NR599 Final exam Questions And 100% Verified Answers Latest Update (GRADED A+)

NR599 Final exam Questions And 100% Verified Answers Latest Update (GRADED A+) Smart documentation forms - ANSWER-forms that are tailored based on patient data to emphasize data elements pertinent to the patient's conditions and healthcare needs. Order sets, care plans and protocols - ANSWER-Structured approaches to encourage correct and efficient ordering, promote evidence-based best practices, and provide different management recommendations for different patient situations. Parameter guideline - ANSWER-algorithms to promote correct entry of orders and documentation. Critiques and "immediate warnings" - ANSWER-Alerts that are presented just after a user has entered an order, a prescription or a documentation item, to show a potential hazard or a recommendation for further information. Relevant data summaries - ANSWER-A single-patient view that summarizes, organizes and filters a patient's information to highlight important management issues. Multiple monitors - ANSWER-a display of activity among all patients on a care unit, which helps providers prioritize tasks and ensures that important activities are not omitted while providers are multitasking among patients. Predictive and retrospective analytics: - ANSWER-Analytic methods that combine multiple factors using statistical and artificial intelligence techniques to provide risk predictions, stratify patients and measure progress on broad initiatives. "Info" buttons - ANSWER-filtered reference information and knowledge resources within fields or "buttons" where info is provided to the end user in the context of the current data display also referred to as metadata, or "data about data". Expert workup and management advisers - ANSWER-Diagnostic and expert systems that track and advise a patient workup and management of the patient based on evidence-based protocols. Event-triggered alerts - ANSWER-Warnings triggered within the system based on data that alert the clinical user to a new event occurring asynchronously, such as an abnormal lab result. Reminders - ANSWER-Time-triggered events within the system reminding the clinical user of a task needed to be based on predetermined time within the system. clinical transformation - ANSWER-relative to workflow redesign; it is a complete alteration of the clinical environment and should be used cautiously to describe redesign efforts; transformation is defined as "a radical change approach that produces a more responsive organization that is more capable of performing in unstable and changing environments that organizations continue to be faced with"; - this would imply that the manner in which work is carried out and the outcomes achieved are completely different from the prior state. which is not always true when the change involves implementing technology - technology can be used to launch or in conjunction with a clinical transformation initiative but the implementation of technology alone is not considered transformational. - Optimization - ANSWER-- when workflow analysis occurs post implementation, it is often referred to as ________________ - it is the process of moving conditions past their current states and into more efficient and effective methods of performing tasks. -it is considered to be the act, process, or methodology of making something (as a design, system or decision) as fully perfect, functional, and effective as possible. Process Analysis - ANSWER-breaking down the work process into a sequential series of steps that can be examined and assessed to improve effectiveness and efficiency; explains how work takes place, gets done, or how it can be done. Workflow analysis - ANSWER-observation and documentation of workflow to better understand what is happening in the current environment and how it can be altered is referred to as this process. - it requires careful attention to detail and the ability to moderate group discussions, organize concepts, and generate solutions. - this is part of every functional area the INS engages in. Process Map - ANSWER-a typical output of workflow analysis is a visual depiction of the process called a ______ ________; this provides an excellent tool to identify specific steps in the workflow analysis process. - it also provides a vehicle for communication and a tool upon which to build educational material, procedures and policies. - an example is the swim-lane technique Workflow - ANSWER-- a term used to describe the action or execution of a series of tasks in a prescribed sequence. - a progression of steps (tasks, events, interactions) that consitute: 1) a work process 2) involves two or more persons 3) creates and adds value to the organizations activities. - also known as a process or process flow particularly in the context of implementation. Swim-lane technique - ANSWER-because workflow crosses many different care providers, it may be useful to construct the process map using this technique, which uses categories such as functional work groups and roles to visually depict groups of work and to indicate who performs the work. Value-added activity - ANSWER-- is a step that brings the process closer to completion or changes the product or service for the better. - an example is placing a label or name tag on a specimen sample, The name tag is necessary for the laboratory personnel to identify the