NR599 Midterm Review Practice Exam with Answers (96 Solved Questions)

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General principles of Nursing InformaticsVerbalize the importance of health information systems with clinical practice.Have knowledge of types and clinical and administrative uses of health information systems.Ensure confidentiality of protected patient health information.Assure access control in the use of health information systems.Informatics:Science and art of turning data into info.Nursing Informatics ANS:The specialty that integrates nursing science with multiple information andanalytical sciences to identify, define, manage, and communicate data, information, knowledge, andwisdom in nursing practice.oNursing Informatics supports nurses, consumers, patients, the inter-professional healthcare team,and all other stakeholders in their decision making in all roles and settings to achieve desiredoutcomes.o2 Levels NI practice: generalists and informatics-nurse specialists.KnowledgeAwareness and understanding of a set of information and ways that information can be made useful tosupport specific task or arrive at a decisionInformation that’s synthesized so that relationships are identified and formalized.Processed information that helps to clarify or explain some portion in our environment or world that wecan use a as basis for action or upon which we can act.Often affected by assumptions and central theories of a scientific discipline and is derived by discoveringpatterns of relationships between different clusters of information.Answers questions of “why” and “how”Data– uninterpreted items, often referred to as data elements. An example might be a person’s weight.Without additional data elements such as height, age, overall well-being it would be impossible tointerpret the significance of an individual number.Information– a group of data elements that have been organized and processed so that one caninterpret the significance of the data elements.oFor example, height, weight, age, and gender are data elements that can be used to calculate theBMI. The BMI can be used to determine if the individual is underweight, overweight, normalweight or obese.[1]

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Knowledge- is built on a formalization of the relationships and interrelationships between data andinformation. A knowledge base makes it possible to understand that an individual may have a calculatedBMI that is over 30 and not be obese.At this time, several automated decision support systems included a knowledge base and a set of rules forapplying the knowledge base in a specific situation.oFor example, the knowledge base may include the following information. A fever or elevatedtemperature often begins with a chill. At the beginning of the chill the patient’s temperature maybe normal or even sub-normal but in 30 minutes it is likely the patient will have spiked a temp. Arule might read: if a patient complains of chills, then take the patient’s temperature and repeat in30 minutes.WisdomAppropriate use of data, information, and knowledge in making decisions and implementing nursingactions.Guides the nurse in recognizing the situation at hand based on patients’ values, nurse’s experience, andhealthcare knowledge.Implies a form of ethics, or knowing why certain things or procedures should or should not beimplemented in healthcare practice.Includes the ability to integrate data, information, and knowledge with professional values whenmanaging specific human problems.The use of knowledge and experience to heighten common sense and insight so as to exercise soundjudgment in practical matters.Thought to be the highest form of common sense, resulting from accumulated knowledge.Ability to apply viable and valuable knowledge, experience, understanding, and insight while beingprudent and sensible.Appropriate use of knowledge to solve human problems.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, andnursing.The sciences underpinning nursing informatics: Nursing science, information science, and computerscience[2]

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The advent of nursing science, specifically middle-range nursing theories, expanded the discipline ofnursing. Thorough understanding of nursing theory provides a solid foundation for advanced nursingpractice.The importance of using science-based concepts to evaluate and enhance health care delivery andimprove patient outcomes.The Foundation of Knowledge ModelModel that proposes that humans are organic information systems constantly acquiring, processing, andgenerating information or knowledge in both their professional and personal lives.Involves integrating four main kinds of knowledge, which are: knowledge acquisition, knowledgedissemination, knowledge generation and knowledge processing.oKnowledge worker: working with info. And generating info and knowledge as a product.oKnowledge acquirer:Providing convenient and efficient means of capturing and storingknowledge.oKnowledge engineers:Designing developing, implementing, and maintaining knowledge.oKnowledge managers:Capturing and processing collective expertise and distributing it.oKnowledge developers and generators:Changing and evolving knowledge based on the tasks athand and the information available.With time, we begin to transform our experiences and applied knowledge into it highest form knownas...wisdom.Knowledge is a powerful tool and that nurses focus on information as a key building block of knowledge.Computer scienceStudies the theory underpinning information and computation and their implementation in computersystems.Looks at how the human mind works from an information processing perspective.Studies the theoretical foundations of information and computation and their implementation andapplication in computer systems.Study of storage/memory, conversion and transformation, and transfer or transmission of information inmachines.Algorithms are detailed, unambiguous action sequences in the design, efficiency and application ofcomputer systems, whereas practical implementation problems deal with the software and hardware.[3]

