Handbook Of Informatics for Nurses and Health Care Professionals

, by Hebda, Toni Lee; Czar, Patricia; Mascara, Cynthia M.

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ISBN: 9780130311023 | 0130311022
Cover: Paperback
Copyright: 1/1/2001

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For undergraduate- and graduate-level courses in Nursing Informatics and/or Healthcare, Nursing Trends and Issues, and Nursing Research.The Handbook serves as an introduction to informatics for students in the healthcare professions, as well as practicing professionals. It is an easy-to-read guide that provides useful information on topics that range from basic computing concepts and electronic communication, data integrity and security, to information system selection and implementation, disaster planning and recovery, telehealth, and Informatics applications for education and research.

Preface

xvii

Acknowledgments

xxi

About the Authors

xxiii

SECTION ONE General Computer Information

(80)

Informatics in the Health Care Professions

(11)

Applications of Nursing Informatics

(2)

Nursing Practice

(1)

Nursing Administration

(1)

Nursing Education

(1)

Nursing Research

(1)

The Current Status of Health Care Delivery

(1)

Benefits of Nursing Informatics for Other Health Care Professionals

(2)

The Role of the Nurse in Information Handling

(2)

The Role of the Nursing Informatics Specialist

(1)

Case Study Exercise

(1)

Summary

(1)

References

(2)

Hardware, Software, and the Roles of Support Personnel

(20)

Hardware

(2)

Input Devices

(1)

Central Processing Unit (CPU)

(1)

Secondary Storage

(1)

Output Devices

(1)

Computer Categories

(1)

Types of Computers

(1)

Peripheral Hardware Items

(2)

Networks

(2)

How Computers Work

(1)

Binary Representation of an Arabic Number

(1)

Selection Criteria

(2)

User Needs

(1)

Physical Constraints

(1)

Measures to Reduce Computer-Related Discomfort

(1)

Software

(1)

Examples of Ergonomic Devices

(1)

Operating Systems

(1)

Application Software

(1)

Utility Programs

(1)

Common Types of PC Software Applications

(1)

Roles of Support Personnel

(3)

Superuser

(1)

Help Desk Technician

(1)

Microcomputer or PC Specialist

(1)

Analyst

(1)

Clinical Liaison

(1)

Programmer

(1)

Network Administrator

(1)

Trainer

(1)

Security Officer

(1)

Chief Information Officer (CIO)

(1)

Webmaster

(1)

Case Study Exercises

(1)

Summary

(1)

References

(2)

Ensuring the Quality of Information

(15)

Example of Coded Data: Employment Status Codes

(1)

Examples of Data and Information

(1)

Data Integrity

(3)

Ensuring Correct Data Collection and Entry

(2)

Data Management

(2)

Data Storage

(1)

Outsourcing Data Management and Storage

(1)

Storage Media

(3)

Data Retrieval

(1)

Data Exchange

(1)

Characteristics of Quality Information

(1)

Threats to Information Quality, Availability, and Confidentiality

(1)

Case Study Exercises

(1)

Summary

(1)

References

(1)

Electronic Communication and the Internet

(33)

The Internet

(2)

E-mail

(1)

E-Mail: Advantages and Disadvantages

(2)

File Transfer

(1)

Informal Rules for E-Mail Use

(1)

The World Wide Web

(1)

The World Wide Web: Advantages and Disadvantages

(3)

Steps in Creating, Posting, and Maintaining a Home Page

(11)

Browsers

(1)

Search Tools

(1)

Listservs

(1)

News Groups

(1)

Bulletin Board Systems

(1)

Access to Health Care Information

(3)

On-Line Publication and Journals

(1)

Marketing Services

(1)

E-health

(2)

Concerns Related to the Use of the Internet

(3)

Firewalls

(1)

Web Security

(1)

Organizational Policy

(1)

Overload

(1)

Viral Contamination

(1)

The Development of Intranets

(1)

Purpose

(1)

Advantages of Intranets

(1)

Problems

(1)

Extranets

(1)

Case Study Exercises

(1)

Summary

(1)

References

(5)

SECTION TWO Health Care Information Systems

(176)

Health Care Information Systems

(17)

Clinical Information Systems

(3)

Nursing Information Systems

(1)

Advantages of a Nursing Information System

(1)

Automation of Traditional Nursing Documentation Methods

(2)

Clinician Information Systems

(1)

