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LICEO DE CAGAYAN UNIVERSITY

BACHELOR OF SCIENCE IN NURSING


LEVEL 3

BSNG-2202: NURSING INFORMATICS


LECTURE PRELIM TERM
Clinical Instructor: Dolores Mercado S.Y. 2023 - 2024 1ST SEMESTER
TRANSCRIBE BY: MA. EM CONCEPCION LAGARE (MECTL)

CHAPTER
TOPIC
SUBTOPIC

MEETING NO. 01

NOTES-August 19, 2023

PPT 1: HISTORICAL PERSPECTIVE OF NURSING

1970’s

COMPUTERS IN NURSING

• Computers is already in used in health care system since 1978 – some prominent
hospital in Manila – for admission processes.
• Today use of computer by nursing has increased rapidly due to the usability in the
day-to-day nursing processes
• Patient data is entered in the computer – all appropriate departments are
automatically notified – saving the nurses from many phone calls.
• Nursing assessment, patient monitoring and plans, medication processes,
administration records, even discharge plans are also optimized.
• Computers are important tool in nursing practice.

IMPORTANT TOOL IN NURSING PRACTICE

• Nurses began to recognize the value of computer for their profession.


• Computer potential for improving documentation of nursing practice, quality
of patient care and managing patient care

1980’s

• clinical practice
- document nursing care
- communicate physician’s orders
• monitor clients
- receive and send information about admission
- discharge and transfer
- received laboratory test results
- pharmacy report

MAJOR HISTORICAL PERSPECTIVE OF NURSING & COMPUTER

1960’s

1990’s

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LICEO DE CAGAYAN UNIVERSITY
BACHELOR OF SCIENCE IN NURSING
LEVEL 3

BSNG-2202: NURSING INFORMATICS


LECTURE PRELIM TERM
Clinical Instructor: Dolores Mercado S.Y. 2023 - 2024 1ST SEMESTER
TRANSCRIBE BY: MA. EM CONCEPCION LAGARE (MECTL)

Post – 2000 10. Integration with the other


system such as laboratory,
accounting etc. is a problem

Computer Information System

Advantages Disadvantages

1. Data maintenance 1. Implementation requires


2. Low maintenance cost severe justification
3. Volume of data is not an issue 2. High starting cost
4. No paper is required 3. Requires training for
5. No problem with nursing and health care
interpretation/transcription giver
6. Data can be converted into 4. Requires additional effort
information to implement
7. Readiness of the information and 5. Additional manpower is
data necessary
8. Accessibility to any health care 6. Data communication
personnel & institution system will have an
9. Data cannot be corrupted easily additional cost
(with back-up) 7. Data can easily be
10. Can be integrated with other corrupted (if no back-up)
system such as laboratory, 8. Information management
pharmacy, accounting, is essential
management 9. Readiness of data and
11. Data handling is easy information is possible
12. Data integrity is preserved when software is provided
13. Data communication is possible in the health information
14. Statistical information system can system
be provided 10. Requires extensive
15. Migration to other system is easy planning, designing and
16. Can be expanded commercial
17. Easy data profiling implementation

Manual Health Care System

Advantages Disadvantages

1. Easy to implement: 1. Problems with maintenance

- low cost

- no extra training required 2. Problem with flavescent paper

2. Requires minimum effort: 3. Volume of data becomes a


problem

- quick processing
4. Problem with interpretation/
- can be stored anywhere transcription

3. Cannot be easily corrupted: 5. Needs lots of paper

- easy to prepare

- data profiling can be processed easily


6. Data is not converted easily to
information

7. Accessibility to any health care


professional and institutions

8. Once the data is burned it cannot


be reproduced easily

9. Coordination of data and


information is a problem

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LICEO DE CAGAYAN UNIVERSITY
BACHELOR OF SCIENCE IN NURSING
LEVEL 3

BSNG-2202: NURSING INFORMATICS


LECTURE PRELIM TERM
Clinical Instructor: Dolores Mercado S.Y. 2023 - 2024 1ST SEMESTER
TRANSCRIBE BY: MA. EM CONCEPCION LAGARE (MECTL)

