Handbook Of Informatics for Nurses and Health Care Professionals

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

• ISBN13: 9780130311023
• ISBN10: 0130311022
• Edition: 2nd
• Format: Paperback
• Copyright: 2001-01-01
• Publisher: Prentice Hall

Summary

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.

Table of Contents

Preface	xvii
Acknowledgments	xxi
About the Authors	xxiii
SECTION ONE General Computer Information	1	(80)
Informatics in the Health Care Professions	2	(11)
Applications of Nursing Informatics	4	(2)
Nursing Practice	4	(1)
Nursing Administration	4	(1)
Nursing Education	5	(1)
Nursing Research	5	(1)
The Current Status of Health Care Delivery	6	(1)
Benefits of Nursing Informatics for Other Health Care Professionals	6	(2)
The Role of the Nurse in Information Handling	8	(2)
The Role of the Nursing Informatics Specialist	10	(1)
Case Study Exercise	11	(1)
Summary	11	(1)
References	11	(2)
Hardware, Software, and the Roles of Support Personnel	13	(20)
Hardware	14	(2)
Input Devices	14	(1)
Central Processing Unit (CPU)	15	(1)
Secondary Storage	15	(1)
Output Devices	16	(1)
Computer Categories	16	(1)
Types of Computers	17	(1)
Peripheral Hardware Items	18	(2)
Networks	20	(2)
How Computers Work	22	(1)
Binary Representation of an Arabic Number	22	(1)
Selection Criteria	23	(2)
User Needs	24	(1)
Physical Constraints	25	(1)
Measures to Reduce Computer-Related Discomfort	25	(1)
Software	25	(1)
Examples of Ergonomic Devices	26	(1)
Operating Systems	26	(1)
Application Software	27	(1)
Utility Programs	27	(1)
Common Types of PC Software Applications	28	(1)
Roles of Support Personnel	28	(3)
Superuser	29	(1)
Help Desk Technician	29	(1)
Microcomputer or PC Specialist	29	(1)
Analyst	29	(1)
Clinical Liaison	29	(1)
Programmer	30	(1)
Network Administrator	30	(1)
Trainer	30	(1)
Security Officer	30	(1)
Chief Information Officer (CIO)	30	(1)
Webmaster	31	(1)
Case Study Exercises	31	(1)
Summary	31	(1)
References	31	(2)
Ensuring the Quality of Information	33	(15)
Example of Coded Data: Employment Status Codes	35	(1)
Examples of Data and Information	35	(1)
Data Integrity	35	(3)
Ensuring Correct Data Collection and Entry	36	(2)
Data Management	38	(2)
Data Storage	38	(1)
Outsourcing Data Management and Storage	39	(1)
Storage Media	40	(3)
Data Retrieval	41	(1)
Data Exchange	42	(1)
Characteristics of Quality Information	43	(1)
Threats to Information Quality, Availability, and Confidentiality	44	(1)
Case Study Exercises	45	(1)
Summary	46	(1)
References	47	(1)
Electronic Communication and the Internet	48	(33)
The Internet	50	(2)
E-mail	51	(1)
E-Mail: Advantages and Disadvantages	52	(2)
File Transfer	53	(1)
Informal Rules for E-Mail Use	54	(1)
The World Wide Web	54	(1)
The World Wide Web: Advantages and Disadvantages	55	(3)
Steps in Creating, Posting, and Maintaining a Home Page	58	(11)
Browsers	59	(1)
Search Tools	60	(1)
Listservs	60	(1)
News Groups	61	(1)
Bulletin Board Systems	62	(1)
Access to Health Care Information	62	(3)
On-Line Publication and Journals	65	(1)
Marketing Services	66	(1)
E-health	67	(2)
Concerns Related to the Use of the Internet	69	(3)
Firewalls	69	(1)
Web Security	70	(1)
Organizational Policy	71	(1)
Overload	72	(1)
Viral Contamination	72	(1)
The Development of Intranets	72	(1)
Purpose	73	(1)
Advantages of Intranets	73	(1)
Problems	74	(1)
Extranets	74	(1)
Case Study Exercises	74	(1)
Summary	75	(1)
References	76	(5)
SECTION TWO Health Care Information Systems	81	(176)
Health Care Information Systems	82	(17)
Clinical Information Systems	83	(3)
Nursing Information Systems	85	(1)
Advantages of a Nursing Information System	86	(1)
Automation of Traditional Nursing Documentation Methods	87	(2)
Clinician Information Systems	88	(1)
Monitoring Systems	88	(1)
Order Entry Systems	89	(1)
Features of Monitoring Systems	89	(4)
Laboratory Systems	89	(1)
Radiology Systems	90	(2)
Pharmacy Systems	92	(1)
Other Clinical Systems	93	(1)
Using Information Systems to Reduce Medication Errors	93	(1)
Administrative Systems	94	(1)
Other Common Clinical Systems	94	(1)
Administration Information Systems Used in the Hospital Setting	94	(1)
Decision Support and Expert Systems	95	(1)
Registration Systems	95	(1)
Scheduling Systems	95	(1)
Decision Support and Expert Systems	95	(2)
Case Study Exercises	97	(1)
Summary	97	(1)
References	97	(2)
Strategic Planning	99	(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