Informatics Midterm Review Sheet
1. General principles of Nursing Informatics:
2. Knowledge
o Awareness and understanding of a set of information and
ways that information can be made useful to support a
specific ta
...
Informatics Midterm Review Sheet
1. General principles of Nursing Informatics:
2. Knowledge
o Awareness and understanding of a set of information and
ways that information can be made useful to support a
specific task or arrive at a decision. This knowledge building is
an ongoing process engaged in while a person is conscious
and going about his or her normal daily activities.
3. Wisdom:
Knowledge applied in a practical way or translated into
actions; the use of knowledge and experience to heighten
common sense and insight so as to exercise sound judgment
in practical matters. Sometimes thought of as the highest form
of common sense, resulting from accumulated knowledge or
erudition (deep, thorough learning) or enlightenment
(education that results in understanding and the
dissemination of knowledge). Wisdom is the ability to apply
valuable and viable knowledge, experience, understanding,
and insight while being prudent and sensible. It is focused on
our own minds; it is the synthesis of our experience, insight,
understanding, and knowledge. Wisdom is the appropriate
use of knowledge to solve human problems. It is knowing
when and how to apply knowledge.4. Scientific Underpinning:
The scientific underpinnings of practice provide the basis of
knowledge for advanced nursing practice. These scientific
underpinnings include sciences such as biology, physiology,
psychology, ethics, and nursing.
Nursing science, information science, and computer science
5. The Foundation of Knowledge Model
The Foundation of Knowledge model is also introduced as the
organizing conceptual framework of this text, and the model
is tied to nursing science and the practice of nursing
informatics.
6. Computer science:
o Branch of engineering (application of science) that studies
the theoretical foundations of information and computation
and their implementation and application in computer
systems. The study of storage/memory, conversion and
transformation, and transfer or transmission of information in
machines— that is, computers—through both algorithms and
practical implementation problems. Algorithms are detailed,
unambiguous action sequences in the design, efficiency, and
application of computer systems, whereas practical
implementation problems deal with the software and
hardware.
7. Cognitive science:
o Interdisciplinary field that studies the mind, intelligence, and
behavior from an information processing perspective.
8. Information science
o Information science enables the processing of information.
This processing links people and technology. Humans are
organic ISs, constantly acquiring, processing, and generating
information or knowledge in their professional and personal
lives. This high degree of knowledge, in fact, characterizes
humans as extremely intelligent organic machines. The
premise of this text revolves around this concept, and the text
is organized on the basis of the Foundation of Knowledgemodel: knowledge acquisition, knowledge processing,
knowledge generation, and knowledge dissemination.
9. Standard Terminology:
o Standardized terminologies (STs) contribute to the
development of knowledge because they ensure that all
professionals share the same understanding or meaning of a
given concept, to clarify communication, facilitate research,
and provide structure for decision support tools and EHRs. As
you look at the Foundation of Knowledge model, STs support
knowledge acquisition, dissemination, generation, and
processing.
o STs are structured, controlled languages developed to
represent concepts in a given domain in a clear,
unambiguous fashion that conveys the exact same meaning
for data, information, and knowledge across settings, regions,
and even different countries. This consistency affords access
to information and knowledge when it is needed without
regard to the current model or period of care. STs are key to
the development of an EHR in order to represent,
communicate, exchange, reuse, and report data,
information, and knowledge, including Meaningful Use
criteria (Matney & Lundberg, 2013).
10. Informatics Competencies:
A set of essential skills related to informatics deemed
appropriate for various levels of nursing practice.
One challenge that has been identified in the literature and
continues to plague health care is the vast differences in
computer literacy and information management skills that
healthcare workers possess (Gassert, 2008; McNeil, Elfrink,
Beyea, Pierce, & Bickford, 2006; Topkaya & Kaya, 2014).
Gassert (2008) felt that new graduates were not adequately
literate. Barton (2005) believed that new nurses should have
the following critical skills: use e-mail, operate Windows
applications, search databases, and know how to work with
the institution-specific nursing software used for charting and
medication administration. These skills should not be limited to
just new nurses, but instead should be required of all nurses
and healthcare workers.