MEETING NO. 02

NOTES-August 26, 2023

PPT 2: NURSING INFORMATIC – EXPLORING THE FIELD

During the course of any day, nurses handle large amounts of DATA and INFORMATION and
apply KNOWLEDGE. This is true to all nurses, whether they provide direct care or serve a
administrator, educators, researchers etc. add to scientifics
Process, manage
Informatics foundation of
DATA & analyze data
nursing
• A collection of numbers, characters, or facts gathered according to some perceived
need for analysis and possibly action at a later point in time.
• A single datum is meaningless, but a collection of data can be examined for a
patterns and structure that can be interpreted.
improved patient NURSING
care SCIENCE
INFORMATION

• Is data that have been interpreted

KNOWLEDGE
❖ NURSING SCIENCE+ INFORMATION SCIENCE = NURSING INFORMATICS
• Synthesis of information derived from several sources to produce a single concept
or idea.
• Based on a logical process of analysis and provides order to thoughts and ideas
THE NURSE AS KNOWLEDGE WORKER
and decreases uncertainty.
• Advancement in knowledge, skills, and interventions, and drugs are growing at an
WISDOM (experience)
exponential rate.
• Occurs when knowledge is used appropriately to manage and solve problems • Increase in acuity level of clients
• It results from understanding and requires human effort • Everything that we do to out pt are knowledge based
• Comes from cumulative experiences.
• Example:
To whom do we need to give bag blood, to an older person or to an older person?
- give the blood to the one who needs it the most
- [ In a critical situation] give the blood to the one who has a higher chance of
surviving.

Data

Information Example:

Tasked based:
Knowledge
- giving meds
- doing procedures in clinical areas
Wisdom - carrying out dr. orders

ROLE OF NURSES DURING THE COURSE OF CLIENT CARE:

1. Data gatherer
❖ Current demands for safer, cost- effective, quality care require evidence of the best 2. Information user
practices supported by research. 3. Knowledge user
4. Knowledge builder
COMPUTERS AND INFORMATION TECHNOLOGY (IT)
GOOD INFORMATION MANAGEMENT
• Provide tools that aid data collection and the analysis associated with research to
support the overall work of nurses. ❖ Helps the information technology.
• Ensures access to the right information at the right time for the people who need it.
INFORMATION TECHNOLOGY (IT) • Particularly important when the volume of information exceeds human processing
capacity
• Refer to the management and processing of information with the assistance of - If volume of explanation exceeds human understanding capability, information
computers. technology can be helpful.
• (software; without this, hardware will not function)
• Computer = hardware KNOWLEDGE MANAGEMENT

• Refers to the creation of systems that enable organizations to tap into the knowledge,
experiences, and creativity of their staff to improve their performance.

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LICEO DE CAGAYAN UNIVERSITY
BACHELOR OF SCIENCE IN NURSING
LEVEL 3

BSNG-2202: NURSING INFORMATICS


LECTURE PRELIM TERM
Clinical Instructor: Dolores Mercado S.Y. 2023 - 2024 1ST SEMESTER
TRANSCRIBE BY: MA. EM CONCEPCION LAGARE (MECTL)

• Structured process for the generation, storage, distribution, and application of both “To err is human.”
tacit knowledge (personal experience) and explicit knowledge (evidence) in
organizations • Nearly 15 million instances of medical harm (US)

INFORMATICS THE PUSH FOR PATIENT SAFETY

• First coined (1957) by German computer scientist, Karl Steinbuch, as “Informatik” Current problems related to patient care:
• followed by Phillippe Dreyfus in 1962 as “Informatique”
• further translated into “Informatics” by Walter F. Bauer the term informatics • Look-alike, sound-alike medications
combined the terms “information” and “automation” to name automatic information • Patient identification
processing • Communication during patient hand-over
• The combination of “informat” with the suffix “ics” broadened the definition to address • Correct procedure and body site
the actual science and inherent theories of information and information processing • Electrolyte solution concentration
• INFORMATICS is the science and art of turning data into information. • Medication accuracy
• Catheter and tubing misconnections
HISTORY OF NURSING INFORMATICS • Needle reuse and injection devise safety
• Hand hygiene
Florence Nightingale has been recognized as an early informatics nurse because of her use of
data to inform knowledge and change nursing practices. In 1863 she wrote: IT UTILIZATION IN NURSING

