Basics of nursing informatics
- 2. NETIQUETTE
- 3. NETIQUETTE: APPROPRIATE ONLINE BEHAVIOUR ● ETIQUETTE has to do with politeness and civility - with rules for getting along so that people won’t get upset or suffer hurt feelings ● fine dining - which fork to use. ● NETIQUETTE or “network etiquette” - appropriate online behavior ● Generally; two basic rules: • Don’t waste people’s time • don’t say anything to a person online that you wouldn’t say to his or her face
- 4. SOME SPECIFIC RULES (Williams & Sawyer) ● Consult FAQs: Most online groups post FAQs (frequently asked questions) that explain expected norms of online behavior for a particular group. ● Avoid flaming: a form of speech unique to online communication ● flaming is writing an online message that uses derogatory, obscene, or inappropriate language. ● is a form of public humiliation inflected on people who have failed to read instructions/or have not observed rules
- 5. LEGAL IMPLICATIONS Republic Act 9262 “Antiviolence against Women and Children An Act defining violence against women and their children, providing for protective measures for victims, prescribing penalties therefore and other purposes. Republic Act 10175 “Cybercrime Prevention Act of 2012” An Act Defining cybercrime, providing for the prevention, investigation, suppression and the imposition of penalties therefore and for other purposes Republic Act 10627 “Anti-Bullying Act of 2013” An Act requiring all Elementary and Secondary School to Adopt Policies to prevent and address the acts of bullying in their institutions
- 6. - Don’t SHOUT. Use of all-capital letters is considered the equivalent of SHOUTING. (capitalize words sparingly only when it is required for emphasis) - Be careful with jokes. In email subtle are often lost, so jokes may be taken as insults or criticism.
- 7. - Avoid sloppiness, but avoid criticizing other’s sloppiness. avoid spelling, punctuation, and grammatical errors- But don’t criticize those same errors in other’s messages. ● Don’t send huge file attachments, unless requested: If file attachments are too large, use an application such as WinZip or Stuffit to reduce file sizes before attaching them ● When replying, quote only the relevant portion.
- 8. ● If replying to an important matter in a long email posting, don’t send back the entire message. ● Don’t over forward. Don’t automatically forward emails to your friends without checking if the contents are true and appropriate.
- 11. Nursing Informatics (Healthcare Information and Management Systems Society (HIMSS), 2017) A specialty in the nursing profession It integrates nursing science with multiple information management and analytical sciences to identify, define, manage, and communicate data, information, knowledge, and wisdom in nursing practice. NI supports nurses, consumers, patients, the interprofessional healthcare team, and other stakeholders in their decision-making in all roles and settings to achieve desired outcomes. This support is achieved through the use of information structures, information processes, and information technology.
- 12. Nurse Informaticians (American Medical Informatics Association, 2017) Developers of communication and information technologies, Educated, Researchers, Chief Nursing Officers, Chief Information Officers, Software Engineers, Implementation Consultants, Policy Developers, And Business Owners,
- 13. Validity of Sources (Evener, 2017), (Georgetown University Library, 2017), (The University of Edinburgh, 2017) Evaluating validity of websites for relevant and appropriate health information Who wrote/sponsored/published the site? When was the site last updated/copyrighted? What links connect the site? Who is the website trying to reach? What is the site’s domain? Where is the site getting its information? A A A O C Rule
- 14. AAAOC Rule Audience Check on the websites’ intended audience Scholarly audience or experts General public or novices Evaluating on the site’s relevance to one’s phenomenon of interest
- 15. AAAOC Rule Authority The author should be found on the website Is he recognizable as an expert in the field of interest Check his/her qualifications, references Is he/she affiliated with an academic institution or credible organization?
- 16. AAAOC Rule Accuracy Is it free from spelling errors? Is the text well-written and grammatically correct? Has the content been through an editing process or been peer reviewed? Are the sources cited reliable and can they be verified elsewhere?
