Textbook Notes

Question 1

There are foundational skills that are required for an information-driven culture. These include ___ literacy, ___ literacy, and (for the consumer), ___ literacy.

Answer 1

computer, information, health

Question 2

Without computer literacy, ___ cannot be accessed/addressed

Answer 2

the other forms of literacy (information, health)

Question 3

Joint Commission International (2017) lists six patient safety goals that focus upon correct ___, effective ___, improved safety of ___ medications, procedures that do not ___, decreased risk of ___, and reduced risks of harm secondary to ___.

Answer 3

identification, communication, high-alert, introduce harm, healthcare-acquired infections, falls

Question 4

HIT can improve safety and quality through alerts and decision support that help to improve the ___ process—a point where many errors occur—and through the use of ___.

Answer 4

hand-off, checklists

Question 5

___ errors include mistakes, slips, and lapses made by ___, while ___ errors occur with imperfect organization design such as those seen with incomplete procedures, poor training, and poor labeling.

Answer 5

Active, clinicians, latent

Question 6

Administrative information systems (AIS) support client care by managing ___ and ___ information and providing ___ capabilities.

Answer 6

financial, demographic, reporting

Question 7

___ information systems (___) focus on management of clinical (patient) data and information as compared to ___ information systems.

Answer 7

Clinical (CIS), administrative (AIS)

Question 8

Client scheduling and discharge would be part of the ___ information systems (___)

Answer 8

administrative (AIS)

Question 9

___ systems focus upon the acquisition, review, and use of patient data. Functions may include order entry, results-reporting, scheduling, and documentation.

Answer 9

Clinical information systems (CISs)

Question 10

___ systems can include registration and scheduling; tracking through admission, transfer and discharge; patient acuity and staff scheduling; financial or accounting systems; risk management; payroll and human resources; quality assur-ance; and contract management functions.

Answer 10

Administrative (AIS)

Question 11

The American Recovery and Reinvestment Act (ARRA) of 2009 included the Health Information Technology for Economic and Clinical Health Act (HITECH), which authorized incentive payments to specific types of hospitals and healthcare professionals for adopting and using ___

Answer 11

interoperable health information technology and EHRS

Question 12

(In addition to the standard requirements) MU included a menu of ___ other EHR tasks from which providers could choose to implement ___ in 2011 to 2012.

Answer 12

10, 5

Question 13

The Centers for Medicare and Medicaid Services (CMS) developed core criteria that defined basic functions EHRSs must demonstrate, including: basic entry of ___ such as demographic data, vital signs, medications, and allergies; use of several ___ that begin to realize the true potential of EHRSs to improve the safety, quality, and efficiency of care through clinical decision support; and entry of ___ with safety measures within the software.

Answer 13

clinical information, software applications, clinical orders

Question 14

The Medicare and Medicaid EHR Incentive Programs include ___ stages with increasing requirements for participation.

Answer 14

three

Question 15

What is a goal of the health information exchange (HIE)?

Answer 15

data sharing between providers, patients, insurance, etc.

Question 16

Nurse informaticists, sometimes called ___ nurses, work in the interdisciplinary area of ___ in healthcare organizations. They organize patient care software and electronic medical records, using their clinical nursing knowledge to optimize these systems.

Answer 16

informatics nurses

information technology (IT)

Question 17

A clinical systems vendor and a medical device manufacturer would be likely to employ a ___ nurse

Answer 17

informatics

Question 18

Duplicate orders cause quality issues in patient care.

What helps to resolve this problem?

Answer 18

Providing training and reminders

Question 19

The HIMSS Electronic Medical Record Adoption Model (EMRAM) is exclusively designed to assess ___. It is used for ___ only. To assess ___ communities, refer to HIMSS ___

Answer 19

acute hospital settings, inpatients only

outpatient, HIMSS Outpatient EMRAM (O-EMRAM)

Question 20

___ is a/an eight stage model used to assess ___ for hospitals and health systems

Rated from 0 to 7

Answer 20

EMRAM (Electronic Medical Record Adoption Model)

EMR implementation and adoption

Question 21

The benefits of interoperability include increased ___, reduced ___, and reduced ___.

