Nursing informatics m3 Exam 39 Questions with Verified Answers
Evidenced-based practice (EBP), Evidence-based Nursing Practice - CORRECT ANSWER
... [Show More] Numerous evidences show that implementation of ______________________________(EBP) in the nursing (or ___________________________________) and other healthcare related fields result in higher quality of healthcare, improved patient outcomes, less variation in care, and reduced cost compared with care that is immersed in tradition or based on outdated policies and practices.
EBP, evidence-based, job satisfaction, group cohesion - CORRECT ANSWER It has also been established that when nurses believe in the value of _____ and are able to implement _______________________ care, they have higher _______________________ and better _____________________.
research, research, technology, technology - CORRECT ANSWER It should be noted that unlike ____________ that generates new knowledge and evidence for practice, EBP translates evidence from ____________ into clinical practice to improve health care quality and patient outcomes. It is certain that the use of _______________ can enhance the delivery of evidence-based healthcare. However, _______________ must be used by clinicians who implement the steps of EBP and health-care organizations that cultivate system-wide cultures of EBP if high-quality evidence-based care is to be sustained.
Sackett and colleagues, problem-solving - CORRECT ANSWER In 2000, ____________ and ________________ defined EBP as the conscientious use of current best evidence in making decisions about patient care. Since then, EBP has been broadened and described as a ______________________ approach to the delivery of care that integrates the best evidence from well-designed studies with a clinician's expertise and patient preferences and values in making clinical decisions.
external evidence, internal evidence, evidence-based decision-making - CORRECT ANSWER Both _______________________ (i.e., findings from research) and ____________________ (i.e., evidence that is generated from outcomes management or quality improvement projects) should be used in ____________________________. When clinicians deliver EBP in a context of caring as well as an organizational culture and environment that supports EBP, the highest quality of care and best patient outcomes are achieved.
healthcare systems, internal and external - CORRECT ANSWER If ___________________________ are to be re-designed to improve the quality of care and patient outcomes as well as reduce costs, clinicians must translate _______________ and _____________________ evidence that is collected, analyzed, and critically appraised into useful information to guide best practices.
spirit of inquiry, asking of burning clinical questions, patient population, intervention, interest area, comparison intervention or group, outcome, time, answer the question - CORRECT ANSWER There are seven steps in the EBP process. In the first step, which is step 0, a ______________________ in clinicians and a culture of EBP must be cultivated to stimulate the ___________________________________ to improve patient care. Once a clinical question is generated, step 1 in the EBP process involves formatting clinical questions into PICOT format (P = ____________________, I = _______________ or ______________________, C = _______________________________, O = ______________, and T = __________). Formatting clinical questions in PICOT format is necessary to streamline the search for evidence to _________________________. An example of a PICOT question about a treatment is: In depressed adolescents (P), how does the delivery of cognitive behavior therapy in person (I) versus delivery of Web-based cognitive behavior therapy (C) affect depressive symptoms (O) three months after treatment (T)?
entering each key word, database, search words, systematic reviews, clinical practice guidelines, pre-appraised literature, peerreviewed journals - CORRECT ANSWER In Step 2 of the EBP process, a search for the evidence is conducted by ____________ each __________________ from the PICOT question into the _____________ that is being searched (e.g., Medline, CINHAL) and then combining the ____________________ together to reveal the studies that may answer the question. Reliable resources that should be used to find an answer to the PICOT question include __________________________, _______________________________, ________________________, and studies from ______________________________.
critical appraisal, research evidence,
integrated, expertise, preferences, values, outcomes
Evaluation, successful, effective, equitable, timely, modified or discarded
disseminating, presentation or publication - CORRECT ANSWER In Step 3 of EBP, a rapid ______________________l of the studies from the search is conducted followed by an evaluation and synthesis of the _________________________.
In Step 4, evidence is _____________ with the clinician's ________________ and patient ________________ and __________ to decide regarding whether a practice change should be made. Once a practice change is made based on the best evidence, _____________ should be measured to determine positive outcomes of the change (i.e., Step 5).
Step 5 or ________________ of outcomes is an essential step in EBP as it helps determine if the EBP practice change was ________________, _______________, ________________, ____________, and needs to be _________________ or ________________.
