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Nursing Informatics Module 3 5
Nursing Informatics Module 3 5
EVALUATION
Computer can record and store observations,
patient's responses to nursing intervention and
the nurses' evaluation
May also use information from other health
care team members for future actions and In a study conducted, the implementation of clinical
discharge planning pathways in the emergency department and inpatient
May use as basis for re-evaluation for outcomes settings, has been shown to reduce in-hospital
that has not be achieved. complications and improve documentation with no
negative effects on cost or length of stay as compared
to usual care.
CLINICAL PATHWAYS AND GUIDELINES
The AIM of a clinical pathway is to improve the quality
CLINICAL PATHWAYS of care, reduce risks, increase patient satisfaction and
A clinical pathway is a structured plan of care, increase the efficiency in the use of resources.
used to translate current medical evidence into
a framework of recommendations, at times CLINICAL GUIDELINES
tailored to the local healthcare setting. It details Clinical Guidelines are evidenced based
the steps in management and aims to recommendations which are usually generated
standardize care and reduce variation for a from an authority group consisting of experts
specific clinical context (Lawak et. al, 2016). in the field and published regularly (Alexander
A clinical pathway is a method for the patient- et. al., 2019).
care management of a well-defined group of Clinical Guidelines are recommendations that
patients during a well defined period of time. serve as a guide to decisions and provide
A clinical pathway explicitly states the goals criteria for specific practice areas.
and key elements of care based on Evidence- Clinical practice guidelines are informal or
Based Medicine (EBM) guidelines, best practice formal rules or guiding principles that a
and patient expectations by facilitating the healthcare provided uses when determining
communication, coordinating roles and diagnostic tests and treatment strategies for
sequencing the activities of the multidisciplinary individual patients.
care team, patient and their relatives.
Clinical pathways (CPWs) are considered as a
common component in the quest to improve
the quality of health.
CPWs are used to reduce variation, improve
quality of care and maximize the outcomes for
specific groups of patients.
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DIFFERENCE BETWEEN CLINICAL PATHWAY AND ADVANTAGES OF ELECTRONIC JOURNALS
CLINICAL PRACTICE GUIDELINES 1. Contents pages and/or the full text of journals
can be searched to find articles on a certain
Clinical Pathways Clinical Practice subject.
(CP) Guidelines (CPG) 2. Journal articles can be read on your desktop,
Implements Offers explicit laptop or any mobile device.
CPG recommendatio 3. Articles can be emailed to yourself which can
Purpose recommendati ns of clinical downloaded or printed.
on in actual decision-making. 4. The article are always be available, no need to
practice go to a library.
Charts the Usually covers 5. Hypertext links allow you to move to different
care to be specific clinical sections within individual journals or articles
Scope given for the circumstances and can link you to related resources on the
entire clinical Internet.
course 6. e Journals can include images and audio-visual
A group of Governmental material.
local doctors and non- 7. e Journals can be interactive - you can e-mail
Developers the author or editor with your comments.
and nurses governmental
agencies
Institution- Not institution INTEGRATING EVIDENCE BASED PRACTICE
Use
specific specific EVIDENCE-BASED PRACTICE (EBP)
Designed No timelines A core skills necessary to improve nursing
around provided care and enhance the safety of patients.
Timelines The components of EBP include a
specific
timelines systematic and critical evaluation of the
current literature, the nurses' clinical
Expected Do not trace a
expertise and available resources and
intermediate patient's
patients' values and preferences.
patient outcomes
Patient This information is used to make deliberate
outcomes to
progress clinical decisions based on theory and
evaluate a
relevant research to guide patient care.
patient's
progress
USE OF e JOURNALS
An electronic journal is a periodical publication
which is published in electronic format, usually
on the Internet.
An electronic journal are journals which are
published online.
The articles which are published within journals
are written by subject experts, and many
undergo a rigorous quality check called peer
review.
Journal articles are considered as:
reliable
conform to high academic standards
good to use in assignments.
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ELECTRONIC DATABASES TO SUPPORT EBP
PubMed
A free resource supporting the search and
retrieval of biomedical and life sciences
literature with the aim of improving
health–both globally and personally.
contains more than 32 million citations and
abstracts of biomedical literature
Available to the public online since 1996
PubMed was developed and is maintained
by the National Center for Biotechnology
Information (NCBI)
Does not provide full text access to articles
but can be access through link out
functionality
An effective way to use PubMed as a search
engine is through Medical Subject Headings
(MeSH) - a thesarus of controlled-
vocabulary terms
Cumulative Index to Nursing and Allied Health
Literature (CINAHL)
A database that indexes a comprehensive
body of healthcare literature.
It indexes publications from several of the
prominent nursing associations and from
many publishers.