Answer 21

productivity, costs, errors

Question 22

Codes which support outpatient billing

Answer 22

Current procedural terminology (CPT)

Question 23

One major benefit of nursing informatics is that it improves ___ among the healthcare team to improve ___.

Answer 23

communication, outcomes

Question 24

What reduces and organizes terms for easier searches

Answer 24

Taxonomic vocabularies

Question 25

A ___ is typically a controlled vocabulary with a hierarchical structure, with the understanding that there are different definitions of a hierarchy. Included terms have relations to other terms within. These are typically: parent/broader term, child/narrower term, or often both if the term is at mid-level within a hierarchy.

Answer 25

taxonomy

Question 26

A provider electronically orders blood work at a laboratory. The provider must ensure the local lab system can properly communicate with the provider’s system for the results to be usable.

Which is the correct term that would be found in these systems?

Answer 26

Logical observation identifiers names and codes (LOINC)

Question 27

The Logical Observation Identifiers, Names, and Codes (LOINC) is a terminology that includes ___ and ___ observations.

Answer 27

laboratory, clinical

Question 28

___ is:

• A common language (set of identifiers, names, and codes) for clinical and laboratory observations.
• A rich catalog of measurements, including laboratory tests, clinical measures like vital signs and anthropomorphic measures, standardized survey instruments, and more.
  
  • A standard which enables the exchange and aggregation of clinical results for care delivery, outcomes management, and research by providing a set of universal codes and structured names to unambiguously identify things you can ___ or ___.

Answer 28

LOINC

measure or observe

Question 28

___ is:

• A common language (set of identifiers, names, and codes) for clinical and laboratory observations.
• A rich catalog of measurements, including laboratory tests, clinical measures like vital signs and anthropomorphic measures, standardized survey instruments, and more.
  
  • A standard which enables the exchange and aggregation of clinical results for care delivery, outcomes management, and research by providing a set of universal codes and structured names to unambiguously identify things you can ___ or ___.

Answer 28

LOINC

measure or observe

Question 29

___ is a set of ___ standards used to transfer and share data between various healthcare providers. More specifically, it helps bridge the gap between health IT applications and makes sharing healthcare data easier and more efficient when compared to older methods.

Answer 29

HL7

international

Question 30

___ interoperability

The ability to exchange the data from one point to another

Answer 30

Technical

Question 31

___ interoperability

The exchange of data in which the meaning remains the same on both ends of the transaction

Answer 31

Semantic

Question 32

___ interoperability

Coordinates systems enabling business processes at the organization(s), and allowing the systems to work together

Answer 32

Process

Question 33

___

The ability of two or more systems to pass information between them and use the exchanged information

Answer 33

Interoperability

Question 34

A patient is being transferred to a trauma hospital in the area. The current hospital uses a different electronic health record (EHR) than the receiving hospital.

Which process allows interoperability of the health information exchange (HIE) between the two hospital systems?

Answer 34

Consolidated-Clinical Document Architecture (C-CDA)

Question 35

Which measure is included in the vital signs section, in addition to temperature, blood pressure, respiration, and heart rate?

(the 5th vital sign)

Answer 35

Pain scale

Question 36

What is the meaning of confidentiality of patient records

Answer 36

A healthcare provider can disclose health information with specific permission.

Question 37

What are three types of networks or information exchanges?

Answer 37

Local area network (LAN)

internet

wide area network (WAN)

Question 38

How does an informatics nurse institute manual and automated procedures to manage data security, accuracy, and integrity?

Answer 38

Monitors patterns and exceptions

Question 39

___ is a not-for-profit, membership-based organization that works to improve healthcare through meaningful measurement

Answer 39

NQF

Question 40

Which merit-based incentive payment system (MIPS) category replaces the reporting program that assesses care provided to Medicare patients, to ensure patients get the right care at the right time?

