Part 3: Informatics Application Flashcards
“The conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients”
Evidenced Base Practice
“Involves the synthesis of knowledge from research,
retrospective or concurrent chart review, quality
improvement and risk data, international, national, and
local standards, infection control data, pathophysiology, cost effectiveness analysis, benchmarking data, patient preferences, and clinical expertise”
Evidenced Base Practice
published research studies are used in healthcare
quality initiatives as the evidence behind the
development of practice algorithms designed to
decrease practice variability, increase patient safety,
improve patient outcomes, and eliminate unnecessary
costs
Evidenced Base Practice
Use of___promotes the use of _____ and
_____in relation to the patient’s contextual
situation and preferences, with procedures and protocols being linked to ______ rather than based on what is customary practice or opinion
EBP
clinical judgment
knowledge
scientific evidence
Research results are crucial to furthering ____The
concept of using randomized controlled trials and
systematic reviews as the gold standard against which
one should evaluate the validity and effectiveness of a
clinical intervention was introduced in 1972 by Archie
Cochrane, a scientist and a physician
EBP
___ viewed the randomized clinical trial as means
of validating clinical interventions and limiting the
interventions to those that were scientifically based,
effective, and necessary
Cochrane
standards of practice, codes of ethics, philosophies of
nursing, autobiographic stories, esthetic criticism, works of art, qualitative studies, and patient and clinical
knowledge
Evidence
The context change from medicine to nursing requires
nurses to apply other knowledge and nursing theory The
use of research results as the sole basis for clinical
decision making ignores other types of evidence inherent
in nursing practice
Evidence
To use evidence in practice, the weight of the research, also called______ must be determined Evidence hierarchies have been defined to grade and
assign value to the information source For example, an evidential hierarchy developed by Stetler et al 1998
prioritized evidence into six categories
research validity
Evidential hierarchy (6)
Meta analysis Individual experimental studies Quasi experimental studies Nonexperimental studies Program evaluations, such as quality improvement projects Opinions of experts
The
time between research dissemination and clinical
translation may be significant, and this delay may
adversely affect patient outcomes __________
between research and practice requires an understanding
of the key concepts and barriers, access to research
findings, access to clinical mentors for research
understanding, a reinforcing culture, and a desire on the
part of the clinician to implement best practices
Bridging the gap
Lack of EBP knowledge and skills is a barrier to
EBP
Organizational cultures that do not support EBP is a barrier to
EBP
Lack of resources, including clinical decision support tools is a barrier to
EBP
Executive leaders and managers who do not model and/or
support EBP is a barrier to
EBP
Inadequate access to databases by clinicians in order to track
patient and system outcomes is a barrier to
EBP
Negative attitudes toward research is a barrier to
EBP
Strong beliefs about the value of EBP and the ability to implement it facilitates
EBP
EBP knowledge and skills facilitates
EBP
Organizational cultures that support it facilitates
EBP
EBP mentors who have in depth knowledge and skills in
evidence based care as well as individual and organizational
change facilitates
EBP
Administrative support facilitates
EBP
Clinical promotion systems that incorporate EBP competencies facilitates
EBP
EBP tools at the point of care, such as clinical decision support
systems facilitates
EBP
1st Step of EBP
Cultivate a spirit of inquiry
2nd Step of EBP
Ask the burning clinical question in PICOT format
What Step in EBP?
a spirit of inquiry in clinicians and a
culture of EBP must be cultivated in order to stimulate the asking of burning clinical questions to improve patient care
Step 1
What Step in EBP?
process involves formatting clinical questions into PICOT format
Step 2
P I C O T
patient population intervention or interest area comparison intervention or group outcome time
What Step in EBP?
Search
for the evidence is conducted by entering each
key word from the PICOT question into the database that is being searched (e g Medline, CINHAL) and then combining the search words together to reveal the studies that may answer the question
Step 3
Step 3 in EBP?
