NR 599 / NR599 Final Exam Study Guide (Latest 2024 / 2025) Nursing Informatics for Advanced Practice – Chamberlain
NR-599 Nursing Informatics for Advanced Practice
Informatics NR599 Final Exam Study Guide
Workflow
Correct Answer:
Execution of a series of tasks in a prescribed sequence.
Sequential Workflow vs Parallel Workflow
Correct Answer:
Each step depends on the occurrence of the previous step. Two or more
steps can occur concurrently.
Maya, Autodesk, and Promode
Correct Answer:
Workplace analysis process mapping tools
Workflow Analysis
Correct Answer:
Study of the way work (inputs, activities, and outputs) moves through an
organization.
Workflow Design
Correct Answer:
To engage in the analysis and redesign of processes and tasks surrounding
the use of technology
Clinical Decision Support Systems (CDSS)
Correct Answer:
Computerized programs used within the health care setting to support
decision making by helping to analyze data and information and provide
recommendations. (will flag for allergies to help prevent medication errors).
Benefits of combining CDSS and EHR
Correct Answer:
Allows medication information to be combined with patient information to
create alerts about drug-drug interactions, drug allergy contraindications,
and other important situations.
Advanced uses of CDSS
Correct Answer:
Looks for trends in values, such as the rate of fall of the hematocrit or the
rising weight of an ICU patient who is accumulating extracellular fluid, where
an absolute number may not be notable, but an alert to the trend may be
important and prompt action.
Challenges for CDSS
Correct Answer:
Alert fatigue, clinical burnout, and financial implications.
Examples of CDS tool
Correct Answer:
Computerized alerts and reminders for providers and patients, drug-drug
interaction alerts, under-dose or overdose alerts based on renal or liver
function or age or drug levels.
Process Map
Correct Answer:
Ranges from simplistic to fairly complex and provides an excellent tool to
identify specific steps.
Informatics Nurse Specialist (INS)
Correct Answer:
Has develop techniques necessary to assess and improve human-computer
interaction.
Essential
Correct Answer:
The name tag is necessary for the laboratory personnel to identify the
specimen and, therefore, its placement is a(n) _ or valueadded step in the process.
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Workflow
Execution of a series of tasks in a prescribed sequence.
2 MULTIPLE CHOICE OPTIONS
Sequential Workflow vs Parallel Workflow
Each step depends on the occurrence of the previous step. Two or more steps can occur concurrently.
Maya, Autodesk, and Promode
Workplace analysis process mapping tools
Workflow Analysis
Study of the way work (inputs, activities, and outputs) moves through an organization.
3 MULTIPLE CHOICE OPTIONS
Workflow Design
To engage in the analysis and redesign of processes and tasks surrounding the use of technology
1 MULTIPLE CHOICE OPTION
Clinical Decision Support Systems (CDSS)
Computerized programs used within the health care setting to support decision making by helping to analyze data and information and provide recommendations. (will flag for allergies to help prevent medication errors).
3 MULTIPLE CHOICE OPTIONS
Benefits of combining CDSS and EHR
Allows medication information to be combined with patient information to create alerts about drug-drug interactions, drug allergy contraindications, and other important situations.
Advanced uses of CDSS
Looks for trends in values, such as the rate of fall of the hematocrit or the rising weight of an ICU patient who is accumulating extracellular fluid, where an absolute number may not be notable, but an alert to the trend may be important and prompt action.
Challenges for CDSS
Alert fatigue, clinical burnout, and financial implications.
Examples of CDS tool
Computerized alerts and reminders for providers and patients, drug-drug interaction alerts, underdose or overdose alerts based on renal or liver function or age or drug levels.
1 MULTIPLE CHOICE OPTION
Process Map
Ranges from simplistic to fairly complex and provides an excellent tool to identify specific steps.
1 MULTIPLE CHOICE OPTION
Informatics Nurse Specialist (INS)
Has develop techniques necessary to assess and improve human-computer interaction.
3 MULTIPLE CHOICE OPTIONS
Essential
The name tag is necessary for the laboratory personnel to identify the specimen and, therefore, its placement is a(n) _ or value-added step in the process.
Results Management
An approach to evaluating the outcomes of a process to determine whether that process was useful or valuable.
Mobile Health (mHealth)
Refers to healthcare professionals using smartphones or tablets to access health records stored in the cloud, and patients using digital devices to monitor their conditions and treatments.
3 MULTIPLE CHOICE OPTIONS
Mobile Medical Apps
Accessories to a regulated medical device or are software that transforms a mobile platform into a regulated medical device
2 MULTIPLE CHOICE OPTIONS
Mobile Devices
Mobile phones or smartphones, tablet computers, smartwatches, and point-of-care (POC) devices.
United States Food and Drug Administration (FDA)
Entity that oversees medical applications and assesses their potential misuse or malfunction in order to reduce these risks to the public which includes addressing the management of cybersecurity risks and hospital network security.
3 MULTIPLE CHOICE OPTIONS
Mobile Medical Applications Guidance for Industry and Food and Drug Administration Staff
Offers clear distinction between an unregulated “mobile application” and a “mobile medical application” which are subject to overt FDA regulation.