Answer 40

Quality

Question 41

MIPS (Merit-based Incentive Pay System) includes four performance categories: ___, ___, ___ ___, and Promoting ___ (formerly ___ ___)

Answer 41

Quality, Cost, Improvement Activities, and Promoting Interoperability (formerly Meaningful Use)

Question 42

What are two items that exempt eligible clinicians from a merit-based incentive payment system (MIPS)

Answer 42

Low-threshold provider who bills Medicare less than $90,000 yearly

Two hundred or fewer Medicare patients seen annually

Question 43

In the context of health IT, meaningful use is a term used to define ___

Answer 43

minimum U.S. government standards for electronic health records (EHR)

Question 44

Meaningful use Stage 1

___ to ___

Data ___ and ___

Answer 44

Question 45

Meaningful use Stage 2

20__

Advance ___ ___

Answer 45

Question 46

Meaningful use Stage 3

20__

Improved ___

Answer 46

Question 47

Five rights of Clinical Decision Support (CDS)

_{(Hint: Right ___to the right___ in the right ___through the right___ at the right ___in___)}

Answer 47

1. The right information: evidence-based, suitable to guide action, pertinent to the circumstance
2. To the right person: considering all members of the care team, including clinicians, patients, and their caretakers
3. In the right CDS intervention format: such as an alert, order set, or reference information to answer a clinical question
4. Through the right channel: for example, a clinical information system (CIS) such as an electronic medical record (EMR), personal health record (PHR), or a more general channel such as the Internet or a mobile device
5. At the right time in workflow: for example, at time of decision/action/need

Question 48

What can healthcare staff do to keep patient information that has been accessed with a mobile device protected?

Answer 48

Install device updates when available

Question 49

Which mobile device feature may reside on a device indefinitely

Answer 49

Text messages

Question 50

What is the correct order of the system development life cycle phases

Answer 50

Designing, planning, implementation, analysis, evaluate

Question 51

___ ___ helps prioritize limited resources and ensures system standards are upheld.

Answer 51

Change control

Question 52

Which phase of implementation uses small groups of individuals to evaluate potential issues that may occur when making a new systems transition

Answer 52

Pilot phase

Question 53

When a new system is adopted instantly, with no transition period between the old and new systems (two terms)

Answer 53

Big bang adoption or direct changeover

Question 54

___ conversion operates both the old and the new system for a limited time. ___ conversion changes to the new system in phases, introducing some of the new applications while still using some of the old applications, or converting some departments or locations at a time.

Answer 54

Parallel, Phased

Question 55

Kurt Lewin developed a change model involving three steps: ___, ___ and ___.

Answer 55

unfreezing, changing, refreezing

The process of change entails creating the perception that a change is needed, then moving toward the new, desired level of behavior and finally, solidifying that new behavior as the norm. The model is still widely used and serves as the basis for many modern change models.

Question 56

“___ is the right to control access and disclosure or nondisclosure of information pertaining to oneself and to control the circumstances, timing, and extent to which information may be disclosed”

Answer 56

Privacy

Question 57

The Technology ___ Guiding Education Reform (TIGER) Initiative was established in 2006 in the United States to develop key areas of informatics in nursing. One of these was to integrate ___ competencies into nursing curricula and life-long learning.

Answer 57

Informatics, informatics

Question 58

___ ___ is a process in which organizational leaders determine their vision for the future as well as identify their goals and objectives for the organization

Answer 58

Strategic planning

Question 59

A ___ Statement defines the company’s business, its objectives and its approach to reach those objectives. A ___ Statement describes the desired future position of the company.

Answer 59

Mission, Vision

Question 60

The 5 basic phases in the project management process are:

• Project ___
• Project ___
• Project ___
• Project ___
• Project ___

Answer 60

• Initiation
• Planning
• Execution
• Monitoring and Controlling
• Closing

Question 61

PM Phase 1 - Project ___

• Define ___
• Create a ___
• Complete a project ___
• Draw up list of ___

Answer 61

Initiation

• Define goals
• Create a business case
• Complete the project charter
• Draw up the list of stakeholders

Question 62

PM Phase 2 - Project ___

• Define ___
• Create a project ___
• Set a ___ baseline
• Define ___ and ___

Answer 62

Planning

• Define scope
• Create a project plan
• Set a budget baseline
• Define roles and responsibilities

Question 63

PM Phase 3 - Project ___

• Allocate project ___
• Manage project ___
• ___ the product or process
• ___ often and fix issues as they arise

Answer 63

Execution

• Allocate project resources
• Manage project resources
• Build the product or process
• Meet often and fix issues as they arise

Question 64

PM Phase 4 - Project ___

• Track ___ and ___
• Monitor project ___
• Ensure ___
• Prevent any chance for ___