It is used by nurses and other medical
personnel, and social workers, counselors,
and physical therapists.
Provides full text for hundreds of journals
indexed in the CINAHL database
4
MODULE 4 HIPAA LISTS 18 DIFFERENT INFORMATION IDENTIFIERS
POLICIES, GUIDELINES AND LAWS IN NURSING THAT, WHEN PAIRED WITH HEALTH INFORMATION.
INFORMATICS 1. name;
2. address (anything smaller than a state);
Health Insurance Portalibity and Accountability Act of 3. dates (except years) related to an individual --
1996 (HIPAA) birthdate, admission date, etc.;
A federal law that applies to healthcare 4. phone number;
providers, health plans, and healthcare 5. fax number;
clearinghouses that conduct transactions 6. email address;
electronically . 7. Social Security number;
Signed into a law by Pres. Bill Clinton into 1996 8. medical record number;
addressing the need for standards to regulate 9. health plan beneficiary number;
and safeguard health information and making 10. account number;
provisions for health insurance coverage for 11. certificate or license number;
employed persons who change jobs. 12. vehicle identifiers, such as serial numbers,
A law that was developed to : license plate numbers;
protect electronic health information and 13. device identifiers and serial numbers;
implement reasonable and appropriate 14. web URL;
administrative safeguards that established 15. Internet Protocol (IP) address;
the foundation for a covered entity's 16. biometric IDs, such as a fingerprint or voice
security program. print;
protect the privacy and security of certain 17. full-face photographs and other photos of
health information and promote efficiency identifying characteristics; and
in the health care industry through the use 18. any other unique identifying characteristic.
of standardized electronic transaction.
B. SECURITY OF HEALTH DATA
4 KEY ASPECTS OF HIPAA HIPAA requires healthcare organizations to
A. PRIVACY OF HEALTH INFORMATION implement safeguards to ensure any health
HIPAA restricts the individuals who are able to data created, stored, maintained, or
view healthcare data and who healthcare data transmitted is kept secure at all times.
can be shared with without first obtaining Those controls include:
permission from patients. administrative measures
Access to health data is restricted to healthcare physical security for paper records and
employees who need to view health and electronic devices that store health data
personal information in order to provide technical controls such as encryption, anti-
healthcare services and perform any virus software, and firewalls
administration duties.
Permission must be obtained from patients C. NOTIFICATION OF BREACHES OF MEDICAL RECORDS
before their personal health information (PHI) HIPAA requires healthcare organizations and
can be shared with companies for reasons such their business associates to issue notifications
as research and marketing. (60 days) to patients when health data is
Personal/Protected Health Information (PHI) - compromised or stolen.
the demographic information, medical histories, Allows breach victims to take action to protect
test and laboratory results, mental health their identities and reduce the risk of becoming
conditions, insurance information and other a victim of fraud
data that a healthcare professional collects to
identify an individual and determine
appropriate care.
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D. RIGHT TO OBTAIN COPIES OF HEALTHCARE DATA DATA PRIVACY ACT OF 2012
HIPAA gives patients the right to obtain copies
of the health information created or held by Republic Act 10173
healthcare organizations. By obtaining copies of (Data Privacy Act of 2012)
heath data patients can take a much more
active role in their own healthcare. SECTION 1. Short Title. – This Act shall be known as the
By obtaining copies of health information, “Data Privacy Act of 2012” or Republic Act 10173
patients can easily share that information with
any healthcare organizations, including research “AN ACT PROTECTING INDIVIDUAL PERSONAL
organizations. INFORMATION IN INFORMATION AND
One other important reason for obtaining COMMUNICATIONS SYSTEMS IN THE GOVERNMENT
copies of health data is to check health records AND THE PRIVATE SECTOR, CREATING FOR THIS
for errors. PURPOSE A NATIONAL PRIVACY COMMISSION, AND FOR
OTHER PURPOSES “
COMMON ORGANIZATIONAL POLICIES AND PRACTICES
TO COMPLY WITH HIPAA SEC. 2. Declaration of Policy. – It is the policy of the
State to protect the fundamental human right of privacy,
1 Provision of HIPAA training for all employees of communication while ensuring free flow of
2 Employees sign a disclosure contract information to promote innovation and growth. The
acknowledging understanding of privacy State recognizes the vital role of information and
requirements communications technology in nation-building and its
3 Conduct annual HIPAA reviews and updated for inherent obligation to ensure that personal information
employees in information and communications systems in the
4 Require paper documents with PHI to be government and in the private sector are secured and
shredded protected.
