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NCM 200:
NURSING INFORMATICS
Ms. Ma. Joya Jimenea Genzola, RNLecturer
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CHAPTER 24:
INTERNET TOOLS FOR
ADVANCED NURSING PRACTICE
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Three search strategies:
1. name precisely the information being sought
2. use search strings rather than single words
3. enhace search strings by using boolean ornatural language method
Basic and Advanced Internet Search Method
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Government Domain (.gov) Food and Drug Adminitration (www.fda.gov) The National Center for Complementary and
Alternative Medicine
Educational Domain (.edu) Indiana University edu domain Purdue University Indianapolis P450 Drug Interaction
Organizational Domain (.org) [email protected]
Commercial Domains (.com) medscape.com
rxlist.com
Four Internet Domains
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Internet-Available Clinical Practice Tools
Assessment
Diagnosis
TreatmentOutcomes Evaluation
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Nursing Assessment is the first step in the nursingprocess.
Using cardinal signs
Primary care practice
Risk assessments
Assessment
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Examples of web-found health risk calculators:
Body Mass Index Calculator from the National Heart,Lung and Blood Institutes of Health
Cancer Risk tools (Harvard Center for CancerPrevemtion)
Coronary Heart Disease Risk Calculator
Health Risk Calculators form the University ofMaryland Medicine for 24 Health conditions
Assessment
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Classification Systems
Medical Classification of Disease (ICD-WHO,American Medical Association)
Nursing Classifications of Human responses to Illnessand Health (NANDA)
Functional Health and Disability (ICFHD-WHO)
Diagnosis
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I. New Threats to Health
Mass Trauma Preparedness and Response Bioterrorism Agents/Diseases Chemical Agents
Recent Outbreaks and Incidents
II. Disease Directories
Centers for Disease Control and Prevention
III. Examples of Specific Disease Information New York Online Access to Health (www.noah-health.org)
Diagnosis
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IV. Easy Diagnosis Tool
National Institute of Neurological Disorders andStrokes
V. Standardized Diagnosis Terminologies NANDA Diagnoses and Classification (nanda.org)
VI. Unified Medical Language System (UMLS)
National Library of Medicine (NLM UMLS)
Diagnosis
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II. Disease Diagnoses
Disease Terminologies: International Classification ofDisease-9 & 10-CM
Disease Directories: Centers for Disease Control andPrevention
Medical Dictionaries: Newcastle upon Tyne Dept. of
Oncology,(www.noah-health.org)
Diagnosis
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I.Nursing Treatment Home Health Care Classification
Nursing Interventions Classification
II.Calculators
Martindale's Calculators Online Part I: Nutrition Nursing Calculators for Drug Administration purposes
III. Drug Management
Drug Enforcement Agency (www.dea.gov)
IV. Practice and Treatment Guidelines: ProfessionalOrganization Sites
American Diabetes Association, Clinical Recommendations American Cancer Society Guidelines for Screening,
Surveillance and Early Detection of Adenomatous Polypsand Colorectal Cancer
Treatment
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Application Exercise #1
A 73 year old male, retired insurance agent, who smoked between 14-25 cigarettesper day between the ages of 18 and 45 years but never any cigars, asks you what
his chances of developing lung cancer. How would you respond?Additional Information:
Patient had no prior history of cancer. Ate at least 3 fruits and vegetables daily Smoked between 14-25 cigarettes daily between 18-45 years old Never smoked cigars Lived in the city his entire life
Was never exposed to asbestos, carcinogenic chemicals or manufacturingprocess
Has no family history of lung cancerTo answer this patients question, the advanced practice nurse with the patient accessesthe Harvard Center for Cancer Prevention.Access http://www.yourcancerrisk.harvard.edu/ and click on cancer.After arriving the results, print the screen result (click PRINT SCREEN)
Access the same website and avail the cancer risk questionnaire using your personalinformation. Then print the result (click PRINT SCREEN).
SUBMIT THESE TWO RESULTS WITH YOUR NAME, SECTION AND GROUP NUMBERONOR BEFORE MAY 11, 2010.
It is recommended that you pass as a class in a brown envelop labelled with your section.