Search for and collect the most relevant best evidence.
Step 4 in EBP?
Critically appraise the evidence.
What Step in EBP?
Rapid
critical appraisal of the studies from the search is
conducted, followed by an evaluation and synthesis of the
research evidence
Step 4
Step 5 in EBP?
Integrate the best evidence …with one’s clinical
expertise and patient preferences and values in making a practice decision or change.
What Step in EBP?
Evidence
is integrated with the clinician’s expertise and
patient preferences and values to make a decision
regarding whether a practice change should be made
Step 5
Step 6 of EBP
Evaluate outcomes of the practice decision or change
based on evidence.
What step of EPB? Once a practice change is made based on the best evidence, outcomes should be measured to determine positive outcomes of the change
Step 6
Step 7 of EBP?
Disseminate the outcomes of the EBP decision or
change
What Step of EBP? Disseminating the outcome of the practice change through presentation or publication so that others can benefit from the process
Step 7
Computers are used in all areas of research (1)literature search databases, such as CINAHL (2)online literature reference lists, such as RefWorks (3)data capture, collection, and coding (4)data analysis (5)data modeling (6)meta analysis (7)Qualitative analysis and (8)dissemination of results
The role of _____
Informatics
__ has brought to healthcare
a compendium of new tools which support EBP
Information technology
Nursing professionals range in age from their early
20 s to their 60 s with the average age of a registered
nurse today in their early_____
50 s
Nurses use experientially acquired information from
interactions with peers, patients, colleagues, and
physicians ___than scientific evidence from medical and research journals
greater
3 Decision Support Systems
Model Management System
User Interface
Knowledge Base
are automated tools designed to support decision
making activities and improve the decision making
process and decision outcomes
Decision support systems
such systems are intended to use the enormous amounts
of data that exist in information systems to facilitate
decision processes
Decision support systems
are systems designed to support healthcare providers in making decisions about the delivery and management of patient care
Clinical decision support systems
has the potential to improve the patient safety and
outcomes for specific patient populations, as well as
compliance with clinical guidelines and standards of
practice and regulatory requirements
Clinical decision support systems
are systems designed with multiple rules and access to multiple databases for information
Evidenced-based Adaptive Clinical Decision Support Systems
complex systems and contain mechanisms to incorporate
new findings and evidence
Evidenced-based Adaptive Clinical Decision Support Systems
Within the complexity of today’s healthcare
environment, there is an increasing need for accessible
information that supports and improves the effectiveness
of decision making and promotes clinical accountability
and the use of best practices
Clinical Decision Support Systems
Clinical tasks to which ___may be applied include
alerts and reminders, diagnostic assistance, therapy
critiques and plans, medication orders, image
recognition and interpretation, trend analysis, and
information retrieval
Clinical Decision Support Systems
The primary goal of ____ is to optimize the efficiency
and effectiveness with which clinical decisions are made
in order to improve the manner in which care is
delivered
Clinical Decision Support Systems
Without the ability to recall and process all available
complex information, decisions in healthcare often
cannot be justified on the basis of available knowledge,
costs, benefits, possible risks, and patient preferences
Clinical Decision Support Systems
tools that aid nurses in improving their
effectiveness in care delivery, identifying appropriate
interventions, determining areas in need of policy or
protocol development, and supporting patient safety
initiatives and quality improvement activities are
increasingly needed
Clinical Decision Support Systems
It is important to remember that the clinical user’s
experience, knowledge base, and understanding of the current context of care are ____ by, but, rather,
supported in the decision making process.
not replaced
Final decisions should always be made by clinicians who can accept or reject the ____information within the context of the existing healthcare situation.