“In attempting to arrive at the truth, I have applied everywhere for information, but in scarcely an  Barcode and medication administration
instance have I been able to obtain hospital records fit for any purpose of comparison...if wisely  E-prescribing
used, these improved statistics would tell us more of the relative value of particular operations and  Patient identification
modes of treatment than we have any means of obtaining at present. They would enable us,  Computerized Physician (or provider) Order Entry (CPOE)
besides, to ascertain the influence of the hospital ...upon the general course of operations and - Local area network
diseases passing through its wards; and the truth thus ascertained would enable us to save life and - Only in the hospital
suffering, and to improve the treatment and management of the sick and maimed poor.” - Example: A request for mediation – sent to Pharmacy – Pharmacy will prepare –
then deliver to Nurses – nurses then do the procedure
NURSING INFORMATICS (ANA, 2007)  Decision support software
-used specifically by managers
• a specialty that integrates nursing science, computer science, and information
science to manage and communicate data, information, knowledge, and wisdom APPLICATIONS OF NURSING INFORMATICS
into nursing practice
• facilitates the integration of data, information, knowledge, and wisdom to support 1. Nursing Practice
patients, nurses, and other providers in their decision making in all roles and settings 2. Nursing Administration
3. Nursing Education
TIGER Initiative 4. Nursing Research

• Technology Informatics Guiding Education Reform (2007)


• Nursing must transform itself as a profession to realize the benefits that electronic
patient records can provide
• NURSES- to provide safer, higher quality patient care through the use of IT

Redesign nursing education to:

• keep up with rapid changes in technology


• active participation by nurses in the design of informatics tools
• Increased visibility by nurses in the national health IT agenda

ENTRY-LEVEL CORE COMPETENCIES FOR THE BEGINNING NURSE

Scope and Standards of NI Practice (ANA, 2007)

1. Basic computer literacy, use basic desktop applications and electronic


communication.
2. Use IT to support clinical and administrative processes (evidence-based practice)
3. Access data and perform documentation via computerized patient records
4. Support patient safety initiatives via use of IT
5. Recognize role of informatics in nursing

THE INFORMATICS NURSE

Has advance preparation in information management and possesses the following skills (ANA,
2007):

1. Proficiency with informatics applications to support all areas of nursing practice


including quality improvement activities, research, project management, system
design, development, analysis, implementation, support, maintenance, and
evaluation
2. Fiscal management
3. Integration of multidisciplinary language/standards of practice
4. Skills in critical thinking, data management and processing, decision making, and
system development and computer skills
5. Identification and provision of data for decision making

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LICEO DE CAGAYAN UNIVERSITY
BACHELOR OF SCIENCE IN NURSING
LEVEL 3

BSNG-2202: NURSING INFORMATICS


LECTURE PRELIM TERM
Clinical Instructor: Dolores Mercado S.Y. 2023 - 2024 1ST SEMESTER
TRANSCRIBE BY: MA. EM CONCEPCION LAGARE (MECTL)

PPT 3: STANDARDS AND POLICIES

MEETING NO. 03 HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA)

NOTES-September 02, 2023 • to improve public and private health programs by establishing standards to facilitate
efficient transmission of electronic health information. (Public Law, 104-191, 1996)

POLICY NATIONAL AGENDA FOR NURSING INFORMATIC.

• A course of action that guides present and future decision; based on given conditions • responsible for setting national policy to guide the preparation of the nursing
and selected from among identified alternatives. workforce, including preparation in the area of NI