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I. Nursing Home and Home Healthcare Setting
Minimum Data Set (MDS) site (www.cms.hhs.gov) OASIS
II. Health Plan Outcomes Minnesota Department of Health HEDIS Reports (www.health.state.mn.us) Missouri Department of Health and Senior Services (www.dhss.mo.gov)
III. Office Tools: Online Healthcare Record Audit and PatientSatisfaction Forms
Patient Satisfaction Form (www.geomedics.com)
IV. Short Form Health Survey SF-36.org Medical Outcome Trust
V. Outcomes Measurement: Internet Available Biostatistical andAnalytical Tools
Qualitative Database Software
Outcomes Evaluation
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CHAPTER 25:
INFORMATICS SOLUTION FOREMERGENCY PREPAREDNESS
AND RESPONSE
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A New Definition of Community
Federal Responsibilities for Healthcare Providers
New Visibility of CDC Promotes Informatics Solutions
Changes in the Federal System Affecting
Emergency Preparedness and Response
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To detect outbreaks rapidly and to monitor the health ofthe nation
Facilitate the electronic transfer of appropriate information
from clinical information system to public healthdepartments
Reduce provider burden in the provision of information
Enhance both the timeliness and quality of informationprovided
Purposes of the National Electronic
Disease Surveillance System (NEDSS)
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Decision Support Systems
Syndromic Surveillance
Helping Clinicians Respond
Role of AHRQ in Stimulating New
Informatics Solutions
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Hospital Bioterrorism Preparedness Program
Bioterrorism Training and Curriculum DevelopmentProgram (BTCDP)
Role of HRSA in Promoting Informatics
Educational Solutions
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Competency-Based Learning and Informatics Needs
Informatics and the Emergency Operations Center
Informatics and Volunteerism
The National Health Information Infrastructure (NHII) in
Fighting National Threats
Other Changes Affecting Emergency
Preparedness and Response
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CHAPTER 26:
VENDOR APPLICATIONS
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Nursing is an untapped and underserved resources inprovider organizations
Workflow inefficiencies are not well addressed by existing
solutions
Automation is not a high priority for nursing in theirorganzitaions
Vendors are out of sync with nursing needs
Some new tools and technologies have complicated ratherthan simplified nursing practice
Commonly reported perceptions:
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Vendor product design process driven by engineers,financila system analysts or Mds
Insufficient nursing representatives on vendor executiveand development teams
The HCIT industry's overall woeful lack of adequaterequirements definition, functional specifications and
process analysis
Early focus on automation of the paper chart without a fullunderstanding of underlying nursing process, workflowsand ergonomic challenges
Root causes of poorly designed nursing
applications include:
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Vendors are now expected to deliver Next Generationclinical applications that:
Support multi- and interdisciplinary care
Promote data integrity via data validity checks andembedded tools
Provide ready access to interbal standards
Enable evidence-based care via automation of integratedmultidisciplinary clinical pathways and incorporation ofdecision support mechanisms
Vendor Response
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... continuation
Collect work load management data as byproduct ofclinical documentation, including deriving prospectiveacuity data from clinical documentation
Support productivity management, staffing and budgetingactivities
Support process and outcomes monitoring, management,and continuan improvement via standard reports and
database mining
Support charge capture, supply management, andinventory reconciliation
Support for medical disease and population management
Vendor Response
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CHAPTER 30:
VENDOR APPLICATIONS
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Information Seeking
Communication and Support
Personal Health Records
Decision Support
Disease Management
Application Areas: Consumer Use
of Computers for Health
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Variability in Quality of Information Available to Consumers
Lack of Security in Internet-based Transactions
Uneven Accessibility Across Age, Ethics and Socioeconomic
Groups: The Digital Divide
Educational and Cultural Barriers
Physical and Cognitive Disabilities
Impact on Relationship with Healthcare Providers
Issues in Consumer
Computing for Health
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The Nurse Informatician's Role
in Consumer and Patient Computing
Scope and Standards of Nursing Informatics Practice
Areas of Nursing Expertise that can be Applied toConsumer/Patient Computing
Deep expertise in patient education Cultural diversity in the workforce and a strong ethic of
cultural sensitivity Strong background in both patient- and community focused
research Strong heritage of patient advocacy and patient
empowerment
Special Considerations in Designing Applications for Patientsand Consumers
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The Nurse Informatician's Role
in Consumer and Patient Computing1. Lay versus professional nomenclature
2. General literacy and health literacy
3. Computer literacy and the digital divide
4. Special needs of the elderly
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CHAPTER 31:
DECISION SUPPORT FOR
CONSUMERS
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The Nurse Informatician's Role
in Consumer and Patient ComputingI. Health-Related Decision-Making
II. Shared Decision-Making and Informed Choice
III. Patient Preferences
IV. ComputerTechnology and Patient Decision-Making Assessing Utilities of Health Outcomes Envisioning Treatment Options
Facilitating Data Management Linking Preferences with Treatment Decisions
V. Efficacy of Decision Aids
VI. Points of Decision Support System Intervention
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the end
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