The last step in the EBP process, Step 6, is _________________ the outcome of the practice change through ______________________ or _________________ so that others can benefit from the process.
(a) misperceptions by clinicians that it takes too much time,
(b) lack of EBP knowledge and skills,
(c) organizational cultures that do not support EBP,
(d) lack of resources, including clinical decision support tools,
(e) executive leaders and managers who do not model and/or support EBP,
(f) lack of EBP mentors to work with point-of-care staff on implementing evidence-based care,
(g) inadequate access to databases by clinicians in order to track patient and system outcomes, and
(h) negative attitudes toward research - CORRECT ANSWER Barriers and Facilitators of Evidence-based Practice:
There are multiple barriers to advancing EBP in health-care systems, including:
(a) strong beliefs about the value of EBP and the ability to implement it,
(b) EBP knowledge and skills,
(c) organizational cultures that support EBP,
(d) EBP mentors who have in-depth knowledge and skills in evidence-based care as well as individual and organizational change,
(e) administrative support,
(f) clinical promotion systems that incorporate EBP competencies, and
(g) EBP tools at the point of care, such as clinical decision support systems - CORRECT ANSWER Barriers and Facilitators of Evidence-based Practice:
Findings from studies also have established key facilitators of EBP that include
system-wide, key component, buy-in, model EBP, staff advancement, resources, supports - CORRECT ANSWER To cultivate a culture and environment that supports and sustains EBP, an organization (hospital, clinic, or health center) must provide _________________ support for evidence-based care. This support begins with a vision, philosophy, and mission that incorporate EBP as a __________________, which are made visible to all throughout the organization. High-level administration and nurse managers must not only "___________" to this vision, but also _______________ themselves as much of how clinicians perform is learned through observation of their key leaders and managers. Integrating EBP and the newly created EBP competencies for registered nurses and advanced practice nurses throughout the clinical ladder system if one exists also establishes the importance of evidencebased care for ______________________. Furthermore, ample ______________ and _____________ must be provided to clinicians that enhance their ability to provide evidence-based care.
cost, safety, quality, variation, quality and outcomes, reimbursement - CORRECT ANSWER Technology Tools in Clinical Practice:
Nurses, nurse practitioners, and healthcare providers today are very cognizant of the push for _______ containment, improved patient ________, improved ___________ of care, and reduced _____________ in care throughout not only the United States but the world. It is readily observed there is a shift in healthcare choices being made based on ______________ and ______________, not solely cost as ____________________ moves toward payments for quality.
Information technology (IT), IT, information, point of care - CORRECT ANSWER ______________________________ has brought to healthcare a compendium of new tools which support EBP. Consequently, _____ has not only improved, but also complicated many currently existing processes. A goal of informatics is to use technology to bring critical and essential ______________ to the _______________ to increase efficiency, make healthcare safer and more effective, and improve quality and outcomes
information technology, evidence-based care - CORRECT ANSWER Despite the advancement in _______________________, the most effective, _______________________ remains evasive for nurses
learning skills, comfort, technology, evidence-based practice - CORRECT ANSWER Professional nurses range in age from their early 20s to their 60s with the average age of a registered nurse today in their early 50s. This range presents a significant range of ______________ skills and _________ with _________________ and ___________________________.
Nursing students, National League of Nursing (NLN), computer literacy, information literacy, informatics, computer literacy, information literacy, and informatics - CORRECT ANSWER ____________________ today are very adept with using iPADs, iPhones, laptops, and other technology devices. They have been using them since childhood. In 2006, a _________________________________ study revealed 60% of nursing programs had a _____________________ requirement and 40% had an __________________________ requirement. Less than 50% of the respondents stated ______________ was integrated into the curriculum and experience with information systems provided during the clinical experiences (National League for Nursing, 2008). As an outcome of the study the NLN published a position statement recommending nursing schools require all nursing students graduate with knowledge and skills in each of three critical areas: ______________________, ___________________, and __________________.