specimen. Non-Value-Added Activities - ANSWER-does not alter the outcome of a process or product - activities such as handling, moving, and holding. these activities should be evaluated during workflow analysis. -ex: manipulating papers, moving through computer screens, and walking or transporting items. - Tasks that are not necessary for the purpose of compliance or regulatory reasons should be eliminated. Waste - ANSWER-a key underpinning of the lean philosophy is the removal of _____ activities. - Seven forms: 1. overproduction 2. waiting 3. transport 4. inappropriate processing 5. unnecessary inventory 6. unnecessary motion 7. defects Variation - ANSWER-in workflow this is considered the enemy of all good processes and should be eliminated when possible. - this occurs when workers perform the same function in different ways. - it usually arises because of flaws in the way a process was originally designed, lack of knowledge about the process, or inability to execute a process as originally designed due to disruption or disturbances in the workflow Gap analysis - ANSWER-necessary to move from the current state to the future state; - zeros in on the major area most affected by the change--namely, technology. - generates ideas from the group about how best to utilize the technology to transform practice. 6 techniques to overcome resistance to change - ANSWER-1. Education and Communication 2. Participation and Involvement 3. Support and Facilitation 4. Negotiation and Agreement 5. Manipulation and Co-optation 6. Explicit and Implicit Coercion Metrics - ANSWER-provide an understanding about the performance of a process or function. -within clinical technology projects, we identify and collect ___________ about the performance of the technology or capture the level of participation or adoption. -should focus on the variables of time, quality, and costs. - examples include: turnaround times, cycle times, throughput, change-over time, set-up time, system availability, patient satisfaction, and employee satisfaction The goal of workflow analysis - ANSWER-is to create a future-state solution that maximizes the use of technology and eliminates non-value added activities. Health Information exchange/Medical Home model - ANSWER-- requires the NI to visualize how patients move through the entire continuum of care and not just a specific patient care area. - an information technology platform that enables the seamless exchange of important patient information among many providers in a healthcare system. - Typically the pcp (__________ _____________) initiates the collection of patient data, coordinates the care of the patient and helps to maintain the accuracy of such data. - other care providers access the information and add to it as they provide services to patients. Big Data - ANSWER-many different types - including indexes; images and videos; social networks such as Twitter and Facebook; surveillance data; company records including medical records; and data heavy fields such as astronomy; genetics and economics. - the masses of unstructured textually rich data within the EHR are among the prime examples. 5 Uses of Big data in the healthcare industry - ANSWER-1.) Big data explorations and mining techniques to improve decision making. 2.) 360-degree view of the customer, extending the ability to view the healthcare consumer by internal and external data sources. 3.) Security and intelligence to lower risk, detect fraud and monitor cybersecurity. 4.) Operational and clinical analysis to improve healthcare outcomes, quality and cost. 5.) Ability to augment data warehouse capabilities to integrate and use big data to increase efficiencies and improve outcomes. Data mining - ANSWER-a method in computer science that is used to discover patterns and trends within large data sets. Anomaly detection - ANSWER-a data mining technique - pattern detection of data errors or unusual deviations from the norm - ex: detection of disease outbreaks. Association rule learning - ANSWER-a data mining technique that identifies association between variables to predict outcomes. - Identifies relationships in variables associated with an outcome of interest; can be preliminary work to predictive modeling Cluster Analysis - ANSWER-- Discovering groups or structures in the data - a data mining technique that discovers groups or structures in the data, such as clusters of patients who tend to go to one hospital in a given ZIP code or county. Classification - ANSWER-a data mining technique - Generalizing known structure to new data or information - Classifying patient safety errors related to HIT can support taxonomy development Regression Modeling - ANSWER-a data mining technique - Modeling data for prediction or explaining some phenomenon with the least amount of error as possible - often used for predictive analytics such as predicting factors that are associated with mortality or 30-day readmission. Summarization - ANSWER-a data mining technique - business intelligence (BI) tools that aggregate cubic views of data or report certain outcomes. - tools allow an end user to drag and drop and quickly identify patterns and trends in the data based on the summarization of tables. Mobile health (mHealth) - ANSWER-- the use of wireless communication to support efficiency in public health and clinical practice. - generation, aggregation, and dissemination of health information via