chapter 13 nursing in format i csf 09

7/28/2019 Chapter 13 Nursing in Format i Csf 09

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Nursing Informatics andEvidence-based Practice


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Strategic HIT Planning for the Decade

2004-2014

The Decade of Information Technology(Thompson, & DHHS, 2004)

Information Technology (IT)

Critical needs of the health care system

Avoid medical errors Improve use of resources

Accelerate diffusion of knowledge


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Strategic HIT Planning for the

Decade 2004-2014 (cont'd)

Reduce variability in access to care

Advance consumer role

Strengthen privacy and dataprotection

Promote public health andpreparedness


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Strategic HIT Planning for theDecade 2004-2014 (cont'd)

Established four goals

1) Inform clinical practice 2) Interconnect clinicians

3) Personalize care for

clients 4) Enhance public health


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Nursing Informatics

Emerging field

Informatics refers to: Broader field of understanding the

information needs

How information can or should be stored and

retrieved How to use information technology


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Nursing Informatics (cont'd) Part of the larger field of health care and

medical informatics

Mechanism to collect and analyze datafrom nursing care

Establish and maintain computerizeddocumentation systems


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Strategic Directions for Nursing

Informatics

Include informatics in nursing education

Prepare nurses with specialized informaticsskills

Enhance nursing practice and educationthrough informatics projects

Increase nursing faculty preparation in

informatics

Encourage collaboration


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Question Is the following statement true or false?

The specialist in nursing informatics helpsto build a systematic nursing language,making data more secure from hackers andenhancing the ability to use the data to

build aggregated information upon whichinsurance decisions can be based.


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AnswerFalse.Rationale: with an interdisciplinary focus, thespecialist in nursing informatics helps tosystematize the nursing language, making

data more retrievable and enhancing theability to use the data to build aggregatedinformation upon which practice decisionscan be based.

One aspect of this work is to make electronichealth care information safe, but has nothingto do with insurance decision making.


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Using Information Technology

Within the Care Setting

Employers expectations

Understanding IT systems

Security systems

Billing systems

Patient information retrieval


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Using Information TechnologyWithin the Care Setting (cont'd)

Order entry

Nursing data entry

Computerized medication

administration systems

Other computer resources


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Accessing Information Resources

Texts and reference

books

Libraries

Policies and standards


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Accessing Information Resources

(cont'd) The Internet

E-mail

Online group discussions

World Wide Web

Search engines

Health-related Web sites

Blogs

Bookmarking Web sites


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Healthcare Indexes for FindingInformation Resources

Indexes available

MEDLINE, produced by the National Library ofMedicine (NLM)

CINAHL (Cumulative Index for Nursing and AlliedHealth Literature), produced by the CINAHL

corporation International Nursing Index

RNdex

Hospital Literature Index


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Healthcare Indexes for FindingInformation Resources (cont'd)

Psych Index

Social Sciences Index

Many journals publish their own annual

index


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Healthcare Indexes for FindingInformation Resources (cont'd)

Techniques for effective searching

Subject

Author

Thesaurus for the index

Understanding the ways in which publications areindexed

Key words


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Question

Jeff Scott, RN, is a graduate nurse just startinghis practice in a transplant step-down unit thatdeals mostly with heart and lung transplants.He finds that there are many ethical issues in

his practice that he was not expecting.Jeff chooses to deal with these issues bystarting a blog on the Internet. What is a blog?

A. Online group discussionB. Online journal

C. E-mail server site

D. Ethical discussion board


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Answer

B. Online journal

Rationale: a blog (short for web-log) is aweb site on which an individual (theblogger) publishes a journal providing

information and opinion usually inrelationship to a particular area of subjectmatter.


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Evidenced-based Practice

Development

Types of evidence used

Research studies

Patient care data

International, national, and local standards


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Evidenced-based Practice (cont'd) Infection control data

Pathophysiology

Cost-effectivenessanalysis

Patient preferences


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The Research Process

Statement ofproblem/question

Review of literature

Theoretical framework

Refining the plan

Implementing the study


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The Research Process (cont'd) Analyzing the data

Presenting and interpretingfindings

Limitations

Disseminating research results


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Question

In some nursing studies it falls to the staff nursto collect the data for the study. When thishappens, it is important that:

A. Everyone learns the collection process fromeach other.

B. The researcher picks out only the data thatinterests them.

C. The researcher teaches everyone to collect thdata in a specific way.

D. Everyone learns the collection process fromthe charge nurse on their shift.


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Answer

C. The researcher teaches everyone to collect thedata in a specific way.

Rationale: if multiple people are collectingdata, it will be important to ensure that all are

carrying out the study tasks in the same way.If different data collectors functiondifferently, the results of the study may not beaccurate.


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Reading Research

Types ofresearch

Quantitative

Qualitative

Combined

Meta-analysis


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Reading Research (cont'd)

Understanding research terminology

Abstract

Research question and purpose

Hypothesis

Population vs. sample

Groups


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Reading Research (cont'd) Variable

Validity and reliability

Probability and statisticaltests

Clinical significance


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Legal and Ethical Considerations in

Research

Institutional approval

Institutional review board

Educational institution review board

Funding agencies


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Legal and Ethical Considerations inResearch (cont'd)

Consent for research

Informed consent

Formal consent form

o Describes the researchers credentials

o How the participant was chosen

o Purposes of the research

o Procedures that will be followed


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Legal and Ethical Considerations inResearch (cont'd)

Risks

Discomforts Benefits expected

Guaranteed anonymity or at least confidentiality

If alternative treatments are available, they must alsobe described

Participation is voluntary and can be terminated atany time


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Question

Is the following statement true or false?

The beginning of a code of conductpertaining to research was the

Nuremberg Code. This document hasbeen updated and modified severaltimes, the last time being in 1983.

Throughout these revisions a singletheme has been: first, do no harm.


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AnswerTrue.

Rationale: the most recent revision of this codewas in 1983 (Code for Federal Regulations,1983). Three principles guide these regulations.First, the research should do no harm. Second,the participants should be free from

exploitation. Third, there should be carefulattention to the risk:benefit ratio of theresearch.


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Personal Involvement in Research

Identifying problems

Excellent observers

Responsible for putting the whole complex ofpatient care together

Assisting with ongoing research

Your patients Follow procedures and protocols exactly

Frontline safeguards


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Systematic Analysis of Information

and Evidence

Reliability of the source

Bias of the source

Timeliness

Purpose

Comparing settings or

situations


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Implementing New Practices

Based on Evidence

Institutional development of EBP

Iowa Model of Evidence-based Practice ACE Star Model of EBP for Knowledge

Transformation

Focus on continuous improvement

Barriers to utilizing research in practice


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Implementing New PracticesBased on Evidence (cont'd)

Staff nurse role in EBP

Identify sources of evidence that can be helpful inan individual nursing environment

Evaluate that evidence in relationship to yoursetting

Work collaboratively to introduce changes basedon the evidence

Evaluate the effectiveness of the changes

chapter 13 nursing in format i csf 09

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