- 17. AAAOC Rule Objectivity Is the information covered fact, opinion, or propaganda? Are other points of view explored? Is it a personal website? Does it express personal opinions? Does the author present objective arguments or make it clear when he is expressing biased opinions?
- 18. AAAOC Rule Currency Is the information up-to-date? How frequently is it updated? Is their an indication of when it was published?
- 19. The URL Uniform Resource Locator Domain Published by .ac.uk A UK university .gov.ph The PH government .edu.ph A PH university .org Used by organizations
- 20. Steps in Searching Databases ( The University of Edinburgh, 2017) Principles in searching electronic databases 5 Principles to effectively search relevant information 1. Choose effective search terms (keywords) 2. Use the advanced search option (if one is available) 3. Use Boolean operators 4. Use truncation 5. Use the thesaurus
- 21. Choose effective search terms (keywords) Keywords Consider all the possible words/phrases which describe your topic. E.g. ‘teenagers’, ‘young people’ Consider alternative spellings. E.g. color – colour Consider alternative terminology. Walkway-pavement Expand acronyms. TV-Television
- 22. Use the advanced search option (if one is available) Advanced search
- 24. Use Boolean operators The use of AND, OR, NOT & Parentheses Allows one to create very sophisticated search strategies Saves time and effort by eliminating inappropriate hits that must be scanned before discarding Can greatly reduce or expand the amount of records returned. Focuses searches for more ‘on-target’
- 25. Use Boolean operators AND NARROWS THE SEARCH Requires both terms to be in each item returned E.g. Nursing and informatics (informatics in the nursing profession, role of informatics in nursing)
- 26. Use Boolean operators OR BROADENS THE SEARCH Either term or both will be in the returned document E.g. Ecology or pollution (documents containing the world ecology (but not pollution) as well as documents containing the word pollution (but not ecology) as well as documents with ecology and pollution in either order or number of uses
- 27. Use Boolean operators NOT RETRIEVES RECORDS CONTAINING ONE TERM and EXCLUDES RECORDS CONTAINING THE UNWANTED TERM Reduces the number of references and makes the search more specific. E.g. Mexico and NOT city (contains New Mexico; the nation of Mexico; US-Mexico trade but does not return Mexico city
- 28. Use Boolean operators PARENTHESES ( ) Using the ( ) to enclose search strategies will customize your results to more accurately reflect your topic. Search engines deal with search statements within the parentheses first, then apply any statements that are not enclosed E.g. (smoking or tobacco) and cancer – returns articles containing: smoking and cancer; tobacco and cancer smoking; cancer, and tobacco; but does not return smoking or tobacco when cancer is not mentioned
- 29. Use truncation Truncation Search terms may have variant endings, e.g. nursing, nurse, nursery, nursed E.g. ‘nurs*’ – will yield nurses, nurse, nursing Common truncation symbols are: $ * ? #
- 30. Use the thesaurus Thesaurus Many database use a thesaurus (a controlled vocabulary), to ensure that items on a particular topic have standard search terms assigned to them
- 31. Health information technology (HIT) • is information technology applied to health and health care. It supports health information management across computerized systems and the secure exchange of health information between consumers, providers, payers, and quality monitors.
- 32. Health IT (health information technology) • is the area of IT involving the design, development, creation, use and maintenance of information systems for the healthcare industry. • Automated and interoperable healthcare information systems are expected to improve medical care, lower costs, increase efficiency, reduce error and improve patient satisfaction, while also optimizing reimbursement for ambulatory and inpatient healthcare providers.
- 33. Types of health information technology • The electronic health record (EHR) is the central component of the health IT infrastructure. An EHR or electronic medical record is a person's official, digital health record and is shared among multiple healthcare providers and agencies. • Implementations of EHR systems have increased dramatically in the past few years since the inception of the HITECH Act in 2009, which introduced the EHR meaningful use program.