mobile or wireless device. - 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 applications - ANSWER-to facilitate mHealth; -can be executed on either a mobile platform( i.e. a handheld commercial off the shelf computing platform, with or without wireless connection) or on a web-based software application that is tailored to a mobile platform but is executed on a server Mobile medical applications - ANSWER-- incorporates device software functionality that meets the definition of devices intended to be used as an accessory to a regulated medical device or are software that transforms a mobile platform into a regulated medical device. - these mobile devices may include mobile phones, smartphones, tablet computers, smartwatches and point of care testing (POC). Medical Applications - ANSWER-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. Medical device - ANSWER-"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" FDA regulated devices - ANSWER-An intended use of a mobile app determines whether it meets the definition of a "device" - "intended" use may be shown by labeling claims, advertising materials, or oral or written statements by manufacturers or their representatives. When the intended use of the mobile app is for the diagnosis of disease or other conditions, or the cure, mitigation, treatment, or prevention of disease or is intended to affect the structure or any function of the body of man, the mobile app is a device under section 201h of the FD&C act ; - if a software function is intended for use in performing a medical device function it is a medical device, regardless of the platform on which it runs. ex: mobile apps intended to run on smartphones to analyze and interpret EKG waveforms to detect heart function irregularities would be considered similar to software running on a desktop computer that serves the same function, which is regulated by the FDA. -FDA applies oversight and regulation only to those software applications whose functionality could pose a risk to a patient's safety if the software application were to no function as intended. Examples of regulated medical devices - ANSWER-glucose test system, calculator processing module for clinical use, monitoring spirometer, esophageal stethoscope with electrical conductors, apnea monitor, blood pressure computer, etc. Apps providing access to electronic copies - ANSWER-mobile apps that are intended to provide access to electronic "copies" (e.g. e-books, 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. Examples of apps providing access to electronic copies. - ANSWER-ex: Medical dictionaries, medical textbooks and literature articles such as the physician's desk reference or diagnostic and statistical Manual of Mental Disorders; library of clinical descriptions for disease and conditions, encyclopedia for first-aid and emergency care information; medical abbreviations and definitions; translations of medical terms across multiple languages. Apps for general patient education - ANSWER-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. Examples of mobile apps for general patient education - ANSWER-- 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. - find the closest medical facilities and providers. - provide lists of emergency hotlines and physician/nurse advice lines. - provide and compare costs of drugs and medical products at pharmacies in the user's location. Generic aids or general purpose apps examples - ANSWER-- use a mobile platform as a magnifying glass (but are not specifically intended for medical purposes) - use a mobile platform for recording audio, note-taking, replaying audio with amplifications. - allow patients or healthcare providers to interact through email, web-based platforms, video or other communication mechanisms - provide maps and turn-by-turn directions to medical facilities - allow health care providers to communicate in a secure and protected method (for ex, using a hipaa compliant app to send messages between health care providers in a hospital) - translate unintelligible speech for better clarity. Apps as educational tools - ANSWER-intended for healthcare providers to use as educational tools for medical training or to reinforce training previously received. - may have more functionality than electronic copy of text (e.g. video, interactive diagram), but are not devices because they are intended generally for user education. Examples of apps as educational tools - ANSWER-- medical flashcards with medical images, pictures, graphs - Question/Answer quiz apps - interactive anatomy diagrams or videos - surgical training videos - medical board certification or recertification preparations apps - Games that simulate various cardiac arrest scenarios to train health professionals in advanced CPR skills. Apps automating office operations - ANSWER-mobile apps that automate general office operations in a health care setting. Examples of apps automating office operations - ANSWER-- Determine billing codes like ICD-10 - enables insurance claims data collection and processing and other apps that are similarly administrative in nature. - analyze insurance claims for fraud and abuse. - Perform medical business accounting functions or track and trend billable hours and procedures - Generate reminders for scheduled medical appointments or blood donation appointments - Help patients track, view, and pay medical claims and