5 Limit access to areas holding documents with
PHI (locked doors, cabinets, use of key cards SEC. 4. Scope of DPA
6 Require password to access computers; The DPA applies to the processing of all types of
Passwords needs to be changed regularly personal information and to any natural and
7 Forbid leaving patient information displayed on juridical person, in the country and even abroad,
computers subject to certain qualifications.
8 Forbid sharing of passwords
9 Install firewalls to protect servers THE NATIONAL PRIVACY COMMISSION
10 Forbid access to PHI by caregivers not involved a commission created by this act which is
in care mandated to administer and implement this law
11 Monitor access to electronic medical records for
inappropriate access SEC. 7. Functions of the National Privacy Commission.
To administer and implement the provisions of
12 Limit information on whiteboards to the
this Act,
minimum
To monitor and ensure compliance of the
13 Place general information whiteboards in
country with international standards set for
designated area (least visible to not involved in
data protection
care)
Rule-making, advisory, public education,
investigations and complaints, and enforcement
2
KEY ROLES IN THE DATA PRIVACY ACT
Data Subjects
Refers to an individual whose, sensitive
personal, or privileged information is
processed personal
Personal Information Controller (PIC)
Controls the processing of personal data, or
instructs another to process personal data
on its behalf.
Personal Information Processor (PIP)
Organization or individual whom a personal
information controller may outsource or
instruct the processing of personal data
pertaining to a data subject
Data Protection Officer (DPO)
Responsible for the overall management of
compliance to DPA
National Privacy Commission
Independent body mandated to administer
and implement the DPA of 2012, and to
monitor and ensure compliance of the
country with international standards set for
personal data protection
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ACCESS CONTROL AND SECURITY POLICY Pillar 3: Write your Privacy Management Program and
Personal Records stolen from home of an Privacy Manual
employee – Security Privacy Management Program (PMP)
Viewing of Student Records in Public – Physical A PMP is a holistic approach to privacy and
Security data security protection, important for all
Raffle stubs – Privacy Notice/Storage and agencies, companies or other organization
Disposal Policy involved in processing of personal data.
Universities and Colleges websites with weak The PMP will reduce the risks of privacy
authentication breaches its impact to the organization.
Photocopiers re-sold without wiping the hard Effective implementation of the PMP will
drives help you in identifying the root cause of the
Password hacked/revealed problems in relation to data privacy.
Accidentally sent an email attachment –
Unauthorized Disclosure Pillar 4: Write your Privacy Management Program and
Privacy Manual
Implement your Privacy Data Protection (PDP)
measures
Implementing data privacy governance to carry
out identified security measures.
5
Nursing Informatics – MODULE 5 eHealth
Application of Health Informatics An emerging field of medical informatics which
refers to the organization and delivery of health
CLINICAL PRACTICE services and information using the Web and
APPLICATION OF HEALTH INFORMATICS IN CLINICAL related technology.
PRACTICE Health care initiatives and practice supported
electronic or digital media used usually for
Electronic Health Record patients and family education where
Contains a systematic documentation of a information is communicated electronically.
client's health status and health care in a
secured digital format. APPLICATIONS OF eHealth
A collection of rich data stored a database that Communicating with a patient through a
that possess capacity for customization that can teleconference, email, SMS
be adapted to the needs of the patient, health Recording, retrieving, and mining data in an
care provider and health care organization electronic medical record (EMR/EHR)
which can shared with multiple providers across Providing patient teachings with the aid of
health care setting. electronic tools
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A. PATIENT ADMINISTRATION SYSTEMS
Admission, Discharge, and Transfer B. COMPUTERIZED PROVIDER ENTRY ORDER
Registration -system is used to collect and ENTRY SYSTEMS
store client identification and demographic Refers to the process of providers entering
data that are verified and updated at the and sending treatment instructions –
time of each visit including medication, laboratory, and
Scheduling -allows a health care radiology orders – via a computer
organization to schedule clients and application rather than paper, fax, or
resources efficiently. telephone.
Patient billing or accounts receivable Order entry systems provide major
Utilization management safeguards by ensuring that physician
orders are legible and complete.
B. FINANCIAL MANAGEMENT SYSTEMS C. LABORATORY SYSTEMS
Financial systems manage the expenses and Laboratory Information Systems were one
revenue for providing healthcare. of the first systems ever used in healthcare.
Financial systems often interface to share Systems which includes report on blood,
information with materials management, body fluid and tissue samples along with
staffing, and billing systems to balance the biological specimens that are collected at
financial impact of these resources within the bedside and received in a central
an organization. laboratory.
Accounts payable/Ledger
Materials Management D. RADIOLOGY SYSTEMS
Payroll and Human Resource Systems Radiology Information System (RIS) are
track employee time and attendance, systems schedule, result, and store
credentials, performance evaluations, information as it relates to diagnostic
and payroll compensation information. radiology procedures.
