- Determine whether to develop the system internally or purchase a commercial product
- If the decision is made to purchase a commercial product, initiate activities to research suppliers and products
- Prepare and submit a business case justifying the purchase or development of an electronic health information system
Steps to identify and define the information needs of users
- List all services and functions supported by the system
- Develop workflow diagrams for each process
- Identify data needs for each step in the diagram
- Specify all interfaces and information exchanges required for each work process
- Specify methods of communication required for each interface
- Develop a list of all requirements and assign priorities for each function
Steps in work restriction management- developed as a workflow diagram
- Need for work restriction review identified
- OHN reviews medical record
- Determination if examination or testing is needed
- Performing appropriate occupational examination/testing
- Determine if restriction is appropriate- if not appropriate enter in HIS and close restriction
- Work restriction entered in HIS
- Appropriate people in company notified
- Next evaluation scheduled and employee and manager notified
Steps in work restriction management- developed as a workflow diagram
How is the need for work restriction review identified?
- Result of fitness for duty evaluation
- From private MD
- From case manager
- Follow up from on the job injury
- Request from safety after worksite evaluation
Steps in work restriction management- developed as a workflow diagram
Items that should be reviewed in the medical record
- Health history
2. Job requirements (essential functions)
Steps in work restriction management- developed as a workflow diagram
People who should be notified of a work restriction
- Employee manager
- Safety, if work related
- Personnel, if requesting job accommodation
- Private MD
Steps in work restriction management- developed as a workflow diagram
Reports required by this process
- Counts by type
- Number of persons restricted by department
- Duration
- Cases related to work
- Follow up schedule
Information requirements for work restriction management:
Step 1
Need for work restriction review identified
- Fitness for duty form
- Private MD report
- Case management report
- OJI treatment report
- Safety worksite evaluation report
Information requirements for work restriction management:
Step 2
OHN reviews medical record
- Hard copy or HIS medical record
- Pre placement questionnaire
- On line job description/requirements
Information requirements for work restriction management:
Step 3
Determination if examination or testing is needed
- Written exam guidelines
Information requirements for work restriction management:
Step 4
Performing appropriate occupational examination/testing
- Appointment scheduler
- Notifications: employee, manager
- Examination forms
Information requirements for work restriction management:
Step 5
Determine if restriction is appropriate- if not appropriate enter in HIS and close restriction
- Written work restriction guidelines
- HIS record retrieval and review
- HIS restriction modification function
Information requirements for work restriction management:
Step 6
Work restriction entered in HIS
- HIS restrictions review function
2. HIS restriction modification and tracking functions
Information requirements for work restriction management:
Step 7
Appropriate people in company notified
- Notifications to employee and manager
- Form letter to private MD
- Interface with personnel database
- Interface with safety
Information requirements for work restriction management:
Step 8
Next evaluation scheduled and employee and manager notified
- Appointment scheduler
2. Notifications to employee and manager
How to use an occupational health system review grid
- Using a scale of 1 (least) to 5 (greatest), indicate the priority of each function to you
- Give each system a score according to its ability to perform a function
- Multiply the score by the priority to arrive at a weighted score for each function