Information Management In The Occupational Health Setting Flashcards
0
Q
ANA definition of nursing informatics
A
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
1
Q
Nursing informatics
A
A combination of computer science, information science and nursing science designed to assist in the management and processing if nursing data, information and knowledge to support the practice of nursing and the delivery of nursing care
2
Q
Nursing informatics support is accomplished through the use of:
A
- Information structures
- Information processes
- Information technology
3
Q
Two components of nursing informatics
A
- Management components
2. Processing components
4
Q
Management component
A
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
5
Q
Processing component
A
Refers to the transformation of data into information and of information into knowledge
6
Q
Factors that necessitate more efficient management of information
A
- 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
7
Q
Examples of health-related legislation requirements related to informatics
A
- Protection of information
- Extensive record keeping
- Tracking
- Reporting
- Documentation
8
Q
Changes in demographics of client populations that necessitate more efficient management of information
A
- 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
9
Q
Nursing informatics principles can be applied to the following activities in occupational and environmental health nursing
A
- 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
10
Q
Information management systems can be applied to these aspects of the occupational health service
A
- 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
11
Q
Occupational health information management systems
A
Computerized programs that provide a mechanism to collect, assess and use large amounts of information from many different sources in a single repository
12
Q
Types of occupational health information management systems
A
- Client centered systems
- Site management systems
- Combination of both types of system
13
Q
Client centered systems
A
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
14
Q
Information maintained in a client centered system includes the following:
A
- 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
15
Q
Site management systems
A
Enable the occupational health professional to document activities related to physical work environment, a corporation or some geographic region
16
Q
Examples of data captured by a site management system
A
- 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
17
Q
Combination systems
A
- Usually modular in design
- Can be tailored to the specific needs of the organization
18
Q
Combination systems enable occupational health professionals to…
A
Select, purchase and implement those functions that are most applicable to their specific needs
19
Q
What type of system is increasingly preferred?
A
Combination systems because of the expanding role of the occupational and environmental health nurse
20
Q
Group that described the essential characteristics of effective health information systems
A
American Nurses Association Task Force on Nursing Information Systems
21
Q
Essential characteristics of effective health information systems
A
- 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
22
Q
Example of an information system being flexible to meet changing requirements
A
Incorporating new functionality to help track workers in a new exposure group
23
Q
Internal/external systems that the occupational health information systems should be compatible with
A
- Personnel
2. Human resources
24
Ways a health information system can support the work of the nurse without increasing the effort
Eliminating double entry of the same data
25
Examples of useful outputs from a health information system
1. Reports
2. Letters
3. Notices
26
Other characteristics important to include in systems
1. Standardized vocabulary and coding system
| 2. Drop down lists
27
What do drop down lists force among users?
Consistency among users and avoid errors in data entry
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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
29
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
30
Typical team members participating in the selection process may include the following:
1. Occupational and environmental health nurses
2. Occupational physicians
3. Industrial hygienists
4. Safety professionals
5. Employee assistant personnel
6. Management representative
7. Person assigned from corporate information systems department
8. Representatives from the human resources or personnel department
31
Steps for health information systems selection team
1. Identify and define the information needs of users, other departments and the company
2. Determine whether to develop the system internally or purchase a commercial product
3. If the decision is made to purchase a commercial product, initiate activities to research suppliers and products
4. Prepare and submit a business case justifying the purchase or development of an electronic health information system
32
Steps to identify and define the information needs of users
1. List all services and functions supported by the system
2. Develop workflow diagrams for each process
3. Identify data needs for each step in the diagram
4. Specify all interfaces and information exchanges required for each work process
5. Specify methods of communication required for each interface
6. Develop a list of all requirements and assign priorities for each function
33
Steps in work restriction management- developed as a workflow diagram
1. Need for work restriction review identified
2. OHN reviews medical record
3. Determination if examination or testing is needed
4. Performing appropriate occupational examination/testing
5. Determine if restriction is appropriate- if not appropriate enter in HIS and close restriction
6. Work restriction entered in HIS
7. Appropriate people in company notified
8. Next evaluation scheduled and employee and manager notified
34
Steps in work restriction management- developed as a workflow diagram
How is the need for work restriction review identified?
