workbook for nursing informatics and the foundation of … · · 2018-04-13practice from...

Upon successful completion of this course, continuing education hours will be awarded as follows:Nurses: 30 Contact Hours**Western Schools is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

Workbook for

Nursing Informatics and the Foundation

of Knowledge

Custom 4th Edition

Workbook by

Emily J. Gesner, DNP, RN-BC

P.O. Box 1930Brockton, MA 02303800-438-8888

Nurse Planner: Michelle Doran, RN, MSThe planner who worked on this continuing education activity has disclosed that she has no significant financial or other conflicts of interest pertaining to this course book.

Copy Editor: Graphic World, Inc.Western Schools’ courses are designed to provide healthcare professionals with the educational information they need to

enhance their career development as well as to work collaboratively on improving patient care. The information provided within these course materials is the result of research and consultation with prominent healthcare authorities and is, to the best of our knowledge, current and accurate at the time of printing. However, course materials are provided with the understanding that Western Schools is not engaged in offering legal, medical, or other professional advice.

Western Schools’ courses and course materials are not meant to act as a substitute for seeking professional advice or conducting individual research. When the information provided in course materials is applied to individual cases, all recom-mendations must be considered in light of each case’s unique circumstances.

Western Schools’ course materials are intended solely for your use and not for the purpose of providing advice or recom-mendations to third parties. Western Schools absolves itself of any responsibility for adverse consequences resulting from the failure to seek medical, or other professional advice. Western Schools further absolves itself of any responsibility for updat-ing or revising any programs or publications presented, published, distributed, or sponsored by Western Schools unless other-wise agreed to as part of an individual purchase contract.

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ISBN: 978-1-68041-559-9

COPYRIGHT© 2018—S.C. Publishing. All Rights Reserved. No part(s) of this material may be reprinted, reproduced, transmitted, stored in a retrieval system, or otherwise utilized, in any form or by any means electronic or mechanical, including photocopying or recording, now existing or hereinafter invented, nor may any part of this course be used for teaching without written permission from the publisher.

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ABOUT THE WORKBOOK AUTHOREmily J. Gesner, DNP, RN-BC, is a Nurse Planner at Western Schools and is an adjunct professor at Northeastern University. She is ANCC-certified in informatics nursing. She holds a Doctor of Nursing Practice from Northeastern University and a master’s degree in nursing informatics from Excelsior College. Dr. Gesner has also worked in multiple implementations of electronic health records, including Cape Cod Healthcare and Partners HealthCare.

Emily J. Gesner has disclosed that she has no significant financial or other conflicts of interest pertaining to this course book.

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COURSE INSTRUCTIONSIMPORTANT: Read these instructions BEFORE proceeding!

HOW TO EARN CONTINUING EDUCATION CREDITTo successfully complete this course you must: 1)Read the entire course 2)Pass the final exam with a score of 75% or higher* 3)Complete the course evaluation

*You have three attempts to pass the exam. If you take the exam online, and fail to receive a passing grade, select “Retake Exam.” If you submit the exam by mail or fax and you fail to receive a passing grade, you will be notified by mail and receive an additional answer sheet.

Final exams must be received at Western Schools before the Complete By date located at the top of the FasTrax answer sheet enclosed with your course. Note: The Complete By date is either 1 year from the date of purchase, or the expiration date assigned to the course, whichever date comes first.

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ONLINE: BEST OPTION!

v continued on next page

WESTERN SCHOOLSCOURSE EVALUATIONNURSING INFORMATICS AND THE

FOUNDATION OF KNOWLEDGEINSTRUCTIONS: Using the scale below, please respond to the following evaluation statements. All responses should be recorded in the right-hand column of the FasTrax answer sheet, in the section marked “Evaluation.” Be sure to fill in each corresponding answer circle completely using blue or black ink. Leave any remaining answer circles blank.

A B C D

Agree Agree Disagree Disagree Strongly Somewhat Somewhat Strongly

LEARNING OUTCOMES: After completing this course, I am able to: 1. Describe the process of synthesizing data into information and knowledge. 2. Apply the concepts of computer science and the foundation of knowledge model to informatics. 3. Discuss how ethical decision-making concepts are used to manage ethical problems in nursing

informatics. 4. Apply nursing informatics metastructures, concepts, and tools to the nursing process. 5. Discuss the concepts that define nursing informatics as a specialty. 6. Discuss the current and ongoing legislation and regulations that shape 21st-century practice. 7. Describe how administrative information systems are improving patient care outcomes. 8. Explain the importance of the human-technology interface in health care. 9. Describe the core fundamentals of the electronic health record and informatics. 10. Recognize informatics tools that help promote patient safety and quality outcomes. 11. Explain how nursing informatics practice applications provide patients electronic access to their

own records and to more health information. 12. Discuss the use of nursing informatics tools to improve population and community health. 13. Describe how telehealth and telenursing are improving patient health outcomes.