HEALTH CARE POLICY ROLE OF TECHNOLOGY IN THE MEDICATION – USE PROCESS

• Is established on local, state, and national levels to guide the implementation of 1. Medication error
solutions for the populations’ health need. - 44 – 98 thousand pt dies each year in the US from preventable medical error
2. Preventable Adverse Drug Event (ADE)
• Department of Health
- Inadvertent administration of a massive overdose of chemotherapeutic agent over 4
HEALTH POLICY AND NURSING INFORMATICS AS A SPECIALTY days
- No malpractice but: simply interpreted an ambiguous handwritten chemotherapy
• Nursing informatics is a differentiated practice given in the scope and standards order incorrectly
documentation. (ANA 2001) • EX: a pt died bc the nurse has given the wrong med to the pt bc of the misinterpretation
• Focuses on knowledge and skill in information and information management of the handwriting of the doctor’s order
techniques.
• Demonstrates specialized knowledge of information technology – exceeds the ability
COMPUTERIZED PRESCRIBED ORDER ENTRY (CPOE)…
to use technology.
• Should assist with the development and implementation of technology tools for clinical
• A system used for direct entry of one or more types of medication orders by prescriber
practice, evaluation of the effectiveness of technology tools on nurse’s work, and help
into a system that transmit those orders electronically to the appropriate department
prepares nurse to use information technologies.
• Allow prescribers to access records and enter orders from their office or homes
• NI emphasizes its interaction with informatics disciplines such as mathematics,
• Prescribers selectable standardized single orders or order sets
statistics, linguistics, engineering, computer science, and health informatics
• Implementation of organization-specific standing orders based on specific situations
• Essential to practice in an interdisciplinary team
such as before or after a procedure
• Vocabulary summit
• Menu-driven organization-specific lists of medications on formulary
-Bring together nursing and medical informatics vocabulary experts to explore how
• Passive feedback system that presents patient-specific data in an organized fashion
further language development by nursing can facilitate the integration of computerized
language among health care discipline.
BAR – CODE ENABLED POINT – OF – CARE TECHNOLOGY (BPOC)
HEALTH CARE POLICY IMPACT ON NURSING INFORMATICS PRACTICE

A. Nursing shortage: • Helps verify that the right drug is administered to the right pt at the right dose by the
right route and at the right time.
• Older nursing workforce • Admission: patients are issued individualized bar code wristband – when given
• Higher ratio of older associate degree graduates rather than their younger medication – nurse scans their bar-code employee identifier and the pt bar code to
baccalaureate counterparts confirm their identity.
• The availability of more attractive career opportunities for women • Still double check – what if there is a failure to the machine?
• Decreased interest in nursing as a career • Verify the dispensing authority of the nurse; confirm pt identity; match the drug identity
with their mediation profile in the pharmacy.
• Difficult work environments
• Aging of the baby boomers will increase demand for hospital services. • Medication Administration Records (MAR) – online: makes this more accurate
• Enable nurse: greater accuracy in recording the timing of medication administration,
B. American Association of College of Nursing (AACN) computer generates actual “real- time” log of medication administration

• Lack of faculty to supervise students.


AUTOMATED DISPENSING CABINETS (ADC)
C. Patient safety: To Err is Human: Building a safer Health System
• A computerized point- of – use medication management system designed to replace
• California Law 1875 passed 2003 – to install IT to help health care professional to the traditional unit- dose drug delivery system
reduce error. • Staff enter a unique log – on and password to access the system- touch screen monitor
• National Alliance for Health Information Technology NAHIT): influence the use of or fingerprint identification. Once log – on – nurse must obtain pt specific medication
technology to improve patient safety, quality and efficiency. from drawers or bins that open after a drug is chosen from a pick list.
• Connecting for Health (CFH): work to enable technology to improve people’s live • Staff must change password every 3 months and do not give anybody your username
and password.
NATIONAL INFORMATICS INITIATIVES
“SMART” INFUSION PUMP DELIVERY SYSTEM
EO, 2004: April 27, 2004 – President Georg W. Bush issued an Executive Order “Incentives for
the use of Health Information Technology and Establishing the Position of the National Health • To regulate IV using regulator
Information Technology Coordinator” • "Smart" infusion pumps are medication delivery devices that use a combination of
computer technology and drug libraries to limit the potential for dosing errors.
• Establish a national health information technology coordinator • an infusion pump is operated by a trained user, who programs the rate and duration
• Work to develop a nationwide interoperable health IT infrastructure. of fluid delivery through a built-in software interface. Infusion pumps offer significant
• Develop, maintain, and direct implementation of strategic plan to guide implementation advantages over manual administration of fluids, including the ability to deliver fluids
of - interoperable health IT both public and private. in very small volumes, and the ability to deliver fluids at precisely programmed rates
or automated intervals. They can deliver nutrients or medications, such as insulin or
other hormones, antibiotics, chemotherapy drugs, and pain relievers.