1. Result of fitness for duty evaluation
2. From private MD
3. From case manager
4. Follow up from on the job injury
5. Request from safety after worksite evaluation
35
Steps in work restriction management- developed as a workflow diagram
Items that should be reviewed in the medical record
1. Health history
| 2. Job requirements (essential functions)
36
Steps in work restriction management- developed as a workflow diagram
People who should be notified of a work restriction
1. Employee manager
2. Safety, if work related
3. Personnel, if requesting job accommodation
4. Private MD
37
Steps in work restriction management- developed as a workflow diagram
Reports required by this process
1. Counts by type
2. Number of persons restricted by department
3. Duration
4. Cases related to work
5. Follow up schedule
38
Information requirements for work restriction management:
Step 1
Need for work restriction review identified
1. Fitness for duty form
2. Private MD report
3. Case management report
4. OJI treatment report
5. Safety worksite evaluation report
39
Information requirements for work restriction management:
Step 2
OHN reviews medical record
1. Hard copy or HIS medical record
2. Pre placement questionnaire
3. On line job description/requirements
40
Information requirements for work restriction management:
Step 3
Determination if examination or testing is needed
1. Written exam guidelines
41
Information requirements for work restriction management:
Step 4
Performing appropriate occupational examination/testing
1. Appointment scheduler
2. Notifications: employee, manager
3. Examination forms
42
Information requirements for work restriction management:
Step 5
Determine if restriction is appropriate- if not appropriate enter in HIS and close restriction
1. Written work restriction guidelines
2. HIS record retrieval and review
3. HIS restriction modification function
43
Information requirements for work restriction management:
Step 6
Work restriction entered in HIS
1. HIS restrictions review function
| 2. HIS restriction modification and tracking functions
44
Information requirements for work restriction management:
Step 7
Appropriate people in company notified
1. Notifications to employee and manager
2. Form letter to private MD
3. Interface with personnel database
4. Interface with safety
45
Information requirements for work restriction management:
Step 8
Next evaluation scheduled and employee and manager notified
1. Appointment scheduler
| 2. Notifications to employee and manager
46
How to use an occupational health system review grid
1. Using a scale of 1 (least) to 5 (greatest), indicate the priority of each function to you
2. Give each system a score according to its ability to perform a function
3. Multiply the score by the priority to arrive at a weighted score for each function
47
Examples of areas to evaluate in an occupational health system review
1. General tasks
2. Pre placement tasks
3. Employee health record tasks
4. Medical surveillance tasks
5. Immunization/vaccination records tasks
6. Motor vehicle accidents tasks
7. Employee training tasks
8. Case management tasks
9. Drug testing tasks
10. Work restrictions tasks
11. Industrial hygiene tasks
12. Security tasks
13. Audits tasks
14. System management tasks
15. Health promotion tasks
16. Information technology tasks
48
Examples of general tasks to be evaluated in an occupational health system review
1. Windows based
2. Utilizes company network and platform
3. Imports demographics from HR
4. Ad hoc reporting
5. User defined standardized reports
6. User defined selection lists
7. User generated letters, forms, notices and questionnaires
8. Schedules appointments
9. Maintains activity log by site, staff, etc
10. Contains standard lists, ICD, MSDS
11. Tracks costs/savings
12. Archives records
13. Provides online help for users
14. Maintains vendor/provider lists
15. Internet enabled
16. Email connected
17. Produces charts/graphics
18. Interfaces with laboratory
19. Instrument interfaces
20. Word processing editing
21. Search engine
49
Examples of pre placement tasks to be evaluated in an occupational health system review