Staggers, Gassert, and Curran (2001) advocated that nursing
students and practicing nurses should be educated on core
NI competencies. Although information technology andinformatics concepts certainly need to be incorporated into
nursing school curricula, progress in this area has been slow. In
the 1980s, a nursing group of the International Medical
Informatics Association convened to develop the first level of
nursing competencies. While developing these
competencies, the nursing group found that nurses fell in to
one of the following three categories: (1) user, (2) developer,
or (3) expert. These categories have since been expanded.
Staggers and colleagues (2001) decided that the NI
competencies developed in the 1980s were inadequate and
needed to be updated. These authors reviewed 35 NI
competency articles and 14 job descriptions, which resulted
in 1,159 items that were sorted into three broad categories:
(1) computer skills, (2) informatics knowledge, and (3)
informatics skills. These items were then placed in a database,
where redundant items were removed. When this process
was completed, 313 items remained.
When these items were then further subdivided, Staggers and
colleagues, along with the American Medical Informatics
Association (AMIA) work group, realized that these
competencies were not universal to all nurses; thus, before it
could be determined if the competency was an NI
competency, nursing skill levels needed to be defined. The
group determined that practicing nurses could be classified
into four categories: (1) beginning nurse, (2) experienced
nurse, (3) informatics nurse specialist, and (4) informatics
innovator. Each of these skill levels needed to be defined
before Staggers and colleagues (2001) could determine
which level was the most appropriate for that skill set. Table 7-
1 provides the definition criteria for each skill level. Once the
levels were defined, the group determined that 305 items
were NI competencies and placed them into appropriate
categories.
11. Information literacy:
Ability to identify when information is needed as well as the
skills to find, evaluate, and effectively use the same.
Evaluation of online resources for quality
Ability to search literature databases effectively
12. Health literacy:
The acquisition of knowledge that promotes the ability to
understand and to manage one’s health.13. Meaningful Use
The American Recovery and Reinvestment Act of 2009
specifies three main components of meaningful use: (1) the
use of a certified electronic health record (EHR) in a
meaningful manner, such as e-prescribing; (2) the use of
certified EHR technology for electronic exchange of health
information to improve quality of health care; and (3) the use
of certified EHR technology to submit clinical quality and
other measures. The criteria for meaningful use will be staged
in three steps. Stage 1 (2011–2012) set the baseline for
electronic data capture and information sharing. Stage 2
(2013) and Stage 3 (expected to be implemented in 2015)
continue to expand on this baseline and be developed
through future rule making.
14. Patient-centered Information Systems:
Patient-centered information systems focused on collecting
data and disseminating information related to direct care.
Several of these systems have become mainstream types of
systems used in health care. The four types of systems most
commonly found in healthcare organizations include (1)
clinical documentation systems, (2) pharmacy information
systems, (3) laboratory information systems, and (4) radiology
information systems.
15. Clinical Decision Support Systems:
A computer-based program designed to assist clinicians in
making clinical decisions by filtering or integrating vast
amounts of information and providing suggestions for clinical
intervention. May also be called a clinical decision support
system (CDSS).
Clinical decision support (CDS) tools are designed to help sift
through enormous amounts of digital data to suggest next
steps for treatments, alert providers to available information
they may not have seen, or catch potential problems, such
as dangerous medication interactions. Alert fatigue and clinical burnout are common byproducts of
poorly implemented clinical decision support features that
overwhelm users with unimportant information or frustrating
workflow freezes that require extra clicks to circumvent.
16. Electronic Medical Records: (EHR)
Computer-based data warehouses or repositories of
information regarding the health status of a client, which are
replacing the former paper-based medical records; they are
the systematic documentation of a client’s health status and
health care in a secured digital format, meaning that they
can be processed, stored, transmitted, and accessed by
authorized interdisciplinary professionals for the purpose of
supporting efficient, high-quality health care across the
client’s healthcare continuum. Also known as electronic
medical records (EMRs).
17. Human-Technology Interface:
The hardware and software through which the user interacts
with any technology (e.g., computers, patient monitors,
telephone).
18. Health Information Technology:
Is comprised of "hardware, software, integrated technologies
or related licenses, intellectual property, upgrades, or
packaged solutions sold as services that are designed for or
support the use by healthcare entities or patients for the
electronic creation, maintenance, access, or exchange of
health information" (p.149).
HIT has been promoted as a key element in the National
Quality Strategy (NQS) to achieve three aims: better care,
affordable care, and healthy populations and communities.
19. Alarm fatigue:
o Multiple false alarms by smart technology that cause workers
to ignore or respond slowly to them.
