Scopes and Standards NI Flashcards

1
Q

What is Nursing Informatics?

A

NI is the specialty that transforms data into needed information and leverages technologies to improve health and HC equity, safety, quality and outcomes.

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2
Q

NI specialty circle -
(1)Identification
(2)Management
(3)Communication
(4)Integration

A

(1) Data - Naming, Collecting, Organizing (Inner circle for all 4 Decision making, Nurses, HC consumers etc.)
(2)Information - Organizing, Defining, Interpreting
(3) Knowledge - Interpreting, Integrating, Understanding
(4)Wisdom - Understanding, Discovering, Ethical application

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3
Q

NI Value Statements
(1)Combination of
(2)Understanding of
(3)DIKW
(4)NI leadership
(5)HC
(6)Scientific
(7)Integration of
(8)Education across

A

(1)Nursing and Informatics
(2)HC delivery and operational flow
(3)DIKW for individuals and populations
(4)ORG stragegy
(5)Policy influence
(6)Scientific research and discovery
(7)Sociotechnical framework
(8)the spectrum of HC systems

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4
Q

Nursing Metaparadigm

A

four concepts,
Nurse
Person
Health
Environment

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5
Q

Blum Data, Information, Knowledge

Widsom -

A

Data - discrete entities without interpretation (90, 20)
Information - Data that have been interpreted organized or structured
Hr 90, rr 20
Knowledge - Information synthesized so that relationships are identified

Widsom - application of knowledge in the management of human problems

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6
Q

DIKW
numbers 36.9, 88, 120/80

A

numbers = data
vital signs = information
Knowledge = patient age, medications Hx etc.
Widsom - what to do with the knowledge

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7
Q

Benner experience stages

A
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8
Q

Nursing Informatics is concerned with

A

Creation, structure, storage, delivery, exchange, interoperability and reuse of nursing and clinical information

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9
Q

Wisdom Antecedents
(1)Personal related factors
(2)Setting related factors

A

(1)personal - age, education, life experiences
(2)Setting related factors - setting culture, decision support system etc.

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10
Q

ANA recognized Standard Nursing interface terminologies
(1)CCC
(2)ICNP
(3)NANDA
(4)NIC
(5)NOC
(5.5)OHMAHA
(6)PNDS
(7)ABC codes

A

(1)clincal care classification system
(2)International classication for nursing practice
(3)NANDA
(4)Nursing interventions classifications
(5)Nurisng outcomess classifications
(5.5)
(6)Periop nursing data set
(7)alternative medicine billing and coding

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11
Q

Minimum data sets
(1)NMDS
(2)NMMDS

Reference terminologies
(1)LOINC
(2)SNOWMED-CT

A

(1)Nursing minimum data set
(2)Nursing Managment minimum data set

(1)Logical observation identifiers names and codes
(2)systemized nomenclature of clinical terms of medicine clinical terms

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12
Q

(1)HITAC

A

Health information technology advisory committee - will recommend to ONC, policies, standards etc. replaces HITECH?

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13
Q

with data and information an expert system can generate:

A

care suggestions, warnings/alerts. Nurses must use wisdom in decision making from alerts.

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14
Q

Data lake

A

data is all forms of data in an unorganized, non-hierarchical structure. Is easier than structured data for data analytics.

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15
Q

AI -

Machine learning+NLP =

A

Artifical intelligence - the mathematical expression of human intelligence to enginer expert systems
encompasses both machine learning and NLP which encompasses:

(2)deep learning

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16
Q

NLP -
(2)Machine learning

A

(1)
(2)Clusters patient traits targeting identifiers for diseases. Linear regression + machine learning = neural networks?

