ANCC Infomatics Practice Test 1 Flashcards

Question

25. When notified that a costly upgrade to the EHR is scheduled for implementation within the next few months, the first step should be to: A. Evaluate the need for the upgrade. B. Send RFIs to other vendors. C. Determine how long the current version will be supported. D. Request details and a demonstration.

Answer 1

D. Request details and a demonstration. When notified that a costly upgrade to the EHR is scheduled for implementation within the next few months, the first step should be to request details and a demonstration. Most vendors will provide a demo version so that the organization can have a clear idea of the changes. Updates, such as adding new medications to the medication list, are frequent and usually involve no disruption in workflow or utilization of the EHR, but upgrades may be more problematic so they must be thoroughly assessed. Upgrades often improve functioning or respond to changes in regulations or technology.

Answer 2

A. Phishing When a perpetrator attempts to obtain another person's personal information, such as user name and password, through email by pretending to be an authorized individual, this is an example of phishing, which is a social engineering tech-nique. Additionally, phishing emails may contain infected downloads or links to malware. The emails may contain links to fake websites that are replicas of the real websites. In some cases, phishing may involve instant messaging or pop-up windows that ask for verifying data.

Answer 3

B. Necessary legacy data are transmitted to the new system. In many cases, when a computer information system (CIS) is decommissioned, legacy data, such as workflows and clinical data, may need to be transferred to the new CIS. In that case, a migration plan should be developed to outline the project, including the legacy system structure and exactly what components will be transferred. Any migration requirements for hardware and software must be included as well as strategies and quality assurances for data migration and a security overview. The migration plan should also include the impact on interfaces, testing plan, and risks.

Answer 4

B. Unfreezing Change theory stages: 1. Motivation to change (unfreezing): Dissatisfaction occurs when goals are not met. Previous beliefs are brought into question and survival anxiety occurs. Sometimes learning anxiety about having to learn different strategies causes resistance that can lead to denial, blaming others, and trying to maneuver or bargain without real change. 2. Desire to change (unfrozen): Dissatisfaction is strong enough to override defensive actions and desire to change is strong but these must be coupled with identification of needed changes. 3. Development of permanent change (refreezing): New behavior becomes habitual, often requiring a change in perceptions of self and establishment of new relationships.

Answer 5

A. Know the sender and expect the attachment. Staff members should be advised not to open an email attachment unless they know the sender and expect the attach-ment. Even running a virus scan program is not sufficient because new viruses may be undetectable. The most common method for uploading malicious coding or viruses to a computer or network is to send them through email as an attachment. For this reason, some organizations prohibit the use of email or prohibit opening of any attachments.

Answer 6

A. Staff practice new EHR using real computers and software with test patients For staff education, an example of high-fidelity simulation is when staff practices a new EHR using real computers and software with test patients. High-fidelity simulations use real or realistic materials and equipment in order to learn new skills. Low-fidelity simulations, on the other hand, are usually less expensive and utilize verbal, print, audio, or video materials, and may involve discussing processes and case studies rather than actually carrying out processes.

Answer 7

D. ANA The agency/organization that develops standards for information systems to support documentation of nursing practice is the ANA (American Nurses Association) through its Nursing Information and Data Set Evaluation Center (NIDSEC). The ANA also evaluates information systems that are voluntarily submitted to the organization to determine if they meet the standards. The ANA Committee on Nursing Practice Information Infrastructure (CNPII) reviews and recognizes taxonomies, nomencla-tures, and vocabularies. 31. D: The agency/organization that develops standards for information systems to support documentation of nursing practice is the ANA (American Nurses Association) through its Nursing Information and Data Set Evaluation Center (NIDSEC). The ANA also evaluates information systems that are voluntarily submitted to the organization to determine if they meet the standards. The ANA Committee on Nursing Practice Information Infrastructure (CNPII) reviews and recognizes taxonomies, nomencla-tures, and vocabularies. 31. D: The agency/organization that develops standards for information systems to support documentation of nursing practice is the ANA (American Nurses Association) through its Nursing Information and Data Set Evaluation Center (NIDSEC). The ANA also evaluates information systems that are voluntarily submitted to the organization to determine if they meet the standards. The ANA Committee on Nursing Practice Information Infrastructure (CNPII) reviews and recognizes taxonomies, nomencla-tures, and vocabularies.

Answer 8

A. Usability The primary focus of HCI is usability related to human performance during interactions with computers in different con-texts, including concerns regarding overall ease of use, difficulty in learning, efficiency, satisfaction, ability to carry out error-free interactions, and ability of the computer system to match the tasks. Another focus is the mental model of users, the idea that the users have regarding interactions with computers based on knowledge and experience.

Answer 9

A. Ensure secure internet exchange of information through standards, policies, and services. The primary purpose of the Nationwide Health Information Network (NwHIN) is to ensure secure internet exchange of information through standards, policies, and services. NwHIN is funded by the Office of the National Coordinator for Health Information Technology (ONC). The primary goal is to assist healthcare providers to move from a system of paper medical records to a secure electronic health record that can be easily accessed by various healthcare providers and utilized to evaluate the quality of care.

