NI MIDTERM PART 1

Triple Aim

is an approach developed by the Institute for Healthcare Improvement (IHI) in order to optimize health systemperformance

The goal of the Triple Aim

improve the patient care experience, improve the health of a population, and reduce per capita health care costs.

Quadruple Aim

is an extension of the Triple Aim

Quadruple Aim

It is about improving the patient experience of care (including quality and satisfaction), improving the health of populations, and reducing the per capita cost of health care.

Telehealth

Can be considered another component of the e-health concept, with the difference being around the delivery mechanisms, which can include live video conferencing; store-and-forward systems, such as those used to store digital images; telephone conferencing; and remote patient monitoring

M-health

typically refers to the use of a wireless communication device that supports public health and clinical practices.

M-Health

is seen as a valuable tool as the digitization of health and wellness data increases

Electronic Health Records

Studies are being conducted to define the optimal algorithms for predictive modeling, transforming electronic records from documenting the care of one patient to assessing patterns across patients to support better health (Rajkomar et al., 2018)

EVIDENCE-BASED PRACTICE

(EBP)

EVIDENCE-BASED PRACTICE (EBP)

provides care standardization

Health information technology

What is the building block of EBP?

TRUE

Informatics and health information technology are integrated into evidence-based care and healthcare decisions.

1. Misperceptions by clinicians that it takes too much time
2. Organizational cultures that do not support EBP.
3. Negative attitudes toward research

THE BARRIERS TO EBP

TRUE

Nursing is an information-based discipline

TRUE

Nursing informatics unites nursing science, computer science, and
information science in ways that transform what this mean

Standardized terminologies

What terminologies promote safety and communication among the healthcare team, standardized terminologies are needed to enable communication exchange across systems and settings.

- Common terms
- Nomenclature or classifications to be shared among all members of the healthcare team
- Allow for a more seamless collection
- Retrieval and Reuse of

Standardized terminologies include:

Data Mining

Process used to gather information from large data set

TRUE

Evidence-based practice (EBP) provides the most effective and efficient patient care.

TRUE

Implementation of EBP by healthcare professionals’ results in higher quality healthcare, improved patient outcomes, care standardization, improved workflow, and reduced costs compared to care steeped in tradition or based on outdated policies and practices

Decision support systems (DSS)

are automated tools designed to support decision making activities and improve the decision–making process and decision outcomes.

Clinical decision support systems (CDSS)

are systems designed to support healthcare providers in making decisions about the delivery and management of patient care

Data-driven clinical decision support systems

are adaptive systems designed to incorporate large heterogeneous
healthcare data sets theoretically driven to provide practice based-evidence and adapt as data change supporting the learning health system concept.

Patient Safety Indicators

uses administrative data to help providers

Tacit knowledge

The rationale and impact of elevated blood pressure

Explicit knowledge

The patient's blood pressure is not well-managed on current medicaton

Data

Smallest Unit

Data

Observation result and Object or event

Data

Patient observation and Lab results

Information

Data + meaning

Information

Nondiscrete and Expands understanding of data

Information

Patient Blood pressure and requires thought related to information

Knowledge

Further understanding the meaning of information

Knowledge

The "how" and "why" of the information

Wisdom

Appropriate understanding and use of knowledge

Wisdom

Recognition of impact and alternatives

Health Information Technology for Economic and Clinical Health Act

(HITECH)

Health Information Technology for Economic and Clinical Health (HITECH) Act

was enacted in 2009 to improve patient care outcomes and healthcare delivery through major investments in health information technology.

• improve quality, safety, and efficiency of patient care
• engage patients and families
• improve care coordination
• and ensure adequate privacy and security for personal health
information

HITECH’s goals:

Critical Care Application

Areas where patients require complex assessment, high-intensity medication, continuous therapy and interventions, and unrelenting nursing attention and continuous watchfulness.

Critical Care Nursing

Is the nursing specialty that deals with human response to life-threatening problems

Critical Care Nurses (CCNs)

provide direct, hands-on care for critically ill or injured patients in pre-and postoperative medical settings.

- They provide care for patients who are ill or injured because of life-threatening circumstances.
- Is responsible to ensure that critically ill patients are seriously conditioned individuals.
- Ensure that families of the medically ill patients should receive optimal care.

Role of Critical Care Nurses

Care provider

provides comprehensive and at times highly technical direct care to the patient and family in response to life-threatening health problems

Manager

coordinates the care provided by various health care workers to achieve the specific goal of providing optimal nursing care to critically ill patients

Educator

provides patient and family with education based on their learning needs and the severity of the situation and allows the patient to assume more responsibility for meeting health care needs as health condition

Advocate

protects the patient’s right

Medical information Bus

MIB

Medical information Bus (MIB)

Has the ability to filter, store and select information sent for inclusion into the clinical medical record on the clinical computer system

- Computer Processor
- Signal Conditioners
- File to rank and order information

Physiologic Monitoring System include:

Hemodynamic Monitor

closely examine cardiovascular function

Hemodynamic Monitor

Assess vascular system integrity

Arrhythmia Monitors

Computerized monitoring and analysis of cardiac rhythm have proved reliable and effective and in detecting potentially lethal heart rhythms

Arrhythmia Monitors

A key functional element is the system’s ability to detect ventricular fibrillation and respond with an alarm

A. Sensor
B. Signal conditioner
C. Cardiograph
D. Pattern recognition
E. Rhythm analysis
F. Diagnosis
G. Written report

Basic Components of arrhythmia Monit

Critical Care Information System (CCIS)

is a system designed to collect store, organize, retrieve, and manipulate all data related to care of the critically ill patient.

Critical Care Information System (CCIS)

Provides real-time resource utilization data and management of
information and access critical care areas through the integration of the medical facilities in the critical care or intensive care unit to an intelligent computer system which is capable of processing all data. restricted to a single unit

1. Patient management
2. Vital Sign Monitory
3. Diagnostic Testing Result

Critical Care Information System include:

Goal of Community Health Informatics

Effective and timely assessment that involves monitoring and tracking the health status of populations including identifying and controlling disease outbreaks and epidemics.

Community Health Informatics

A synthesis of nursing practice and public health practice applied to promoting and preserving the health of populations

Community Health Network Systems

An innovative ambulatory care system developed to provide services via computer

- Preventing, identifying, investigating, and eliminating
communicable health problems
- Accessibility of data and information, through communication Educating and empowering individuals to adopt healthy lifestyle.
- Facilitate of the retrieval of data
- Effective transformation of data information
- Effective integration of information too the disciplined to
concretized knowledge and creates better understanding

Primary focus of community health information systems

Ambulatory Care Information System

Provides automated processing of data and information

Ambulatory Care Information System

Involves one-time registration required per visit. It also facilitates the management of doctors schedules

An ambulatory care

patient as " as individual presenting for personal health services who is neither bedridden nor currently admitted to any health care institution

Ambulatory Care Nurses

take care of patients in environments outsides of hospitals. Their primary focus lies in pain management and general health education for patients with chronic injuries or illness

Ambulatory Care Nursing

includes those clinical, management, and research activities provided by registered nurses and assistance with health maintenance , health promotion and/or health related problems

Centers for Disease Control and Prevention

CDC

National Disaster Risk Reduction & Management Council

NDRRMC

Disaster Risk Reduction and Management

DRRM

prevention, protection, mitigation, response and recovery

National Preparedness Goal describes five mission areas