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17
Q

(1)AI =
(2)Machine Learning
(3)Deep learning

A

(1)AI = rules, COnditional logic
(2)ML =Pattern detection, regression, clustering
(3)DL = Image classification

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18
Q

Strategy of INS

A

to make all interactions with technology beneficial and easy. they are “barons” of the user experience

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19
Q

User experience encompasses

(2)Human factors

A

Human factors, which are ergonomics, Useability and Human computer interaction

(2)Studying how humans interact with things - e.g. precribing errors

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20
Q

Definitions
Human factors
(2)Ergonomics
(3)Human-Computer interaction
(4)Usability

A

(1)understangin interactions of humans and the elements of a system
(2)study and design of working environments and their componenets for the benefit of the workers productivity and health
(3)design, evaluation and implementation of interactive computer systems
(4)how a system, product or service can be used to achieve goals efficiently and effectively

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21
Q

Definitions
(1)Management
(2)Admistration
(3)Leadership
(4)informatics leadership ex

A

(1)Management - an art of getting things done through and with people in formally organized groups
(2)Administration - the process of running and ORG, office or business. creating rules and regs, making decisions etc.
(3)Leadership - the ability to provide a setting where everyone feels empowered to to contribute creatively to solving problems. Leader provide inspiration - and people want to follow them.
()4)CNIO, CIO, CCIO - Chief nursing, chief informatics, chief clinical inf.

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22
Q

Four competencies for interprofessional collaboration
(1)Work with individuals
(2)Use the Knowledge
(3)Communication with patients
(4) Apply relationship-building

A

(1)Work with individuals of other professions to maintain a climate of mutual respect
(2)Use the Knowledge of one’s own role and those of other professions to address the HC needs of patients and advance health of population
(3)Communication with patients, families, communities etc in a responsible manner to promote Tx of disease
(4) Apply relationship-building values and the principles of team dynamics to perform effectively in different team roles

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23
Q

Project management definition

(2)PM phases (five)

A

planned set of interrelated tasks to be completed within a time frame - and know what goals are and how to achieve them.

(2)Initiation/design, planning, implementation Monitor, Close

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24
Q

IN or INS PM skills:

(2)according to the IHI they should especially have skills in

A

Defining scope, doing a GAP analysis, workflow or SWOT analysis, Gantt chart

(2)QI project management. The IHI has developed a tool to manage Quality improvement projects