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Facilitates the acquisition and manipulation of data and information by nurses, who can then synthesizethese into evolving knowledge and wisdom base.Cognitive scienceStudy of thought, learning, and mental organization, which draws on aspects of psychology, linguistics,philosophy, and computer modeling.Interdisciplinary field that studies the mind, intelligence, and behavior from an information processingperspective.Information scienceDeals with the retrieval and management of information as well as human-computer interactions.Studies the application and usage of information and knowledge in organizations and the interface orinteraction between people.Concerned with the input, processing, output, and feedback of data and information through technologyintegration with a focus on comprehending the perspective of the stakeholders involved and then applyingIT as needed.An interdisciplinary, people-oriented field that explores and enhances the interchange of information totransform society, communication science, computer science, cognitive science, library science, and thesocial sciences.Encompasses aspect of computer science, cognitive science, social science, communication science, andlibrary science to deal with obtaining, gathering, organizing, manipulating, managing, storing, retrieving,recapturing, disposing of, distributing, and broadcasting information.Studies everything that deals with information and can be defined as the study of ISs.Enables the processing of information.Links people and technologyImpacts information interfaces, influencing how people interact with information and subsequentlydevelop and use knowledge.Standard Terminology (Week 1)Standardized terminologies (STs) contribute to the development of knowledge because they ensure thatall 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.[4]

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As you look at the Foundation of Knowledge model, STs support knowledge acquisition, dissemination,generation, and processing.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 acrosssettings.Guidelines addressed aspects that include content, concepts, and identification of concepts, hierarchy,relationships and formal definitions.Are based upon concepts rather than terms and allow for growth over time.Current Terminology:oNomenclaturerefers to a system of rules and procedures for adding names used in an art orscience, such as nursing.oClassificationsystems that capture categories, which are then used to determine costs oroutcomes but are insufficient in detail for clinical documentation purposes.oTaxonomywhich uses classification according to a predetermined system, with the resultingcatalog used to provide a conceptual framework for discussion, analysis, or information retrieval.oData setwhich refers to a named collection of data consisting of individual information organizedin a prescribed fashion.International Statistical Classification of Diseases and Related Health Problems (ICD) and CurrentProcedural Terminology (CPT) provides a description and a classification of known diseases and injuries.oCollection of morbidity and mortality statisticsoAutomated clinical decision supportoAssignment of codes to medical diagnoses and procedures assoc. with hospital utilization in theUS.It improves communication, supports data reuse, contributes to the further development of nursingknowledge and provides a framework for EHRs.Informatics Competencies (Week 2)Information Literacy:Refers to the use of digital technology to locate, navigate, manage, integrate,evaluate, create, and effectively communicate in a rapidly changing healthcare environment. The mostimportant aspects of information literacy reflect information discovery, retrieval, and delivery as well asthe ability to acquire, process, generate, and disseminate knowledge in ways that help those managingthe knowledge reevaluate and rethink what an individual understands.[5]

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oAbility to identify when information is needed as well as the skills to find, evaluate, and effectivelyuse the sameoEvaluation of online resources for qualityoAble to search literature databases effectivelyComputer LiteracyoBasic familiarity with computer uses and common applicationsoAbility to navigate hyperlinksoAble to set up and use a database to collect and retrieve informationClinical Information ManagementoUses clinical decision making (CDS) and system safeguards to protect patients and protected healthinformation (PHI)oAble to request and evaluate reports for the purpose of informed decision makingoParticipate in the selection, design, and evaluation of clinical information systems and patient-caretechnologiesoUses available technologies to appropriately and effectively communicateHealth literacy (Week 2)Degree to which individuals have the capacity to obtain, process, and understand basic health informationand services needed to make appropriate health decisions.Is dependent on individual and systemic factors: Communication skills of lay persons and professionals.Is a major goal of Healthy People 2010Meaningful Use (Week 3)The American Recovery and Reinvestment Act of 2009 specifies 3 main components of meaningful use:oUse of certified HER in a meaningful manner, such as e-prescribingoUse of certified HER tech. for electronic exchange of health info. to improve quality of health careoUse of certified HER tech. to submit clinical quality and other measures.Defined by the use of certified EHR technology in a meaningful manner (for example electronicprescribing); ensuring that the certified EHR technology connects in a manner that provides for theelectronic exchange of health information to improve the quality of care.Developed as an incentive program to assure that EHRs are used according to standards that achievequality, safety, and efficiency measuresStaged in 3 steps[6]

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