Quiz 3- Module 6 ( Informatics, Communication & technology Flashcards
What is the definition of informatics?
“The science and practice which integrates nursing, it’s information & knowledge, their management with info & communication technologies to promote health of ppl, families & communities worldwide”
**Science/practice that integrates nursing with technology to promote health
What do information & communication technologies do? (ICT’s)
Add value to our healthcare system by increasing pt centeredness & Cost
What are the 3 CASN entry to practice competencies
1) Uses info to support delivery of evidence informed care
2) Uses ICT’s in accordance with professionals & regulatory standards
3) uses info tech in delivery of patient care
What is CIHI
Canadian institute for health info records
What does CIHI do?
Records, analyzes and disseminates essential data and analysis on Canada’s health system and the health of canadians
What does CHI stand for ?
Canadian health infoway
What does CHI do?
Helps to develop a canada wide digital presence in healthcare
they provide funds
What is SNOMED CT
Systematized nomenclature of Medicine clinical terms
what does it do?
Along with international classification of nursing practice (ICNP) helps to standardize the language and implementation of standardized assessments and documentation to platforms to strengthen communication
What are the 2 things that focus on standardizing assessments, doc and language
SNOMED & ICNP
what does ICNP stand for
International classification of nursing practice
What is HI:NC
Health info, nursing components
what must health info have to ensure a nurses voice?
1) Pt. status
2) Interventions
3) outcomes
4) Resource intensity
5) Primary nurse identifyer
What is an EMR
revers to a record of only one visit
What is an EHR
refers to a lifetime of visits
How does EMR relate to EHR
One EHR is made up of many EMRs
What was canadian health infowar’s goal?
50% of canadians to have an EHR by 2010
What is the purpose of an EHR
-Positive impact on patient care quality through Inter-professional collaboration with improved data availablity and improving patient safety through the use of clinical decision support
What are the components of EHR
- Linked lifetime record
- Problem list (w/status)
- Standardized measurements
- Documentation of clinical reasoning
- Confidentiality/ privacy & audit trails
- continuous access
- sametime access
- links to database of internet resource
- decision making tool
- physician data entry
- cost & quality of care
- flexible / expandable
- result of diagnostic measure
How does EHR improve pt. care? (Six components) by providing access to…
1) Patient registry
2) Provider registry
3) Diagnostic images
4) Laboratory results
5) Drugs dispensed
6) Clinical report/immunizations
How is patient confidentiality protected?
By enforcing privacy rules which will prevent unauthorized access or disclose of pt. data
what does EHR enable?
The secure exchange of HC data between care providers
Why do we use institutional ethnography
to investigate the promises and practice for Canadian nursing EHR orientiented transformations
What else does EHR do?
reduces tech infrastructure costs by providing a single provincial data exchange hub
What does campbell and rankin say
Choice of EHR platform should be scrutinized well both pre and post implement
how many Canadians believe in the importance of personal health infromation
2/3 of canadians
Regardless of the practice setting or technology level, you are ethically, professionally and legally obligated too…
Protect the personal information of your patient
What parts are confidential?
- Physical & mental health services received
- organ donations
- testing
What are clinical decision making tools for?
To promot continuity to optimize care based on the best evidence (Muiltidisiplinary)
What is a clinical pathway
Multidisciplinary resource that support the routine care of a patient with in a set time frame
- no appropriate for all
- often surgical patients
What are the components of a clinical pathway
the path which is the dailey plan of care, pt. outcomes, progress and variance recording (@ end of shift) complementary documents (DR orders, pt. education books)
What are algorithms
Evidence based clinical practice guidelines that can help nurses to asses and manage patient conditions
-It is a sequence of steps
what are the advantages of algorithms
Logical, step by step process that can help refine nurses skills in decision making. Great for novice nurses
What are the drawbacks of algorithms
To rigid and encourage robotic decision making, lack consideration of all factors only as strong as the underlying evidence it is based on
What does the BC CDC do
monitor how effective vaccines are
With changing times… pt will begin to demand the use of…
tech integrated care
we must be careful with…
confidentiality, privacy, exclusionary practice and greater possibility for surveillance
What are the outcomes to emerge from E-nurse strategy
1) Nurses will integrate ICT into their practice to achieve valuable outcomes
2) Nurses will have required information & knowledge to support practice
3) Human resources planning will be facilitated
4) New models of nursing practice and health delivery supported
5) Nursing groups well connected
6) ICT will improve the quality of nurse work environments
7) Canadian nurses will contribute globally
What is the critical path
dailey plan of care, gives direction for interventions: assessments, treatment, activity, nutrition, education, consultation, trasitions, discharge plan
What are the 3 components
- Path
- Physician order
- Patient education booklets
What is an algorithm
Explicit description of an ordered sequence of steps to be take in patient care under specific circumstance
- Evidence based
- Can guide assessment
What are the drawbacks of an algorithm
don’t account for comorbidities, meds/social history & drug interactions
What is the sentinel practitioner surveillance
Monitors how well influenza vaccine protects ppl from the virus each year
What is an Institutional ethonography (IE)
used to examine transformations in a professional nurses work associated with her engagement with a hospitals electronic health record
- Expected to increase decision making and healthcare
- Increases efficiency, and effectiveness
- Better integrated
What is the patient 2.0
- Empowered through access of unprecedented amount of health knowledge, new forms of collaboration and self management
- new forms of collaboration & self management
- Vast majority of advice not from HC professional
What does nursing informatics do?