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25
Steps of Systems design life cycle (1)P (2)S (3)S (4)D (5)I (6)D (7)O
(1)Planning (2)Systems analysis and requirements (3)Systems design (4)Development (5)Integration and Testing (6)Implementation and deployment (7)Operations and maintenance
26
Defintion: (1)Clinical Informatics (2)Pharmacy informatics (3)Medical Informatics (4)Nutritional informatics
Clinical informatics is the application of informatics and information technology to deliver healthcare services. AKA applied clinical informatics and operational informatics. Clinical informatics transforms health care by analyzing, designing, implementing and evaluating information and communication systems (2)Pharmacy informatics - focuses on medication related data and knowledge within the HC system (3)Medical informatics is design, development adoption and application of IT based innovations in HC (4)Nutritional informatics - informatics for food and nutrition
27
(1)Data Management (2)The national Quality strategy (NQS) (3)INS focus on Master data management with the NQS
(1)Data Management - data must be managed effectively for P4P(value based). The American Hospital association estimated that 80% of the data collection was on the hospital, only 20% supplied by the vendor. (2)better care, healthy people and communities and affordable care (3)INS role on master data management - developing people, techonology and processes to support the ORG. one the PEOPLE end they may associate with culture, governance on the IT end data accuracy
28
INS activities in the process domain
-communication about program releases -reports are accurate -Voice of the customer is an integral business requirement -use-based data quality -agile design
29
(1)HCI tools and Methods - Heuristics - Cognitive walkthroughs -
(1)Heurisitics - mental shortcuts that allow people to solve problems and make judgments quickly.(aka cognitive shortcuts) Cognitive walkthrough - walkthrough each step of a workflow answering questions. goal is to ID where interface could be challenging
30
INS nurses and standardization of data capture. re-evaluating Nursing languages required knowledge of
Nursing and medical vocabularies e.g. ICD -10 to aid in meaningful use
31
INS methods use tools and methods to: (1)maintain data (2)facilitate data (3)develop and analyze
(1)integrity (2)standardization, aggregation and analysis (3)process outcomes and balancing
32
INS competencies for intermedia analystics (1)analyze (2)Utilize data (3)Utilize data management examples: check to see if alert for sepsis IDs sepsis risk determine if data is being reported accurately to CMS
(1)analyze data and info accurately (2)Ultilize dat from EHR (3)Utilize data management, data mining and data sharing
33
HIPPAA access requirement (2)HITECH act 200_ (3)what is the OMNIBUS HIPAA rule? (4)Who performs audits for HIPAA violations?
(1)HIPAA access requirement - PHI was added as a requirement in 2013. applies to health plans, HC clearinhouses (2)HITECH 2009. HITECH went above the original protections established by HIPAA in 1996. (3)OMNIBUS HIPAA rule = increased protection for PHI with significant fines for violations (4)Department of Health and Human services. e.g. penalties, neglegence etc.
34
INS must also consider regulatory requirements (beyond HIPAA) for:
genetic information nondiscrimination act (GINA) International laws like the general data protection regulation
35
(1)What Acts required EHRs? (2)What agencies provide incentives to implement informatics? (3) what is replacing ROI payment models? (4)What is the 3rd leading cause of death in the US?
(1)America recovery and reinvestment act and HITECH (2)AHRQ, Leapfrog, Institute for Healthcare Improvement (IHI) (3) Value based care models (4)Medical errors
36
Types of research INS may be involved in: (1)Exploratory research - e.g. (2)Experimental research - e.g. (3)Process/quality improvment (4)Nursing vocabularies
(1) data mining (2)randomized trials
37
Health Information Technology is a Key element of the National Quality Strategy (NQS) to achieve three aims:
Better Care, affordable care and Healthy populations and communities -this requires robust reporting systems
38
What agencies provider regulatory guidance? (2)INS must meet ethical standards by:
CMS, FDA, NIH, NIST (2)Revising procedure for staff, establish technical process to maintain compliance, meet new regulatory mandates
39
INS should have skills in:
Clinical Nursing (2)Project management (3)process design (4)strategic IT planning (5)system implementation (6)writing for publications (7)requests for proposals
40
What is the TIGER Initiative?
Technology Informatics Guiding Education Reform - 2006- all nurses should able to practice in a technology driven world.
41
Education for regular nurses informatics (1)the Healthcare Leadership alliance five domains: (2)Quality and safety education for Nurses goal (3)NLN