20. Digital natives:
o A digital native is an individual who was born after the
widespread adoption of digital technology. The term digital
native doesn't refer to a particular generation. Instead, it is acatch-all category for children who have grown up using
technology like the Internet, computers and mobile devices.
21. Information Literacy Competency Standards for Nursing:
Information Literacy Competency Standards for Nursing
According to the Information Literacy Competency Standards for Nursing (2013),
an information-literate individual can demonstrate the following:
Determine the extent of information needed
Access the needed information effectively and efficiently
Critically evaluate the procured information and its sources, and as
a result, decides whether or not to modify the initial query and/or
seek additional sources and whether to develop a new research
process
Use information effectively to accomplish a specific purpose
Understand the economic, legal, and social issues surrounding the
use of information and access and use information ethically and
legally
Information Literacy
As discussed in the lesson from Week 2, the TIGER initiative
identified three components for the TIGER nursing informatics
competencies model: (a) basic computer competencies, (b)
information literacy, and (c) information management.
Additionally, health care providers must be able to determine
what information is needed, utilize the appropriate resources
to find the information, use valid resources to critique the
information, provide evidence-based care based on this
information, and evaluate the outcomes of the process.
Information literacy refers to the use of digital technology to
locate, navigate, manage, integrate, evaluate, create, and
effectively communicate in a rapidly changing information
environment in the pursuit of knowledge. The National
Organization of Nurse Practitioner Faculties (NONPF) Core
Competencies advocated incorporating competencies from
technology informatics with Advanced Practice Nursing
(APN) curricula to teach nurse practitioner students how to
use available technology to enhance the safety and health
outcomes of their patients (NONPF, 2017, p. 8). The Essentials
of Master's Education in Nursing written by the AmericanAssociation of Colleges of Nursing (AACN) (2013) recognized
that master's-prepared nurses use technologies to deliver and
coordinate patient care as well as to enhance
communication. Graduate level Quality and Safety
Education for Nurses (QSEN) Competencies recommended
the use of information and technology to communicate,
manage knowledge, mitigate error, and support decision
making (Dolansky & Moore, 2013). The National League for
Nursing (NLN) Program Outcomes and Competencies for
Graduate Academic Nurse Educator Preparation are
"grounded in the core values of the NLN - caring, integrity,
diversity, and excellence. The concepts of evidence-based
teaching, the science of learning, research in nursing
education, and personal and professional development are
reflective of these values assuming different dimensions
across program type" (NLN, 2017, p.2). Each organization
incorporates aspects of information and/or literacy with core
competencies; however, the extent of inclusion and items
differ vastly.
The most important aspects of information literacy reflect
information discovery, retrieval, and delivery as well as the
ability to acquire, process, generate, and disseminate
knowledge in ways that help those managing the knowledge
reevaluate and rethink what an individual understands. The
goals of the Information Literacy Competency Standards for
Higher Education (2013), published by the American Library
Association (ALA) are a response to the changing
perceptions of how information is created, evaluated, and
used.
22. HITECH Act:
HITECH strengthened HIPAA security and privacy rules and
provided monies and incentives to increase the adoption of
EHRs that meet eligibility requirements for Meaningful Use. The
underlying idea was that financial incentives would
encourage the adoption of EHR systems, moving the United
States closer to a national infrastructure that would support an
EHR for every American and provide information via
Meaningful Use core criteria that could be used to collect
information that could be used to improve population health.
Providers that comply with Meaningful Use requirements
qualify for additional reimbursement monies over a period of
several years. Penalties will be imposed for providers that do
not use approved technology to comply with Meaningful Userequirements. Providers have some latitude on the core
criteria that are met from a prescribed set. Funds allocated
by HITECH also support regional centers that guide providers
as they adopt EHRs and offer technical support.
Meeting the criteria for meaningful use (MU) of an EHR is one
of the methods of Medicare and Medicaid reimbursement
associated with the HITECH Act. The Centers for Medicare &
Medicaid Services (CMS) serves as the primary regulator, with
each individual state dictating the Medicaid operations
within its jurisdiction (Health Information Technology for
Economic and Clinical Health Act, 2009). This statute identifies
the eligible providers, including APNs, for the Medicare and
Medicaid reimbursement structure. Such prescriptive
language does not recognize, embrace, or support the
interprofessional team and the critical and collaborative work
completed by such an entity to improve access, improve
health care, and reduce costs.