- enhances decision-making in all nursing roles through: Collection, extraction, aggregation, analysis and interpretation of standardized data using principles and methods of data science
- adds value to health care system while decreasing cost
- aligns with CNA’s position on primary health care
- further the shift toward person-centred approaches to care delivery focused on health promotion and disease prevention
Informatics is essential to…
-achieve a person-centred model of health and wellness (helps individuals stay digital connected with their health and helps them to manage and improve their health)
what is [Digitally] connected health-technology enabled model of patient centred care?
Conceptual model of health management where devices, services or interventions are designed around the patients needs and health related data is shared in a way that the patent can receive care proactively and efficiently
The CNA & CNIA position:
- Nursing informatics competencies are essential
- nurses need informatics specialization to support decision making
- systematized nomenclature of medicine, clinical terms all across Canada
- nursing professional need to develop and adopt standardized assessment methodologies and documentation tools which are safe and provide quality care across the continuum
- informatics will continue to evolve, shift focus dependent on new technologies and approaches
What are SNOMED-CT and ICNP
standardized clinical terminologies best suited for documenting, communicating, aggregating and analyzing nursing contribution to care
-link and compare data from other professions
what is C-HOBIC
project that has adopted SNOMED CT/ICNP to document standardized nursing assessment methodology. Support comparison of pt. outcomes
-determines the impact of nursing care for individual patients, organizations can see how well they are managing clinical outcomes
what is LOINC
can document assessment scales & intake/output
C-HOBIC & LOINC purpose
make it easier to document, communicate, analyze nursing contribution to patient care
Which are standardized clinical reference technologies?
ICNP, SNOMED-Ct
what are standardized approaches to nursing documentation?
C-HOBIC, LIONC
what is progress/variance recording
end of shift, sign pathway to indicate if interventions / outcomes were achieved & notes variances
Positives of clinical pathways?
- Standardized but flexible
- Patient appreciates the continuity of care, same document from pre-admission to discharge
Two major functions of communication technologies?
- Add value to health care system
- Decrease cost
eHealth
The use of information and communication technologies (ICT) for health
Early definition of NI (Nursing informatics)
focused on technology and effective utilization in practice
More recent definition of NI
focus more on the role of information management and the role of the nurse as an information manager
Evolution of NI definitions
1) Technology focus
2) conceptual focus
3) Role centered
4) Practice based
What is COACH
canadian organization for advancement of computers in health
what is HIP
health information professional competency framework
What are the 2 health services
- Canadian health systems
- Clinical and health services
What are management sciences
- Project management
- organization and behavioural management
- analysis and evaluation
Health informatics…. intersection of
1) Clinical
2) Information management and information technology
3) Manamagement practices to achieve better health
What is MIS
management information systems
MIS developed guidelines for..
the collection of data for demographic, statistical and resource utilization and consumption purpose
What are the problems with MIS data
like hospital discharge summaries, health information was restricted to physician driven data and contains no clinical nursing data
What happened in 1993
the merger of MIS, hospital medical records institute , portions of statics Canada and portion of health nd welfare Canada to create the CIHI
What are standards and clinical interoperability
standards in health care data management refer to a nationally or internationaly agreed upon protocol representing all types of health info provides, location of care, provision, pharmacy ordering and dispensing and billing
infoway path to clinical interoperability?
1) Unleash the clinical leadership
2) Realign the effort to focus on interoperability specifications
3) use simple, open technical solutions to enable interoperability
4) Migrate health information exchange implementation and operation to service model
5) Allow all stakeholders to have a voice in clinical interoperability
ICNP (International classification for nursing practice) currently available
- community nursing
- disaster nursing
- nursing care of children with HIV & AIDS
- nursing outcomes indicators
- paediatric pain management
- palliative care
- patterning with individuals and families to promote adherence to treatment
- prenatal nursing care
What are the 3 fundamental directions
1) Access
2) Competencies
3) Participation
What is meant by access
access to quality ICT is important for nurses to realize full benefits, organizations have responsibility to ensure nurses have connectivity and resources
What is meant by competencies
CNA encourages nurses to develop competencies in application of ICT and advocates for them to be part of nursing programs
What is meant by participation
Strategic partnerships with nurses in clinical practice, employers and admins educators and researchers. With effective partnerships, nurses can help select the design IT application and continue to educational programs
CNA mandate includes..