Clinical Decision Support Systems
CDSS is a ____system, not a _____ system
Tool
Rule
Implementation of ___requires the development of a strategy built on an understanding of available ___
tools, clinician readiness to adopt and use ___, and
areas within the organization that carry significant risks
to patient safety
Clinical Decision Support Systems
Implementation of ___requires the development of a strategy built on an understanding of available ___
tools, clinician readiness to adopt and use ___, and
areas within the organization that carry significant risks
to patient safety
Clinical Decision Support Systems
A CDSS is only as effective and accurate as its
underlying _____
knowledge base
3 Pillars supporting the full benefits of CDS
Best knowledge available when needed
High adoption and effective use
Continuous improvement of knowledge and CDS
methods
Five rights in CDS:
“right ___to the right ___in the right
_____ through the right ____
at the right ____in workflow”
information people intervention formats channels point
1.Assist in problem solving with semi structured
problems
2.Support but not replace, the judgment of a manager
or clinician
3.Improve the effectiveness of the decision making
process
are the purposes of
Decision Support System
There is growing pressure for clinicians including nurses to use_____ that is based on
researched evidence
knowledge at the point of care
Use of CDSS to find and _____related to gaps between optimal and actual practice can result in improved quality of care
prevent errors
CDSS impact on clinicians include electronic ___, medical _____, drug ____, other databases, and expert _____
libraries
dictionaries
formularies
opinion
a bedside tool that uses vital signs to identify patients
likely to deteriorate At least one hospital has moved this tool to an electronic format providing for more speed in the decision process with a 50 reduction in code blue events
Modified Early Warning System
DUAL NATURE OF INFORMATION NEEDS FOR
DECISION SUPPORT
First, evidenced based information ( content) needs to be available at the point of care to inform the ____
patient encounter
Second, key data entered in the process of
documentation needs to be entered in a manner that it can be able to be aggregated to inform ___patient
encounters
present
future
“TRIP” to “TPIR”
DUAL NATURE OF INFORMATION NEEDS FOR
DECISION SUPPORT
translating research into practice
translating practice into research.
1.Administrative Systems Strategic Planning Budgeting Financial Analysis Quality Management Continuous Process Improvement Clinical Benchmarking
Are the contents of a ___
Classic CDSS
Real Time Decision Support, Goal Orientation, and Intelligence gathering is the content of a
Classic CDSS
CLASSIFICATIONS OF DECISION SUPPORT SYSTEMS
4
Data based
Model based
Knowledge based
Graphics based
CLASSIFICATION OF DECISION SUPPORT SYSTEMS
provides decision support with a
population perspective and uses routinely collected,
longitudinal, cohort, and cross sectional database
Data based
CLASSIFICATION OF DECISION SUPPORT SYSTEMS
driven by access to and manipulation of
a statistical, financial, optimization, and/or simulation
Data based
CLASSIFICATION OF DECISION SUPPORT SYSTEMS
relies on expert knowledge that is
either embedded in the system or accessible from
another source and uses some type of knowledge
acquisition process to understand and capture the
cognitive processes of healthcare providers
Data based
In a “____“system, the provider needs to take some
action independent of the usual workflow to initiate a
request for support or to query the system for additional information (CDSS)
pull
in a “ ___“system the system automatically
generates the alert in response to a clinician action such as a medication order for which the patient has reported an allergy (CDSS)
push
CLINICAL DECISION SUPPORT SYSTEMS DEVELOPMENT requires a team ___
approach
CLINICAL DECISION SUPPORT SYSTEMS DEVELOPMENTrequires a team approach
1.Identification of the ___needs
2.Identify the ___with interest in the topic
( nurses, admin staff and patients)
3.Synthesize and validate a unified ____ of goals and objectives
4.Determination of potential___ is necessary to determine whether assignment of resources to a
development project is justified
information
stakeholders
working list
frequency of use
CLINICAL DECISION SUPPORT SYSTEMS DEVELOPMENT
5._____of all available information systems such as laboratory, radiology, and pharmacy systems as well as the clinical record system, order systems, and
administrative systems as data and information sources
6.___base of the CDSS must be clearly defined and a system for knowledge update must be in place
7.Identification of when and how ____are
triggered, the data source and content of the
intervention, how the information is delivered to the
recipient, and also needs a feedback mechanism
Inventory
Knowledge
interventions
CLINICAL DECISION SUPPORT SYSTEMS DEVELOPMENT
8. After a CDSS is built, it must be tested and only then
should it ___ and system launch requires planning that addresses not just a date but all the necessary ___preparation of the end users
9. Final step of CDSS development is evaluation and
____enhancement as needed
-Ongoing assessment of intervention use and usability, evaluation of intervention performance against objectives, and continuous enhancement of CDSS provides value to ____
“go live”
educational
system
users
A ____ is a set of care guidelines that outline the
course of treatment and the recommended interventions
that should be implemented to achieve optimal results By
using a standardized plan of care, these systems present
clinicians with treatment protocols to maximize patient
outcomes and support best practices Information
technology in health care is positioned to support the
development of interdisciplinary care plans
care plan
Recommendations that serve as a guide to decisions and provide criteria for specific practice areas.
