NR 599 Final Exam Study Guide

Ethical Decision Making - -Process that requires striking a balance between science and morality. -Making informed choices about ethical dilemmas based on a set of standards differentiating right from wrong. Nonmaleficience: "Do no harm" Accountability - the fact or condition of being accountable (required or expected to justify actions or decisions); responsibility (having an obligation to do something, or having control over or care for someone, as part of one's job or role). Ethical use of social networking applications - Nurses must-- exercise judicious use of social media to protect their patients' rights.- understand their obligation to their chosen profession, particularly as it relates to personal behavior and the perceptions of their image as portrayed through social media.- be mindful that once communication is written and posted on the internet, there is no way to retract what is written; it is a permanent record that can be tracked, even if the post is deleted. Casuistry - - A case-based ethical reasoning method that analyzes the facts of a case in a sound, logical, and ordered or structured manner.- The casuist approach to ethical decision making grew out of the call for more concrete methods of examining ethical dilemmas. Security Risk Assessment - An evaluation of threats and vulnerabilities of a network and PHI. (breaches in HIPPA requirements) 5 security risk steps - 1) REVIEWING THE EXISTING SECURITY OF PHI 2) IDENTIFYING THREATS AND VULNERABILITIES 3) ASSESSING RISKS FOR LIKELIHOOD AND IMPACT 4) MITIGATING SECURITY RISK 5) MONITORING RESULTS (ONC, ND) Risk Mitigation - -A risk response strategy whereby the project team acts to reduce the probability of occurrence or impact of a risk. -the process of reducing risk exposure and minimizing the likelihood of an incident. Ex: Disaster recovery plan 4 types of risk mitigation strategies - Risks to accept — An organization may decide to accept certain risks. Risks to avoid — An organization may seek to eliminate a risk from occurring. Risks to reduce — An organization may seek to reduce the impact of a risk. Risks to transfer — An organization may transfer the risk and its consequences to a third party. American Nurses Association- Code of Ethics for Nurses with Interpretive Statements. - provides specific guidance for ethical decision making and provides a valuable framework that can be used when working with HIT ANA Code of Ethics for Nurses (7) "Ethical decision making" - 1. Respect human dignity 2. Respect individual right to self-determinism 3. Primary commitment to patient (individual, fam, group, community) 4. Advocacy for patients 5. Advancing the profession 6. Collaborating with others to meet health needs 7. Shaping social policy Bioethics - - The study of ethics related to issues that arise in health care. - Takes on relevant ethical problems experienced by healthcare providers in the provision of care to individuals and groups. Fundamental Background of Bioethics (3) - - The nature and needs of humans as living, thinking beings - The purpose and function of the healthcare system in a human society - An increased cultural awareness of human beings' essential moral status Bioethical Standards (6) - Autonomy, freedom, veracity, privacy, beneficence, and fidelity are maximally appropriate to the health care setting. Autonomy - The right to choose for himself or herself; respecting the clients opinions, perspectives, values and beliefs. Freedom - The ability of an individual to act independently, without coercion or constraint in ones choice and action veracity - Being completely truthful with patients; a patients right to truth. privacy - The right to be left alone when you want to be, to have control over your own personal possessions, and not to be observed without your consent Beneficence - Actions performed that contribute to the welfare of others; Action of doing good or right by and for the patient. Fidelity - Right to what has been promised; keeping to one's promise. Telehealth - Use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration. Technologies include videoconferencing, the internet, store-and-forward imaging, streaming media, and terrestrial and wireless communications. Telehealth encompasses three broad methods of digital care delivery that are "away" from the patient: - 1.Telemedicine (stationary scheduled remote diagnostics of health status) 2.Remote management/monitoring/coaching (stationary home or facility based, with scheduled and as-needed remote transmission of health status) 3.Mobile health (mHealth) "community" groups/social media (wearable mobile patient-generated health data with scheduled and as-needed remote transmission of health status)Remote clinical health services mHealth (Mobile Health) - -The practice of medicine and public health supported by mobile devices such as mobile phones, tablets, personal digital assistants and the wireless infrastructure. -The use of wireless communication to support efficiency in public health and clinical practice. "Generation, aggregation, and dissemination of Health Info via mobile and wireless devices" mHealth areas of growth (3) - - examples of areas of growth are: 1. prevention medicine and health promotion can be leveraged through education and awareness applications .2. portable diagnostic devices that allow monitoring of human conditions in clinical settings or offsite locations. 