COURSE CONTENT 14. The course content was presented in a well-organized and clearly written manner. 15. The course content was presented in a fair, unbiased and balanced manner. 16. The course content presented current developments in the field. 17. The course was relevant to my professional practice or interests. 18. The final examination was at an appropriate level for the content of the course. 19. The course expanded my knowledge and enhanced my skills related to the subject matter. 20. I intend to apply the knowledge and skills I’ve learned to my practice.

A. Yes B. Unsure C. No D. Not Applicable

CUSTOMER SERVICEThe following section addresses your experience in interacting with Western Schools. Use the scale below to respond to the statements in this section. A. Yes B. No C. Not Applicable 21. Western Schools staff was responsive to my request for disability accommodations. 22. The Western Schools website was informative and easy to navigate. 23. The process of ordering was easy and efficient. 24. Western Schools staff was knowledgeable and helpful in addressing my questions or problems.

ATTESTATION 25. I certify that I have read the course materials and personally completed the final examination based

on the material presented. Mark “A” for Agree and “B” for Disagree.

COURSE RATING 26. My overall rating for this course is

A. Poor B. Below Average C. Average D. Good E. Excellent

You may be contacted within 3 to 6 months of completing this course to participate in a brief survey to evaluate the impact of this course on your clinical practice and patient/client outcomes.

Note: To provide additional feedback regarding this course, Western Schools services, or to suggest new course topics, use the space provided on the Important Information form found on the back of the FasTrax instruction sheet included with your course.

Course Evaluation— vi Nursing Informatics and the Foundation of Knowledge

C O N T E N T SCourse Evaluation ...................................................................................................................................vIntroduction .............................................................................................................................................................. ixLesson Plan ................................................................................................................................................................1Pretest .........................................................................................................................................................................3Learning Objectives .................................................................................................................................................5Final Exam .................................................................................................................................................................9

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I N T R O D U C T I O N

LEARNING OUTCOMESAfter completing this course, the learner will be able to:

1. Describe the process of synthesizing data into information and knowledge.2. Apply the concepts of computer science and the foundation of knowledge model to

informatics.3. Discuss how ethical decision-making concepts are used to manage ethical problems in

nursing informatics.4. Apply nursing informatics metastructures, concepts, and tools to the nursing process.5. Discuss the concepts that define nursing informatics as a specialty.6. Discuss the current and ongoing legislation and regulations that shape 21st-century

practice.7. Describe how administrative information systems are improving patient care outcomes.8. Explain the importance of the human-technology interface in health care.9. Describe the core fundamentals of the electronic health record and informatics.10. Recognize informatics tools that help promote patient safety and quality outcomes.11. Explain how nursing informatics practice applications provide patients electronic access

to their own records and to more health information.12. Discuss the use of nursing informatics tools to improve population and community health.13. Describe how telehealth and telenursing are improving patient health outcomes.

OVERVIEW

The specialty of nursing informatics (NI) combines nursing science with computer science and information science. The core value of NI is to facilitate the dissemination of data, information,

knowledge, and wisdom in nursing practice. Data, information, knowledge, and wisdom provide sup-port in decision making for patients and clinicians (American Nurses Association, 2015). Nursing informatics practice centers on managing and communicating information and knowledge within a healthcare system, supported through information structure, processes, and technology.

Nursing curriculum includes NI from the baccalaureate level to doctoral preparation; the use of infor-mation, data, and knowledge are implemented in all aspects of nursing, from the bedside to the board-room. It is essential that nurses are familiar and comfortable with the knowledge base of informatics to integrate the concepts into their professional practice.

Introduction—x Nursing Informatics and the Foundation of Knowledge

Nursing professionals are expected to discover opportunities to use NI, participate in the design of solutions, and be challenged to identify, develop, evaluate, modify, and enhance applications to improve patient outcomes.

This course is designed to provide the reader the information and knowledge needed to meet these expectations. This course provides a set of practical tools to ensure that the learner gains an understand-ing of NI and moves from information through knowledge to wisdom. The course provides a compre-hensive framework that enables learners to develop their knowledge and the wisdom necessary to act on and apply the knowledge.

Professional nurses who are practicing or entering the specialty of NI will find this comprehensive and user-friendly custom text a great resource and reference in applying NI knowledge and skills to their practice. For the nursing instructor, this course provides a comprehensive subject matter introduction for teaching the content of NI.

ReferenceAmerican Nurses Association. (2015). Nursing informatics: Scope and standards of practice (2nd ed.).

Silver Spring, MD: Author.

L E S S O N P L A NNURSING INFORMATICS AND THE

FOUNDATION OF KNOWLEDGE

This educational offering incorporates the information contained in Nursing Infor

matics and the Foundation of Knowledge, custom 4th edition, by Dee McGonigle and Kathleen Mastrian, into an integrated learning experience. One learning outcome and several chapter objectives are provided for each chapter. Chapter objectives focus individual study on information contained within each chapter of the textbook. The final exam questions are based on the individual chapter objectives and are meant to evaluate the reader’s learning of each objective.