Clinical guidelines
According to the World Intellectual Property Organization (WIPO), intellectual property (IP) is divided into two categories, namely, ___
industrial property and copyright.
____includes inventions (patents), trademarks, industrial designs, and geographic indications of source;
Industrial property
______
includes literary and artistic works such as novels, poems and
plays, films, musical works, artistic works such as
drawings, paintings, photographs and sculptures, and
architectural designs.
copyright
exclusive rights of the
scientists, researchers, inventors, artists, and other gifted citizens
in our country are not suitably protected as they should be. Most
of them have apprehensions in applying for ___
intellectual property
rights.
Copyright and Related Rights is an ________ right
Intellectual property
Trademarks and Service Marks is an ________ right
Intellectual property
Geographic Indications is an ________ right
Intellectual property
Industrial Designs is an ________ right
Intellectual property
Patents is an ________ right
Intellectual property
Layout-Designs (Topographies) of Integrated Circuits is an ________ right
Intellectual property
Protection of Undisclosed Information is an ________ right
Intellectual property
The agency of the government in charge of the implementation of the Intellectual Property Code is the _____ which replaced the Bureau of Patents, Trademarks and Technology Transfer
Intellectual Property Office
The agency of the government in charge of the implementation of the Intellectual Property Code is the Intellectual Property Office which replaced the _____
Bureau of Patents, Trademarks and
Technology Transfer.
The 6 Bureaus of Intellectual property Code
Bureau of Patents
Bureau of Trademarks
Bureau of Legal Affairs
Documentation, Information and Technology Transfer Bureau
Management Information System and EDP Bureau
Administrative, Financial and Personnel Services Bureau.
The ___is the lead agency responsible for handling the registration and conflict resolution of intellectual property rights.
Intellectual Property Office of the Philippines (IPOPHL)
IPOPHL was created by virtue
of Republic Act No. 8293 or the______, which took effect on January 1, 1998 under the
presidency of Fidel V. Ramos.
Intellectual Property Code of the Philippines
A ____is a grant issued by the government through the Intellectual Property Office of the Philippines.
Patent
It is an exclusive right granted for a product, process or an improvement of a product or process which is new, inventive and useful.
Patent
This exclusive right gives the inventor the right to exclude others from making, using, or selling the product of his invention during the
life of the patent.
Patent
A patent has a term of protection of_____years providing an inventor significant commercial gain. In return, the patent owner must share the full description of the invention.
twenty (20)
Any technical solution of a problem in any field of human activity which is new, involves an inventive step and is industrially applicable shall be ___
patentable.
Is Discovery a patentable invention?
No
Is Scientific theory a patentable invention?
No
Are Mathematical methods a patentable invention?