3. applications for data management, training medical personnel and mobile payments. Mobile Medical Applications (Apps) - -The United States Food and Drug Administration (FDA) oversees medical applications and assesses their potential misuse or malfunction in order to reduce risks to the public. -Accessories to a regulated medical device or are a software that transforms a mobile platform into a regulated medical device. -Facilitates mHealth -FDA regulated Medical Application uses: (5) - 1. Apps providing access to electronic copies. 2. Apps for general patient education. 3. Generic aids or general purpose apps. 4. Apps as educational tools. 5. Apps automating office operations. 1. Apps providing access to electronic copies. ex: mobile apps that are intended to provide access to electronic "copies" (e.g. ebooks, audio books) of medical textbooks or other reference materials with generic text search capabilities.NOT considered medical devices because they are intended to be used as reference materials and not for diagnosis, tx, mitigation, cure, prevention of disease or to replace clinical judgment. 2. Apps for general patient education. ex: mobile apps that facilitate patient access to commonly used reference information; These apps can be patient-specific (i.e. filter info to pt-specific characteristics), but are intended for increased patient awareness, education, and empowerment and ultimately to support patient-centered care.- NOT considered a medical device because they are intended generally for pt education. - provide a portal for healthcare providers to distribute educational information (e.g., interactive diagrams, useful links and resources) to their patients regarding their disease, condition, treatment, or up-coming procedures.-help guide patients to ask appropriate questions to their provider relevant to their particular disease, condition, or concern.- provide information about gluten-free food products or restaurants- help match patients with potentially appropriate clinical trials.- provide tutorials or training videos on how to administer first-aid or CPR.- Allow users to input pill shape, color or imprint and display pictures and names of pills that match this description.These are NOT considered mHealth apps for the following: 3. Generic aids or general purpose apps. ex: - use Examples of FDA regulated devices: - glucose test system, calculator processing module for clinical use, monitoring spirometer, esophageal stethoscope with electrical conductors, apnea monitor, blood pressure computer, etc. Medical Devices - "an instrument, apparatus, implement, machine, contrivance, implant, in vitro reagent, or other similar or related articles, including any component, part or accessory that is intended for use in performing a function for diagnosis of disease or other conditions or the cure, mitigation, treatment of prevention of disease" examples: single use devices (i.e. syringes, catheters) implantable (i.e. hip prothesis, pacemakers) imaging (i.e. ultrasound and CT scanners) medical equipment (i.e. anesthesia machines, patient monitors, hemodialysis machines) software (i.e. computer aided diagnostics) Rationale APP is NOT Considered Medical Devices - Apps that are not intended for use in the diagnosis of disease or other conditions, or in the cure, mitigation, treatment, or prevention of disease. -Does NOT require FDA oversight FDA Oversight for Medical Devices - -Regulatory body that oversees mobile apps that are medical devices and whose functionality could pose a risk to a patient's safety if the mobile app were to not function as intended. -Also oversee the cybersecurity management of these devices as well as the hospital network security. Medical Applications/Medical Devices Regulatory Standards - The United States Food and Drug Administration (FDA) oversees medical applications and assesses their potential misuse or malfunction in order to reduce risks to the public. (POC) Point of Care - Testing and diagnosis at the patient's side and can be conducted anywhere the patient is, such as the home, physician office, ambulance, or hospital bedside -- Allows for quick, on-the-spot testing with immediately available results -Use of technology in patient care delivery The most common point-of-care tests are blood glucose monitoring and home pregnancy tests. Other common tests are for hemoglobin, fecal occult blood, rapid strep, as well as prothrombin time/international normalized ratio (PT/INR) for people on the anticoagulant warfarin. "Point of care" in healthcare refers to the location or context where medical care is provided directly to the patient, often at or near the location where the patient is situated. It emphasizes the convenience of delivering medical services and information where patients are present, rather than requiring them to travel to a separate medical facility. Point-of-care settings can include various places, such as: Clinics and Urgent Care Centers: These are healthcare facilities where patients can receive immediate medical attention for non-life-threatening conditions without needing to go to a hospital emergency room. Doctor's Offices: Primary care physicians and specialists often provide medical care directly to patients in their office settings. Hospitals: In addition to providing specialized care, hospitals also offer point-ofcare services for routine check-ups, tests, and minor treatments. Home Healthcare: Medical professionals can provide care to patients in their own homes, especially for individuals with mobility limitations or chronic illnesses. Nursing Homes and Assisted Living Facilities: Residents can receive routine medical care and monitoring without leaving their living environment. Pharmacies: Many pharmacies offer point-of-care services like vaccinations, healt (POC) Point-of-care: Biometric Devices - - Based on technology that can identify a person using their unique facial characteristics, fingerprints, DNA, or iris/retinal pattern.