- provide leadership for development of nursing and health informatics in Canada
- establish national networking opportunities for nurse informatics
- facilitate informatics educational opportunities for all nurses in canada
- to engage in international NI initiatives
- Acts as a nursing advisory group in matter of nursing and health informatics
Key ideas about critical pathways
- Unifies groups of professional to provide cohesive efforts to minimize duplication of service
- Used concurrently its tracking device from outcome
- case managers use pathways to direct and evaluate standard interventions against a time frame
- care is standardized against external benchmarks/guidelines
- can also be used in goal setting
- not designed to replace physician orders or dictate care plan
- it is to reduce variation
- offers common outcome criteria for all disciplines
What does an algorithm look like
flow chart
-allows tracing a care through system
Process flow analysis is completed to identify steps that
- drive people to perform services well
- inhibits adequate performance
- states what resources are necessary
- states what indicators are used to confirm adequate performance
reasons for evaluating outcomes
- payers/customers demand info about results of care
- integral part of accreditation
- regulatory agencies demand info about outcomes
- represent basic reason for providing care (reflects nurses contribution)
- evaluate the changes in delivery of health care
- evaluating outcomes helps nurses incorporate evidence-based practice into care and help reduce cost
Algorithms can….
- Guide assessment or management of a given clinical problem
- define posible end points
- help nurses to determine the best course of action
Traditionally it was paper records which were…
Episode oriented
separate record for each patient
key info was sometimes lost
this jeopardized pt. safety
Electronic health record
longitudinal/life long health encounters
electronic medical record
legal record that details a single encounter
2 Promises of EHR
1) Positive impacts on the quality of patient care through collaboration with improved data availability & information synthesis
2) improve patient safety through use of clinical decision suport
* **Improves continuity of health care
Key advantages of EHR for nurses
- compare current clinical data to previous health care encounters
- maintain ongoing record of education & patients response to the Info
quality of care is dependent on…
nurses ability to communicate with healthcare team
When a care okay us not communicated to everyone…
care becomes fragmented, tasks are repeated, delays or omissions in care can occur
Key ideas of confidentiality
- legally and ethically required to keep information confidential
- essential part of BSN education
- must not care info with patients or other health care staff that aren’t caring for particular patient
- access to EHR’s is trackable on computer
- breech is often careless and not intentional
What are some examples of confidentiality breeches
- accessing information not related to your duties
- discussion of patient info in inappropriate areas
- revealing to a caller, confidential patient or coworker details
- emailing a patient through a public internet service
- leaving confidential material in a public area
PHI includes…. (personal health information)
- individually identifiable health information such as demographic
- Facts that relate to an individuals past, present or future physical or mental condition
- Provision of care
- payment of provision of care
PIPEDA (personal information protection and electronic documents) …
- Federal legislation that protects personal info (including health info)
- delineates how private sector organizations may collect, use or disclose personal information
- patient has right to access and can request a correction
Logical & physical restriction…
- Automated sign off
- fire walls
- computers or file serves in restricted areas
- privacy filters on screens
- passwords
Handling and disposing of information
- essential responsibility of all health care members
- destroy/shred anything that is no longer needed
- must destroy papers immediately after faxing
Steps to enhance fax security
- confirm number
- cover sheet
- autheticate
- dont use speed dial
- encription
- fax machines in secure area
- log fax transmissions
What are the common social media & device expectations
1) benefits & risks
2) Professional image
3) confidentiality
4) privacy
5) boundaries
6) Expectations
7) integrity
8) employer policies
9) accountability
what are the 6 P’s of social media
- professional
- positive
- patient/ person-free
- protect yourself
- privacy
- pause before you post
What is meant by benefits and risk
- know the benefits and risks
- know how to use the technology
- reflect on intent
what is meant by professional image
- use same professionalism online as face-to face
- personal and professional lives separate
- different account for personal and professional activities
What is meant by confidentiality
- don’t share any client info
- just leaving out details when you post info or images doesn’t protect confidentiality
- report beeches immediately
What is meant by privacy
- set and maintain privacy settings
- even with highest setting, ppl can share you info without consent
what is meant by boundaries
maintain professional boundaries
don’t accept clients requests
what is meant by expectations
- use cation when identifying as a nurse online
- others may ask u for advice
- using a name that hides your identity doesn’t release you form this expectation
what is meant by integrity
- protect personal & professional integrity
- use proper communication channels for workplace issues
- give same respect as you would in the workplace
- “liking” a disrespectful post is just as bad as you posting it urself
What is meant by accountability
0make sure u can answer for ur actions
- reflect on why, how and when u use social media
- know that personal social media use while working could be viewed as client abandonment
- use professional judgement
- keep ur obligations to others