- 34. HL7 International ( HL7 – Health Level Seven) • HL7 International(Health Level Seven) has developed and promulgated several popular standards, most recently FHIR (Fast Health Interoperability Resources).
- 35. Nursing Informatics andTechnology Electronic Health Records and Electronic Medical Records
- 36. What is an Electronic Health Record? An electronic health record (EHR) is a digital version of a patient’s paper chart. EHRs are real-time, patient-centered records that make information available instantly and securely to authorized users.
- 37. EHRs can: Contain a patient’s medical history, diagnoses, medications, treatment plans, immunization dates, allergies, radiology images, and laboratory and test results Allow access to evidence-based tools that providers can use to make decisions about a patient’s care Automate and streamline provider workflow
- 41. ACROSS BORDERS One of the key features of an EHR is that health information can be created and managed by authorized providers in a digital format capable of being shared with other providers across more than one health care organization.
- 42. EHRs are built to share information with other health care providers and organizations – such as laboratories, specialists, medical imaging facilities, pharmacies, emergency facilities, and school and workplace clinics – so they contain information from all clinicians involved in a patient’s care.
- 43. What information does an electronic health record (EHR) contain? An electronic health record (EHR) contains patient health information, such as: Administrative and billing data Patient demographics Progress notes Vital signs Medical histories
- 44. Diagnoses Medications Immunization dates Allergies Radiology images Lab and test results
- 45. Advantages of EHRs: EHRs help providers better manage care for patients and provide better health care by: Providing accurate, up-to-date, and complete information about patients at the point of care Enabling quick access to patient records for more coordinated, efficient care Securely sharing electronic information with patients and other clinicians Helping providers more effectively diagnose patients, reduce medical errors, and provide safer care
- 46. Improving patient and provider interaction and communication, as well as health care convenience Enabling safer, more reliable prescribing Helping promote legible, complete documentation and accurate, streamlined coding and billing Enhancing privacy and security of patient data
- 47. Helping providers improve productivity and work-life balance Enabling providers to improve efficiency and meet their business goals Reducing costs through decreased paperwork, improved safety, reduced duplication of testing, and improved health.
- 48. Privacy Concerns Privacy concerns in healthcare apply to both paper and electronic records. According to the Los Angeles Times, roughly 150 people (from doctors and nurses to technicians and billing clerks) have access to at least part of a patient's records during a hospitalization, and 600,000 payers, providers and other entities that handle providers' billing data have some access also.
- 49. PHI and HIPAA Act of 2009 Protected Health Information (PHI) and its management is addressed under the Health Insurance Portability and Accountability Act (HIPAA) as well as many local laws. The HIPAA protects a patient's information; the information that is protected under this act are: information doctors and nurses input into the electronic medical record, conversations between a doctor and a patient that may have been recorded, as well as billing information.
- 50. Clinical Decision Support Systems
- 51. What is CDDS? A clinical decision support system (CDSS) is a health information technology system that is designed to provide physicians and other health professionals with clinical decision support (CDS), that is, assistance with clinical decision-making tasks.
- 52. Physicians, nurses and other healthcare professionals use a CDSS to prepare a diagnosis and to review the diagnosis as a means of improving the final result.
- 53. Data mining may be conducted to examine the patient's medical history in conjunction with relevant clinical research. Such analysis can help predict potential events, which can range from drug interactions to disease symptoms.
- 54. Some physicians prefer to avoid over- consulting their CDSS, instead relying on their professional experience to determine the best course of care.
- 56. There are two main types of CDSS: Knowledge-based Non-knowledge-based
- 57. Knowledge based applies rules to patient data using an inference engine and displays the results to the end user Non-knowledge based rely on machine learning to analyze clinical data
- 58. Knowledge-based The knowledge base contains the rules and associations of compiled data which most often take the form of IF-THEN rules. If this was a system for determining drug interactions, then a rule might be that IF drug X is taken AND drug Y is taken THEN alert user.