No
Scheme, rule and method of is a _ invention
Non patentable invention
performing mental act is a ____ invention
Non patentable invention
playing games is a ____ invention
Non patentable invention
doing business is a ____ invention
Non patentable invention
program for computer is a ____ invention
Non patentable invention
Method for treatment – human or animal body by surgery
or therapy & diagnostic method is a _____ invention
Non patentable invention
Plant variety or animal breed or essentially biological
processes for the production of plants and animals is a _ invention
Non patentable invention
Aesthetic creation is a _ invention
Non patentable invention
Invention contrary to public order or morality is a _ invention
Non patentable invention
3 requirements for Patentability
Novelty
Inventive Step
Industrial Applicability
Requirements for filing a patent
Request for the Grant of Patent
Description of the Invention (Specification and Claim/s)
Drawings necessary for the Invention (if any)
Filing Fee
___ means any visible sign capable of distinguishing the
goods (trademark) or services (service mark) of an enterprise
and shall include a stamped or marked container of goods.
“Mark”
is a tool used that differentiates goods and services
from each other.
trademark
It is a very important marketing tool that
makes the public identify goods and services.
trademark
A ____ mark can be one word, a group of words, sign, symbol, logo, or a combination of any of these.
trade
Generally, a trademark refers to
both trademark and _____,
service mark
is used to identify those marks used for services only
service mark
A trademark can be protected through __.
registration
_____
gives the trademark owner the exclusive right to use the mark
and to prevent others from using the same or similar marks on
identical or related goods and services.
Registration
TRADEMARK REGISTRATION
The ___and ___of the applicant
The name of a State of which the applicant is a national or where he has ____
Where the applicant is a_____, the law under which it is organized and existing
The appointment of an agent or representative, if the applicant is not domiciled in the ____
name ..address
domicile
juridical entity
Philippines
TRADEMARK REGISTRATION
Where the applicant claims the priority of an earlier
application, an indication of:
The name of the ____with whose national office the
earlier application was filed or it filed with an office other than a national office, the name of that office
The ___on which the earlier application was filed
Where available, the application number of the earlier application
Where the applicant claims ___as a distinctive feature of the mark, a statement to that effect as well as the name or names of the color or colors claimed and an indication, in respect of each color, of the principal parts of the mark which are in that color;
State
date
color
TRADEMARK REGISTRATION
Where the mark is a____ mark, a statement to
that effect
One or more ___of the mark, as prescribed in the ___
A _____or translation of the mark or of some parts of the mark, as prescribed in the Regulations
three-dimensional
reproductions ….Regulations
transliteration
TRADEMARK REGISTRATION
The names of the goods or services for which the registration is sought, grouped according to the classes of the ___, together with the number of the class of the said Classification to which each group of goods or services belongs
A ___by, or other self-identification of, the applicant or his representative.
Nice Classification
signature
_____is the legal protection extended to the owner of the
rights in an original work.
Copyright
___ refers to every production in the
literary, scientific and artistic domain. Among the literary and
artistic works enumerated in the IP Code includes books and
other writings, musical works, films, paintings and other
works, and computer programs.
“Original work”
Works are protected by the sole fact of their
___, irrespective of their mode or form of expression, as
well as their content, quality and purpose. Thus, it does not
matter if, in the eyes of some critics, a certain work has little
artistic value. So long as it has been independently created and
has a minimum of creativity, the same enjoys copyright
protection.