1 MULTIPLE CHOICE OPTION
Medical Apps that FDA intends to exercise enforcement discretion
Apps that coach patients with conditions such as cardiovascular disease, hypertension, diabetes or obesity, and promote strategies for maintaining a healthy weight, getting optimal nutrition, exercising and staying fit, managing salt intake, or adhering to predetermined medication dosing schedules by simple prompting.
3 MULTIPLE CHOICE OPTIONS
FDA (2013) Intentions for Oversight
Mobile apps that are medical devices and whose functionality could pose a risk to a patient’s safety if the mobile app were to not function as intended
1 MULTIPLE CHOICE OPTION
Privacy
The right of people not to reveal information about themselves.
2 MULTIPLE CHOICE OPTIONS
Confidentiality
The assurance that messages and information are available only to those who are authorized to view them.
2 MULTIPLE CHOICE OPTIONS
Cybersecurity
The state of being protected against the criminal or unauthorized use of electronic data, or the measures taken to achieve this.
3 MULTIPLE CHOICE OPTIONS
Mobile Platform
Provides the ability to access the Internet from a variety of mobile devices such as smartphones, tablets, and other ultra-lightweight laptop computers
Higher Risk Apps
Apps that formulate drug dosing schedules, such as warfarin dosage, based on a patient’s international normalized ratio readings.
Lower Risk Apps
Apps that provide easy access to information for doctors or patients without treatment suggestions, or those that perform simple calculations used in everyday practice, such as a Glasgow coma scale calculator.
Patient Safety
The most important factor that ensures _ __ is the accuracy and reliability of the information within apps
Clinicians
Person who must judge whether the electronic information we use is reliable, up to date, and does no harm to our patients.
Telehealth/Telemedicine
Wide range of health services that are delivered by telecommunications-ready tools, such as the telephone, videophone, and computer for medical information exchange.
3 MULTIPLE CHOICE OPTIONS
Human Technology Interface (HIT)
The portion of the assistive technology system with which the user interacts.
3 MULTIPLE CHOICE OPTIONS
Telemedicine applications types (2)
- Store-and-forward or asynchronous – exchange pre recorded data between 2 or more individuals at different times 2. Real-time or synchronous – all involved individuals are present for immediate exchange of information.
Robodocs
Telemedicine interventions, from InTouch Health, used by patients in remote geographic areas that connects physicians and specialists with patients and other doctors who are too distant to consult with them in person.
1 MULTIPLE CHOICE OPTION
Credibility
The quality of being trusted and believed.
1 MULTIPLE CHOICE OPTION
Pocket Doctor and iTriage
Example of specific Apps that suggest possible diagnoses on the basis of inputs from patients.
2 MULTIPLE CHOICE OPTIONS
Point -of-care (POC)
Allows for testing and diagnosis at the patient’s side and can be conducted anywhere the patient is, such as the home, physician office, ambulance, or hospital bedside.
3 MULTIPLE CHOICE OPTIONS
Example of POS Devices
FDA-approved medical devices, such as insulin pumps, pacemakers, defibrillators.
1 MULTIPLE CHOICE OPTION
Patient Centered Information Systems (PCIS)
Focused on collecting data and disseminating information related to direct care.
1 MULTIPLE CHOICE OPTION
Data Mining
The use of a variety of statistical analysis tools to uncover previously unknown patterns in the data stored in databases or relationships among variables
1 MULTIPLE CHOICE OPTION
Peripheral Biometric Devices
Consist of fully integrated systems, such as a vital signs monitor, or they may be stand-alone telecommunications-ready devices, such as blood pressure cuffs and blood glucose meters.
1 MULTIPLE CHOICE OPTION
Haptic devices
Tactile Feedback
Just Culture
Accounts for three types of behaviors leading to patient safety compromises: (1) human error (unintentional mistakes); (2) risky behaviors (workarounds); and (3) reckless behavior (total disregard for established policies and procedures).
Ethical Decision Making
Process that requires striking a balance between science and morality.
2 MULTIPLE CHOICE OPTIONS
Ethical Decision Making Process
- Identify the ethical dilemma
- Discover alternative actions
- Decide who might be affected
- List the probable effects of the alternatives
- Select the best alternative.
Do No Harm
Organizations and individuals that provide health information on the Internet have obligations to be trustworthy, provide high-quality content, protect users’ privacy, and adhere to standards of best practices for online commerce and online professional services in healthcare
Rational Justification
Developed through a logical process of decision making that gives proper attention to such things as facts, alternative perspectives, consequences to all stakeholders, and ethical principles.
American Nurses Association (ANA)
Professional organization that represents all registered nurses.
1 MULTIPLE CHOICE OPTION
ANA’s Code of Ethics for Nurses
- Respect for human dignity
- Respect for individual right to self-determinism
- Primary commitment is to the patient (individual, family, group or community)
- Advocacy for the patient
- Participation in the creation, maintenance, and improvement of healthcare environments
- Advancing the Profession
- Collaboration with others to meet health needs
- Shaping social policy.