Answer 10

D. Translate medical/nursing research into interventions. The goal of translational research is to translate medical/nursing research into interventions so that it is a basis for evi-dence-based practice. An important factor in translational research is that the scientific aspects of the research are understood by the healthcare providers so that they comply with the recommended interventions. One problem associated with translating research into interventions is that research often presents the most positive aspects of change rather than the negative, so problems may arise during application.

Answer 11

C. During alpha or beta testing before implementation User acceptance testing (UAT) should ideally be completed during alpha testing (by the developer) or beta testing (by end users) before implementation of the system so that problems can be identified and user acceptance evaluated. Some actual end users should be included in testing, although some surrogate users may be included. If user acceptance is low, then the technology may not be used in the way in which it was intended, and this could result in errors.

Answer 12

A.Desired learning outcomes Training objectives should be clearly linked to the desired learning outcomes so that the training has a defined purpose and outlines the path that participants need to achieve mastery. For example, if a training objective is for participants to be able to properly use medication management software, a desired learning outcome may be a reduction in medication errors. Training objectives should be written with action verbs, consistent with compliance and industry standards, and should meet the specific, measurable, relevant, time-bound (SMART) goal-setting system objectives.

Answer 13

B. Demonstrate how tasks are done and by whom A workflow diagram is a visual illustration of the steps of a process and the individuals (e.g., nurse, doctor, clerk, information technologist) who carry out the process. Workflow diagrams use standardized shapes and symbols, such as arrows to indicate flow, rectangles for steps, diamonds for decision points, and ovals for beginning and ending points. Connectors (lines) join the different steps, and steps may be labeled with text. Types of workflow diagrams include flowcharts, process flow diagrams, data flow diagrams, and swim lane diagrams.

Answer 14

D. Record and chart changes in height and weight Under Meaningful Use regarding EHRs for eligible hospitals and critical access hospitals (CAHs), a core objective is to record and chart changes in height and weight. Current core objectives include using CPOE for medication orders; implementing drug/drug and drug/allergy interaction checks; maintaining current problems, medication, and allergy lists; recording demographics; recording and charting changes in height, weight, BMI, and BP, as well as growth charts for children; recording smoking status for patients at least 13 years; implementing one clinical decision support rule of a high priority hospital condi-tion; providing electronic copies of health information and discharge instructions on request; and protecting electronic health information.

Answer 15

D. Liaison When an institution is transitioning to a CPOE, a primary role of the informatics nurse is that of liaison to promote multidisciplinary collaboration and cooperation among the various members of the healthcare team, including nurses, physicians, and IT specialists, to ensure that the end-product has the functionality that is needed for workflow and that it meets the requirements for safety and security. Needs regarding both hardware and software must be clearly communicated to IT personal

Answer 16

D. SSD In a computer, an SSD (solid-state drive) is a type of permanent data storage. Another type of permanent storage is a hard disk, where the information is encoded into magnetic bits. While data storage is considered permanent, hard disks and SSDs can fail, resulting in loss of data. By the same token, data that have simply been deleted can often be retrieved, posing a security risk for decommissioned equipment. As such, more drastic measures are required to completely destroy information on permanent storage. This can include strong magnets, fire, or crushing force.

Answer 17

B. Untethered Untethered PHRs are standalone and not connected to a particular system or EHR. Information may be carried on a smart card, flash card, CD, or DVD. These pose more security risks than tethered PHRs and require more input from the individual to maintain accurate records. In tethered PHRs, data are tied to a particular system and EHR and are often web-based. A secure patient portal is provided so the individual can access all or parts of the records. In networked PHRs, data are derived from multiple sources in a network rather than one system. This allows for more flexibility. In paper/personal files, patient-maintained paper records are contained.

Answer 18

C. Electronic protected health information HIPAA established the Privacy and Security Rules, both of which took effect in 2003: Privacy Rule: Ensures patients' rights. Protects any information included in a medical record (paper or electronic) as well as conversations between a doctor and another healthcare provider, billing information, and any other form of heath information Security Rule: Focuses on electronic protected health information. The rule protects the privacy of individuals but allows the adoption of new technologies, so it allows for flexibility and scaleability

Answer 19

C. Completing a blood draw for a lab test Process mapping may be done at three different levels: Macro level: A general overview of a process with many component parts, such as admission procedures Mini level: Process steps in a procedure that involves a number of different tasks, such as completing wound assess-ment, irrigation, and dressing change or transferring a patient Micro level: Process steps in detail that one individual will take to carry out one procedure, such as completing a blood draw

Answer 20

A. Field study During the explorative phase of selecting an information system, the assessment method that is most useful in order to observe the practices in an organization and to identify those agents controlling change is a field study, which obtains data from the work environment itself. Data may be obtained by direct observation as well as one-on-one interviews, questionnaires, and surveys. Those conducting the field study may do so as a complete observer (not interacting) or as a participant.