To complete this course, study the objec-tives provided in this workbook (pages 5-8) pertaining to each chapter of the textbook. Read each chapter in the textbook, and answer the final exam questions (workbook pages 9-21) as indicated in this lesson plan. Answers to the final exam questions should be logged on the FasTrax answer sheet provided with the course.

NOTE: Before getting started, log into your account at www.westernschools.com/my-courses to take your exam as you read the course. You can save your progress and can return it at any time. If complet-ing by mail or fax, please be sure you are using the FastTrax® answer sheet labeled Nursing Informatics and the Foundation of Knowledge.

Chapter 1: Introduction to Information, Information Science, and Information SystemsRead Chapter 1 and answer questions 1-5.

Chapter 2: Computer Science and the Foundation of Knowledge ModelRead Chapter 2 and answer questions 6-15.

Chapter 3: Ethical Applications of InformaticsRead Chapter 3 and answer questions 16-25.

Chapter 4: History and Evolution of Nursing InformaticsRead Chapter 4 and answer questions 26-35.

Chapter 5: Nursing Informatics as a SpecialtyRead Chapter 5 and answer questions 36-45.

Chapter 6: Legislative Aspects of Nursing Informatics: HITECH and HIPAARead Chapter 6 and answer questions 46-55.

Chapter 7: Administrative Information SystemsRead Chapter 7 and answer questions 56-60.

Chapter 8: The Human-Technology InterfaceRead Chapter 8 and answer questions 61-65.

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Lesson Plan—2 Nursing Informatics and the Foundation of Knowledge

Chapter 9: The Electronic Health Record and Clinical InformaticsRead Chapter 9 and answer questions 66-75.

Chapter 10: Informatics Tools to Promote Patient Safety and Quality OutcomesRead Chapter 10 and answer questions 76-80.

Chapter 11: Patient Engagement and Connected HealthRead Chapter 11 and answer questions 81-85.

Chapter 12: Using Informatics to Promote Community/Population HealthRead Chapter 12 and answer questions 86-90.

Chapter 13: Telenursing and Remote Access TelehealthRead Chapter 13 and answer questions 91-100.

THIS CONCLUDES THE COURSE.Please complete the evaluation on page v of this workbook.

P R E T E S T

1. Begin this course by taking the pretest. Circle the answers to the questions on this page, or write the answers on a separate sheet of paper. Do not log answers to the pretest questions on the FasTrax test sheet included with the course.

2. Compare your answers to the answers in the PRETEST KEY located at the end of the pretest. The pre-test key indicates the page where the content of that question is discussed within the textbook. Make note of the questions you missed, so that you can focus on those areas as you complete the course.

3. Read the entire course and complete the exam questions at the end of the course. Answers to the exam questions should be logged on the FasTrax test sheet included with the course.

Note: Choose the one option that BEST answers each question.

1. In the field of informatics, a healthcare professional is also known as

a. a knowledge worker.b. an information scientist.c. a nurse scientist.d. a statistician.

2. Which prominent figure in nursing should be recognized as an early public health informaticist?

a. Clara Bartonb. Dorothea Dixc. Florence Nightingaled. Jean Watson

3. According to the American Nurses Association (2015), the specialty of nursing informatics combines analytical science, nursing science, and

a. physical science.b. biological sciences.c. human sciences.d. information sciences.

4. One of the most important roles in nursing informatics is to

a. develop software that can be easily updated.

b. analyze data and information to ensure patient safety.

c. use hardware that has been thoroughly tested.

d. solicit feedback from end users.

5. Bioethics is best described as

a. individual and universal systems.b. the study and formulation

of healthcare ethics.c. networking among systems.d. organization and efficiency.

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PRETEST KEY1. A Chapter 12. C Chapter 23. D Chapter 44. B Chapter 105. C Chapter 12

L E A R N I N G O U T C O M E S

CHAPTER 1: Introduction to Information, Information Science, and Information SystemsLearning Outcome

After completing this chapter, the learner will be able to describe the process of synthesiz-ing data into information and knowledge.Chapter Objectives

After completing this chapter, the learner will be able to:1. Define the characteristics of data and

information.2. Discuss the importance of information

processing.3. Describe how information science influ-

ences people.4. Identify key processes that occur in infor-

mation systems.

CHAPTER 2: Computer Science and the Foundation of Knowledge ModelLearning Outcome

After completing this chapter, the learner will be able to apply concepts of computer sci-ence and the foundation of knowledge model to informatics.Chapter Objectives

After completing this chapter, the learner will be able to:1. Identify the components of a computer

and how it is used as a tool for managing information.

2. Explain the relationship between the foun-dation of knowledge model and concepts of computer science.

3. Discuss how computers can support col-laboration, networking, and information exchange.

CHAPTER 3: Ethical Applications of InformaticsLearning Outcome

After completing this chapter, the learner will be able to discuss how ethical decision-making concepts are used to manage ethical problems in nursing informatics.Chapter Objectives

After completing this chapter, the learner will be able to:1. Discuss the ethical model for ethical deci-

sion making.2. Identify ethical issues associated with pri-

vate information and technology.3. Discuss ethical issues associated with sup-

portive decision making.4. Identify ethical dilemmas in nursing

informatics.