- 59. Non-knowledge-based CDSS CDSSs that do not use a knowledge base use a form of artificial intelligence called machine learning, which allow computers to learn from past experiences and/or find patterns in clinical data.
- 60. There are pros and cons to implementing clinical decision support systems. The foremost challenge is that a CDSS must be integrated with a healthcare organization's clinical workflow, which is often already complex. Some clinical decision support systems are standalone products that lack interoperability with reporting and electronic health record (EHR) software.
- 61. Current trends and applications of Nursing Informatics In Nursing Education, In Evidence Based Practice and in Healthcare Consumerism
- 62. Current trends and applications of Nursing Informatics in Nursing Education •U.S. Boards of Nursing and the Use of High-Fidelity Patient Simulators in Nursing Education •High-fidelity patient simulation is becoming an essential component of pre licensure nursing education. •Such findings have implications for alterations in the pre licensure nursing curriculum that could examine patient safety and quality concerns addressed by the public and leading health and nursing organizations.
- 64. High-fidelity patient simulation with Nursing Instructors
- 65. RealSpine - an Innovation
- 66. • At the International Congress on Nursing Informatics in June 2012, the president of the Canadian Nursing Informatics Association shared that a current demand for more nurses in the health informatics field continues to emerge, especially since the majority of informatics roles are not filled by nurses. • Many individuals employed in health informatics today have a Bachelor’s and/or a Master’s in Information Technology and Health Information Management. Many health organizations are incorporating informatics roles in their IT departments however they are doing this without the clinical knowledge. • Across Canada there is significant restructuring with some provinces growing informatics and others decreasing it (M. Kennedy, personal communication, June 29, 2012) . • The positions that nurses hold in informatics are varied within jurisdictions across Canada. Some of the current nursing informatics roles focus on:
- 67. • Clinical expertise • Embedding clinical information into systems • Change management • Workflow • Education • Research • Administration (analysis, decision support, recording) Please view the following video to learn more about current nursing informatics roles and responsibilities.
- 68. Implementing and Upgrading Clinical Information System: Current Hospital Based MIS (Management Information System) • The Clinical Information System (CIS) Provide nurses knowledge of many aspects organized for effective and efficient healthcare delivery. • Assists clinicians with data necessary for decision-making and problem solving • Must serve the organization and the patient in much the same way an efficient healthcare delivery system involves all appropriate departments in establishing healthcare delivery processes • Major CIS requirement for nursing are: • Administer a nursing department • Assist the management of nursing practice • Assist nursing education • Support nursing research
- 69. References The University of Edinburgh. (2017). Help searching Library databases & online resources. Retrieved from The University of Edinburgh: http://www.ed.ac.uk/information-services/library-museum-gallery/finding-resources/library-databases/databases- overview/databases-search Alliant Libraries. (2017). What is a Boolean Operator? Retrieved from Alliant Libraries: https://library.alliant.edu/screens/boolean.pdf American Medical Informatics Association. (2017). Nursing Informatics. Retrieved from American Medical Informatics Association: https://www.amia.org/programs/working-groups/nursing-informatics Evener, J. (2017). University of St. Augustine for Health Sciences. Retrieved from Criteria for Evaluating the Accuracy/Validity of a Website: http://usa-document.com/lb/Evaluating%20Websites.pdf Georgetown University Library. (2017). Evaluating Internet Resources. Retrieved from Georgetown University Library: http://www.library.georgetown.edu/tutorials/research-guides/evaluating-internet-content Healthcare Information and Management Systems Society (HIMSS). (2017). What is Nursing Informatics? Retrieved from Healthcare Information and Management Systems Society: http://www.himss.org/what-nursing-informatics The University of Edinburgh. (2017). The University of Edinburgh. Retrieved from How to evaluate website content: http://www.ed.ac.uk/information-services/library-museum-gallery/finding-resources/library-databases/databases- overview/evaluating-websites