Monitoring Systems

(1)

Order Entry Systems

(1)

Features of Monitoring Systems

(4)

Laboratory Systems

(1)

Radiology Systems

(2)

Pharmacy Systems

(1)

Other Clinical Systems

(1)

Using Information Systems to Reduce Medication Errors

(1)

Administrative Systems

(1)

Other Common Clinical Systems

(1)

Administration Information Systems Used in the Hospital Setting

(1)

Decision Support and Expert Systems

(1)

Registration Systems

(1)

Scheduling Systems

(1)

Decision Support and Expert Systems

(2)

Case Study Exercises

(1)

Summary

(1)

References

(2)

Strategic Planning

(15)

The Mission

100

(1)

Mission Statement of St. Francis Medical Center, Pittsburgh, PA

101

(1)

Goals and Objectives

101

(1)

Developing Strategies

102

(1)

Areas of Potential Strategic Planning

102

(1)

Strategic Planning for Information Systems

103

(1)

Steps of the Strategic Planning Process

104

(4)

Identification of Goals and Scope

105

(1)

Scanning the External and Internal Environments

105

(1)

Data Analysis

106

(1)

Identification of Potential Solutions

107

(1)

Selecting a Course of Action

107

(1)

Information Technology Considerations for Strategic Planning

108

(1)

Pros and Cons Associated with the Outsourcing of Services

109

(2)

Implementation

109

(1)

Ongoing Evaluation and Feedback

110

(1)

Measures to Ensure a Positive Outsourcing Experience

111

(1)

Case Study Exercises

111

(1)

Summary

112

(1)

References

112

(2)

Selecting a Health Care Information System

114

(18)

Needs Assessment

115

(4)

The Steering Committee

117

(1)

Consultants

118

(1)

Developing a Common Vision

118

(1)

Qualities of an Effective Consultant

119

(1)

Understanding the Current System

119

(1)

Determining System Requirements

119

(1)

Sample of Criteria Defining ``Musts'' and ``Wants''

120

(4)

System Selection

124

(1)

Additional Sources of Information

125

(1)

Request for Information

125

(1)

System Selection Criteria

125

(4)

Request for Proposal

126

(2)

Evaluation of RFP Responses

128

(1)

Questions to Ask During a Site Visit

129

(1)

Contract Negotiations

130

(1)

Case Study Exercises

130

(1)

Summary

130

(1)

References

131

(1)

System Implementation and Maintenance

132

(13)

System Implementation

133

(1)

Develop an Implementation Committee

133

(1)

Install the System

133

(1)

Characteristics of a Successful Implementation Committee

134

(6)

Analyze Hardware Requirements

136

(1)

Develop Procedures and Documentation

136

(1)

Testing

137

(1)

Provide Training

137

(1)

Go-Live Planning

138

(1)

Common Implementation Pitfalls

139

(1)

Maintenance

140

(2)

User Feedback and Support

140

(1)

System Maintenance

141

(1)

Technical Maintenance

141

(1)

The Information System's Life Cycle

142

(1)

Case Study Exercises

142

(1)

Summary

143

(1)

References

144

(1)

Information Systems Training

145

(18)

Identification of Training Needs

147

(1)

User Needs

147

(1)

Who Might Need Training?

148

(3)

Training Class Content

149

(2)

Class Schedules

151

(1)

Sample Screen Options for Reviewing Lab Results

151

(2)

Hardware and Software Requirements

152

(1)

Training Costs

152

(1)

A Training Center

152

(1)

Training Approaches

153

(1)

Selecting a Training Site: Factors to Consider

153

(1)

Selecting a Training Method: Factors to Consider

154

(1)

Training Approaches: Advantages, Disadvantages, and Tips

155

(3)

Proficiency Testing

157

(1)

Selecting a Trainer: Factors to Consider

158

(1)

Additional Training Considerations

158

(2)

Training Students

159

(1)

Case Study Exercises

160

(1)

Summary

160

(1)

References

161

(2)

Information Security and Confidentiality

163

(22)

Privacy, Confidentiality, and Security

164

(1)

Information System Security

165

(3)

Security Risks

165

(3)

Characteristics of Malicious Programs

168

(1)

Security Mechanisms

168

(1)

Tips for How to Avoid Malicious Programs

169

(1)

Physical Security

169

(1)

Passwords and Other Means of Authentication

169

(1)