bills online. - manage shifts for providers manage or schedule hospital rooms or bed-spaces. - provide wait times and electronic check-in for hospital emergency rooms and urgent care facilities. - allow healthcare providers and staff in healthcare settings process payments using HIPAA compliant apps. - track or perform patient satisfaction surveys after an encounter or a clinical visit. - enable individuals to interact with PHR systems or EHR systems. Mobile apps that provide or facilitate supplemental clinical care, by coaching or prompting, to helps patients manage their health in their daily environment - ANSWER-examples include apps that coach patients with conditions such as cardiovascular disease, hypertension, diabetes, or obesity, and promote strategies for maintaining a healthy weight, getting optimal nutrition, exercising and staying fit, managing salt intake, or adhering to pre-determined medication dosing schedules by simple prompting. Mobile apps that provide patients with simple tools to organize and track their health information - ANSWER-apps that provide simple tools for patients with specific conditions or chronic diseases (e.g. obesity, anorexia, arthritis, diabetes, heart disease), to log, track, or trend their events or measurements (e.g. blood pressure measurements, drug intake times, diet, daily routines or emotional state) and share this information with their health care provider as part of a disease-management plan. Mobile apps that provide easy access to information related to patients' health conditions or treatments (beyond providing an electronic "copy" of a medical reference) - ANSWER-- apps that use a patient's diagnosis to provide a clinician with best practice treatment guidelines for common illnesses or conditions such as influenza; - apps that are drug-drug interaction or drug-allergy look-up tools. Mobile apps that are specifically marketed to help patients document, show, or communicate to providers, potential medical conditions - ANSWER-- apps that serve as videoconferencing portals specifically intended for medical use and to enhance communications between patients, healthcare providers, and caregivers. - apps specifically intended for medical uses that utilize the mobile device's built-in camera or a connected camera for purposes of documenting or transmitting pictures (e.g. photos of a patient's skin lesion or wounds) to supplement or augment what would otherwise be a verbal description in a consultation between healthcare providers or between healthcare providers and patients/caregivers. Mobile apps that perform simple calculations routinely used in clinical practice - ANSWER-examples of such general purpose tools include medical calculators for Body Mass Index (BMI), total body water/urea volume of distribution. Mobile apps that enable individuals to interact with PHR and EHR systems - ANSWER-ex include apps that provide patients and providers with mobile access to health records systems or enables them to gain electronic access to health information stored within a PHR or EHR. Mobile apps that meet the definition of Medical Devices Data Systems - ANSWER-ex include apps that are intended to transfer, store, convert format, and display medical device data, without controlling or altering the functions or parameters of any connected medical device. Clinical uses for telehealth technologies & sample clinical applications - ANSWER-1. transmitting images for assessment of diagnosis - ex: transmitting of digital images such as images of wounds 2. Transmitting clinical data for assessment, diagnosis, or disease management. - remote pt monitoring and transmitting pt's objective and subjective clinical data, such as monitoring VS or answers to disease management questions. 3. Providing disease prevention and promotion of good health. - case management provided via smartphone and pt education provided through asthma and weight management programs conducted in schools 4. Using telephonic or video interactive technologies to provide health advice in emergent cases. - performing teletriage in call centers or real-time stroke consultation btwn rural health centers and an academic medical center. 5. Using real-time video - exchanging health services or education live via videoconference. Point-of-care (POC) testing - ANSWER-allows for testing and diagnosis at the pt's side and can be conducted anywhere the patient is, such as at the home, physician office, ambulance or hospital bedside. - this technology allows for quick, on-the-spot testing, with immediately available results that can be downloaded directly into the EHR through. - decreases the risk of error in manually entered results Telehealth - ANSWER-refers to a wide range of health services that are delivered by telecommunications-ready tools, such as the telephone, videophone, and computer. Telehealth encompasses three broad methods of digital care delivery that are "away" from the patient: - ANSWER-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) Knowledge acquisition - ANSWER-involves the telenurse receiving the informationi from the telehealth device via a variety of communication modes - for ex, the telenurse receives the patient's vital signs taken in the home and the patient's response to customized questions, which is transmitted to a central server or website. Knowledge processing - ANSWER-- the result of the telenurse's knowledge