Answer 64

Monitoring and Control

• Track effort and cost
• Monitor project progress
• Ensure adherence to plan
• Prevent any chance for disruptions

Question 65

PM Phase 5 - Project ___

• ___ deliverables
• ___ project deliverables
• Get project results ___
• Document project ___

Answer 65

Completion

• Handover deliverables
• Review project deliverables
• Get project results approved
• Document project learnings

Question 66

NANDA

Answer 66

North American Nursing Diagnosis Association

A working definition of nursing diagnosis was adopted by the North American Nursing Diagnosis Association (NANDA) Biennial Business Meeting in March 1990.

Question 67

A suite of designated standards for use in U.S. Federal Government systems for the electronic exchange of clinical health information and is also a required standard in interoperability specifications of the U.S. Healthcare Information Technology Standards Panel

Answer 67

SNOMED CT

Question 68

An ___ is a record of healthcare information of an individual created and managed within one healthcare organization. An ___ is a record of healthcare information of an individual that conforms to recommended interoperability standards for ___ which is used across multiple healthcare organizations.

Meanwhile, a ___ is an electronic application through which patients can maintain and manage their health information (and that of others for whom they are authorized) in a private, secure, and confidential environment.

Answer 68

EMR, EHR

Standards for HIT (Health Information Technology)

PHR (Personal Health Record)

Question 69

Meaningful Use incentives were imbibed into law in the ___

Answer 69

Health Information Technology for Economic and Clinical Health (HITECH) Act

Question 70

The aim of the ___ incentive program is to improve the quality, efficiency, and coordination of patient care by leveraging certified EHR technologies securely and efficiently.

Answer 70

Meaningful Use

Question 71

___ enable unauthorized users to gain access to your computer without being detected

Answer 71

Rootkits

Question 72

A ___ replicates itself by infecting other computers that are on the same network. They’re designed to ___ and ___

Answer 72

Worm

consume bandwidth, interrupt networks

Question 73

___-based care refers to the payment a health care provider receives for services a patient might need. The type of service and quality of service does not really make a difference in the amount a provider might receive.

(Sometimes referred to as a ___ care)

Answer 73

Volume

fee-for-service

Question 74

___-based care is sometimes known as accountable care. This type of system focuses on getting value from quality services. Payments are based on this specialized care and other things, such as cost reduction, which could lead to an emphasis on ___ care.

Answer 74

Value, preventative

Question 75

___ are computer-based programs that analyze data within EHRs to provide prompts and reminders to assist health care providers in implementing evidence-based clinical guidelines at the point of care. Applied to cardiovascular disease (CVD) prevention, for example, by reminding providers to screen for CVD risk factors, flagging cases of hypertension or hyperlipidemia, providing information on treatment protocols, prompting questions on medication adherence, and providing tailored recommendations for health behavior changes.

Answer 75

Clinical decision support systems (CDSS)

Question 76

___ telemedicine is “store-and-forward video-conferencing,” which is the “transmission of a (pre-)recorded health history to a health practitioner, usually a specialist.”

Answer 76

Asynchronous

Question 77

While ___ refers specifically to remote clinical services, ___ can refer to remote non-clinical services, such as provider training, administrative meetings, and continuing medical ___, in addition to clinical services.

Answer 77

telemedicine, telehealth

continuing medical education

Question 78

This system is comprised of the hardware and software that make up an organization’s infrastructure.

Answer 78

Information Systems

The terms healthcare information system and hospital information system (HIS) both refer to a group of systems used within a hospital or enterprise that support and enhance healthcare.

Question 79

This science, originally a sub-discipline of computer science, supports the collection and management of information and applies technology to make information usable.

Answer 79

Information Science

Question 80

This nurse is expected to have fundamental information-management and computer-technology skills and use existing information systems and established information-management practices.

Answer 80

The Beginning Nurse

Question 81

Known as the ability to read and understand the written word and numbers as well as the ability to recognize when information is needed.

Answer 81

Information Literacy

Question 82

This initiative called for improving nursing education competencies for the development of a workforce capable of delivering patient care through health information technology

Answer 82

The Technology Informatics Guiding Education Reform Initiative (TIGER)

Question 83

This system is integrated with other administrative and clinical systems and tracks a patient’s activities and locations from hospital or clinic

Answer 83

Admission/Discharge/Transfer (ADT) system

Question 84

This interdisciplinary team is tasked with planning, testing, training, and other responsibilities when an EHRS has been purchased.