1. Questionnaire/form
2. Notices
3. Establishes evaluation by job title
50
Examples of employee health record tasks to be evaluated in an occupational health system review
1. Encounters
2. Clinical notes
3. Procedures
4. Allergies/serious health problems
51
Examples of medical surveillance tasks to be evaluated in an occupational health system review
1. Target groups by risk
2. Exam protocols/ test panels
3. Tracks exam/test results
4. Imports environmental monitoring
5. Imports job description, physical requirements
6. Tracks equipment calibration records
7. Hearing conservation program
8. Respiratory protection program
52
Examples of immunization/ vaccination record tasks to be evaluated in an occupational health system review
1. BBP required forms
2. Titer results
3. Prophylaxis records
4. Notification of boosters/doses
5. Captures serum information
53
Examples of motor vehicle accident tasks to be evaluated in an occupational health system review
1. Accident details
2. Claim details
3. Costs to the company
54
Examples of employee training tasks to be evaluated in an occupational health system review
1. Documents course, attendance, hrs
2. Schedules
3. Generates rosters
55
Examples of case management tasks to be evaluated in an occupational health system review
1. Case profile
2. Duration guidelines
3. PVT MD/ IME reports
4. Workers compensation history
5. Rehab record
6. Tracks costs
7. Tracks days lost/restricted days
8. Records FMLA criteria
56
Examples of drug testing tasks to be evaluated in an occupational health system review
1. Produces random selection
2. Notifies employee/ supervisor
3. Records results
4. Produced DOT reports
57
Examples of work restrictions tasks to be evaluated in an occupational health system review
1. Automatic re-evaluation notification
2. Lists essential functions by job
3. Transmits info to HR database
4. Notifies employee/supervisor
5. Calculates restricted work days
6. Exports restricted day count to OSHA log
58
Examples of industrial hygiene tasks to be evaluated in an occupational health system review
1. Tracks sampling by area, employee
| 2. Calculates exposure levels, TWA
59
Examples of security tasks to be evaluated in an occupational health system review
1. Multi level password protected
2. Audit trails for all files and records
3. Encryption/coding capability
4. Time lock for changes to record
60
Examples of audits tasks to be evaluated in an occupational health system review
1. Standard forms
2. Schedule of locations/areas
3. Produces randomized site selection
4. Generates supervisor report
61
Examples of system management tasks to be evaluated in an occupational health system review
1. System cost, license fee, # user fee
2. Module/feature costs
3. Cost of required hardware
4. Cost of ongoing support
5. User training
6. System documentation
7. User training manuals, job aids
8. User groups
9. Loss of customization with upgrades
10. Designated customer rep
11. Response to change requests
62
Examples of health promotion tasks to be evaluated in an occupational health system review
1. Lists programs
2. Captures roster/attendance
3. Tracks individual attendance over time
4. Distributes notices
5. Captures costs
63
Examples of information technology tasks to be evaluated in an occupational health system review
1. Compatibility
2. Networking capability
3. Firewall issues
4. Expandability
5. Internet connectivity
6. Ability to export to other programs
64
Activities to research suppliers and products for health information systems
1. Attend trade shows and vendor exhibits at conferences (ie AAOHN Symposium and Expo)
2. Network with occupational and environmental health nurses who are users of automated systems
3. Review literature on specific products in journals, newsletters and websites
4. Invite vendors to demonstrate software products, using the list of functionality and specifications generated by the selection team
5. Interview customers of specific software programs regarding functionality and support provided by the vendor
65
Implementation of an occupational and environmental health information system can be facilitated by....
