1. Nursing Informatics and Evidence-based Practice
Chapter 13

2. 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

3. Strategic HIT Planning for the Decade 2004-2014 (cont'd)
Reduce variability in access to care
Advance consumer role
Strengthen privacy and data protection
Promote public health and preparedness

4. Strategic HIT Planning for the Decade 2004-2014 (cont'd)
Established four goals
1) Inform clinical practice
2) Interconnect clinicians
3) Personalize care for clients
4) Enhance public health

5. 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

6. Nursing Informatics (cont'd)
Part of the larger field of health care and medical informatics
Mechanism to collect and analyze data from nursing care
Establish and maintain computerized documentation systems

7. Strategic Directions for Nursing Informatics
Include informatics in nursing education
Prepare nurses with specialized informatics skills
Enhance nursing practice and education through informatics projects
Increase nursing faculty preparation in informatics
Encourage collaboration

8. Question Is the following statement true or false?
The specialist in nursing informatics helps to build a systematic nursing language, making data more secure from hackers and enhancing the ability to use the data to build aggregated information upon which insurance decisions can be based.

9. Answer
False.
Rationale: with an interdisciplinary focus, the specialist in nursing informatics helps to systematize the nursing language, making data more retrievable and enhancing the ability to use the data to build aggregated information upon which practice decisions can be based.
One aspect of this work is to make electronic health care information safe, but has nothing to do with insurance decision making.

10. Using Information Technology Within the Care Setting
Employers expectations
Understanding IT systems
Security systems
Billing systems
Patient information retrieval

11. Using Information Technology Within the Care Setting (cont'd)
Order entry
Nursing data entry
Computerized medication administration systems
Other computer resources

12. Accessing Information Resources
Texts and reference books
Libraries
Policies and standards

13. Accessing Information Resources (cont'd)
The Internet
Online group discussions
World Wide Web
Search engines
Health-related Web sites
Blogs
Bookmarking Web sites

14. Healthcare Indexes for Finding Information Resources
Indexes available
MEDLINE, produced by the National Library of Medicine (NLM)
CINAHL (Cumulative Index for Nursing and Allied Health Literature), produced by the CINAHL corporation
International Nursing Index
RNdex
Hospital Literature Index

15. Healthcare Indexes for Finding Information Resources (cont'd)
Psych Index
Social Sciences Index
Many journals publish their own annual index

16. Healthcare Indexes for Finding Information Resources (cont'd)
Techniques for effective searching
Subject
Author
Thesaurus for the index
Understanding the ways in which publications are indexed
Key words

17. Question
Jeff Scott, RN, is a graduate nurse just starting his practice in a transplant step-down unit that deals 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 by starting a blog on the Internet. What is a blog?
A. Online group discussion
B. Online journal
C. server site
D. Ethical discussion board

18. Answer B. Online journal
Rationale: a blog (short for web-log) is a web site on which an individual (the blogger) publishes a journal providing information and opinion usually in relationship to a particular area of subject matter.

19. Evidenced-based Practice
Development
Types of evidence used
Research studies
Patient care data
International, national, and local standards

20. Evidenced-based Practice (cont'd)
Infection control data
Pathophysiology
Cost-effectiveness analysis
Patient preferences

21. The Research Process Statement of problem/question
Review of literature
Theoretical framework
Refining the plan
Implementing the study

22. The Research Process (cont'd)
Analyzing the data
Presenting and interpreting findings
Limitations
Disseminating research results

23. Question
In some nursing studies it falls to the staff nurses to collect the data for the study. When this happens, it is important that:
A. Everyone learns the collection process from each other.
B. The researcher picks out only the data that interests them.
C. The researcher teaches everyone to collect the data in a specific way.
D. Everyone learns the collection process from the charge nurse on their shift.

24. Answer
C. The researcher teaches everyone to collect the data in a specific way.
Rationale: if multiple people are collecting data, it will be important to ensure that all are carrying out the study tasks in the same way. If different data collectors function differently, the results of the study may not be accurate.

25. Reading Research Types of research Quantitative Qualitative Combined
Meta-analysis

26. Reading Research (cont'd)
Understanding research terminology
Abstract
Research question and purpose
Hypothesis
Population vs. sample
Groups

27. Reading Research (cont'd)
Variable
Validity and reliability
Probability and statistical tests
Clinical significance

28. Legal and Ethical Considerations in Research
Institutional approval
Institutional review board
Educational institution review board
Funding agencies

29. Legal and Ethical Considerations in Research (cont'd)
Consent for research
Informed consent
Formal consent form
Describes the researcher’s credentials
How the participant was chosen
Purposes of the research
Procedures that will be followed

30. Legal and Ethical Considerations in Research (cont'd)
Risks
Discomforts
Benefits expected
Guaranteed anonymity or at least confidentiality
If alternative treatments are available, they must also be described
Participation is voluntary and can be terminated at any time

31. Question Is the following statement true or false?
The beginning of a code of conduct pertaining to research was the Nuremberg Code. This document has been updated and modified several times, the last time being in Throughout these revisions a single theme has been: first, do no harm.

32. Answer
True.
Rationale: the most recent revision of this code was 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 careful attention to the risk:benefit ratio of the research.

33. Personal Involvement in Research
Identifying problems
Excellent observers
Responsible for putting the whole complex of patient care together
Assisting with ongoing research
Your patients
Follow procedures and protocols exactly
Frontline safeguards

34. Systematic Analysis of Information and Evidence
Reliability of the source
Bias of the source
Timeliness
Purpose
Comparing settings or situations

35. 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

36. Implementing New Practices Based on Evidence (cont'd)
Staff nurse role in EBP
Identify sources of evidence that can be helpful in an individual nursing environment
Evaluate that evidence in relationship to your setting
Work collaboratively to introduce changes based on the evidence
Evaluate the effectiveness of the changes