- Example: fingerprint scanner, facial recognition, retina patterns (POC) Point-Of-Care: Biologic Devices - Medical devices derived from biological sources or contains components of living organisms. Designed to interact with biological systems and tissues, serving as diagnostic or therapeutic services. Examples: vaccines, blood or blood components, gene therapy, allergenics Biological Implant- incorporate biological component, tissue, cell, protein. Biological heart valve from animal Bioactive Coatings- medical devices coated with growth factor, enzymes, to ensure tissue integration healing Tissue-engineered products: combne living cell (animal/human) with biocompatible materials to create functional tissue organs ex: skingrafts, bone grafts, tissue scaffolding Cellular therapies: using live cells to treat or replace damaged tissues or cells in body ex: stem cell therapy, genetherapy) Biomaterials- collagens, HA, natural polymers (wound healing, tissue repair, drug delivery) (POC) Point-of-care: Haptic Devices - - Transmit tactile information using sensations such a vibration, touch, and force feedback.. - Example: joysticks, data gloves, to feel a sense of manipulation of control a virtual 3-D object attributes to texture, shape, surface, temp and weight. Haptic devices in healthcare, particularly in a point-of-care setting, refer to technologies that provide tactile feedback or simulate the sense of touch to enhance medical procedures, training, and diagnostics. These devices allow users to interact with virtual or remote environments through the sense of touch, opening up new possibilities in healthcare applications. Here are some ways haptic devices are used in healthcare: 1. **Medical Training and Simulation:** Haptic devices can create realistic touch sensations for medical trainees, allowing them to practice procedures in a virtual environment. Surgeons can practice surgical techniques, medical students can learn to perform physical exams, and clinicians can simulate various medical scenarios. 2. **Surgical Planning:** Surgeons can use haptic feedback to virtually manipulate organs and tissues before an actual surgery. This helps in planning complex procedures and understanding the unique anatomy of each patient. 3. **Robot-Assisted Surgery:** In robot-assisted surgery, haptic devices allow surgeons to remotely control robotic instruments with a sense of touch. Surgeons can feel the resistance, texture, and other tactile cues while performing delicate procedures. 4. **Physical Rehabilitation:** Haptic devices can be used in rehabilitation programs to provide patients with real-time feedback on their movements. This helps patients regain mobility and strength after injuries or surgeries. 5. **Telemedicine and Remote Consultations:** Haptic technology can enable remote physicians to assess patients' conditions more accu mobile technology - Broad range of technologies that enable communication, information access, various functionalities through mobile devices such as smartphones, tablets and wearables. It encompasses hardware, software, applications, and services designed to function on these portable devices. examples: phones, tablets, subnotebook, micro computers, GPS, Mobile technology has revolutionized the healthcare industry by enabling healthcare professionals, patients, and stakeholders to access information, communicate, and manage health-related tasks through mobile devices such as smartphones and tablets. Here are some ways mobile technology is used in healthcare: 1. **Mobile Apps:** Numerous healthcare apps are available for patients and healthcare professionals. These apps can provide tools for tracking health data (such as blood pressure, glucose levels, and fitness), medication reminders, symptom assessment, and more. 2. **Telemedicine and Remote Consultations:** Mobile technology facilitates telehealth services, allowing patients to have virtual consultations with healthcare providers through video calls. This is especially useful for follow-up appointments, minor medical concerns, and reaching patients in remote areas. 3. **Health Records and EHR Access:** Mobile apps allow patients to access their electronic health records (EHRs), view test results, and communicate with their healthcare providers securely. 4. **Medication Management:** Mobile apps can send medication reminders, track medication schedules, and provide information about prescriptions, potential interactions, and side effects. 5. **Health Tracking and Wearables:** Wearable devices like fitness trackers and smartwatches collect health data such as heart rate, steps taken, and sleep patterns. This data can be synced with mobile apps for analysis and sharing with healthcar Human Technology Interface (HTI) - The portion of the assistive technology system with which the user interacts. The hardware (keyboard, monitor) and software anything stored electronically) throguh which the user interacts with any technology (computer, telephone, patient monitors). Anytime a human uses technology some type of hardware and software enables and supports the interaction. ex: Lightswitch, barcode reader, defibrillator, PCA pump, electronic thermometers, telephones and pagers The Human-Technology Interface (HTI) in healthcare refers to the point of interaction between healthcare professionals, patients, and various technological systems within the healthcare environment. It encompasses the design, usability, and interactions that occur between individuals and healthcare technology. In the context of healthcare, an effective HTI is crucial to delivering high-quality care, improving patient outcomes, and enhancing the overall healthcare experience. Here are some key aspects of the Human-Technology Interface in healthcare: 1. **Electronic Health Records (EHRs) and Clinical Systems:** The interface between healthcare professionals and electronic health record systems is a critical HTI. Designing user-friendly interfaces for EHRs and clinical systems ensures that healthcare providers can efficiently access patient information, document care, and make informed clinical decisions. 