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LICEO DE CAGAYAN UNIVERSITY
BACHELOR OF SCIENCE IN NURSING
LEVEL 3

BSNG-2202: NURSING INFORMATICS


LECTURE PRELIM TERM
Clinical Instructor: Dolores Mercado S.Y. 2023 - 2024 1ST SEMESTER
TRANSCRIBE BY: MA. EM CONCEPCION LAGARE (MECTL)

HEALTHCARE DATA STANDARDS DATA CONTENT STANDARD

• The methods, protocols, terminologies, and specifications for the collection, exchange, • National Uniform Claim Committee (NUCC)
storage, and retrieval of information associated with health care applications including  To develop, promote, and maintain a standard data set for use in non-
medical records, medications, radiological images, payment and reimbursement, institutional claims and encounter information
medical devices and monitoring systems and administrative processes • Standard Guide for Content and Structure of the Computer- Based Patient Record
(ASTM E1384-96)
 Proposes minimum essential content drawn from a developing annex of
HEALTH DATA INTERCHANGE STANDARDS dictionary elements

Message Format Standard STANDARD COORDINATION EFFORTS

• Medical device communication • International Organization of Standards (ISO)


• Digital imaging communication  Develops and publishes standards internationally
• Administrative data exchange • European Technical Committee for Standardization (CEN TC 251)
• Clinical data exchange  Works to develop a wide variety of standards in the area of healthcare
data management and interchange
Institute of Electrical and Electronic Engineers • American National Standards Institute (ANSI)
 Coordinator for voluntary standard activity in the US
• Develop a medical information bus (MIB) • Health Insurance Portability and Accountability Act (HIPAA)
• Supports real time continuous and comprehensive capture and communication data  Administrative overhead (enrolling in a health plan, paying health
from bedside medical devices such as those found in ICU, OR, and ER insurance premiums, checking insurance eligibility, getting
authorizations etc.)
National Electrical Manufactures Association (NEMA) • National Committee on Vital and Health Statistics Subcommittee on Standards and
Security (NCVHS)
• Formed Digital Imaging Communication in Medicine (DICOM): generic digital format  Focus on administrative and financial transactions, the administrative
and a transfer protocol for biomedical images and image-related information simplification provisions.
• Standard development process highlighted the sociopolitical context in which
Accredited Standards Committee X12N/Insurance
standards are developed and the potential impact it has on the availability and
currency of standards
• Developed a broad range of electronic data interchange (EDI) standards to facilitate
electronic business transactions

National Council for Prescription Drug Programs (NCPDP)

• Develops standards for information processing for the pharmacy services sector of the
health industry

TERMINOLOGIES

- anywhere you go, the meaning of the word is the same.

• The ability to represent concepts in an unambiguous fashion between both the sender
and receiver of the message
• Standardize terminologies enable data collection at the point of care and retrieval of
data, information, and knowledge in support of clinical practice
• International Statistical classification of disease and related health problems: Ninth
Revision and Clinical Modifications (ICD-9-CM)
 WHO, 1980 – latest revision of mortality and morbidity classification
• International Statistical Classification of Disease Related Health problems: Tenth
Edition (ICD-10)
 Most recent revision of the ICD classification system of mortality and
morbidity
• Current Procedural Terminology, Fourth Revision (CPT-4)
 Listing of descriptive terms and codes for reporting medical services and
procedures
• Systemized Nomenclature of Human and Veterinary Medicine International, Clinical
Terms (SNOMED)
 Comprehensive, multiaxial nomenclature and classification system
created for indexing human and veterinary medical vocabulary,
including signs and symptoms, diagnoses and procedures
• Logical Observation Identifiers Names and Codes (LOINC)
 Provides set of universal names and numeric identifier codes for
laboratory and clinical observations and measurements in a database
structure
• RxNorm
 Provides standard names for clinical drugs (active ingredient + strength
+ dose form) and for dose forms as administered
• Unified Medical Language System
 Specific vocabularies, code sets, and classification systems for almost
every practice domain in healthcare

