Nursing Informatics

Nursing Informatics Terminology Self Study: data display, throughput, data mining, RFID, RDBMs, and etc.

When displaying patient data for clinical decision making, which type of display tends to slow cognitive processing of the data? — multiple displays on one screen (distracting and slow cognitive processing of data. in most cases, multiple modes of presentation of data provide the best information)

The effective display or patient data for clinical decision making requires that information be rapidly available with minimal cognitive effort. The decision tree is a common presentation with potential options, consequences, and expected outcomes.

Graphs: line graphs, column graphs, and bar charts (compare variables), pie charts and area charts (illustrate the percentage composition of an entity)

Line graph: used to show data over a period of time. is considered the best type of chart for displaying data over time.

Table: use labeled columns and rows to present statistical or alphabetical data in an organized way. although technically not visual aids, they provide a different way of grouping and presenting analyzed data that an analyst wants to communicate to proposal readers.

Pictorial displays: visual indicators, such as colors, may be used to highlight information, such as abnormal lab results, and pictorial displays can be effective.

According to the Foundation of Knowledge Model, early in a career, a nurse focuses primarily on knowledge –acquisition–

  • according to the Foundation of Knowledge Model (Mastrian), early in a career, a nurse focuses primarily on knowledge acquisition because the nurse has numerous pieces of information that have not yet coalesced into a whole. the new nurse is still dependent on others, such as supervisors or instructors, to generate and disseminate knowledge while the nurse begins to process the information gained. the nurse gains experience and confidence as information is processed. because of the fast changes in information, all nurses must continue to acquire knowledge regardless of experience

Some of the most common techniques used by the nurse informatician to gather requirements include interview, survey, and observation.

Knowledge viability” refers to applications that –provide valid information from a variety of sources–

  • this information should be easy to access, accurate, and timely, and presented in such a way that it can generate further knowledge.
  • Knowledge viability relies on a system that is adaptive and can manage situations and scenarios that are complex.
  • a viable system is able to respond in variety of ways to changing situations in order to survive.

According to system theory (von Bertalanffy), the element of a system that comprises actions that take place in order to transform input is — Throughput–

The 5 elements in a system include (Bertalanffy believed that all of the elements of a system interact in order to achieve goals, and change in any one element will impact the other elements and alter outcomes. )

  • Input: this is what goes into a system in terms of energy or materials (insert substance or data)
  • Throughput: these are the actions that take place in order to transform input, is the activity of the system. it is the system performs process on its inputs to produce outputs, or create some sort of result.
  • Output: this is the result of the interrelationship between input and processes, a result of system process.
  • Evaluation: monitoring success of failure
  • Feedback: this is information that results from the process and can be used to evaluate the end result

 

The role of the nurse informaticists will broaden as the organizations comply with federal legislation. Informaticists are needed to mine data, analyze data aggregates, help in care-process redesign-especially information workflows, and design functional and clinically valid decision support. 

Data mining” refers to –sorting through data to identify patterns and relationships–

  • data mining refers to sorting through data to identify patterns and relationships in large relational databases in order to extract and utilize data. data mining algorithms search data warehouses for patterns using algorithms. It is a knowledge management tool that engages software to uncover interrelationships within large data-sets and naturally leads to the knowledge discovery in databases paradigm.
  • Data mining allow data to be extracted and transformed, stored in a database, accessed, and analyzed by software programs.
  • the data retrieved can be presented in various forms, such as in graphs or tables. the types of relationships that are commonly found in data mining include classes, clusters, associations, and sequential patterns. (associations, sequences, clustering, and trends)
    • associations are patterns that occur together at the same time
    • sequences are patterns of actions that take place over a period of time
    • clustering is the pattern that develops among a group of people
    • trends are patterns that are noticed over a period of time
  • data mining supports sifting through large volumes of data at rapid speeds. Data mining would be inappropriate for hiding confidential information in databases using real values. however, confidentiality of individual records may be protected by hiding confidential information while maintaining underlying aggregate relationships of database.

(retrieved from Systems Analysis and Design, 9th ed. )

 

The rate of suspected adverse drug reaction (ADR) among clients in the maternity unit is climbing. The nurse manager is aware that a World Health Organization (WHO) ADR database analyzes millions of suspected ADR reports in order to uncover new adverse effects. This WHO tracking is an example of — knowledge discovery— knowledge discovery is defined as ” the non-trivial extraction of implicit, unknown, and potentially useful information from data.”