Recommendations for Password Selection and Use

170

(2)

Firewalls

171

(1)

Application Security

171

(1)

Antivirus Software

172

(1)

Administrative and Personnel Issues

172

(5)

Level of Access

173

(1)

User Authentication

174

(1)

Personnel Issues

174

(2)

System Security Management

176

(1)

Audit Trails

177

(1)

Handling and Disposal of Confidential Information

177

(3)

Computer Printouts

178

(1)

Faxes

178

(2)

E-mail and the Internet

180

(1)

Web-Based Applications for Health Care

180

(1)

Electronic Storage

180

(1)

Case Study Exercises

180

(1)

Summary

181

(1)

References

182

(3)

Network Integration

185

(12)

Interface Engines

187

(1)

The Benefits of Integration

187

(1)

Interface Engine Benefits

188

(1)

Integration Issues

189

(1)

Factors that Slow Integration

189

(1)

The Need for Integration Standards

190

(2)

Data Dictionary

190

(1)

Master Patient Index

190

(1)

Uniform Language

191

(1)

Data Exchange Standards

191

(1)

Benefits of Integration

192

(1)

Integration Implications for Nursing

193

(1)

Emerging Integration Solutions

194

(1)

Case Study Exercises

194

(1)

Summary

194

(2)

References

196

(1)

The Computer-Based Patient Record

197

(14)

Definitions

198

(1)

Characteristics of the CPR

199

(4)

Benefits of the CPR

203

(1)

Current Status of the CPR

204

(1)

Qualities of a Successful CPR

205

(1)

Impediments to CPR Development

205

(1)

Concerns Associated with the CPR

206

(2)

Data Integrity

207

(1)

Ownership of the Patient Record

207

(1)

Privacy and Confidentiality

207

(1)

Electronic Signature

208

(1)

Smart Cards

208

(1)

Considerations for the Future

208

(1)

Case Study Exercises

209

(1)

Summary

209

(1)

References

210

(1)

Regulatory and Accreditation Issues

211

(15)

Privacy and Confidentiality Issues

212

(1)

Previous Attempts at Legislation to Protect the Privacy of Medical Records

213

(1)

ACLU Principles for Formulating a Health Information Privacy Policy

214

(1)

The Health Insurance Portability and Accountability Act

215

(2)

HIPAA Standards

215

(1)

HIPAA Compliance

216

(1)

Accreditation and Reimbursement Issues

216

(1)

Evaluation of Current Security Measures for HIPAA Compliance

217

(3)

JCAHO

217

(2)

CARF

219

(1)

Reimbursement Issues

219

(1)

Minimum Data Set for Nursing Home Resident Assessment and Care

220

(1)

Special Facility Issues

221

(2)

Geriatric and Long-Term Facilities

222

(1)

Psychiatric Facilities

223

(1)

Case Study Exercises

223

(1)

Summary

224

(1)

References

224

(2)

Community Health Information Networks

226

(9)

Components of a CHIN

227

(2)

Information Available in a CHIN Data Repository

229

(1)

Services Provided by CHINs

229

(1)

Development of a CHIN

229

(2)

Connectivity

229

(1)

Data Elements

229

(1)

Centralized Data Repository

229

(1)

CHIN Developers

229

(2)

Benefits Associated with CHINs

231

(1)

Access to Client Information

231

(1)

Cost Reduction

231

(1)

Limiting Factors

232

(1)

Client Confidentiality Issues

232

(1)

Ownership of the CHIN

232

(1)

Initial Development Costs

232

(1)

Current Status of CHINs

233

(1)

Case Study Exercises

233

(1)

Summary

233

(1)

References

234

(1)

Disaster Planning and Recovery

235

(22)

What Is Disaster Planning?

236

(1)

Advantages of Disaster Planning

237

(1)

Environmental Disaster Versus System Failure

238

(1)

Threats to Normal System Operation

239

(1)

Suggested Areas for Yearly Review to Avert System Disasters

240

(1)

Steps of the Disaster Planning Process

240

(4)

Identification of Essential Information

240

(1)

IS Policy and Procedure Development

241

(2)

Backup and Storage

243

(1)

Manual versus Automated Alternatives

244

(1)

Recommended PC Maintenance

245

(1)

Ways to Increase Disaster Awareness and Successful Recovery

246

(1)

Recovery

247

(1)

Salvaging Damaged Records

248

(1)

General Salvage Rules

248

(1)

