NURS 360 – Midterm SP22 Study Guide This study guide is not all inclusive but, it is meant to
guide your studying.
gerontology
Chapters 1, 2, 3, 6, 8, 15, and 20
1. Number of preventable adverse events leading to serious harm fell in the approximate range
of _4.4 mili to __8.8 mili cases per year.
2. Health informatics is both a ___________ as well as a(n) ____________?
- Is a discipline and a profession (page 2)
3. The top three uses of the U.S. Army’s telehealth network include all of the following?
- “Behavioral health telehealth makes up 55% of their services, followed by cardiology and
dermatology.” (page 3)
4. What is the main idea of the subsection titled “Why Informatics Is Needed in Healthcare: An
Example”?
-
An interoperable healthcare system that provides clear, concise patient data and
information among institutes is lacking in many facilities, and its presence would greatly
facilitate things such as patient transfers
5. The chapter (Chapter 1) makes the argument for increased automation for such things as
managing supplies, because?
-
Nurses waste time finding equipment
6. What is the primary difference between an open and closed system?
- Open system has a semipermeable boundary and will filter both inputs and outputs
when interacting with the environment (page 15)
- Closed systems are enclosed within an impermeable boundary and do not interact with
the environment
7. The primary characteristics used to analyze an open system?
- Structure: “systems are structured to perform their functions” (page16)
- Purpose: reason for the system’s existence
- Functions: “How will the system achieve its purpose?”
Page 16
8. What is the set of unintended consequences down the line, produced by an initial change?
-
Reverberation is when change is expanded, creating an unintended consequence
“Reverberation is reflected in the intended and unintended consequences of system
change”. Page 18
-
“Change within any part of the system will be reflected across the total system this is
referred to as reverberation”page 18
9. What are the aspects of chaotic systems? Pg 18
-
Bizarre, unpredictable behavior
Dynamic systems
- Output are not proportional to the input (nonlinear)
- Reiterative feedback loop
- A major or minor change in the input can result in a minor or major change to the
output
- Deterministic
- fractural -type patterns
- Emerges from output
- Repeating non regular geometric shapes
- Out of chaos comes order
10. Be able to describes the measurement of information as defined by the Shannon and
Weaver model.
- The amount of information is measured by the extent the message decreases entropy
page 22
- The sender (info source)
- Originator of the message
- Transmitter (encoder)
- Converts the content of the message to a code
- Channel and noise
- What is used to carry the message
- This is accompanied by noise (static) usually
- Not apart of the message
- Receiver (decoder)
- Converts message to format that can be understood
- Destination
- The person who listens to the message
11. Knowledge is the point of convergence across the areas of?
- Evidence based practice, improvement and informatics
12. What two hurdles does the STAR Model address in employing evidence-based practice?
-
The volume and form of knowledge (page 42)
The model articulates a necessary process for reducing the volume and complexity
of research knowledge, evolving one form of knowledge to the next, and
incorporat- ing a broad range of sources of knowledge throughout the EBP process.
the volume of current professional knowledge and the form of knowledge that
healthcare professionals attempt to apply in practice.
13. What is the form of knowledge gained in discovery research?
-
Results from single research studies (page 42)
14. Which type of review is considered the most rigorous?
-
Systematic reviews (page 43)
15.What are the stages of EBP is represented?
-
Translation to guidelines (page 44)
16. Define the electronic health record (EHR).
- “An electronic record of health-related information on an individual that conforms to
nationally recognized interoperability standards and that can be created, managed, and
consulted by authorized clinicians and staff across more than one healthcare
organization.” (page 91)
17. What are the stages of the EMR adoption model developed by Health Information
Management Systems Society (HIMSS)?
Clinical decision making
- Stage 0
- No ancillary systems installed
- Stage 1
- Major ancillary systems installed that include Laboratory, Radiology, and
Pharmacy
- Stage 2
- CDR with Controlled Medical Vocabulary, CDS system; may have document
imaging; health information exchange
- Stage 3
- Clinical documentation to include flow sheets, vitals, nursing notes, eMar; CDS
system (error checking); PACS available outside Radiology
- Stage 4
- See ex CPOE; CDS system (clinical protocols)
- Stage 5
- Full radiology-PACS
- Stage 6
- Physician documentation (structured templates); full CDS system (variance and
compliance); closed loop medication administration (pharmacy-CPOE-barcodeeMar)
- Stage 7
- Complete EMR; CCD transactions to share data; data warehousing in use; data
continuity with emergency department, ambulatory, outpatient; data analytics
(page 94)
18. Which system is recommended as a method to address patient safety and reduce errors
that occur during the actual administration of medicines? (Pg 96)
● Bar Code Medication Administration (BCMA) is a method used to address patient safety
and reduce errors that occur during the actual administration of medicines.
19. Which would be considered a niche application? (Pg 97)
● Specialty or niche applications are software programs created to address the
requirements of specific departments and groups of users.
● A maternity care information system (MCIS), A surgical information system (SIS),
The emergency department information system (EDIS).
20. What is a closed-loop medication management system?
- Revolutionary process that integrates automated and intelligent systems to completely
close the inpatient medication management and administration loop
21. Which government organization manages the largest telehealth program in the United
States?
- Department of Veteran Affairs (page 134)
22. What are the two overarching types of telehealth technologies?
- Asynchronous: store and forward (page 136)
- Example: E-mail teledermatology consultation
- Synchronous: real-time or live (page 134)
- Example: videoconferencing; internet chat
23. The development of telemedicine and telehealth across state lines has been most
hampered by?
- The need to obtain licenses to practice in each state in the network (page 143)
*some states have adopted the Nurses Licensure Compact (NLS) to allows them to work in the
states that joined the legislation*
24. What is the most important element for operationalizing and ensuring telehealth acceptance
by providers?
- training
25. The migration of informatics and telehealth toward uHealth means:
-
Ecosystems of interoperable technologies and services organized to meet global
patients needs in a ubiquitous manner
26. Approximately what percent of the healthcare apps tested included an ability to link the
mobile device to a sensor or other healthcare device?
- 10%
27. Example of the use of mHealth can be facilitated by SMS, the simplest core mobile phone
function?
-
Connecting patients to providers
28.Point-of-care decision support tools contained within a mobile device all rely on?
-
Accurate algorithms and protocols
29. Which is not a major driving force fueling the mHealth movement?
-
An aging society
30. Which is most available throughout Africa?
- Mobile phone service
31. Which examples are natural disasters that could affect IT systems?
- Snowstorm
- Tornado
- Tsunami
- Earthquake
- Flood
- Hurricane
32. Which is an example of healthcare IT physical infrastructure?
- Biomedical devices (page 339)
- batteries
- cabling
- electrical power
- scanners
33. Which system is an example of a core clinical application?
- Electronic health record,electronic medical record, emergency department,
computerized provider order entry (CPOE), clinical documentation, medication
administration record (MAR), surgical was services, and anesthesia information system
(page 340)
34. Which system is an example of an ancillary service application?
- Pharmacy
- Radiology and imaging information system
- Laboratory
Page 98/ Table 20.2 page 340
35. If the planned single system downtime is less than 1 hour in the middle of a Sunday night,
which downtime level should be assigned?
- `Level 1 (table 20.5 Downtime Levels page 343)
- Level 1: only part of the system is down, majority is still accessible less than 1 hr
- Level 2: majority of system is down, little accessibility up to 4 hrs
-
Level 3: multiple systems unavailable greater than 4hrs
Level 4: no accessibility greater than 4 hrs
Level 5: systems need to be rebuilt