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LICEO DE CAGAYAN UNIVERSITY
BACHELOR OF SCIENCE IN NURSING
LEVEL 3

BSNG-2202: NURSING INFORMATICS


LECTURE PRELIM TERM
Clinical Instructor: Dolores Mercado S.Y. 2023 - 2024 1ST SEMESTER
TRANSCRIBE BY: MA. EM CONCEPCION LAGARE (MECTL)

PPT 4: Fundamentals of Information and Communication Technologies (ICT)

MEETING NO. 04

NOTES-September 09, 2023

Creating a software can also be done by a Nursing Informatics specialist

Without BIOS and OS you cannot see anything on your computers

OPEN SOURCE

- free, no payment; internet cafe

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LICEO DE CAGAYAN UNIVERSITY
BACHELOR OF SCIENCE IN NURSING
LEVEL 3

BSNG-2202: NURSING INFORMATICS


LECTURE PRELIM TERM
Clinical Instructor: Dolores Mercado S.Y. 2023 - 2024 1ST SEMESTER
TRANSCRIBE BY: MA. EM CONCEPCION LAGARE (MECTL)

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LICEO DE CAGAYAN UNIVERSITY
BACHELOR OF SCIENCE IN NURSING
LEVEL 3

BSNG-2202: NURSING INFORMATICS


LECTURE PRELIM TERM
Clinical Instructor: Dolores Mercado S.Y. 2023 - 2024 1ST SEMESTER
TRANSCRIBE BY: MA. EM CONCEPCION LAGARE (MECTL)

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LICEO DE CAGAYAN UNIVERSITY
BACHELOR OF SCIENCE IN NURSING
LEVEL 3

BSNG-2202: NURSING INFORMATICS


LECTURE PRELIM TERM
Clinical Instructor: Dolores Mercado S.Y. 2023 - 2024 1ST SEMESTER
TRANSCRIBE BY: MA. EM CONCEPCION LAGARE (MECTL)

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LICEO DE CAGAYAN UNIVERSITY
BACHELOR OF SCIENCE IN NURSING
LEVEL 3

BSNG-2202: NURSING INFORMATICS


LECTURE PRELIM TERM
Clinical Instructor: Dolores Mercado S.Y. 2023 - 2024 1ST SEMESTER
TRANSCRIBE BY: MA. EM CONCEPCION LAGARE (MECTL)

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LICEO DE CAGAYAN UNIVERSITY
BACHELOR OF SCIENCE IN NURSING
LEVEL 3

BSNG-2202: NURSING INFORMATICS


LECTURE PRELIM TERM
Clinical Instructor: Dolores Mercado S.Y. 2023 - 2024 1ST SEMESTER
TRANSCRIBE BY: MA. EM CONCEPCION LAGARE (MECTL)

PPT 5:HOSPITAL INFORMATION SYSTEMS

• Uterine contractions and FHR (DR)


• Brain waves among patients with seizure and sleep disorders (through oscilloscope)
MEETING NO. 05 • IVP in neurologic patients at risk for cerebral aneurysm (ICU)

NOTES-September 16, 2023 HIS

• Medical information system


“Without software, hardware is not nonfunctional!” • Patient care system
• Manage info to facilitate daily hospital operations by all health care personnel
• Semiclinical and clinical support modules
INFORMATION SYSTEMS
SEMICLINICAL MODULES

• Collection and integration of various pieces of hardware and software and the human ❖ ADT – monitors and controls flow of patients from admission to discharge, and
resources that meet the data collection, storage, processing, and report generation prepares midnight census and activity reports
needs of an organization ❖ OE – order-entry-results- reporting module
• For most large health care organizations, the hardware must always be purchased to ❖ Order entry – staff can enter lab, pharmacy and radiology orders
fit the software requirements ❖ Results reporting – (ex.) lab results (paperless)
• 3 key pieces in IS: hardware, software & databases

CLINICAL SUPPORT MODULES


TYPES OF INFORMATION SYSTEM
CHARTING SYSTEMS
1. Management Information Systems (MIS)
2. Bibliographic Retrieval Systems • Online charting
3. Stand-Alone, Dedicated, or Turnkey Systems • Medication administration
4. Transaction systems • Admission, shift, and special assessments
5. Physiologic Monitoring Systems • NCPs, VS, wound care, hygienic care
6. Decision Support Systems
7. Expert Systems POINT-OF-SERVICE SYSTEMS (POS)
8. Artificial Intelligence Systems
9. Natural Language System • Uses hand-held or bedside PC to ensure that data are recorded at the point at which
they are collected to avoid errors and other problem

