Nursing Informatics

Nursing Informatics Self Study- Six Sigma : Well-selected and -defined improvement projects equal better, faster results

What is Six Sigma?

  • A comprehensive and flexible system for achieving, sustaining and maximizing business success.
  • is uniquely driven by close understanding of customer needs, disciplined use of facts, data, and statistical analysis, and diligent attention to managing, improving, and reinventing business processes.
  • The goal of Six Sigma is to eliminate all defects
  • Six Sigma implies a goal of no more than 3.4 defects per 1 million opportunities

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Nursing Informatics

Nursing Informatics Terminology Self Study: usability, ergonomics, change theory

Usability studies can be used to support IT in a number of ways. Which of the following are reasons to complete these studies in a health care setting? –assesses the adequacy of a design or redesign early in the systems life cycle, helps determine or clarify users’ requirements determination

Usability: the ease with which people can use an interface to achieve a particular goal. issue of human performance during computer interactions for specific tasks within a particular context. which deals with specific issues of human performance during computer interactions for specific tasks within a particular context. usability issues address the efficiency and effectiveness of an application. For example:

  • the ease of learning an application
  • the ease of using an application
  • satisfaction with using
  • efficiency of use
  • error tolerance
  • fit of the system to the task
    • the speed of task completion and errors that occurred during application use when determining which system or application would be best used on a nursing unit.
  • Heuristic Evaluation = discount usability evaluation method: to detect problems early in the design process, when they can be most easily and economically corrected.
  • Formal usability test: use either experimental or observational studies of actual users using the interface to accomplish real-world tasks.

Ergonomics: the design and implementation of equipment, tools, and machines related to human safety, comfort, and convenience. commonly refers to attributes of physical equipment or to principles of arrangement of equipment in the work environment.

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Nursing Informatics

Nursing Informatics Terminology Self Study: Systems Development Life Cycle, Needs Assessment, Analysis Phase, Gap Analysis, Risk Analysis, Risk Management

A systems development life cycle (SDLC) is a frame work for describing the phases of developing information systems.

  • nursing informatics is the nursing specialty practice that “integrates nursing science, computer science, and information science to manage and communicate data, information, knowledge, and wisdom in nursing practice” (ANA 2008).
  • the standards of nursing informatics practice:
    • assessment
    • problem identification
    • outcomes identification
    • planning
    • implementation (coordination of activities, teaching/ promotion/ education, consultation)
    • evaluation
  • The SDLC contains:
    • initiation, analysis, design, implementation, and continuous improvement of support
    • The nurse informatician working on tasks in the design phase of the Systems Development Life Cycle uses the findings of the –Analysis phase as a blue print– the findings and plans developed in the analysis phase provide the guide for the design phase of the SDLC

The informatics specialist is in a unique position to promote the integration of consumer informatics into the mainstream of health care delivery. true statement about the nurse informatics clinical specialist? –the nurse informatics clinical specialist can be part of the life cycle process. — with the increase in health care technology, the incorporation of a nurse informatics specialist can help to provide patients and nurses the tools to understand the use of technology and promote the widespread adoption of consumer informatics.

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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.

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Nursing Informatics

Nursing Informatics Terminology Self Study: GUI, Dashboard, CPT codes, and etc.

As the nurse informatician moves toward implementation of a system, user support becomes paramount. Procedure manuals will be developed that will describe how to perform business tasks while using the system.

Gap analysis is used to determine the steps required to move from a current state or actual performance or situation to a new one or potential performance or situation, and the “gap” between the two that requires action or resources. Steps to gap analysis include:

  • assessing the current situation and listing important factors, such as performance levels, costs, staffing, and satisfaction, and all processes
  • identifying the current outcomes of processes
  • identifying the target outcomes for projected processes
  • outlining the process required to achieve target outcomes
  • identifying the gaps that are present
  • identifying resources and methods to close the gaps

While performance appraisal is sometimes prompted by disciplinary action, this is not usually the case, and while the actual review of the performance appraisal may be scheduled and the time in which an individual should reach a goal limited, generally performance appraisal should be an ongoing process that continues from one review period to another (usually annually) in order to provide feedback to the individual and help the individual reach goals.

The GUI (graphical user interface) facilitates interaction between the user and the computer. The user interface is the means by which the individual interacts with the computer. Provided by Microsoft Windows, the GUI provides a means of navigating within the computer environment. The GUI is part of the computer operating system. It is the “desktop”screen, usually with icons that can be activated by clicking them with a mouse or selecting with a trackball or other device, such as menus, windows, and other standard screen features intended to make using a computer as intuitive as possible. The design of the GUI should be intuitive so that the user can determine what actions to take without written instructions, and thus decreasing the amount of time required to learn new programs and eliminate the need to memorize commands.

A dashboard (also called a digital dashboard), like the dashboard in a car, is an easy access and read computer program that integrates a variety of performance measures or key indicators into one display (usually with graphs or charts) to provide an overview of an organization. It might include data regarding patient satisfaction, infection rates, financial status, or any other measurement that is important to assess performance. The dashboard provides a running picture of the status of the department or organization at any point in time, and may be updated as desired, such as daily, weekly, or monthly.

  • dashboard display
    • is intended to piece all of relevant information together from various systems on one screen
    • reflect real-time data
    • bring together key performance indicators for business decisions or clinical data from several systems into clinical dashboard

The ADA provides disabled persons, including those with mental impairment, access to employment and the community. Employers are only allowed to ask applicants if they need accommodations, not if they have disabilities. Applicants may be asked if they can carry out essential functions of a job, not incidental, and medical examinations can only be required after a job is offered. Accommodations can include alterations in a work station, speech recognition software, screen magnifying software, optical character recognition systems, video captioning, Braille readers and screen readers, adapted keyboards, and on-screen keyboard, TTYs (text telephones), and amplification systems.

CPT codes:

  • developed by the American Medical Association (AMA) in 1966
  • define those licensed to provide services and describe medical and surgical treatments, diagnostics, and procedures.
  • The use of CPT codes is mandated by both CMS and HIPPA to provide a uniform language and to aid research.
  • The code set is copyrighted by the AMA and is continually evaluated and updated annually in October of each year coordination with CMS.
  • These codes are used primarily for billing purposes for insurances (public and private). HHS has designed CPT codes as part of the national standard for electronic health care transactions: (Medicare utilizes an adjusted form of CPT, the HCPCS code. While ICD-9 codes are used to code for procedures, ICD-9 coding is used only for inpatients.
  • 3 categories of CPT
    • Category I: Identify a procedure or services
      • evaluation and management
      • anesthesiology
      • surgery
      • radiology
      • pathology and laboratory
      • medicine
    • Category II: Identify performance measures, including diagnostic procedures
    • Category III: Identify temporary codes for technology and data collection
  • The HCPCS: developed to covered the CPT coded services and other services, such as DME, supplies, drugs, or ambulance services.
    • is in 2 levels
      • level I: same as CPT codes
      • level II: more extensively for supplies, equipment, and auxilliary services not normally passing through a physician’s office.

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