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Final Exam—6 Nursing Informatics and the Foundation of Knowledge

CHAPTER 4: History and Evolution of Nursing InformaticsLearning Outcome

After completing this chapter, the learner will be able to apply nursing informatics metastruc-tures, concepts, and tools to the nursing process.Chapter Objectives

After completing this chapter, the learner will be able to:1. Discuss the evolution of nursing informatics

from concept to current practice.2. Discuss the importance of standardized ter-

minology in nursing documentation.3. Explain how nursing informatics has sup-

ported the nurse as a knowledge worker.

CHAPTER 5: Nursing Informatics as a SpecialtyLearning Outcome

After completing this chapter, the learner will be able to discuss the concepts that define nursing informatics as a specialty.Chapter Objectives

After completing this chapter, the learner will be able to:1. Describe the facilitative and transformative

role of information technology in nursing.2. Explain how the scope and standards of

nursing informatics defines the practice as a specialty.

3. Describe the roles that nursing informatics play in health care.

CHAPTER 6: Legislative Aspects of Nursing Informatics: HITECH and HIPAALearning Outcome

After completing this chapter, the learner will be able to discuss the current and ongo-ing legislation and regulations that shape 21st- century practice.Chapter Objectives

After completing this chapter, the learner will be able to:1. Discuss the purpose for the Health Informa-

tion Technology for Economic and Clinical Health (HITECH) Act and the Health Insur-ance Portability and Accountability Act (HIPAA).

2. Identify how the HITECH Act can be used to reinforce the HIPAA guidelines.

3. Describe how the HIPAA and HITECH Act affect nursing practice.

CHAPTER 7: Administrative Information SystemsLearning Outcome

After completing this chapter, the learner will be able to describe how administrative information systems are improving patient care outcomes.Chapter Objectives

After completing this chapter, the learner will be able to:1. Discuss the function of administrative infor-

mation systems in health care.2. Examine how administrators use business

software in their practice.3. Discuss information output from administra-

tive information systems used in healthcare organizations.

Final Exam—Nursing Informatics and the Foundation of Knowledge 7

CHAPTER 8: The Human-Technology InterfaceLearning Outcome

After completing this chapter, the learner will be able to explain the importance of the human-technology interface in health care.Chapter Objectives

After completing this chapter, the learner will be able to:1. Define the human-technology interface.2. Examine problems related to the human-

technology interface in health care.3. Discuss the future of the human-technology

interface.

CHAPTER 9: The Electronic Health Record and Clinical InformaticsLearning Outcome

After completing this chapter, the learner will be able to examine the core fundamentals of the electronic health record (EHR) and infor-matics.Chapter Objectives

After completing this chapter, the learner will be able to:1. Identify the financial implications of the

EHR.2. Identify the components of the EHR.3. Discuss the benefits of implementing EHRs.4. Describe the impact of the EHR on nursing

practice.

CHAPTER 10: Informatics Tools to Promote Patient Safety and Quality OutcomesLearning Outcome

After completing this chapter, the learner will be able to recognize informatics tools that promote patient safety and quality outcomes.Chapter Objectives

After completing this chapter, the learner will be able to:1. Identify concepts of the culture of safety in

a healthcare environment.2. Describe human factors that can be contrib-

utors to medical errors.3. Summarize the influence of information

technology on patient safety.

CHAPTER 11: Patient Engagement and Connected HealthLearning Outcome

After completing this chapter, the learner will be able to explain how nursing informatics practice applications provide patients electronic access to their own records and to more health information.Chapter Objectives

After completing this chapter, the learner will be able to:1. Discuss consumer demand for health infor-

mation and barriers to its access.2. Define the concepts of health literacy and

e-health.3. Identify healthcare organization approaches

to encouraging patient engagement.


CHAPTER 12: Using Informatics to Promote Community/Population HealthLearning Outcome

After completing this chapter, the learner will be able to discuss the use of nursing infor-matics tools to improve population and commu-nity health.Chapter Objectives

After completing this chapter, the learner will be able to:1. Discuss the role of community and popula-

tion health informatics in health care.2. Describe tools in informatics that promote

community and population health.3. Identify the impact of community and pub-

lic health informatics on population health.

CHAPTER 13: Telenursing and Remote Access TelehealthLearning Outcome

After completing this chapter, the learner will be able to describe how telehealth and telenursing are improving patient health out-comes.Chapter Objectives

After completing this chapter, the learner will be able to:1. Explain the evolving use of telehealth in

nursing practice.2. Discuss the role of the telehealth nurse.3. Discuss legal, regulatory, and ethical issues

in telehealth.4. Identify future priorities in telehealth.

F I N A L E X A MNURSING INFORMATICS AND THE

FOUNDATION OF KNOWLEDGENote: Choose the one option that BEST answers each question.

Chapter 1

1. A stated number, such as 99.5, is defined as

a. data.b. information.c. knowledge.d. wisdom.

2. The most important characteristics of data include

a. format and delivery.b. quality and integrity.c. storage and retrieval.d. clarity and consistency.