The third and final stage of MU is currently underway and
entails a single set of criteria focused on the advanced use of
EHR systems. CMS decided to move away from the staged
approach and will require all providers (including first-time
participants) to satisfy the objectives and measures of Stage 3
by 2018. Beginning in 2019, the MU program will transition into
a new merit-based incentive payment system (MIPS) program
established by the Medicare Access and CHIP (Children's
Health Insurance Program) Reauthorization Act. The Stage 3
requirements and objectives will be maintained (Resnick,
Meara, Peltzman, & Gilley, 2016).
Throughout the MU phases, providers and hospitals that
implement EHRs meeting federal standards outlined under
the meaningful use regulatory requirements are financially
incentivized with payments from CMS. The incentive program
started in 2011 and extends over several years with the time
table determined by whether a provider elects to access the
Medicaid or Medicare incentive program. Hospitals can
access both Medicaid and Medicare incentives, and in many
cases these incentives equate to millions of dollars.
23. TIGER-based Nursing Informatics Competencies Model:The TIGER (2007) initiative identified steps toward a 10-year vision and
stated a key purpose: ―to create a vision for the future of nursing that
bridges the quality chasm with information technology, enabling nurses to
use informatics in practice and education to provide safer, higher-quality
patient care‖ (p. 4). The pillars of the TIGER vision include the following:
Management and Leadership: Revolutionary leadership that drives,
empowers, and executes the transformation of health care.
Education: Collaborative learning communities that maximize the
possibilities of technology toward knowledge development and
dissemination, driving rapid deployment and implementation of best
practices.
Communication and Collaboration: Standardized, person-centered,
technology-enabled processes to facilitate teamwork and
relationships across the continuum of care.
Informatics Design: Evidence-based, interoperable intelligence systems
that support education and practice to foster quality care and safety.
Information Technology: Smart, people-centered, affordable
technologies that are universal, useable, useful, and standards based.
Policy: Consistent, incentives-based initiatives (organizational and
governmental) that support advocacy and coalition-building,
achieving and resourcing an ethical culture of safety.
Culture: A respectful, open system that leverages technology and
informatics across multiple disciplines in an environment where all
stakeholders trust each other to work together toward the goal of high
quality and safety (p. 4).
If there are any doubts about what these competencies might be,
The Technology Informatics Guiding Education Reform (TIGER)
Initiative (2009), compiled and posted a list of competencies on its
website that every nurse should display. TIGER first came into being
with an invitation-only summit, Evidence and Informatics
Transforming Nursing, in 2006, which invited leaders from nursing,
government, informatics and technology organizations, and other
stakeholders to come together to create a vision to transform
nursing to bridge the quality chasm using technology (TIGER,
2013a). TIGER continues its focus on the use of informatics and
technology to make healthcare safer, more effective, efficient,
patient-centered, timely and equitable by interweaving evidence
and technology seamlessly into practice, education and research
fostering a learning healthcare system and is a useful resource (The
TIGER Initiative, 2013b). The American Association of Colleges of
Nursing has also identified informatics competencies expected for
each program graduate in their Essentials documents as well as across walk document that provides a quick comparison by program
level (American Association of Colleges of Nursing, n.d.).
As defined in McGonigle and Mastrian (2018) by the Health
Information Technology for Economic and Clinical Health (HITECH)
Act, Health information technology (HIT) is comprised of "hardware,
software, integrated technologies or related licenses, intellectual
property, upgrades, or packaged solutions sold as services that are
designed for or support the use by healthcare entities or patients for
the electronic creation, maintenance, access, or exchange of
health information" (p.149). HIT has been promoted as a key
element in the National Quality Strategy (NQS) to achieve three
aims: better care, affordable care, and healthy populations and
communities.
The Technology Informatics Guiding Education Reform (TIGER)
Initiative was created in 2004 to collaborate with nursing
stakeholders to create a vision, action, and strategies to improve
nursing education, practice, and patient care delivery through the
use of health information technology. TIGER formed an Informatics
Competency Collaborative, which define the competencies
recommended for the NI discipline (TIGER, 2010).
24. Nursing Informatics
A specialty that integrates nursing science, computer
science, and information science to manage and
communicate date, information, knowledge, and wisdom in
nursing practice
[Show More]
