Question 1

The nurse is providing care to a patient newly diagnosed with multiple sclerosis. When the patient expresses the desire to communicate with other people living with the disorder, the nurse refers the patient to which source?

Accepted Answer

Listservs can be used in health care to connect groups of patients with common problems or to send updated information to large groups. E-mail has become a common means of communication but would not be focused on the patient's issues. Social media include online technologies such as Facebook, Twitter, and LinkedIn that allow people to communicate easily by the Internet to share information and resources, but they are more general than listservs. These technologies enable a potentially massive community of participants to collaborate, providing a mechanism for tapping into collective power in ways previously unachievable. A blog is a social medium that is usually maintained by an individual and has regular entries of commentary, descriptions of events, or other material such as graphics or videos. Most blogs are interactive, allowing visitors to leave comments and message each other. Many blogs focus on health care issues.

Question 2

The hospital has recently implemented computer charting. The nurse knows the computerization of nursing practice has what impact?

Accepted Answer

Patient data collected by a nurse and recorded electronically are immediately available to all members of the health care team. The computerization of nursing practice data enables capture, storage, retrieval, organization, processing, and analysis of information. The information can be used to make a diagnosis, plan for care, provide nursing decision support, enhance documentation, and identify nursing care trends and costs. Systems that support data collection at the point of care can directly enhance patient care by decreasing the time spent on documentation, reducing the potential for errors, and supporting improved assessment and data communication. Computers, tablets, or pocket devices used at the bedside for documentation are examples of point-of-care technology.

Question 3

The nurse understands that computerized provider order entry (CPOE) is beneficial for what reason?

Accepted Answer

Computerized provider order entry (CPOE) allows orders to be directly communicated to the appropriate department. CPOE systems ensure legible orders and have the potential to reduce ordering and transcribing errors. Disadvantages of CPOE include workflow issues, provider resistance to new technology, and overdependence on technology (AHRQ, 2012).

Question 4

The nurse realizes that information technology (IT) can be used to increase patient safety in what way?

Accepted Answer

IT can be used to increase patient safety. Errors are analyzed to develop strategies for prevention. Diagnostic test results are available faster to support treatment decisions and avoid redundancy in orders. When technology such as a bar-code medication administration (BCMA) system is used as part of the process of medication administration, fewer errors are made. After signing into the system or scanning his/her identification (ID) badge, the nurse electronically scans the bar codes of the patient ID, the medication administration record (MAR), and the drug to determine that the right patient is getting the right drug and dose at the right time. An alert signals a potential error, and it is the nurse's responsibility to verify all information before administration.

Question 5

Patients frequently seek sources for health information online, and nurses, as advocates, need to be prepared to help patients evaluate online sources. To do this, the nurse asks who sponsors the site, is the author listed, and the author's credentials. The nurse is evaluating what concept?

Accepted Answer

Authority involves knowing who the sponsor or publisher is. Is this a personal page? Where does it come from? Is the author or organization listed? What are the author's credentials? Purpose is determining to focus of the site. Does the site inform? Explain? Share? Disclose? Sell? What is the intended audience? Coverage tries to determine if citations are correct. Is there a balance of text and images? Currency refers to when the site was created. How often is it updated?

Question 6

The home health nurse provides care for a patient with congestive heart failure. Daily the patient weighs himself and takes his own temperature, pulse, respirations, and blood pressure. That information is sent as electronic data to the patient's physician and nurse daily to adjust the plan of care as indicated. The nurse understands this is an example of which concept?

Accepted Answer

Telehealth nursing is the transmission by a nurse of electronic data, images, or audio from a patient's bedside or home to other health providers for the purpose of providing care and improving outcomes. Patients may have telehealth hardware in their homes to provide in-home monitoring and direct reporting to their health care providers. Computerized decision support systems (DSSs) include safe practice alerts and reminders that improve the quality of care. Some DSSs assist in determining a correct diagnosis and choosing an appropriate medication. Computerized provider order entry (CPOE) allows orders to be directly communicated to the appropriate department-diet orders to dietary, medication orders to the pharmacy, laboratory orders to the laboratory. Computers, tablets, or pocket devices used at the bedside for documentation are examples of point-of-care technology. Patient data collected by a nurse and recorded electronically are immediately available to all members of the health care team.

Question 7

The Technology Informatics Guiding Education Reform (TIGER) initiative identified a set of skills needed by all nurses practicing in the 21st century. The nurse identifies the TIGER Vision Pillars include which concepts?