acquisition - understanding a set of information and the ways it can be applied to a specific task. - the telenurse assess the patient's vital signs along with subjective data received from the patient as a result of of the customized questions that were asked. - the telenurse then combines this info with the overall pt history and diagnosis to get an up-to-date view of the pt's status and considers where this information fits into the clinical picture being presented for the patient. Knowledge generation - ANSWER-- by using skills and clinical knowledge of the disease process, the telenurse considers all of the data as they apply to the pt and decides the best course of action to take and acts on the data. - the telenurse may then ask a variety of questions to ensure that a complete and accurate decision about next steps for the patient is made. questions might include: - Do i need to gather additional data? - do I need to call the patient? - do I need to call the physician and inquire about a change in the current plan of care? Knowledge dissemination - ANSWER-the telenurse determines how the knowledge will be used and distributed. Various question that were posed in the knowledge generation stage are acted on, including the following possibilities: - calling the doctor - obtaining a change in medication orders. -calling the pt and instructing her in a medication change - reviewing activities that could have led to changes (e.g. eating salty foods) - educating the patient on the disease process, symptoms management, and self- management techniques. Foundation of knowledge Model and Telehealth - ANSWER-the nurse uses various technologies to acquire data; interpret the meaning of the data, thus generating information and knowledge; and then using that knowledge and wisdom to intervene appropriately. At Home Telemonitoring - ANSWER-- the ability to provide better healthcare is the number one benefit of using telehealth. - info collected in the home becomes much more convenient for the pt, and the quality and timeliness of the info is improved dramatically. - this is an enhancement to care - it allows more direct, physical intervention to occur only when it is actually needed. - care is not directed by pre-scheduled appointment or subjective perceptions of condition, but instead can be determined by objective measures of physical status. - with telehealth, care can be delivered at the most appropriate site of care reducing reliance on emergency departments and inpatient facilities. Driving Forces for telehealth - ANSWER-1. Demographics: more individuals with disability/unable to leave home 2. Nursing and healthcare worker shortage: telehealth can enhance job satisfaction 3. Chronic Diseases and conditions: chronic disease limit independence. 4. New, educated consumers: people now more comfortable using technology, want to be more involved in their own care. 5. Excessive costs of healthcare services - telehealth decreases need for in-office visits, can help lower costs of chronic need for health services. telemedicine - ANSWER-The use of medical information exchanged from one site to another via electronic communications to improve patients' health status. telehealth - ANSWER-a term used to encompass a broader definition of remote health care that does not always involve clinical services. ex: videoconferencing, transmission of still images, e-health including patient portals, remote monitoring of vital signs, continuing medical education and nursing call centers. The Health Resources Services Administration description of telehealth - ANSWER-the use of technology to deliver health care, health information, or health education at a distance. - common applications include: teleradiology in which test results are forwarded to another facility for diagnosis; continuing professional education, including presentations by specialists to general practitioners; and home monitoring, a supplement to home visits from nursing professionals. Telehealth - ANSWER-generally used as an umbrella term to describe all of the possible variations of healthcare services that use telecommunications. Can refer to clinical and nonclinical uses of health-related contacts. ANAs Code of Ethics for Nurses - ANSWER-1. Respect for human dignity 2. Respect for individual right to self-determinism 3. Primary commitment is to the patient (individual, family, group or community) 4. Advocacy for the patient 5. Participation in the creation, maintenance, and improvement of healthcare environments 6. Advancing the Profession 7. Collaboration with others to meet health needs 8. Shaping social policy. Issues having an ethical component includes the following: - ANSWER-1. Failure to adopt technology or use it adeptly. 2. Lack of regard for data integrity such as discrepancies. in record information that are noted but no corrective action is taken. 3. Failure to address threats to privacy and personal health information. 4. Inappropriate access of PHI without a need to know. 5. Failure to keep informed of emerging developments and issues. 6. Failure to recognize and use technology to advance the profession. 7. Failure to engage in policy discussion that impact healthcare delivery. 8. Failure to recall that the patient is their primary focus. 9. Failure to actively participate in the selection use, and/or evaluation of technology that has the potential to improve healthcare.