3. Information that is considered valuable and meaningful must be accessible, accurate, and

a. free.b. understandable.c. utilitarian.d. timely.

4. Information science can affect people by

a. telling them what to do.b. allowing them to make their own

decisions without outside influence.c. influencing how they interact with

information and develop knowledge.d. providing a means to give patient care.

5. The retrieval, analysis, or synthesis of data is known as

a. dissemination.b. processing.c. reporting.d. telecommunications.

Chapter 2

6. Computer technology has made data and knowledge more accessible and

a. more logical.b. able to replace hardware.c. able to create philosophies.d. able to be manipulated.

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7. The physical body of the computer and its components are referred to as

a. hardware.b. software.c. the internal processor.d. the decision support system.

8. The component known as the “brain” of the computer is the

a. hard drive.b. memory.c. central processing unit/processor.d. monitor.

9. The application programs designed to facilitate user functions, including writing and artwork, are known as

a. hardware.b. software.c. the internal processor.d. the decision support system.

10. What component(s) can nurses develop through productivity and communication software?

a. Intuition and insightb. Acquisition and disseminationc. Collections of unnecessary datad. Knowledge

11. Which method of dissemination of knowledge has the ability to reach other users on the largest scale?

a. Conferencesb. In servicesc. Electronic journalsd. The World Wide Web

12. Nurses must apply the power of data and information gained from technology to build knowledge and gain

a. wisdom.b. more data.c. understanding.d. more information.

13. Social communication software is used to provide a

a. dynamic virtual environment.b. way to practice nursing.c. sense of personal understanding.d. means to use the operating system.

14. Nurses feel a sense of connection with other professionals when they use

a. a monitoring system.b. a database.c. virtual social networks.d. an operating system.

15. Since the mid-1980s, people have electronically shared information, documents, and communications by exchanging files via

a. telephone.b. postal service.c. courier.d. the World Wide Web.

Chapter 3

16. A methodical examination of different perspectives concerning moral questions of right and wrong is referred to as

a. ethics.b. duties.c. values.d. morals.


17. Which theoretical framework came forth as fundamental for ethical decision making?

a. The Hippocratic oathb. Anti-principlismc. Principlismd. Care ethics

18. The core of the Husted bioethical decision-making model is the professional’s agreement with the

a. physician and nurse.b. patient or client.c. patient or family.d. case manager.

19. What type of information system can create ethical challenges in terms of users and implementation?

a. Decision support systemb. Clinical information systemc. Administrative systemsd. Operating systems

20. Which area of informatics is helpful in gathering and analyzing data for the ethical decision-making process?

a. Healthcare informaticsb. Nursing informaticsc. Consumer informaticsd. Bioinformatics

21. Clinicians must evaluate each patient-specific situation and situational context to make

a. plans for the future.b. software design decisions.c. ethical decisions.d. educational decisions.

22. An example of a nurse violating ethics is if the nurse

a. documents vital signs on a patient.b. shares his or her password with others.c. reviews patient information on patients

assigned only to them.d. reviews research journals.

23. A nurse posts on social media about his or her day on the floor and includes a photo of the messy empty patient room. What is this an example of?

a. Open access to informationb. An ethical dilemmac. An ethical violationd. Ethical compliance

24. What principles should be considered to maintain everyone’s moral rights?

a. Personality, ethics, and lawb. Autonomy, veracity, and fidelityc. Information security, compliance,

and policiesd. Virtue, autonomy, and personality

25. Which example would the nurse informaticist consider an ethical dilemma?

a. A physician providing medical consultation via the Internet across state lines

b. A nurse changing his or her password every 3 months

c. A patient writing about his or her condition on social media

d. A nurse writing a case study with patient information removed for teaching purposes


Chapter 4

26. Who was one of the first statisticians credited with collecting data that changed the way healthcare professionals cared for patients?

a. Dorothea Dixb. Florence Nightingalec. Clara Bartond. Loretta Ford

27. Graves and Cocoran (1989) defined nursing informatics as a blend of

a. information, computer, and nursing science.

b. computer, decision, and nursing science.

c. information science and medical science.

d. information science and nursing science.

28. According to the American Nurses Association (2015), the definition of nursing informatics is

a. an accumulation of research related to nursing theory.

b. an integration of nursing science and other analytical and information sciences.

c. an information system that collects and processes nursing data.

d. a computer system designed to streamline collection of nursing data.

29. What framework is considered the basis of the specialty of nursing informatics?

a. Watson’s theory of caringb. The nursing metaparadigmc. The data, information, knowledge,

and wisdom paradigmd. Transcultural nursing theory

30. Standardized terminology will provide the ability to demonstrate more clearly the contributions and impact of

a. a patient’s needs.b. nursing care.c. administrative decisions.d. institutional policies.