Accepted Answer

The Technology Informatics Guiding Education Reform (TIGER) initiative (2018) identified a set of skills needed by all nurses practicing in the 21st century. The TIGER Vision Pillars include management and leadership, education, communication and collaboration, informatics design, and IT policy and culture. Certification is not one of the pillars.

Question 8

When the nurse manager on a medical-surgical floor has met education and experience requirements in nursing informatics, hospital administration may request the nurse to pursue what additional verification of competence in this area?

Accepted Answer

After meeting the educational and experience requirements, the nurse can receive certification in nursing informatics from the Health Care Information and Management Systems Society (HIMSS) and through the American Nurses Credentialing Center (ANCC). Technical competencies pertain to the use of computers and other technological equipment and the use of a variety of software programs for word processing, spreadsheet and database development, presentation, referencing, and e-mail. Utility competencies address critical thinking and evidence-based practice applications. Nurses who have a utility competency recognize the relevance of nursing data for improving practice and can access multiple information sources for gathering evidence for clinical decision making. Leadership competencies address the ethical and management issues related to using IT in nursing practice, education, research, and administration. Specific leadership competencies include the application of accountability, maintenance of privacy and confidentiality, and quality assurance. Technical, utility, and leadership competencies can be achieved without certification.

Question 9

The nurse knows that computerized provider order entry (CPOE) has which outcome?

Accepted Answer

Computerized provider order entry (CPOE) allows orders to be directly communicated to the appropriate department-diet orders to dietary, medication orders to the pharmacy, laboratory orders to the laboratory. Elimination of an intermediary for order transcription decreases the potential for errors related to the ambiguity of handwritten orders and allows quicker responses by appropriate departments. Legibility and availability of computerized documentation improve provider communication. The Agency for Healthcare Research and Quality (AHRQ) recommends CPOE as one of the safe practices for better health care. CPOE systems ensure legible orders and have the potential to reduce ordering and transcribing errors. Disadvantages of CPOE include workflow issues, provider resistance to new technology, and overdependence on technology (AHRQ, 2017).

Question 10

Nurses working surrounded by computers and mobile IT must develop skills in the use of all available technology. At the same time, it is important for nurses to recognize what fact?

Accepted Answer

Nurses working surrounded by computers and mobile IT must develop skills in the use of all available technology. At the same time, it is important to recognize that the rapid advancement of IT means that the technology in use today may be entirely different tomorrow. Some facilities have computer access at every bedside, and others have mobile computers, sometimes called workstations on wheels (WOWs), that can be taken to each bedside. Nurses using technology as part of patient care need to work within facility policy and HIPAA guidelines. The technology supports bedside and remote charting. Nurses may use a portable device such as a smartphone or tablet computer to access reference materials, including medical information and vast amounts of drug information. Some facilities issue these devices to staff.

Question 11

The nurse can see data relationships, can make judgments based on trends and patterns in the data, is skilled in information management and the use of computer technology, and is able to suggest areas for IT system improvement. The nurse's level of informatics competency can be described by which term?

Accepted Answer

Descriptions of nursing informatics competencies often focus on levels that include beginner, experienced, specialist, and innovator. Beginner skills include computer, information, and web literacy; fundamental skills in information management and computer technology; and the ability to identify and collect relevant data. The nurse at the beginning level may have keyboarding skills, can document in the EHR, and look up medications and other health information on reputable Internet reference sites. The nurse at the experienced level of informatics competencies understands data relationships and makes judgments based on trends and patterns in data, demonstrates skill in information management and the use of computer technology, suggests areas for Internet technology system improvement, relates data posted by others to the nursing assessment, bases the nursing process and clinical decisions on the data, and devises better ways of using data from the EHR. The nurse at the specialist level of competency focuses on information needs for the practice of nursing; integrates and applies information science, computer science, and nursing science; and applies skills in critical thinking, data management, processing, and system development. At the specialist level of competency, the nurse may conduct research based on information trends or patient data, devise applications for computer technology in nursing, or develop new software to enhance nursing care. Nursing informatics innovators conduct research and generate theory. They develop solutions and understand the interdependence of systems, disciplines, and outcomes.

Question 12

Which statement does the nurse recognize as accurate regarding the use of electronic medical records (EMR)?

Accepted Answer

The electronic medical record (EMR), which is the documentation of a single episode of care (i.e., outpatient visit or inpatient stay), becomes a part of the electronic health record (EHR), which is a longitudinal record of care. EHRs are becoming widely used for individual health care encounters and for maintaining patients' health records over long periods. As EHRs become fully implemented, they include provider order entries, progress notes for all disciplines, computerized medication profiles, access to diagnostic test results on a timely basis, decision support systems, and online clinical reminders and alerts.

