Study Flashcards
1
Q
an established and growing area of specialization in nursing.
A
Nursing informatics
2
Q
Computers are incredibly
A
fast, accurate and stupid.
3
Q
Human beings are incredibly
A
slow, inaccurate, and brilliant.
4
Q
In the 21st century, information is
A
doubling every 5 years
5
Q
Technology also facilitates the ______ in nurses,
A
creative process
6
Q
Healthcare is dependent on
A
information.
7
Q
Every action taken depends on
A
previous information and knowledge.
8
Q
The Nursing Informatics model includes
A
cognitive science
computer science
information science
9
Q
informatics is a combination of
A
“information” and “automation” which means automatic information processing
10
Q
“ the application of computer technology to all fields of nursing – nursing services, nurse education and nursing research.”
A
1980, Scholes and Barber
11
Q
Functions of computers in nursing practice
A
record information, provide access to other departments, manage schedules
12
Q
Telecommunications technology is used to
A
assess, diagnose, and treat at a distance.
13
Q
telehealth devices include
A
BP, glucometers, peak flow, pulse oximeters, scales, video monitors
14
Q
Does telehealth transcend state boundaries, true or false?
A
true
15
Q
Biometric technology uses human characteristics to
A
to authenticate or grant access to data or information
16
Q
examples of biometric technology include
A
fingerprints, retinas, irises, voices, facial patterns
17
Q
bedside data entry records clients..
A
assessments, medication administration, progress notes, care plan updating, client acuity and accrued changes.
18
Q
computer-based client record provides
A
easy retrieval of data.
19
Q
computer-based client records help
A
work providers about conflicting meds or client parameters that indicate dangerous conditions
20
Q
Electronic Access to Clients allows
A
Assess and Monitor clients conditions. Data storage for research . Can monitor client Computerized diagnosis Telemedicine
21
Q
practice management is in charge of
A
Order supplies from other depts.
Determine most costly items used by unit.
Modify budget, staffing, increase efficiency.
22
Q
Human resources
A
employee database, administration services.
23
Q
Medical records management allow client records to be
A
searched for trends, number of cases, client outcomes.
24
Q
Facilities management
A
heating, AC, ventilation, alarms.
25
Budget and finance
claims are transmitted more quickly. Can also affect cost-savings by reducing service times.
26
Information literacy
The ability to determine when information is needed and how one can locate, evaluate and use the information appropriately
27
Information technology
The hardware and software that facilitates the storage, retrieval, communication, and management of information
28
Computer literacy
The knowledge and understanding of computers combined with the ability to use them effectively
29
Problem Identification
useful in locating current literature and related concepts.
30
Literature review
software facilitate searches, appropriate terms.
31
Why are you doing the search? Why do you need the information?
Purpose-Focus-Approach
32
Broad and general (basic information for you).
Lay-oriented ( to give to patient)
Professionally oriented (for colleagues)
Narrow and technical with a research orientation
focus
33
Edu
educational institution
34
Org
non-profit organization
35
Com
commercial enterprise
36
Net
internet service provider
37
Gov
governmental body
38
Mil
military
39
Specific criteria useful in evaluating a website
Authority with regard to topic
Author and author’s credentials.
Author’s contact information.
Affiliation of website
40
Evaluating Information on the Internet
Objectivity, accuracy, currency, and usability
41
Objectivity
purpose clear, information factual or opinion, primary or secondary, sponsor
42
Accuracy
documentation and referencing
43
Currency
look for dates, compare with current literature
44
Usability
well-designed, stable, easy to use. Error –free and readable by intended audience.
45
The 6 Competencies
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Patient/Family-Centered Care
Teamwork and Collaboration
Safety
Evidence-based Practice
Quality Improvement
Informatics
```
46
Components
Knowledge
Skills
Attitude
47
Listen to the patient and demonstrate compassion and respect.
Old Patient/Family-Centered Care
48
Recognize the patient or designee as the
source of control and
full partner in providing compassionate and coordinated care based on
respect for patient’s preferences, values, and needs
New Patient/Family-Centered Care
49
Work side by side with other HC professionals while performing
nursing skills.
old Collaboration and Teamwork
50
Function effectively within nursing and inter-professional teams,
fostering open communication, mutual respect, and shared decision-
making to achieve quality patient care
new Collaboration and Teamwork
51
Adhere to internal policies and procedures.
old Evidence-Based Practice
52
Integrate best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal health care.
new Evidence-Based Practice
53
Use data to monitor outcomes of care processes and improvement methods to design and test changes to continuously improve quality and safety of health care systems
new quality improvement
54
Update nursing policies and procedures, chart audits of documentation
old quality improvement
55
focus on individual performance, vigilance to keep patients safe.
old safety
56
Minimize risk of harm to patients and providers through both system effectiveness and individual performance.
new safety
57
What is patient safety?
Decreased risk of harm by individual actions or system design.
58
Who is responsible for patient safety?
All of us
59
When do we address a “safety issue”?
As soon as we see it.