Recovery Costs

249

(1)

Recommended Storage Media Recovery Techniques

249

(1)

Restarting the System

250

(1)

Recommended Insurance Coverage

250

(2)

Using Postdisaster Feedback to Improve Planning

252

(1)

Case Study Exercises

252

(1)

Summary

252

(2)

References

254

(3)

SECTION THREE Specialty Applications

257

(65)

Using the Computer to Support Health Care Education

258

(21)

Applications of Computers in Health Care Education

260

(2)

Potential Audiences for Educational Computer Uses

262

(1)

Formal Nursing Education

262

(1)

Evaluation Criteria for Instructional Software

263

(1)

Features to Look for in Computerized NCLEX-RN Preparation Programs

264

(2)

Continuing Education

265

(1)

Client Education

265

(1)

Instructional Applications of Computer Technology

266

(2)

Computer-Assisted Instruction (CAI)

266

(1)

Multimedia

267

(1)

Teleconferencing

268

(1)

Strategies to Maximize the Benefits of Multimedia Instruction

268

(2)

Distance Learning

269

(1)

Web-Based Instruction (WBI)

269

(1)

Key Points for Students Involved in Distance Learning

270

(2)

Computer Labs

271

(1)

Do's and Don'ts for Developing a Web-Based Course

272

(1)

Evaluation Criteria for a Computer Lab

273

(1)

Educational Opportunities in Nursing Informatics

274

(1)

Case Study Exercises

274

(1)

Summary

275

(1)

References

276

(3)

Telehealth

279

(23)

Terms Related to Telehealth

280

(1)

Some Common Telehealth Terms

281

(1)

Teleconferencing

281

(1)

Videoconferencing

282

(1)

Desktop Videoconferencing (DTV)

282

(1)

Historical Background

282

(1)

Driving Forces

283

(1)

Applications

284

(1)

Telemedicine Benefits

284

(1)

On-Line Databases and Tools

284

(1)

Current and Proposed Telehealth Applications

285

(2)

Education

286

(1)

Continuing Education

287

(1)

Home Health Care

287

(1)

Legal and Privacy Issues

287

(3)

Referral and Payment

287

(1)

Support Personnel

288

(1)

Liability

289

(1)

Barriers to the Use of Telehealth Applications

290

(1)

Licensure Issues

290

(1)

Confidentiality/Privacy

290

(1)

Establishing a Telehealth Link

291

(1)

Formulating a Telehealth Plan

291

(1)

Building the Supporting Framework

292

(1)

Strategies to Ensure Successful Teleconferences

292

(2)

Human Factors

293

(1)

Equipment

294

(1)

Telehealth Costs

294

(1)

Technology Issues

294

(1)

Basic DTV Components for Telehealth Applications

294

(1)

Telenursing

295

(2)

Future Development

296

(1)

Case Study Exercises

297

(1)

Summary

297

(1)

References

298

(4)

Research

302

(20)

Using Computers to Support Research

303

(1)

Identification of Research Topics

303

(1)

Computer Applications That Support Nursing Research

304

(1)

Literature Searches

305

(1)

Suggested Health Care Informatics Research Topics

305

(1)

Pros and Cons of On-Line Literature Searches

306

(3)

Data Collection Tools

306

(3)

Tips for Design and Administration of Web-Based Data Collection Tools

309

(4)

Data Analysis

309

(2)

Data Presentation: Graphics

311

(1)

Computer-Aided Research in Nursing (CARIN)

312

(1)

On-Line Access to Databases

313

(1)

Impediments to Health Care Research

313

(1)

Possible Funding Sources for Nursing Research

314

(2)

Unified Language Efforts

314

(1)

Multi-Institutional Research

315

(1)

Some Databases That Support Nursing

316

(1)

Research in Real Time

316

(1)

Collaborative Research

317

(1)

Students Using Computers for Research

317

(1)

Case Study Exercises

318

(1)

Summary

318

(1)

References

319

(3)

Appendix A: Internet Primer

322

(9)

Appendix B: Career Resources on the Internet

331

(4)

Appendix C: Internet Resources for Nurses and Health Care Professionals

335

(14)

Appendix D: Case Study Exercises--Suggested Responses

349

(18)

Glossary

367

(12)

Index

379

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Handbook Of Informatics for Nurses and Health Care Professionals

Summary

Table of Contents

Supplemental Materials