Pravikoff, Tanner, and Pierce, scientific evidence, EBP, computer illiterate - CORRECT ANSWER ________________, ____________, and ____________ (2005) found that nurses use experientially acquired information from interactions with peers, patients, colleagues, and physicians greater than ______________________ from medical and research journals. This finding still exists today. It is imperative for nurses today to have the skills required to engage in ______. However, in the Philippines and other parts of the world, some nurses are _________________________.
EBP, technology, EBP, Rush, no longer optional
electronic documentation, e-records, nurse informaticists - CORRECT ANSWER Preparing undergraduate nursing students in _______ and the use of the proper __________________ has significance for advancing ______ in nursing. __________ (2008) states, "the preparation of undergraduate nursing students for using evidence to guide practice is _____________________.
Still, in the Philippines, it is costly to train nurses on the use of programs for _______________________ or _______________. This is one of the reasons why ______________________ are scarce in the country.
informatics, nursing informatics, informatics, clinical, research, education - CORRECT ANSWER Informatics Application in Evidence-Based Practice
In the Philippines, the inclusion of ____________ as an integral part of the nursing undergraduate curriculum has been one of the factors for the increased awareness and interest in the field of ___________________. However, the contents of the curriculum were adapted from international materials which ones do not match the local needs. Lack of devices, machines, resources, and methods of utilizing information, computers, and nursing science proved to be challenges in the application of ________________, not only in the ___________ setting, but in _________________ and _______________ as well.
A. Computer Generated Nursing Care Plans
B. Clinical pathways
C. Clinical Guidelines
D. E-Journals - CORRECT ANSWER Despite the challenges, nursing informatics can be seen in the Philippines. Here are some applications:
Computer Information System, Nursing Information System, documentation, desktops or laptops - CORRECT ANSWER A ________________________________ may stand alone be an integral part of a larger system that a healthcare facility utilizes. A _____________________________ can improve efficiency and accuracy in all phases of the nursing process: (Assessment, Diagnosis, Planning, Intervention and Evaluation). It can meet standards and guidelines set for the nursing practice, including __________________. Utilizing machinery such as _______________ or ________________, it may facilitate a more effective nursing process.
record, database, retrieved, Reports, pathways, information, unacceptable - CORRECT ANSWER Computer Generated Nursing Care Plans:
Assessment:
A computer can be used to __________ information such as admission, laboratory results, etc. Information is stored in the computer's _____________ software which may be r____________ easily. ___________ may also be generated using different programs which may help in gathering information
Some software programs may prompt users to ask specific questions which will open specific __________ to gather further needed _________________. At times, some systems may inform the user of ________________ data entries such as abnormal vital signs, inconsistent age, or wrong dates of entry. This will allow the user to fix the error immediately
most appropriate one, list, signs and symptoms, Record review and retrieval - CORRECT ANSWER Computer Generated Nursing Care Plans:
Nursing Diagnosis:
Utilizing standardized methods of producing a nursing diagnosis, a system may assist a nurse in identifying the ___________________________. A computer system may generate a ________ of possible diagnoses for a client with specific ____________ and ________________. _______________________ and _____________ may also be done according to nursing diagnoses.
Up-do-date, Interventions, evidenced-base, Expected outcomes - CORRECT ANSWER Computer Generated Nursing Care Plans:
Planning:
_________________ systems may assist nurses in planning. ________________ may be recommended by the system based on the selected diagnosis. The recommendations are based on ________________ care. _________________________ may also be process and recommended.
interventions, transfer notes, discharge instructions, communicate, Computer-generated, progress notes, documentation - CORRECT ANSWER Computer Generated Nursing Care Plans:
Implementation:
Computers may be used to record _________________s and patient information, such as ___________________ (from one healthcare facility to another) and ___________________ (given to patients upon discharge). It is important to ________________ these to the concerned people effectively to ensure proper continuity of health improvement. _______________________ nurses or _______________ may automatically sort and print out patient data such as medication administration, treatment, post-operative techniques, and vitals signs monitoring. This makes _____________________ more efficient and accurate.
