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81 Cards in this Set
- Front
- Back
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What are the 5 levels of practice (Dreyfus model)
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Novice
Advanced beginner-rules Competent- Goals Proficient-situation specific priorities Expert-becomes instinctive |
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What are the changes in practice levels
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1. movement from a reliance on abstract principles and rules to use of past concrete experience.
2. shift from reliance on analytic, rule-based thinking to intuition 3. Change in learners perception of the situation from one in which it is viewed as a compilation of equally relevant bits into an increasingly complex whole in which certain parts are relevant 4. Passage from detached observer, standing outside the situation, to one of a position of involvement fully engaged in the situations |
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what are the foundations of nursing informatics
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data, information, knowledge, and wisdom
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Nurses in all settings and areas of practice are considered what
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knowledge workers
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What is data
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discrete entities that are described objectively without interpretation. Observation points or parameter values for an object.
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what is information
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data that is interpreted, organized or structured. Data that is organized or has meaningfulness
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what is knowledge
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information that is synthesized so that relationships are identified and formalized. Extends beyond meaningfulness and includes interpretation and analysis
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what is wisdome
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appropriate use of knowledge to manage and solve human problems. Knowing when and how to apply knowledge to deal with complex problems or specific human need.
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what kind of system does data and information make up
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information systems
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what kind of system does knowledge and information make up
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decision support system
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what kind of system does wisdom and knowledge make up
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expert system
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what are the informatics competency levels
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beginner, experienced, informatics specialist, informatics innovator
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what are the beginner informatics competencies of a beginning nurse
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Use email, use internet to locate and download information of interest, use computerized pateint monitoring system, identifiy the basic components of a computer system, recognizes that a computer program has limitations to its design and capacity of the computer
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what are standardized languages
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agreed-upon ways to recored and exchange data within and across information systems
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what are data definition levels
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Abstract- broad definition (hypertension, Patient demographics)
Coarsely defined- more simple (systolic BP, Date of birth) Concrete/Atomic- (October 29, 1990)/(October, 29, 1990) |
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what are the nursing standardized languages
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CCC, ICNP, NANDA, NIC, NOC, Omaha
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what is NANDA
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North American Nursing Diagnosis association, used in diagnoses. Has Taxonomy I and II. II has 6 axes, 12 domains and 167 diagnosis
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What is the NIC
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Nursing interventions classification. Used for nursing interventions. Has 7 domains, 30 classes, 514 interventions
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What is the NOC
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Nursing Outcomes Classification. Specific in outcomes. 7 outcome domains, 31 classes, 330 patient outcomes
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What are the NMDS
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nursing minimum data sets: Nursing care elements, patient demographics, Service items, Environment, Nurse resources, Financial resources
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What is the ICNP
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International classification for nursing practice. All 3 integrated. Has 8 axes for nursing phenomena. 6 axis for nursing interventions
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What is the omaha
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has integrated language. Developed for home care, public health and community. Has 42 client problems with 4 domains. Has 75 targets for nursing interventions with 4 categories. Has a Problem rating scale for outcomes with 3 sub-scales
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What is the CCC
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clinical care classificaiton system. Used in home care. Has linked nursing diagnoses and outcomes, and linked nursing interventions and actions. 21 care components, 182 nursing diagnoses. 198 nursing interventions
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What is the omaha
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has integrated language. Developed for home care, public health and community. Has 42 client problems with 4 domains. Has 75 targets for nursing interventions with 4 categories. Has a Problem rating scale for outcomes with 3 sub-scales
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What is the CCC
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clinical care classificaiton system. Used in home care. Has linked nursing diagnoses and outcomes, and linked nursing interventions and actions. 21 care components, 182 nursing diagnoses. 198 nursing interventions
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what is nursing informatics
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integrates nursing science, computer science, and information science to manage and communicate data, informations and knowledge in nursing practice.
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What are the kinds of informatics
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medical: biomedical (bacteria), dental, bioinformatics(genes), veterinary
Nursing |
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What is a CPT code
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an existing terminology that is used for consistent billing for physician actions. Current Procedure Terminology
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What is an ICD
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and existing terminology that is used to assign medical diagnosis codes to patients for research. International Classification of diseases
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what are interface terminologies/vocabularies
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what you see and work with on paper or the screen. 8 different interfaces
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What are the Reference Terminologies
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translates different terms between different interfaces
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What are the 2 reference nursing vocabularies and what do they cover
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SNOWMED-CT- has 366,000 health care concepts. Uses the CCC, NANDA, NIC, NOC, and Omaha
LOINC- uses Omaha and CCC |
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What are issues with standardizing nursing vocabulary
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multiple terms for same topic. Large number of terms. Overlaps, Gaps, Variance in term abstraction level, absence of rules for constructing terms and encoding, resistance to change, Awkwardness of implementing a new technology and vocabulary simultaneously, lack of benefits realization
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What is the difference between indexing and clinical vocabulary
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indexing is used to represent the topics in research literature in specific databases. Clinical vocabulary is used to represent clinical concepts (patient data, nursing data)
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What is MeSH and what are its components
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medical subject headings. has subject headings, sub-headings, tags, publication type and major focus
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What is HL-7 messaging standard
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standard for electronic interchange of health data
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What is HCIS and HIS and CIS
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Health care information system, hospital information system, clinical information system
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What are the benefits of EHR
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allows for standardization and coding, validity checks, remote access, analysis of aggregate data, back-up, authorization of access, efficiency of time and money
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What is NHIN
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National Helath Information Network
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What are the components of NHIN
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EHR, CPOE, PHR, Payment
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What are the barriers of EHR
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Human factors, organizational factors and system factors
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what are the human factors of EHR
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workflow and socialization issues, changing the culture, double documentation, accessibility of hardware
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What are the organizational barriers of EHR
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large investment, clinical staff has to learn system, changes of workflow and interactions with patients
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What are the system barriers of EHR
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users' information needs, ease of use, standards, legal and social issues, costs, leadership
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what are the advantages to CPOE
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decision support, reduction of errors, faster processing, increased legibility, ability to view active orders, decreased errors in ordering, cross checks meds, allergies, easier medication titration, enables evidence based practice use less expensive lab tests, provides suggesitons for less expensive medication regimes, encourages patients placement on clinical trails
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What are the disadvantages to CPOE
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changes in workflow, takes more times, doing data entry, impact on workload, takes time away from patient, position in working relationship, staff resistance, cost, integration with existing systems, workforce training
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What are the unintended consequences from CPOE
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workflow issues, communication issues, dependence on technology, never ending system demands, emotions, more and new work, new kinds of errors, changes in power structure
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what are the new errors of CPOE
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information errors- assumed dose, medication discontinued ect.