(1)Leadership, communications, professionalism, business knowledge, knowledge of HC environment. (2)added informatics as competency for licensure for nursing education (3)created tool kits to help educators for informatics(NLN informatics toolkit)
42
ONC funding for informatics and new roles (1)Clincical (2)Health information (3)Research (4)Programmer (5)Health information (6)Health IT
(1)Clincical health leader (2)Health information management exchange specialist (3)Research and development scientist (4)Programmer and software eng (5)Health information privacy and security specialist (6)Health IT subspecialist
43
Staggers, Gassert and Curran 4 levels of competency
(1)Beginner - basic computer skills (2)experienced - Inforamtion literacy and management (3)specialist - MSN in informationcs. Analyze HC information to reduce risks, improve care etc. (4)innovator - Doctorate - selection and eval of HC IT systems
44
Nine Provisions of the ANA code of Ethics for INS practice Provision 1 - Nurse practices with Provision 2 - The Nurses Primary commitment
Provision 1 - Nurse practices with compassion and respect... dignity of every person e.g.-INS should listen to all stakeholders and communicate back best possible choices Provision 2 - The Nurses Primary commitment is to the patient e.g. must work to achieve results that will benefit patient care
45
Nine Provisions of the ANA code of Ethics for INS practice Provision 3 - The nurse promotes, advocates for Provision4 - The Nurse has authority, accountability and responsibility
Provision 3 - The nurse promotes, advocates for the rights and safety of the patient e.g. - there is a balance between patient safety and autonomy and data management. What will this technology do for and to the patient Provision4 - The Nurse has authority, accountability and responsibility for nursing practice - optimal care provided e.g. must discuss ethical issues from new health technologies. Privacy and security of patient data
46
Nine Provisions of the ANA code of Ethics for INS practice Provision 5 - Nurse must maintain competence Provision 6- Improve ethical environment of the work setting for safe care
e.g. keep up to date on technology (6)e.g. responsible for monitoring and eval newly implemented technololgies
47
Nine Provisions of the ANA code of Ethics for INS practice Provision 7 -Advance profession through research Provision 8- Protect human rights, reduce health disparities Provision 9- maintain integrity of the profession
(7)INS seek to advance the quality of NSG informatics practice. should improve admin, EDU and research in NSG informatics and disseminate that knowledge (8)system should allow interoperability and data transfer while respecting privacy (9)INS should participate in professional NSG associations, policymaking etc.
48
Four trends that will influence the future of NSG informatics (1)Evolving roles (2)Increasing Informatics (3)Applying rapidly (4)Enhancing new
(1)Evolving roles of informatics nurses (2)Increasing Informatics competency for the NSG profession (3)Applying rapidly evolving tech advances to NSG and HC (4)Enhancing new and emerging federal regulations to support Quality of care
49
Competencies new nurses should have for informatics (1)Knowledge (2)Skills (3)Attitudes what are the two instruments to assess a Nurses informatics competency?
(1)Knowledge surrounding topics: data, education, privacy and security (2)Skills to address data analysis, data structures, programming, system development lifecycles (3)Attitudes to lead and drive the future of informatics --TIGER /TANIC - Level 3 and level 4(informatics innovator)
50
What are the four informatics Nurse competency levels? L1 L2 L3 L4
L1 - Entry level - basic computer literacy, information management L2- experienced nurse - understands relationship between NSG and Health IT for evidence based practice L3 - INS - advanced information management skills and techniques, and leadership attributes L4 - Informatics Innovator - design research studies, analyze data for new insights, eval effectiveness for INS solutions etc.
51
example of incremental technological innovation while keeping established framework (2)example of exponential technology (3)What are some examples where technological innovations will occur in informatics/HC?
e.g. adding a new feature to the EHR or smart pump exponential technologies disrupt current solutions, and cannot do incremental changes. Not easy to predict or plan for - but transform HC delivery (3)AI, VR, wearables, machine learning, nanotech, syndromic surveillance, telehealth
52
Definition (1)Interoperability (2)What are the three levels of interoperability? (TPS) T-
(1)Interoperability - to seamlessly exchange data and information between two or more disparate(apples to oranges - too different to compare) information systems (2)Technical, Process and semantic Technical - moving data between systems. May be unidirectional or bi-directional HL7 interoperability levels - V2, V2, CDA and FHIR. Process? - before making data interoperable INS needs to advise on process flows and make sure data exchanged are semantically equivalent.
53
Machine learning Three areas of Nanotech in HC