31. What is Drucker’s (1994) definition of knowledge work?

a. Repetitive, nonroutine work that entails no cognitive activity

b. Nonrepetitive, routine work that entails some cognitive activity

c. Nonrepetitive, nonroutine work that entails a significant amount of cognitive activity

d. Repetitive, routine work that entails a significant amount of cognitive activity

32. Which activity is an example of a nurse acting as a knowledge worker?

a. Scheduling magnetic resonance imagingb. Checking the computer for lab resultsc. Making a bedd. Interpreting trends from patient

symptoms and lab results

33. Snyder-Halpern (2001) found that nurses assume the roles of information users, knowledge users, and

a. wisdom gatherers.b. knowledge builders.c. wisdom generators.d. clinical gatherers.


34. A decision support system is

a. an information system that collects and processes data and information.

b. a critical-thinking tool to support and manage nursing practice.

c. a system that can recognize a trend in patient data.

d. a computerized application designed to support nursing administration and population health management.

35. An advantage of decision support systems is that they can

a. provide clinical knowledge to nurses.b. collect vital signs for nurses.c. provide feedback on quality

of care provided.d. remind nurses to communicate

with the physician.

Chapter 5

36. Which discipline in health care was the basis of the first clinical information system?

a. Physical therapyb. Speech therapyc. Physical medicined. Nursing

37. Computers have revolutionized the way individuals access

a. information.b. blogs.c. videos.d. paper files.

38. Nursing informatics focuses on representing

a. documentation, patient care, and nursing knowledge.

b. nursing knowledge, wisdom, and patient care.

c. nursing data, information, and knowledge.

d. patient care, data, and wisdom.

39. According to the revised edition of the American Nurses Association (2008, p. 33) scope and standards of practice in informatics nursing, a standard of practice includes to

a. “understand how principles from all sciences play roles in informatics.”

b. “provide feedback on how to build a computer.”

c. “incorporate theories, principles, and concepts from appropriate sciences into informatics practice.”

d. “describe the needs of nurses and physicians to build a better software system.”

40. The types of impacts the nurse informaticist needs to consider when reviewing an informatics solution include social, ethical, and

a. nursing practice.b. legal.c. wisdom.d. knowledge.

41. Functional areas of nursing informatics, per standards of practice, include

a. quality and performance improvement.b. assessment and documentation.c. research and development.d. giving feedback to developers

and end users.


42. Typical roles for informatics nurse specialists are constantly changing because

a. the nurse informaticist likes to change positions.

b. technology is in a constant state of change.

c. the nurse is in a constant state of change.

d. health care needs to change.

43. Common roles that the nurse informaticist assumes include educator, researcher, and

a. web designer.b. case manager.c. holistic nurse.d. project manager.

44. Policy development on a local, national, and international level is an integral part of the

a. consultant role.b. educator role.c. entrepreneur role.d. advocate/policy developer role.

45. Informatics nursing specialists who work at varying levels and serve as a link between nursing and information services in healthcare organizations assume the role of

a. Clinical Analyst/Systems Specialist.b. advocate.c. innovator.d. outcomes manager.

Chapter 6

46. What two key pieces of legislation have molded the nursing informatics field?

a. The Affordable Care Act (ACA) and the Health Insurance Portability and Accountability Act (HIPAA)

b. The Health Information Technology for Economic and Clinical Health (HITECH) Act and HIPAA

c. The ACA and HITECHd. The Meaningful Use Act (MUA) and

American Recovery and Reinvestment Act (ARRA)

47. Which of the following is one of the goals of the Health Insurance Portability and Accountability Act?

a. Enforcement of standards to secure health information

b. Unwarranted security and privacy of health information

c. Education of the consumer about health care

d. Nonstandardized identification of the consumer using health care

48. The federal Health Information Technology for Economic and Clinical Health Act of 2009, as part of the American Recovery and Reinvestment Act, was enacted to

a. address creating, adopting, and implementing health information technology standards and policies.

b. replace the Health Insurance Portability and Accountability Act of 1996.

c. force all healthcare providers to buy a computer.

d. establish a federal agency to support Medicare and Medicaid.


49. Under the Privacy Rule, providers are obligated to safeguard patient health information from

a. themselves.b. improper use or disclosure.c. patients reviewing their information.d. nurses’ use or documentation.

50. What are some examples of “covered entities” as defined by the Health Insurance Portability and Accountability Act?

a. Hospitals and other healthcare providers that transmit any health information electronically

b. Hospitals and doctors’ offices that keep paper records

c. Electronic health record vendors (e.g., Epic, Cerner)

d. Patients’ homes

51. As part of the Health Information Technology for Economic and Clinical Health Act’s effort to improve privacy of health information, it is mandatory for

a. the covered entities to maintain Health Insurance Portability and Accountability Act (HIPAA) compliance of all their business associates.

b. the business associates of covered entities to maintain their own HIPAA compliance.

c. the covered entities and their business associates to work together to maintain HIPAA compliance.

d. the business associates to maintain the covered entities’ HIPAA compliance.

52. What is an example of a “business associate” as defined by the Health Insurance Portability and Accountability Act and the Health Information Technology for Economic and Clinical Health Act?

a. A hospitalb. A doctor’s officec. Electronic health record vendors

(e.g., Epic, Cerner)d. Other healthcare providers

53. Along with patients’ privacy rights, the nurse has a duty under the American Nurses Association Code of Ethics to maintain

a. timely documentation.b. open communication with the IT

department at his or her place of work.c. confidentiality of all patient information.d. a multidisciplinary approach

to patient care.