creation
Books, pamphlets, articles and other writings are covered by _____protection
copyright
Periodicals and newspapers are covered by _____protection
copyright
Lectures, sermons, addresses, dissertations prepared for oral
delivery, whether or not reduced in writing or other material
form are covered by _____protection
copyright
Letters are covered by _____protection
copyright
Dramatic or dramatico-musical compositions; choreographic
works or entertainment in dumb showsare covered by _____protection
copyright
Musical compositions, with or without words are covered by _____protection
copyright
Works of
drawing, painting, architecture, sculpture, engraving, lithography
or other work of art; models or designs for works of art are covered by _____protection
copyright
Original ornamental designs or models for articles of
manufacture, whether or not registrable as an industrial
design, and other works of applied art are covered by _____protection
copyright
Illustrations, maps, plans, sketches, charts and threedimensional
works relative to
geography, topography, architecture or science are covered by _____protection
copyright
Drawings or plastic works of a scientific or technical character are covered by _____protection
copyright
Photographic works including works produced by a process
analogous to photography; lantern slides are covered by _____protection
copyright
Audiovisual works and cinematographic works and works
produced by a process analogous to cinematography or any
process for making audio-visual recordings are covered by _____protection
copyright
Pictorial illustrations and advertisements are covered by _____protection
copyright
Computer programs are covered by _____protection
copyright
literary, scholarly, scientific and artistic works. are covered by _____protection
copyright
In general, the term of protection of copyright for original and
derivative works is the life of the author plus__years after
his death. The Code specifies the terms of protection for the
different types of works.
fifty (50)
In calculating the term of protection, the term of protection
subsequent to the death of the author shall run from the _____ or of publication, but such terms shall always be
deemed to begin on the first day of January of the year following
the event which gave rise to them (i.e. death, publication,
making).
date of
his death
___ consists in infringing any right secured
or protected under the Code. It may also consist in aiding or abetting such infringement.
Copyright infringement
Selling or letting for hire, or by way of trade offering or
exposing for sale or hire, the article w/out permission is ______
Copyright infringement
Distributing the article for the purpose of trade, or for any other purpose to an extent that will prejudice the rights of the copyright owner in the work is _____
Copyright infringement
Trade exhibit of the article in public. without permission is ____
Copyright infringement
COPYRIGHT REGISTRATION
A duly accomplished form in ___for each work,
provided, that a separate application is submitted for each number of a periodical containing a notice of copyright.
duplicate
COPYRIGHT REGISTRATION
support document evidencing ___of the copyright, the manner of its acquisition if the claimant is not the original author translator, or editor, and where and in what establishment the work was made, performed, printed, or produced, and the date of its completion and publication.
ownership
COPYRIGHT REGISTRATION
__showing payment of the registration fee if the application is filed personally, or by postal money order if the
application is filed by registered mail.
Receipt
COPYRIGHT REGISTRATION
Documentary stamps in the correct amount, which shall be
affixed to the registration and deposit certificate.
Two (2) complete copies or __of the work or
replica or picture
Two (2) printed copies with the __notice printed in
front or at the back of the title page or on any conspicuous space
for a non-book material, if the work is a published work.
reproduction
copyright
An____ is the ornamental or aesthetic aspect of an
article.
industrial design
The design may consist of three-dimensional
features, such as the shape or surface of an article, or of two dimensional
features, such as patterns, lines or color.
industrial design
are applied to a wide variety of products of
industry and handicraft: from technical and medical instruments
to watches, jewelry, and other luxury items; from house wares
and electrical appliances to vehicles ; from textile designs to
leisure goods.
industrial designs
To be protected under most national laws, an industrial design
must be ____. This means that an industrial design is
primarily of an aesthetic nature and any technical features of the article to which it is applied are not protected.
non-functional
A___is a protection option, which is designed to
protect innovations that are not sufficiently inventive to meet
the inventive threshold required for standard patents
application.
Utility Model
It may be any useful machine, implement, tools,
product, composition, process, improvement or part of the
same, That is of practical utility, novelty and industrial
applicability.
Utility Model
A utility model is entitled to__years of protection from
the date of filing, with no possibility of renewal.
seven (7)
An application for registration should contain a duly
accomplished request for registration as prescribed by the
Bureau, specification or description containing the following:
Title
Technical field
Background of the Utility Model
Brief description of the several views of the drawings
Detailed description
Claim or claims
Drawings
Abstract of the disclosure.
UTILITY MODELS—REGISTRATION