Question 13

The patient asks the nurse about how to evaluate websites and standards used to evaluate Internet health sites. The nurse appropriately refers the patient to which agency?

Accepted Answer

The Health on the Net Foundation focuses on the promotion and use of reliable online health information. The Computer Ethics Institute (CEI) was founded in 1985 to serve as a forum and resource for identifying, assessing, and responding to ethical issues associated with the advancement of information technologies and to facilitate the recognition of ethics in the development and use of computer technologies. The World Health Organization, the U.S. Food and Drug Administration, and the U.S. Federal Trade Commission are organizations that are consulted on efforts to promote credible online health care information and combat online health fraud.

Question 14

One classification system for nursing informatics competencies uses technical, utility, and leadership categories. The nurse recognizes leadership competencies involve which concept?

Accepted Answer

One classification system for nursing informatics competencies uses technical, utility, and leadership categories. Leadership competencies address the ethical and management issues related to using IT in nursing practice, education, research, and administration. Technical competencies pertain to the use of computers and other technologic equipment and the use of a variety of software programs for word processing, spreadsheet and database development, presentation, referencing, and e-mail. Utility competencies address critical thinking and evidence-based practice applications. Nurses who have a utility competency recognize the relevance of nursing data for improving practice and can access multiple information sources for gathering evidence for clinical decision making.

Question 15

The nurse recognizes the use of telemonitoring offers the opportunity to complete which tasks?

Accepted Answer

The use of telemonitoring offers the opportunity to reduce the cost of health care while improving outcomes and patient satisfaction. Use of health care IT has improved organization, communication, and decision making; reduced duplicate orders, charting time, and paperwork; made medication administration safer; and enhanced information access and administrative functions.

Question 16

While adopting new technology to enhance patient care and safety, nurses can continue to provide what service?

Accepted Answer

While adopting new technology that enhances patient care and safety, it is the nurse's responsibility to continue to provide compassionate care. The spread of IT supports consumer empowerment and self-management of wellness and disease. Consumers can electronically access their own health information, communicate with their health care providers, and seek needed education about health care.

Question 17

The nurse understands that the focus of nursing informatics is which concept?

Accepted Answer

The focus of nursing informatics is not on direct patient care but on how the process of patient care can be improved and patient safety ensured. Documentation time has decreased by using informatics. Different EHRs are used in different facilities.

Question 18

The Computer Ethics Institute has developed guidelines for ethics in the development and use of computer technologies. The nurse knows these guidelines are identified by which term?

Accepted Answer

The Computer Ethics Institute (CEI) was founded in 1985 to serve as a forum and resource for identifying, assessing, and responding to ethical issues associated with the advancement of information technologies and to facilitate the recognition of ethics in the development and use of computer technologies. CEI developed the Ten Commandments of Computer Ethics. The eHealth Code of Ethics, developed by Health Informatics Europe (2005), is "to ensure that people worldwide can confidently and with full understanding of known risks realize the potential of the Internet in managing their own health and the health of those in their care." The Health Insurance Portability and Accountability Act (HIPAA) of 1996 sets the standards on how security and confidentiality of health care information must be maintained. The act also sets the penalties for any breach in security of health care data. The Health on the Net Foundation promotes the use of reliable internet health sites.

Question 19

When technology such as a bar-code medication administration (BCMA) system is used as part of the process of medication administration, fewer errors are made. The nurse knows that the proper procedure when using the BCMA includes which action?

Accepted Answer

When technology such as a BCMA system is used as part of the process of medication administration, fewer errors are made. After signing into the system or scanning his/her ID badge, the nurse electronically scans the bar codes of the patient ID, the MAR, and the drug to determine that the right patient is getting the right drug and dose at the right time. An alert signals a potential error, and it is the nurse's responsibility to verify all information before administration.

Question 20

The nurse knows the integration of nursing, computers, and information science for the management and communication of data, information, knowledge, and wisdom is identified by which term?

Accepted Answer

Informatics is a broad academic field encompassing artificial intelligence, cognitive science, computer science, information science, and social science. Medical informatics refers to informatics related to health care and describes a distinct specialty in the discipline of medicine. Nursing informatics is a specialty area of informatics that addresses the use of health information systems to support nursing practice. The American Nurses Association (ANA, 2015) states that the specialty of nursing informatics integrates nursing computer and information science for the management and communication of data, information, knowledge, and wisdom.

Quiz 15: Nursing Informatics