interaction errors- patient selection, wrong medicaiton |
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what is the relationship between CPOE and EHR
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can't have CPOE without EHR and they are both information systems that use data and information
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what is the PHR
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Personal health recored that the patient is responsible for managing. Immunization cards, birth certificates ect.
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what are the 2 types of electronic PHR
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institutionally sponsored and independent
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what are the principles of decision making
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cognitive heuristics-representativeness, availability, anchoring and adjustment, framing
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What is the difference between artificial and natural intelligence
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Artificial- permanent, east of duplication, less expensive, consistent and thorough, can be documented, faster, and flexible
Natural-creative, uses sensory experience, wide context experience |
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what is CDSS
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clinical decision support system. information system that model and provide support for human decision making processes in clinical situations.
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how does CDSS work
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use advance technology to support clinical decision making by interfacing evidenced based clinical knowledge at the point of care with real time clinical data at significant clinical decision points
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what is a deductive reason
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uses If-then. moves from general to specific. If a robin is a bird, and all birds have wings (premise) then robins have wings
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what is an inductive reason
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moves from specific to general but may not be true. when a bat hits a ball the ball moves, therefore anything hit with a bat moves
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what is an analogical inference
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answers to question derived from analogies. when you infer things about something based on something else that you know is similar. Specific to Specific
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what is forward chaining
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start with available information and draw a conclusion. Data driven approach
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what is backward chaining
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goal driven approach. Start with conclusion or expectation and end with evidence supporting or contradicting the expectation
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what is fuzzy logic
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approximated logic rather than exact or precise logic
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what is passive CDSS
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waits for clinician to ask for specific advise (pull)
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what is active CDSS
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generates automatic alerts, reminders, warnings (Push)
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what is critiquing CDSS role
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expresses agreement or suggests alternative on clinician decisions
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What are the Types of CDSS programs
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Leeds-assists in the decision for abdominal surgery
Internist-Developed at pitt. Now QMR. Uses hypothetical-deductive approach. Symptoms are entered to generate possible diagnosis MYCIN- Developed to aid in diagnosing meningitis and other bacterial infections of blood and to prescribe treatment. Uses If-then Dxplain-Rule based system. Uses clinical findings to generate a ranked list of potential diagnoses |
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What are the benefits of CDSS
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Provide expert advice, reduce variation in quality of care, support education, provide feedback, Support research, If integrated with an EMR, streamline workflow and encourage more efficient data gathering
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what are disadvantages of CDSS
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can be computationally intensive, easily outdated, ambiguous legal implications for wrong answers, potential for alert fatigue, user dependence, cost
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What are the nursing DSS
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CANDI, UNIS, aminotomy decision support system, cancer pain management, COMMES
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What is CANDI
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Nursing diagnosis DSS. Computer aided nursing diagnosis and intervention system. Make recommendations for potential nursing diagnoses
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what is UNIS
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urological nursing information system. Nursing intervention DSS. makes recommendation for action
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what is amniotomy decision support system
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generate recommendations for performing amniotomy for women in normal labor. Nursing intervention DSS
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what is cancer pain management
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nursing intervention DSS. suggest to nurses pain management strategies that were ethnically and gender appropriate
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what are COMMES
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Creighton Online Multiple Modular Expert System. nursing education DSS
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what are the kinds of telehealth
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virtual visit, store and forward, remote monitoring
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what are the telehealth benefits
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cost of care access to care, quality of care
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How uses telehealth
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CHF: monitor weight, COPD: monitor oxygen levels, Diabetes: monitor glucose levels, longs term wound care, elderly, isolated, extended family. Also physicians, nurse, family members, care team, experts, students and instructor.
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What are the telehealth issues
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licensure, accreditation, privacy, malpractice liability reimbursement
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what are the telehealth ethics that effects the patient
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information privacy, access equity, autonomy vs. dependence, machanization of the home environment, informed consent, usability, lack of human touch.
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what are the telehealth ethics that effect caregivers
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mchanization of the home environment, informed consent, usability
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what are the telehealth ethics that effects nurses
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informed consent, usability, lack of human touch
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what types of organizations are using telehealth
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home health agencies, hospitals 3rd party payers, long term care facilities, employers
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