Incorporating Evidence: Use of Computer Based Clinical Decision Support Systems for
MANAGEMENT INFORMATION SYSTEM (MIS) Health Professionals

• Provides managers information about their business operations which aids in decision Decision Support System(DSS)
making processes
• Strategic planning (top-level admin) • Are automated tools designed to support decision-making activities
• Management control (middle managers) • Improve the decision-making process and outcomes
• Operations support (first line managers) • Designed to support healthcare providers in making decisions about the delivery and
management of patient care
BIBLIOGRAPHIC RETRIEVAL SYSTEMS
CDSS
• Retrieval of references, data, document information or literature
• Journal articles, books, monographs, and textual reports • A computer software employing a knowledge base designed for use by a clinician
• Full citations, keywords, abstracts, etc. involved in patient care, as a direct aid to clinical decision-making (Johnston,1994)
• CINAHL, MEDLINE (NATIONAL LIBRARY OF MEDICINE • Software designed to be a direct aid to clinical decision-making, in which the
characteristics of an individual patient are matched to a computerized clinical
STAND-ALONE, DEDICATED, OR TURNKEY SYSTEMS knowledge base and patient assessments or recommendations are then presented to
the clinicians or the patient for decision. (Sims,2001)
• Developed for a single application or set of functions
• Example: Patient classification system Purposes of DSS
• Pharmacy, laboratory or imaging (Radiology)
• Assist in problem solving with semi- structured problems
• Support, not replace, the judgment of a manager or a clinician
TRANSACTION SYSTEMS
• Improve the effectiveness of the decision-making process
• Example: inventory system Types & Characteristics of DSS
• To monitor the distribution of items and to update and reorder supplies
• Repetitious process 1. Administrative and Organizational system
• Process routine medical or nursing orders • Strategic planning, budgeting, financial analysis, quality management, continuous
process improvement and clinical benchmarking
PHYSIOLOGIC MONITORING SYSTEMS
2. Integrated System
• Hospital patient care units, surgery, and private homes
• Heart monitor Support outcomes

• Performance management by integrating operational data (business side- budgeting)


with clinical data (pharmaceutical ordering and dispensing)

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LICEO DE CAGAYAN UNIVERSITY
BACHELOR OF SCIENCE IN NURSING
LEVEL 3

BSNG-2202: NURSING INFORMATICS


LECTURE PRELIM TERM
Clinical Instructor: Dolores Mercado S.Y. 2023 - 2024 1ST SEMESTER
TRANSCRIBE BY: MA. EM CONCEPCION LAGARE (MECTL)

Examples of CDSS Applications

• Reminders and alerts which are computer tools for focusing attention such as “flags”
for abnormal values
• Therapy critiquing and planning as well as care maps, guidelines, protocols, and the
like
• Diagnostic assistance providing patient-specific consultations using diagnostic or
management tools, such as Problem Knowledge Couplers (PKC)
• Signal interpretation such as interpretative alarms for real-time clinical signals in
intensive care units (ICU), automated electrocardiogram (ECG) interpretation, retinal
scans, and voice recognition
• Natural language/ speech recognition which offers interpretation of freely entered
clinical notes and archiving to make electronically accessible in the future
• Lab systems with interpretations of measured values and automated preparation of
reports as well as physician guidance as to which test to order
• Prescribing decision
• support such as drug advisory systems used for advising on drug- drug interactions,
side effects, selecting most cost- effective drugs
• Clinical workstations with on-line literature, e-tools for calculation, patient guidelines
• Evidence-based quality improvement using up-to date and consistent tools
• Image recognition and interpretation with capabilities of mass screening –
mammography assistance with expensive complex investigation (eg. MRI)

Barriers to the use of CDSS

• Lack of noticeable benefits, insufficient cost benefits


• Inadequate staff training and
• Lack of system support
• System costs and a lack of exposure to technology
• Lack of congruence with work flow and additional effort required by the user to fit the
system into usual care process
• The construction and upkeep of clinical protocols or guidelines is not easy or cheap

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