Machine learning is the most common form of AI. Uses data to devlop models to anticipate future trends in HC. Data models were used for COVID-19 (2)pharmaceutical drug delivery, monitoring devices and regenerative tech
54
Population health (2)Robotics
Population health data becomes useful to support research, inform policy and ID best practice to enhance national HC concerns (2)robotics can help with upwards of 30% of nursing daily activities e.g. delivering supplies, remote surgeries, VR, translators, lifting patients
55
Definition Syndromic Surveillance (2)Telehealth
Syndromic Surveillance - monitoring the burden of communicable disease in an area. EHRs are an evolving way to popluation level data. Social media may also be used. (2)Telehealth may vastly expand primary care, mental health and specialty service consultation. Amount of B&M facilities may decrease. With COVID it became accepted almost overnight
56
(1)What was the HITECH meaningful use renamed to in 2018? (2)21 century cures Act
(1)Promoting Interoperability? (2)enacted in 2016 - included medical device app development, and improve patient access to their own health data. Two new rules introduced in 2020 - API(application programming interface - for interoprability of data
57
Essential concepts for current and future innovations in informatics and Health IT (1)Preparing (2)Introducing (3)Designing (4)Incorporating (5)Participating (6)Proactive (7)Developing (8)Scalable
(1)Preparing for tech innovations through EBP (2)Introducing new educationsal models (3)Designing solutions for Health ino tech (4)Incorporating new tech (5)Participating eval of disease patterns (6)Proactive risk mitigation (7)Developing new tech (8)Scalable cloud based tech
58
New innovations from unmet needs originate from the users how often? (2)When were new rules released from CMS and ONC?
77% of the time (2)2020
59
Standards of Practice (1)Standard 1 - Assessment
(1)Standard 1 - Assessment Competencies: -conducts needs analysis -involved HC consumer, family, team etc. -assess needs of HC consumer -uses EBP -uses analytical models -supports development of tech to enchance ability to capture data -Gap, SWOT, workflow deisng
60
Standard 2: Diagnosis
Diagnose- -basic computer problems -ID risks to consumer health and safety -uses standardized clinical language -documents problems
61
Standard 3: Outcomes ID
ID outcomes by: -involves stakeholders -defines expected outcomes -formulates expected outcomes -includes time estimate for outcomes -measureable goals
62
Standard 4: Planning
-develops customized plan -plan priorities -implementation plan with timeline -costs -integrate EB guidelines
63
Standard 5: Implementation
-collection of data for decision support, value based care -fosters high reliability ORG cullture -IDs unintended issues -serves as consultant
64
Standard 5A: Coordination of activities
-Organizises components of the plan -directs implementation of the plan -manages project
65
Standard 5B: Health teaching and Health promotion
-integrates ergonomics, disability adaptations and compliance into clinical practice -applies tech for EB info -population learning help -health promotion with consumer alliances -decision support
66
Standard 6: Evaluation
-conducts criteria based-evaluation of outcomes -uses assessment data to revise diagnoses -documents results of the eval
67
Standard 7: Ethics
-Family as core members of HC team -privacy, security and confidentiality -Escalate ethical issues
68
Standard 8: Culturally congruent
-understand cultural norms -leads interprofessional teams -knowledge of health beliefs and practices
69
Standard 9: Communication
-collaborates with groups to move projects -partners with others to produce positive outcomes through sharing of data, information and knowledge -engages in team-building processes
70
Standard 10: Collaboration
-collaborates to move projects forward -applies group project negotitation techniques -engages in teamwork and team-building
71
Standard 11: Leadership
-Promotes ORGs vision, goals and stragetic plan. -mentors colleagues
72
Standard 12: Education
-Identifies individual learning needs, advances own education, lifelong learning etc.
73
Standards 13: Evidence-based practice
-ID data and info to develop and communicate evidence -uses current evidence-based, evaluates regulatory and requirements -shares peer review research finding
74
Standard 14: Quality of Practice
-uses QI activities to initiate changes -Contributes to continuous improvement -uses data management to optimize data for analysis
75
Standard 15: Professional Practice evaluation
-self eval on regualr basis -obtains feeback -self improvement plan
76
Standard 16: Resource Utilization
-uses resources to enhance ability to interpret data -ID potential for harm/risk complex and outcomes
77
Standard 17: Environmental health
-prevent ergonomics and environmental health risks -reduce health problems e.g. sound, light electromagnetics etc. -quick and easy access to data an information -report safety breaches