Using project management techniques and tools
66
Strategies to ensure that the implementation process is well organized and all possible barriers anticipated
1. Widely publicize the purchase and planned implementation
2. Secure commitment of top level management, unions and other authority figures
3. Develop policies and procedures for appropriate use of the system
4. Appoint a lead representative to work directly with the system vendor/developer
5. Secure a designated representative from the company information systems department
6. Establish evaluation criteria
7. Determine and institute measures to ensure security
8. Provide ways to obtain and maintain appropriate hardware and software
9. Ensure that users have basic computer skills
10. Train one or more users to be super users who can support others during implementation and troubleshoot problems
11. Test the system thoroughly, using scenarios developed by team members
12. Establish a pilot program at a single location and document the experience
13. Implement the system on a limited basis
14. Have users keep a log of their progress, issues and problems
15. Have regular meetings to debrief workers and solve issues as they occur
16. Monitor direct and indirect costs associated with implementation
67
Internet
A worldwide network of computers and users who are able to communicate using standardized protocols
68
Forms of media that can transmitted via Internet
1. Voice
2. Graphics
3. Sound
4. Video
5. Data
69
Original name of Internet
ARPANET
| Advanced Research Project Agency Network
70
When was Internet created?
1969
71
Why was the Internet created?
For the purpose of communicating research data among four universities
72
World Wide Web
- www
- widely used protocol, developed much later than the Internet, that allows users to move freely from one site to another
73
Protocols
Sets of rules or common directions for accomplishing a task
74
The following protocols are commonly used on the Internet:
1. TCP/IP
2. SMTP
3. POP
4. FTP
5. HTTP
6. HTTPS
75
TCP/IP
Transmission Control Protocol/ Internet Protocol
| The suite of protocols that are required for Internet use
76
SMTP
Simple Mail Transfer Protocol
| The protocol used to send electronic mail via the Internet
77
POP
Point of presence or Post Office Protocol
78
Point of presence
Refers to a location where a user connects to a network, usually a city and often with dial-up phone lines. Internet customers should clarify with their Internet service provider if connecting using the assigned POP will require a long distance phone call
79
Post Office Protocol
Refers to the way email software retrieves mail from a mail server
80
FTP
File Transfer Protocol
| A very common method of moving files from one site to another
81
Examples of FTP
Accessing material from a library or catalog or downloading software
82
HTTP
Hypertext Transfer Protocol
The most important protocol used on the www, because it allows files to be moved across the Internet using hypertext, or the language that makes it possible to call up and display another site simply by selecting it
83
HTTPS
Hypertext Transfer Protocol-Secured
Indicates that an HTTP site has had a level of security applied by software that limits access and protects information transmitted by users
84
Important terms related to the Internet
1. HTML
2. Bandwidth
3. Bits
4. Bytes
5. Baud
6. Bookmark
7. Browser
8. Web page
9. Search engines
10. URL
85
HTML
Hypertext Markup Language
86
Hypertext
Enables words, symbols, graphics, sound and video files, and other items to be linked to other sites or items within the site
87
Selecting hypertext items allows users to ----- or ------ from site to site in a nonlinear way
Navigate
| Surf
88
Bandwidth
The amount of data that can be transmitted at once
89
Bits
The smallest unit of computerized data
90
Bandwidth is measured in...