54. Nurses who use social media need to be aware of

a. proper documentation of social media use.

b. breaching confidentiality of patient information.

c. patients who can contact nurses at any time.

d. the bias of the person sharing information.

55. Nurses must be ever mindful of their obligations to report a breach in the privacy or security of public health informatics to their

a. employers.b. friends.c. colleagues.d. family.


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56. What are the functions of clinical and administrative information systems?

a. To assemble and coordinate datab. To organize and categorize datac. To gather, process, and distribute

patient-centered datad. To assess and analyze data

57. The four core business systems lay the foundation for reimbursement, support of best practices,

a. and tracking of patients.b. quality control, and resource allocation.c. and research and development.d. expense monitoring, and budgeting

of capital expenses.

58. Order entry systems ensure that

a. physician orders are in keeping with best practice.

b. handwritten transcriptions are accurate.c. there are scheduled labs that are ordered

on a timely basis.d. there is a level of patient safety that was

absent in the past.

59. Where do many healthcare organizations aggregate data?

a. Serversb. Hard drivesc. A data warehoused. In the cloud

60. Databases’ five usual clinical applications are hospitals, clinical trials, clinical research, ambulatory care, and

a. privately funded research.b. rehabilitation hospitals.c. skilled nursing facilities.d. public health.

Chapter 8

61. Broadly speaking, a human-technology interface is defined as

a. using software on a computer.b. any type of software or hardware that

enables and supports an interaction with technology.

c. using hardware on a computer.d. building a computer from scratch.

62. Examples of human-technology interfaces include defibrillators, patient-controlled analgesia pumps, and

a. a whiteboard.b. a paper patient chart.c. electronic thermometers.d. a hard copy of a drug guide.

63. When a problem concerning a human-technology interface occurs, it is usually due to

a. a flawed development process.b. the technology being mismatched

with the care context and the users.c. users not wanting to adopt

the technology.d. administration outsourcing

for development.


64. Health issues that arise from computer and other technology use include

a. caring-related burnout.b. back injuries.c. computer vision syndrome (CVS).d. influenza.

65. Madden (2013) wrote that what technology is adding human behavior as a wrinkle to interface design?

a. Upgraded electronic health recordsb. Wearable technologyc. Cloud computingd. Smartphones

Chapter 9

66. What proposed solution in health care is aimed at improving the quality of care while controlling costs?

a. Electronic health recordsb. Clinical decision support systemsc. Clinical administrative systemsd. Population health registries

67. Under the American Recovery and Reinvestment Act, an organization that provides incentives to implement electronic health records is the

a. Certification Commission for Healthcare Information Technology.

b. Office of Technology Compliance.c. Joint Commission.d. Centers for Medicare

& Medicaid Services.

68. According to the Institute of Medicine (now the Health and Medicine Division of the National Academies, 2003), the eight components of electronic health records are health information and data, results management, order entry management, decision support, electronic communication and connectivity, patient support,

a. patient tracking, and satisfaction scores.b. nurse job satisfaction scores,

and patient tracking.c. administrative processes, and reporting

and population health management.d. radiologic images, and

laboratory systems.

69. A detailed electronic health record will also contain

a. policies and procedures.b. patient feedback about care.c. nursing assessments and problem lists.d. physician credentials.

70. A type of results an electronic health record manages includes

a. vital signs.b. clinician progress notes.c. nursing care plans.d. laboratory and radiology

procedure reports.

71. In addition to laboratory, radiology, and supply orders, a comprehensive electronic health record will include

a. unit supply orders.b. nursing orders.c. administrative meeting agendas.d. continuing education material.


72. A benefit of electronic health records is online communication among healthcare teams which is called

a. order entry management.b. electronic communication

and connectivity.c. administrative process.d. reporting and population

health management.

73. A common benefit cited of electronic health records is

a. reduced medication errors.b. increased medical errors.c. increased use of care.d. decreased security of patient information.

74. Electronic healthcare data can be mined to demonstrate nursing’s contributions to

a. improving quantity and efficiency of care.

b. improving cost, efficiency, and quality of care.

c. working longer hours.d. teaching evidence-based practice.

75. American Nurses Association’s (ANA) support for the use of recognized terminologies supporting standardized terminology in the EHR which represent aspects of

a. nursing practice.b. physician practice.c. billing.d. hospitals policies and procedures.

Chapter 10

76. A key feature of a safety culture is a blame-free environment in which people can report near misses or errors

a. to investigate employees.b. without fear of reprimand or punishment.c. to decrease patient safety.d. in fear of management.

77. The Joint Commission (2016) released the 2016 Hospital National Patient Safety Goals, and one category, Use Alarms Safely, stated that hospitals must “make improvements to ensure that alarms on medical equipment are

a. heard and responded to on time.b. screened for errors.c. calibrated daily.d. helping nurses have more direct

patient care.