patient data, problems and needs, time frame, record and store, evaluation statements, future actions, discharge planning, achieved, interventions, desired outcomes, reevaluated. - CORRECT ANSWER Computer Generated Nursing Care Plans:
Evaluation:
The power of computers maybe employed to compare massive amounts of _____________. It can help identify outcomes patients are likely to achieve based on individual ________________ and ____________. Estimation of _______________ for reaching outcome goals may also be done. During evaluation, a user may use the computer to ____________ and __________ observations, patient responses to nursing interventions. Nurses may also record their own ______________________________. Information from other members of the healthcare team may also be used to determine ______________ and _________________. If a desired patient outcome is not ____________, users may record new _________________ take to ensure _____________________. New interventions are then ____________________.
care, integrated, critical, care maps - CORRECT ANSWER Clinical pathways are also known as _______ pathways, ____________ pathways, _________ pathways, or ____________.
Clinical pathways - CORRECT ANSWER They are tools used to manage the quality in healthcare concerning standardized care processes.
Clinical pathways, variability, patient outcomes, Clinical pathways, acute, home - CORRECT ANSWER It has been shown that their implementation reduces the ______________ of clinical practice and improves _____________________. ________________________ aim to improve organized and efficient patient care based on evidence-based medicine and aim to optimize outcomes in settings such as ____________ care and _______ care.
clinical guidelines and protocols, clinical guidelines, clinical guidelines and non-clinical - CORRECT ANSWER It should be noted that clinical pathways differ from ______________________ and ____________ as they are a set of practical treatment or interventions detailing how to implement __________________, including both _____________ and ______________________ activities
clinical pathways, pathways, progress, variances - CORRECT ANSWER Physicians use _____________________ to give appropriate instructions. The nurse reviews the orders and confirms their accomplishment. Other care team members carry out all the orders in the ______________ concerned to their respective fields. A patient's ____________ in the pathway will be reviewed and the ______________ will be recorded by nurses and physicians.
continuous improvement, reliable, quality, efficient, effectiveness - CORRECT ANSWER Pathways promote ____________________________________ and ___________ care. In addition, clinical pathways help in pursing the goals of improving patient care __________, maximizing the ____________ use of resources, and supporting clinical ____________________ of healthcare team.
Clinical practice guidelines - CORRECT ANSWER __________________________ are recommendations on how to diagnose and treat a medical condition. They are mainly produced for physicians but are also used by nurses and other healthcare professionals.
Clinical guidelines, Guidelines, evidence-based, guidelines, evidence-based care - CORRECT ANSWER _____________________ are systemically developed statements to assist practitioner decision about appropriate healthcare for specific clinical circumstances. _____________ can be used to reduce inappropriate variations in practice and to promote the delivery of high quality, ____________________ healthcare. The purpose of ______________ is to improve the quality of care for patient and improve clinical effectiveness by implementation of ______________________ in nursing practice.
1. It is essential that guidelines are based on the best available research evidence, and therefore a detailed literature search is done to identify evidence from research studies about the appropriateness and effectiveness of different clinical strategies.
2. Using the research evidence, guideline construction will take place. It may start as a form of a small group work, with representation form as many interested parties as possible.
3. The guideline is tested by asking professionals not involved in the guideline development to review it for clarity, internal consistency, and acceptability. The guideline can then be tested in selected healthcare settings to see whether it is feasible for use in routine practice.
4. The guidelines should be review after a specified time and modified to take into account new knowledge. - CORRECT ANSWER Clinical guidelines can be developed either locally, regionally, or nationally. There are four (4) stages in guideline development:
electronic journal, e-journal - CORRECT ANSWER An _____________________ or _____________ is a periodical publication which is published in electronic format, usually on the internet.
Electronic journals, E-journals, libraries, e-journals - CORRECT ANSWER ______________________ have several advantages over traditional printed journals: one can search the contents pages and/or full text of journal to find articles on a certain subject. ______________ are becoming increasingly in demand both as a means of rapid desktop access to current research material and to view past volumes. However, ______________ cannot physically possess ___________________.
evidence-based practice, validity, relevance - CORRECT ANSWER E-journals:
Nursing students require education that integrates ____________________________ knowledge across classrooms and clinical settings. A wide range of medical journals applying strict criteria for the _____________ of research and _________________ to best nursing practice is an effective tool for nursing. [Show Less]