 

The type of personal health record (PHR) that is standalone and not connected to a particular system or electronic health record (EHR) is —untethered–(information may be carried on a smart card, flash card, CD, or DVD. these pose more security risks than tethered PHRs and require more input from the individual to maintain accurate records. )

Tethered: data tied to a particular system and EHR and often web-based. A secure patient portal is provided so the individual can access all or parts of the records.

Networked: data derived from multiple sources in a network rather than one system. this allows for more flexibility

Paper/ personal files: patient-maintained paper records. Families keep paper files or a notebook listing medications, family health histories, and handwritten notes from doctor visits.

The abbreviation RDBMS refers to –relational database management system

  • RDBMS is a system that uses a relational model to manage data.
  • the relational model was developed by Codd and utilizes a table structure with each item within the table having a distinct identifier. a relational database is organized in meaningful tables, which minimizes the repetition of data, which in turn minimizes errors and storage space
  • The tables comprise unique rows (records) and columns (fields).
  • the tables which comprise the relationship can be manipulated and mined to create new tables from the data that are present.

(retrieved from Systems Analysis and Design, 9th ed. )

The type of data that includes pharmacy transactions, required reports, financial information, and demographic information is —aggregate— (most things not included in the clinical record, such as pharmacy transactions, required reports, demographic information, financial information, hazard and safety practices)

Medical/clinical: patient -specific information regarding the patient, diagnosis, treatment, lab findings, consultations, care plans, physician orders, and information related to informed consent and advance directives. The medical record should included records of all procedures, discharge summary, and emergency care records.

The primary purpose of the Nationwide Health Information Network (NwHIN) is to —ensure secure Internet exchange of information through standards, policies, and services. 

  • NwHIN is funded by the office of the National Coordinator for Health Information Technology (ONC)
  • The primary goal is to assist healthcare providers to move from a system of paper medical records to a secure electronic health record that can be easily accessed by various healthcare providers and utilized to evaluate the quality of care.

The most commonly used structured query language (SQL) operation is –query–

Which of the following is technique that can be used for data reduction —clustering

clustering groups of statistical units into clusters (classes) in order to reduce the overall number of statistical units. A cluster is comprised of elements that are similar to each other and dissimilar to other clusters, so clustering is essentially a method of grouping. to determine why the groups are different, then a different data reduction technique, factor analysis, must be used.

According to Part I of the International Medical Informatics Association (IMIA) code of ethics, legitimate infringement refers to –consideration for the greater good of society in regard to an individual’s right to privacy.

Part I, the introduction, of the IMIA code of ethics includes the six primary ethical principles: autonomy, equality and justice, beneficence, non malfeasance, impossibility, and integrity.  General principles in the introduction include:

  • the right to privacy regarding sharing of personal information and control of types of collection, methods of collection, and storage
  • open process of data collection with patient informed
  • security of all data collection and protection from data manipulation
  • right to access of personal data
  • infringement of right to privacy with minimum interference
  • accountability for infringement

A primary difference between radiofrequency identification (RFID) and barcode is the RFID: –has great read range— While the read range for barcode ranges from inches to a few feet, passive ultra-high frequency (UHF) RFID ranges up to 40 feet if readers are fixed or up to 20 feet if readers are handheld. Active RFID has a read range hundreds of feet. Active RFID tags are battery powered and emit a signal while passive RFID tags require activation by a reader.

  • Radio frequency identification (RFID) chip: an identification chip that stores information for retrieval
  • Radio frequency identifier: a reprogrammable chip that communicates with a reader to aid in identifying an object.

 

Terminology facilitates the monitoring of trends and problems of the health of populations, developing clinical decision support, and expanding our knowledge of diseases and treatments and outcomes through research and clinical data mining. Implementing standardized terminology has many benefits to multiple beneficiaries. Beneficiaries include the patient, the provider, the organization, and the healthcare industry in general. using standardized terminologies ensures compliance with standards coming forth for “meaningful use”, quality measures, and interoperability.

 

The mere implementation of an electronic medical record (EMR), does not guarantee that benefits will be achieved. Data integrity can be compromised in three ways: incorrect entry, data tampering, and system failure. In general, data integrity can be improved by implementing security measures, including the use of audit trails, as well as the development of detailed procedures and policies. 

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