78. In a safety culture, it is important that the safety and effectiveness of technology in health care ultimately depends on

a. the number of patients.b. increased vacation time.c. human users.d. the IT department.

79. A clinical decision support system

a. supports correct medical diagnoses and suggests appropriate interventions using patient data.

b. standardizes all physician orders based on patient diagnosis and treatment.

c. computes medications accurately.d. prescribes treatment and medication

based on the patient findings and assessment entered into the medical record by the physician and nurse.


80. Smart pump alarms include hard alarms that require the clinician to reprogram the pump so that the dosing falls

a. until overridden by an administrator.b. when the infusion is nearing completion.c. during the night.d. within the facility’s intravenous

administration guidelines.

Chapter 11

81. A gap between those who have access to Web-based information and those who do not is called the

a. digital divide.b. gray gap.c. know-do gap.d. weblog gap.

82. Factors associated with the digital divide, according to Fox and Purcell (2010), include age,

a. acute illness, and ethnicity.b. ethnicity, and environmental factors.c. level of education, ethnicity, and income.d. gender, level of education, and income.

83. The capacity of individuals to acquire, process, and understand general health information is referred to as

a. e-health.b. health literacy.c. empowerment.d. e-literacy.

84. What is a benefit of the patient portal provided by the healthcare organization (HCO)?

a. Allowing patients secure access to their health information

b. Accessing patient satisfaction datac. Tracking financial information

the HCO providesd. Providing a means for an e-consult

with specialists

85. How are healthcare organizations (HCOs) using social media as a method of patient engagement?

a. To educate patientsb. To promote themselvesc. To gain feedback on care

received at the HCOd. To run e-consult services

Chapter 12

86. How does public health informatics (PHI) differ from nursing informatics?

a. PHI focuses on the promotion of health and disease prevention in populations and communities.

b. Nursing informatics’ focus is on the changes in social conditions that affect the community.

c. PHI addresses how nursing, computer, and cognitive sciences affect nursing practice.

d. Nursing informatics includes the knowledge of political science and law.


87. What tool does the Environmental Protection Agency use to determine the type and the magnitude of health risks to people?

a. Environmental assessmentb. Health assessmentc. Risk assessmentd. Exposure assessment

88. To determine if there is an early outbreak of a disease, the Centers for Disease Control and Prevention can track which one of the following data sets?

a. Number of people on vacationb. Orders of chest X-raysc. Increased purchase of

healthcare productsd. Assessment findings of

healthcare providers

89. A major benefit of public health informatics for public health officials, clinicians, and patients is

a. the spread of communication and prevention guidelines.

b. the offer of real-time surveillance data.c. that investigations and emergencies will

be managed with the tools of informatics.d. the ability to store information

on exposures.

90. In population health, IT solutions may give

a. timely and complete information leading to community actions.

b. new information on diseases.c. facts for public use.d. ways to understand new possibilities

in population health.

Chapter 13

91. Devices involved in telehealth include

a. computer software.b. computer hardware.c. telephone, videophone, and computer.d. email.

92. Telehealth can help improve patient care outcomes with frequent telecontact in

a. home health care.b. open heart units.c. skilled care facilities.d. medical units.

93. An example of a clinical use of telehealth technology is

a. a telephone conference call.b. midnight shift transmission of radiologic

images to a different time zone for faster interpretation of results.

c. reviewing a videotape regarding changes to a procedure.

d. scanning a photograph of a wound.

94. A benefit of telehealth in home health care for nursing is to allow the nurse to

a. see fewer patients per day.b. see more patients per day.c. take more vacation days.d. take more sick days.

95. A relatively new role for advanced practice nurses is that of a

a. staff nurse.b. compliance nurse.c. computer nurse.d. tele-intensive care nurse.


96. Interstate practice of telehealth nursing requires nurses to

a. request clearance from the Board of Nursing in each state.

b. remain compliant with the laws for each state.

c. maintain licensure to practice in all the states in which they provide telehealth.

d. maintain licensure to practice in the origin state where they provide telehealth.

97. Nurses who use telehealth must assure patients that

a. all the equipment is working properly.b. the transmission of patient information

is secure.c. telehealth services are a benefit

to their long-term health.d. their family can also participate

in the telehealth session.

98. What training is required for all staff in telehealth?

a. Privacy and confidentiality trainingb. Conflict resolution trainingc. Resiliency trainingd. Customer service training

99. A priority of the American Telemedicine Association (2015) is to update the Medicare Chronic Care Initiative to add

a. access to more mobile devices.b. a broader choice of insurance.c. remote patient monitoring.d. access to the Internet.

100. The American Telemedicine Association (2015) is deliberating additional telehealth enhancements, such as

a. having Wi-Fi in every household.b. quantifying care provided to patients.c. promoting telehealth for autism.d. subsidizing the cost of

personal computers.

This concludes the final examination.Please answer the evaluation questions found on page v of this workbook.

workbook for nursing informatics and the foundation of … · · 2018-04-13practice from...

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