Staff Scheduling systems coordinate The benefit of RIS and picture archiving and
staff, services, equipment, and communication system (PACS) is their
allocation of patient beds. ability to assist in diagnosing and storing
vital patient care support data.
2
FEATURES OF LMS B. CONTENT MANAGEMENT SYSTEMS
Features Functionality Tools A database of learning objects which
1. Synchronous Utilize Chat includes items that are developed for
communication virtual office Whiteboard instructions use.
hours Video Allows course developers to create learning
Online Conference objects such as videos, modules,
tutoring and assessments or any materials used for
training online learning.
sessions Allows course developers to create learning
Real-time objects to develop, modify and create
communicati materials which can be integrated with
on course or learning management systems.
Student-led
learning C. MASSIVE OPEN ONLINE COURSES (MOOC)
Visual A model for delivering free learning content
presentation and usually does not require pre-requisites
of concepts other than internet and internet access.
2. Asynchronous Allows user Discussion MOOC provide participants with course
communication to read and Forums
materials that are usually used in a
reply to Email
traditional education setting such as
others Journal
lectures, videos and study materials.
Peer
MOOCs provide an affordable and flexible
interaction
way to learn for career advancement,
Self or group
reflections
college preparation, eLearning and training.
3. Collaborative Promote Wiki
TYPES OF COURSE DELIVERY
projects group Blogs
collaboratio 1. Hybrid - A combination of online delivery and
development
n on site conduct of classes
Sharing of 2. Web-enhanced - Face to face classes use web-
information based technology to facilitate self-studying
Self- 3. Fully online - All content and communication
reflections are conducted entirely online and no face-to-
4. Testing and Allows Online tests face component
grading formative Self-
and assessment TRENDS IN NURSING INFORMATICS
summative Survey
assessment Polls 1. MOBILE COMPUTING
Informal test A technology that allows transmission of data,
questions voice and video via a computer or any other
Vote on wireless enabled device without having to be
issues connected to a fixed physical link.
5. Social media Allows social Twitter Examples:
integration connections Facebook Personal Digital Assistants (PDAs)
Collaboratio YouTube Smart Phones
n RSS (Real Tablets
Building Simple Laptop computers
community Syndication) Computer on Wheels (COW) or Workstation
Feeds on Wheels (WOW)
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2. WIRELESS PATIENT MONITORING 8. SMART BED
Technologies that enable remote surveillance of Uses advanced medical technology at the point
patient vital functions through the use of of care, connecting important information
internally and externally located patient devices. wirelessly, seamlessly, and directly to care
providers.
3. MOBILE SYSTEM ACCESS Smart beds can monitor a patient's BP,
Mobile technologies that enable remote/virtual temperature, heartbeat, oxygen levels, and
access to current clinical systems such as more, and deliver it to a central node which
Electronic Health Records (EHRs) and Picture can be accessed remotely.
Archiving and Communication System (PACS)
Examples: 9. CREATING VIRTUAL ORGANS FROM MEDICAL
Websites IMAGING (3D Printing)
portal Creating digital copies of patients‘ organs to
mobile apps preplan device implantations and assess if there
is improved function or outcomes in a virtual
4. MEDICAL DEVICES (to include Wearables) environment before a patient enters a cath lab
Mobile and/or wireless enabled technologies or operating room.
that capture and track key care compliance and
disease management area. 10. USE OF HIGH FIDELITY SIMULATION IN NURSING
EDUCATION
5. VIRTUAL CONSULTATION HFS seeks to address the cognitive, affective,
Remote connectivity and multimedia solutions and psychomotor domains of active learning
that enable virtual care consultation, education, (Bastable, 2008)
and therapy It has noted that simulation effectively provides
a safe environment for learning and applying
6. AGING IN PLACE essential skills for nursing practice.
Remote technologies that enable clinically
monitored independent living for aging 11. THE RISE OF AUGMENTED AND VIRTUAL REALITY
populations. IN HEALTHCARE
Examples: Aids in neuro-surgical planning and help
Personal Emergency Response Systems educate patients on what will happen during
(PERS) their procedures in true 3-D using the patient's
Video Consultations own imaging scans.
Motion/Activity monitoring
Fall detection, Aggregation and Transport 12. ROBOTICS (Surgery and Invasive Procedures)
Robotics is the engineering science and
7. PHOTOVOICE technology of robots, and their design,
A qualitative method of community-based manufacture, application, and structural
research that uses photographs to encourage disposition
knowledge and transformative change,
especially among marginalized groups.
Patient-participants are asked to capture and
share photographs that relate to a particular
condition, as well as their sentiments regarding
it.