Issues with Ethical Component
- Failure to adopt technology or use it adeptly
- Lack of regard for data integrity such as discrepancies. in record information that are
noted but no corrective action is taken. - Failure to address threats to privacy and personal health information.
- Inappropriate access of PHI without a need to know.
- Failure to keep informed of emerging developments and issues.
- Failure to recognize and use technology to advance the profession.
- Failure to engage in policy discussion that impact healthcare delivery.
- Failure to recall that the patient is their primary focus.
- Failure to actively participate in the selection use, and/or evaluation of technology
that has the potential to improve healthcare.
Bioethical Standards
Autonomy, freedom, veracity, privacy, beneficence, and fidelity are maximally appropriate to the health care setting.
1 MULTIPLE CHOICE OPTION
Virtue Ethics Approach
Moral behavior stems from personal virtues.
1 MULTIPLE CHOICE OPTION
How can mHealth reduce Mortality Rates
Monitor vital signs including respiratory rate, bp, hr, spo2, and temp which can send the wrist monitors that can
info to an EHR which can calculate a wellness index based on the stats and a 0-5 scale (below 2.9 is good but above 3.0 is potentially bad).
ICD10-CM (Clinical Modification)
An Alphanumeric coding system to classify and code diagnoses, symptoms, and procedures maintained by World Health Organization (WHO).
3 MULTIPLE CHOICE OPTIONS
Current Procedural Technology (CPT) codes
Billing codes for medical, surgical and diagnostic services in a 5-digit format.
3 MULTIPLE CHOICE OPTIONS
Logical Observation Identifiers Names and Codes (LOINC)
Provides names and codes for laboratory test results and other observations. Used for more advanced/detailed coding system.
SNOMED-CT (Systematized Nomenclature of Medicine Clinical Terms)
Systematically organized computer processable collection of medical terms providing codes, terms, synonyms, and definitions used in clinical documentation and reporting. Used for more advanced/detailed coding system.
Diagnostic Related Groups (DRGs)
System to classify diagnoses into similar groups and is used to determine the amount of Medicare payment to a healthcare provider.
3 MULTIPLE CHOICE OPTIONS
Major Diagnostic Category (MDC)
Organizes diagnosis-related groups (DRGs) into mutually exclusive categories, which are loosely based on body systems (e.g., nervous system).
1 MULTIPLE CHOICE OPTION
Evaluation and Management (E/M Codes)
These are listed 1st in the CPT manual b/c they are used by all different specialties. they cover physician services that are performed to determine the best course for pt care used for reimbursement.
3 MULTIPLE CHOICE OPTIONS
FDA (Food and Drug Administration)
Determines whether a mobile application is regulated for medical use.
Mobile Apps (Not Medical Device)
Considered reference material when intention is to provide access to electronic copies of medical textbooks with generic text search capabilities.
1 MULTIPLE CHOICE OPTION
FDA enforces discretion
Apps that provide or facilitate supplemental clinical care, by coaching or prompting and apps that provide easy access to information related to patients’ health conditions or
treatments
2 MULTIPLE CHOICE OPTIONS
POE/CPOE/CDS
Practitioner order entry, Computerized practitioner order entry, Clinical decision support
Medical Decision Making (MDM)
Health care management process done after performing a history and physical examination on a patient that results in a plan of treatment. It is based on establishing one or more diagnosis and/or selecting a management or treatment option, amount of data or complexity of data reviewed, and complication and/or morbidity or mortality.
3 MULTIPLE CHOICE OPTIONS
Medical Billing
The process of generating claim forms that list diagnosis and procedure codes, charges, and patient demographic information for reimbursement purposes
3 MULTIPLE CHOICE OPTIONS
Casuistry
The determination of right and wrong in questions of conduct or conscience by the application of general ethical principles; specious argument.
3 MULTIPLE CHOICE OPTIONS
Firewall
A part of a computer system or network that is designed to block unauthorized access while permitting outward communication.
3 MULTIPLE CHOICE OPTIONS
Antivirus Software
Scans and searches hard drives to prevent, detect, and remove known viruses, adware, and spyware.
Ransomware
A type of malicious software designed to block access to a computer system until a sum of money is paid.
1 MULTIPLE CHOICE OPTION
HIPPA
Health Insurance Portability and Accountability Act of 1996
2 MULTIPLE CHOICE OPTIONS
Patient Protection and Affordable Care Act (ACA)
Act in 2010 intended to improve care and reduce disparities and help reform healthcare.
1 MULTIPLE CHOICE OPTION
Nanotechnology
Science, engineering, and technology that is conducted at the level of the nanoscale.
American Recovery and Reinvestment Act of 2009 (ARRA)
Provided funds to government agencies for improving information-technology systems.
1 MULTIPLE CHOICE OPTION
Accountable-Care Organizations (ACOs)
A group of provider organizations that assumes responsibility for the quality and cost of healthcare delivered to a set population of Medicare patients. Consist of a combination of hospitals, primary-care practitioners, and specialists.
National Prevention Strategy (NPS)
Goal is to transform us from a system of sick care to one based on wellness and prevention. Examples of this use is Healthy People 2020 and USPSTF.