Answer 84

Implementation team or committee

Question 85

The first standardized nursing terminology recognized by the ANA and used for nursing diagnosis

Answer 85

North American Nursing Diagnosis Association International (NANDA-I)

Question 86

A collection of patient data controlled by the patient and accessible by patient and providers

Answer 86

Personal Health Record

Question 87

The implementation of __________ terminology within the EHR is essential for healthcare organizations to meet the criteria of Meaningful Use

Answer 87

standardized

Question 88

This is a globally recognized controlled healthcare vocabulary that provides a common language for electronic health applications to exchange data

Answer 88

Systematized Nomenclature of Medicine - Clinical Terms (SNOMED-CT)

Question 89

This is the primary reason nursing participation is essential on the implementation team

Answer 89

Knowledge of workflow/workflow analysis

Question 90

This record provides a snapshot of a person’s current healthcare to a provider who does not have direct access to the EHR; intended to improve continuity and reduce errors

Answer 90

Continuity of Care Record (CCR)

Question 91

This process that uses software to look for hidden patterns and relationships in large data sets

Answer 91

Data Mining

Question 92

Unauthorized access to a server room is an example of this type of threat

Answer 92

Physical Threat

Question 93

Any breach of confidentially within the healthcare environment is subject to the penalties of this act

Answer 93

Health Insurance Portability and Accountability Act (HIPAA)

Question 94

This security measure protects the healthcare provider if they leave the computer abruptly

Answer 94

Automatic Sign-off

Question 95

Software used for detecting security violations, performance problems, and flaws in applications by recording activity by users and systems

Answer 95

Audit Trails

Question 96

This act authorized incentive payments for early EHR adopters and led to the development of Meaningful Use criteria

Answer 96

HITECH

Health Information Technology for Economic and Clinical Health

Question 97

Type of environment that encourages reporting of errors or near misses, and focuses on systematic view of errors rather than individual causation

Answer 97

Blame-free environment

Question 98

Defined as a vision to develop policies, funding, infrastructure, and education to instill knowledge and skills needed by all healthcare executives, clinicians, and informaticists, and the tools to gather and analyze amassed data

Answer 98

Culture of Informatics

Question 99

Alerts, clinical pathways, order sets, dashboards, diagnostic support and drug-drug interaction tools are all examples of these

Answer 99

Decision-support software (DSS) or Clinical Decision Support Software (CDSS)

Question 100

The phenomenon where too many insignificant CDSS warnings or recommendations are presented, and providers begin to dismiss them regardless of the importance

Answer 100

Alert fatigue

Question 101

Since 2018, EHRs are required to demonstrate all the Core Requirements of Meaningful Use (MU). How many can you identify?

Answer 101

Question 102

The use of telecommunication technologies and computers to provide healthcare information and services to clients at another location

Answer 102

Telehealth

Question 103

Videoconferencing, Telestroke, Telepsychiatry, and Robotics belong in this category of services

Answer 103

Synchronous Connected Health Applications

Question 104

Examples of this type of Telehealth include research/data mining, Grand Rounds, remote education, and expert consultation

Answer 104

Non-clinical Telehealth

Question 105

Asynchronous telehealth application that can record and send photos, x-rays, and ECGs to a provider for evaluation

Answer 105

Store and Forward Technology

Question 106

List at least 3 legal or business issues that must be considered prior to adoption of telehealth services by providers

Answer 106

• Privacy & informed consent
• Licensure Reimbursement
• Malpractice liability
• Online prescribing
• Credentialing
• Internet bandwidth

Question 107

Skilled in using information management and computer technology; have strong analytic skills to learn from relationships between different data elements; and be able to collaborate with the informatics nurse specialist to suggest improvement to systems

Answer 107

Experienced Nurse

Question 108

Analytics can be used to forecast the likelihood of ___

Answer 108

an event

Question 109

___ changes are small, ___ changes are larger in scale

Answer 109

Adaptive (new role, new computer/software system)

Transformational (new process/procedure, new department)