2. **Medical Devices and Equipment:** Medical devices and equipment, such as infusion pumps, monitors, and diagnostic tools, require intuitive interfaces to enable healthcare professionals to operate them effectively. These interfaces should provide clear information and alerts while minimizing the potential for errors. 3. **Telehealth and Remote Monitoring:** The HTI in telehealth involves providing patients and healthcare providers with user-friendly platforms fo Privacy - Practice of maintaining the security and confidentiality of patient records. Patient Privacy: Patients have the right to keep their health-related information confidential. This includes personal health information, medical history, test results, and treatment plans. Healthcare providers and institutions are responsible for safeguarding patient privacy and ensuring that sensitive medical information is not disclosed without proper authorization. Individuals have the right to control their personal info, autonomy. Credibility - The quality of being trusted and believed in. Credibility in healthcare refers to the quality of being trusted, reliable, and believable in the context of medical information, research, practices, and professionals. In other words, when something or someone is considered credible in healthcare, it means that they are seen as knowledgeable, honest, and capable of providing accurate and trustworthy information or services. Credibility is of paramount importance when it comes to health apps and devices, as they directly impact individuals' health and well-being. Users need to trust that the information, recommendations, and data provided by these apps and devices are accurate, reliable, and safe. Establishing credibility is essential for building user trust, promoting proper usage, and ensuring positive health outcomes. Here are some key factors that contribute to the credibility of health apps and devices: 1. **Scientific Evidence:** Credible health apps and devices should be built on scientific principles and evidence-based practices. The information and recommendations they provide should be supported by reputable medical research and clinical guidelines. 2. **Expert Involvement:** Involvement of qualified healthcare professionals, medical experts, and researchers in the development and validation of health apps and devices lends credibility to the product. Users are more likely to trust advice from credible experts. 3. **Clinical Validation:** Health apps and devices that undergo rigorous clinical validation demonstrate their effectiveness and safety. Clinical trials and studies can provide objective evidence of a product's impact on health outcomes. 4. **Regulatory Compliance:** Health apps and devices that adhere to relevant regulatory standards and guidelines, such as those set by the FDA or CE marking, demonstrat Relevance - The quality of information that indicates the information makes a difference in a decision. Relevance in healthcare refers to the extent to which information, interventions, practices, research, or data are directly applicable and significant to a specific healthcare context or situation. In other words, something is considered relevant in healthcare when it is directly related to the specific needs, goals, or challenges of a particular patient, condition, treatment, or healthcare setting. Relevance (4) Types in Healthcare: - The quality or state of being closely connected or appropriate. Clinical Relevance: Information, research findings, and medical interventions that directly pertain to the diagnosis, treatment, and management of a patient's medical condition. Population Relevance: Healthcare policies, public health initiatives, and interventions that address the specific health needs and challenges of a particular group or population. Evidence Relevance: Scientific research and evidence that directly inform clinical decisions and practice guidelines for specific medical conditions. Data Relevance: Health data and electronic health records that provide accurate and up-to-date information about a patient's medical history, medications, and treatment progress. In healthcare, relevance goes hand-in-hand with patient-centeredness, evidencebased practice, and the goal of providing the most appropriate and effective care for each individual and population. Reliability - The quality of being trustworthy or of performing consistently well. Safety - The condition of being safe from undergoing or causing hurt, injury, or loss. Confidentiality - The act of holding information in confidence, not to be released to unauthorized individuals. The mandate that all personal information be safegaurded by ensuring that access is limited to only those who are authorized to view that information. Confidentiality, is a professional obligation or ethical duty to protect sensitive information that has been entrusted to a specific party. It pertains to the promise to keep certain information confidential and not to disclose it to unauthorized individuals or parties. Confidentiality is often a legal and ethical requirement in healthcare, as well as in other professional and personal settings.