60
Use information and technology to communicate, manage knowledge, mitigate error and support decision-making
Informatics Definition
61
timely and accurate documentation
old informatics
62
Use information and technology to communicate, manage knowledge, mitigate error, and support decision-making
new informatics
63
What is your responsibility? (informatics)
Timely, accurate data collection
Timely, complete documentation
No falsification of information.
It is up to you to keep patient data “clear and concise” so you don’t muddy the water.
64
A rule of conduct or action prescribed or formally recognized as binding or enforced by a controlling authority.
law
64
A rule of conduct or action prescribed or formally recognized as binding or enforced by a controlling authority.
law
65
the minimum ethic, written down and enforced; behavior that is not merely desired but mandated.
law
66
statutory Law is written by
legislative bodies.
67
Violation is considered a
criminal offense and prosecuted by government authorities.
68
HIPPA (1996)
Health Insurance Portability and Accountability Act
68
HIPPA (1996)
Health Insurance Portability and Accountability Act
69
Detail the conduct of licensed nurses and define behaviors of all health care professionals in promoting public health and welfare.
state statutes
70
Nurse practice act
State board procedure
Child abuse reporting
state statutes
71
Licensure regulated by
each state
72
Good Samaritan Laws (1998) protects health professionals
stopping to help in emergencies
73
Public Health Law laws were created to promote
health and reduce health risks in communities (school immunizations, reporting communicable diseases)
74
Uniform Determination of Death Act (1980) changed standards for
determining death
75
Derives from common usage, custom, and judicial law.
Based on occurrences of events.
Less clear and exact
Fluid and changes over time.
common law
76
Addresses the general welfare of the public.
Carries a punishment
felony
misdemeanor
criminal law
77
legal disputes between parties
civil law
78
civil wrongs committed by one person against another person or a person’s property.
TORTS
79
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Physical harm
Psychological harm
Harm to livelihood
Harm to reputation
Unintentional tort
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torts
80
Signed consent is required for
all routine treatment, hazardous procedures, some treatments, and research
81
a client has the right to be fully informed of the risks, benefits, alternatives, and consequences of refusal for surgery or invasive procedure
Informed consent
82
Student nurses are liable if their actions
cause harm to patients (liability is usually shared)
83
Inadequate staffing/ patient ratios
short staffing
84
Assignments to a department where the nurse does not normally work
floating
85
Nursing judgment when carrying out
Physician’s orders
86
conduct that does not show due care.
Negligence
87
the negligence of a specially trained or educated person in the performance of the job.
Malpractice
88
The nurse owed a duty to the client.
The nurse did not carry out that duty.
The client was injured.
The nurse’s failure to carry out the duty caused the injury.
examples of malpractice
89
A system for ensuring appropriate nursing care and identifying hazards before harm is done to a client.
risk management
90
steps in risk management
```
Identify
Analyze
reduce
Evaluate
Incident/ occurrence reports
```
91
Transfers the legal and any settlement costs related to a suit from the individual to an insurance company.
Liability Insurance
92
meeting customers’ expectations in the delivery of clinically effective, efficient, and affordable health care services.
quality
93
an unexpected occurrence involving death or serious physical or psychological injury or the risk thereof.
Sentinel Event
94
the terms “sentinel event” and “medical error” are not
synonymous
95
```
Communication
orientation/training
Patient assessment
Staffing
Availability of information
competency/credentialing
Procedural compliance
Environment safety and security
Leadership
Continuum of care
Care Planning
Organization culture
```
Root causes of sentinel events
96
the provision of services that meet an appropriate standard
Quality Assurance
97
a continuous process involving all levels of the organization working together across departmental lines to produce better services for health care clients.
Quality Improvement
98
Who was the first nurse to engage in quality improvement activities?
Florence
99
Who is on the team?
staff nurse
nurse manager
QA coordinator
nurse executive
100
Right site, Right patient, Right surgery
make sure there are identifiers for each patient and they receive the appropriate care and surgery.
101
innovative approaches to provide care to different patient populations.
Care Models
102
resource nurse –
clinical nurse specialist.
specialized training of staff nurses
based on the idea that nurses know the most about their patients.
Examples of a Care Model Approach
103
Dedicated unit approach pays special attention to:
physical environment
interdisciplinary collaboration
nurse-initiated clinical protocols of care
activity rooms
104
identify a specific clinical syndrome that’s common to their patient population.
develop clinical and educational tools to detect and manage the disease.
improves comprehensive care delivery.
Syndrome – Specific Model
105
nurse specialist with advanced knowledge and skills follow a patient throughout the hospital stay and continuing after discharge.
assesses patients upon hospital admission and every 48 hours and then when home.
Quality cost model of transitional care
106
Defining Characteristics of Nursing Practice
Human Responses
Theory Application
Nursing Actions
Outcomes
107
Focus on health promotion and illness prevention
Primary Prevention
108
Focus on health promotion and illness prevention
Primary Prevention
109
Focus on early disease detection, treatment
Prevent progression of the disease
Early detection through screening
Secondary Prevention
110
Focus on restoring function, decreasing disease=related complications
Includes rehabilitation and palliative care
Tertiary Prevention
111
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Physician’s offices
Clinics
Community health centers
Public health service organizations
Often the entry point for managed care.