Bits-per-second
91
Bytes
A set of bits, usually 8
92
Kilobyte
1000 bytes
93
Megabyte
One million bytes
94
The metric most often used to describe the space available on a drive or in memory
Byte
95
Baud
The speed at which a computer can send or receive bits of data
96
Bookmark
Aka favorite
A direct link created by the user to a site that was once visited and is likely to be visited again
97
Recommended bookmark site for occupational and environmental health and safety nurses
1. Centers for Disease Control and Prevention (CDC)
2. Occupational Safety and Health Administration (OSHA)
3. American Association of Occupational Health Nurses (AAOHN)
4. American Board for Occupational Health Nurses (ABOHN)
5. National Institute for Occupational Safety and Health (NIOSH)
98
Browser
A software program that is the interface between the user and the Internet and allows users to contact other web servers
99
Web page
A collection of resources at a single Internet address
100
Search engines
Software programs that allow users to search for sites that contain user-specified key words or phrases
101
URL
Uniform resource locator
An Internet address
Every item on the Internet has a distinct URL
102
http://www.cdc.gov/travel/vacinat/htm
The protocol necessary to access the site
http:
103
http://www.cdc.gov/travel/vacinat/htm
The "domain" or who and what type of organization owns the site
www.cdc.gov
104
http://www.cdc.gov/travel/vacinat/htm
The "path" within the site to the desired information
travel/vacinat
105
http://www.cdc.gov/travel/vacinat/htm
The language or coding system used in the site
htm
106
Tips for searching the Internet
1. Use combinations of keywords
2. Use more words for better search results
3. Try synonyms or plural forms of words if desired results are not achieved
4. Use quotation marks to search for phrases or names
5. Use the word OR in caps to expand the search
6. Use a minus sign to exclude sites of information that is not relevant
7. Use multiple search engines to produce more and different results
107
Tips for searching within sites on the Internet
1. Use keywords or phrases in the search box
2. Take advantage of options to exclude words or sites from the search
3. Use alphabetical search options to conduct topic searches when available
4. The use of quotation marks usually specifies exact match
5. Utilize links in search results to go directly to the desired information
6. Observe the title line in the URL box to identify where you are in the site and what search criteria are being used
7. Note the bottom of the search results screen to determine how many documents or sites were identified that match the search criteria are being used
8. Search results are presented in the order of relevance or match
108
The occupational and environmental health nurse may use the Internet for the following purposes:
1. To obtain current information related to a health issue
2. To stay abreast of current legislation and regulations
3. To share experiences with other occupational health professionals
4. To search and shop for products and services to meet the needs of clients
5. To participate in research
6. To obtain continuing education
7. To market services to potential customers
109
The following guidelines should be used by Internet users to assess health information available on the Internet:
1. Authors should be clearly identified
2. Authors should be qualified and their credentials listed
3. Professional references should be listed
4. The site should not focus on the sale of services or products
5. The site owners should indicate that the information offered is not a substitute for services provided directly by a trained professional caregiver
6. A mechanism to request feedback or more information should be supplied
7. Confidentiality must be ensured to individuals requesting information
8. The appearance of the site should be professional
9. Information provided should be current and the date of last revision noted
10. Any sources of funding must be identified
11. If the site is not supported by a government agency it should bear the mark of recognition by one of several organizations that evaluate health information on the Internet
110
Examples of organizations that evaluate health information on the internet
1. American Nurses Association
| 2. Health on the Net Foundtion
111
Intranets
Private networks developed by companies, universities or other agencies to provide information and services to a prescribed audience by means of the same technology used on the Internet
112
Companies use intranets to accomplish the following:
1. Centralize services, such as payroll and benefits
2. Allow workers access to company news and business information
3. Distribute information in a timely, efficient manner
4. Post and maintain business directives and policies in a central location
5. Foster the sharing of information among workers, business units, and organizations within the corporation
113
The occupational health programs and services manager may take advantage of the technology afforded by company intranets to accomplish the following purposes:
1. Distribute health related information to workers via department websites or electronic newsletters
2. Share relevant information with departments such as benefits, safety and personnel
3. Centralize information such as health related policies and procedures
4. Automate, expedite and improve the accuracy of processes such as accident reporting
5. Deliver health-related training to workers, and services such as health-risk appraisals
6. Provide workers with links to important Internet sites that contain relevant health and safety information
7. Communicate and share information with external suppliers of services, such as insurance carriers, laboratories, independent medical examiners or medical supply companies
114
Extranets
- Proprietary systems that allow limited access to an Intranet.
- systems are usually networks that have identified necessary interfaces and established policies and protocols to permit communication through company security mechanisms to specific areas within the Intranet
- access to these specialized networks may be granted to individuals or groups such as customers, vendors or suppliers for a variety of purposes