```
primary Care delivery
112
Hospital
Outpatient surgical center
Specialist’s office
Secondary care delivery
113
Hospital
Acute care facility
Rehabilitation center
Extended care facility
Tertiary care delivery
114
Offered by employers as part of the benefits package
Administered by private companies
Purchased individually
Private Insurance
115
Primary care providers
Health Maintenance Organizations (HMO)
Preferred Provider Organizations (PPO)
Exclusive Provider Organizations (EPO)
Managed care
116
Must stay in-network
Must select PCP
Must get a referral to see a specialist
Health Maintenance Organizations (HMO)
117
Must stay in-network
Don’t select a PCP
No referral necessary
Preferred Provider Organizations (PPO)
118
Not required to stay in-network
Don’t select PCP
No referral necessary
Exclusive Provider Organizations (EPO)
119
payment before the insurer pays for services.
Deductible
120
the fixed amount required to be paid for services.
co-payment
121
maximum amount to be paid.
annual limits
121
maximum amount to be paid.
annual limits
122
fees billed per unit of service
Fee for service
123
pre-paid fixed fee per person
Capitation
124
```
Covers elderly (65 and older) and non-elderly with disabilities.
Administered by the federal government (single-payer)
```
medicare
125
Medicare is financed through
Federal income taxes
Payroll taxes
Out of pocket payments by enrollees
126
Four Parts
A: hospital insurance
B: supplemental insurance
C: managed care
D: prescription drugs
127
Covers certain low-income individuals
Administered by the state government.
Financed jointly by the state and federal governments
medicaid
128
Supplements Medicaid by covering low-income children who are ineligible for Medicaid.
Administered and financed similarly to Medicaid.
State Children’s Health Program (S-CHIP)
129
Health benefits plan available to all veterans.
Services delivered through VA health care facilities
Financed by the federal government
Veterans Health Administration
130
Available on reservations
Indian Health Service
131
Care coordination
Case management
Disease management
Outcomes management
Implications for nursing
132
Meeting the standard of state governmental agency
-certification
Department of health
Medicare/Medicaid
133
Meeting the standards of a non-governmental agency
-accreditation
Joint commission
chap
134
Established by the American college of surgeons and the American society of internal medicine
Evaluate the structural aspects of instructions, policies and procedures, and outcomes of care providers
Looks at the physical plant, the process of care delivery and evaluation, and quality improvement care
Joint Commission
135
A system of principles concerning the actions of the nurse in his or her relationships with patients, patients’ family members, other health care providers, policy makers and society as a whole.
Nursing Ethics
136
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Autonomy
Nonmaleficence
Beneficence
Justice
Fidelity
Confidentiality
Veracity
Accountability
```
Ethical Principles
137
The freedom to make decisions about oneself
Autonomy
138
Requires that no harm be caused to an individual, either unintentionally or deliberately
Nonmaleficence
138
Requires that no harm be caused to an individual, either unintentionally or deliberately
Nonmaleficence
139
This principle means “doing good” for others
Beneficence
140
Nurses need to assist clients in meeting all their needs
Biological
Psychological
Social
141
Every individual must be treated equally
Justice
142
Loyalty
The promise to fulfill all commitments
The basis of accountability
Fidelity
143
Anything stated to nurses or health-care providers by clients must remain confidential
Confidentiality
144
The only times this principle may be violated are:
If clients may indicate harm to themselves or others or
| If the client gives permission for the information to be shared
145
This principle implies “truthfulness”
Veracity
146
Individuals need to be responsible for their own actions
Accountability
147
These are formal statements of the rules of behavior for a particular group of individuals
Ethical codes are dynamic
Most professions have a “code of ethics” to guide professional behavior
ethical codes
148
The nurse, in all professional relationships, practices with compassion and respect for the inherent dignity, worth and uniqueness of every individual, unrestricted by
considerations of social or economic status, personal attributes, or the nature of health problems.
provision 1
149
The nurse’s primary commitment is to the patient, whether an individual, family, group or community.
Provision 2
150
The nurse promotes, advocates for and strives to protect the health, safety and rights
of the patient.
Provision 3
151
The nurse is responsible and accountable for individual nursing practice and determines the appropriate delegation of tasks consistent with the nurse's obligation to provide optimum patient care.
Provision 4
152
The nurse owes the same duties to self as others, including the responsibility to preserve integrity and safety, to maintain competence and to continue personal and professional growth.
Provision 5
153
The nurse participates in establishing, maintaining and improving healthcare environments and conditions of employment conducive to the provision of quality healthcare and consistent with the values of the profession through individual and collective action.
Provision 6
154
The nurse participates in the advancement of the profession through contributions to practice, education, administration and knowledge development.
Provision 7
155
The nurse collaborates with other professionals and the public in promoting community, national and international efforts to meet health needs.
Provision 8
156
The profession of nursing, as represented by associations and their members, is responsible for articulating nursing values, for maintaining the integrity of the profession and its practice and for shaping social policy.
Provision 9
157
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Informed Consent
Refusal of treatment
Use of scarce resources
Cost- containment initiatives that negatively affect client well-being
Incompetent health care providers
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Frequently Occurring Ethical Dilemmas