Answer 21

A. Data mart A collection of data about one particular hospital unit or a specific topic to facilitate decision-making by administration is a data mart. This may be as small as one database or may be a compilation of databases, but is generally a subset of a data warehouse (AKA enterprise data warehouse), which is a very large database or storage depository with integrated data. The data warehouse includes all of an organization's databases. The data warehouse may be utilized for reporting of data as well as data mining for analysis.

Answer 22

D. Office for Civil Rights (OCR) The governmental agency responsible for oversight of HIPAA's Privacy Rule is the Office for Civil Rights (OCR), which is part of the Department of Health and Human Services (DHHS). An organization must have procedures in place to limit access to PHI and to limit disclosures to only authorized personnel. HIPAA's Privacy Rule protects data in the EHR as well as personal communications between the patient and healthcare providers. Billing information is also protected.

Answer 23

B. Team leader When developing teams for quality improvement processes, the informatics nurse should recognize that power issues among the team members often begin with observations of the team leader. The team members observe the manner in which the leader uses power and controls the meetings, and, based on these observations, usually begin to form alliances and may begin to exercise individual or group control. This often occurs early in the team-building development and can facilitate team work or hinder it.

Answer 24

D. Query the state Board of Nursing. If the informatics nurse wants to provide continuing education units for staff training courses, the first step is to query the state Board of Nursing to determine rules and regulations about what an approved course must contain and how many contact hours are needed. The Boards of Nursing may vary in requirements for continuing education units and may have different procedures. For example, the state of California approves providers but not individual courses.

Answer 25

D. Documenting patient information on the wrong record The informatics nurse should be aware that one of the most common problems with EHRs related to safety is documenting patient information on the wrong record. If undetected, this presents a serious danger to the patient. If detected and cor-rected, this takes time away from patient care. One method of assessing this problem is to review when information on one record has been removed or identified as an error and the same information is immediately applied to another record.

Answer 26

A. Manage code changes and maintain a history of revisions. Software version control (aka source control) systems help manage code changes and maintain a history of code revi-sions, including who made the changes and when. Version control systems may be centralized (i.e., all code and history being stored in one repository) or distributed (i.e., each developer has a copy of the code and history). Software version controls systems provide backup so that code is not lost and developers can revert back to an earlier code. It can also allow multiple developers to work on the same project.

Answer 27

C. Resources needed to move from the current state to a proposed state The informatics nurse may recommend gap analysis in order to determine the resources (including time) needed to move from the current state to a proposed state. Gap analysis looks at the "gap" between a current state and a desired one. Steps include assessing the current situation, identifying current processes and outcomes, identifying target outcomes, outlining steps needed to achieve target goals, identifying gaps, and identifying resources and measures needed to close the gaps.

Answer 28

C. Events and causal factors analysis (E&CFA) chart An events and causal factors analysis (E&CFA) chart, which is a combination of affinity diagram and flow chart, is likely most useful for root cause analysis. Steps in a sequence leading up to an event (such as a sentinel event) are outlined as in a flow chart with arrows connecting the events that are listed chronologically and then all possible causal factors are identified for each step by asking why as in am infinity diagram.

Answer 29

A. Creating test scenarios and identifying metrics The informatics nurse should begin planning for usability testing by creating test scenarios, which typically reflect the ways in which participants will need to use the equipment, and identifying usability metrics. Then, the informatics nurse must recruit a representative group of end users to participate in the testing. Participants may be asked to think out loud and talk through the procedure, noting any problems or issues while expert observers take notes of the participants' interactions. Collected data is then analyzed, and a usability report is completed with recommendations.

Answer 30

D. Practice using the EHR with real equipment. When planning staff training for EHR implementation, the informatics nurse should keep in mind that the best retention is likely to occur if the participants practice using the EHR with real equipment, which includes both speaking (providing feed-back, asking questions) and doing. Retention at 24 hours is about 90% with this method of instruction. The least effective method of retention is reading, which results in only about 10% comprehension, followed by listening (20%), viewing (30%), listening and viewing (50%), and speaking and writing (70%).

Answer 31

A. Input, throughput, output, evaluation, and feedback According to von Bertalanffy's systems theory, the five elements in a system include: Input: This is what goes into a system in terms of energy or materials. Throughput: These are the actions that take place in order to transform input. Output: This is the result of the interrelationship between input and processes. Evaluation: This is ongoing monitoring for success or failure. Feedback: This is information that results from the process and can be used to evaluate the end result. Systems theory postulates that the entire system must be viewed holistically rather than concentrating on components of the systems because the interrelationships among different elements of the system must be understood.

Answer 32

A. Load/volume testing If the informatics nurse is concerned that a computer system may not function well during peak times of access, the type of testing needed is load/volume testing. This is a non-functional testing for reliability that assesses the ability of the system to function under various loads, such as at peak times when multiple users in multiple departments are accessing the system. The purpose of load/volume testing is to determine the maximum load capacity and to identify the load at which problems begin to occur. Testing is done at both the safe working load (SWL) and above the SWL.

Answer 33

A. Chain of command Fayol (1916) proposed 14 principles of management, which include the principle of the scalar chain. This principle describes the organizational hierarchy, specifically the chain of command that allows communication to flow from lower to higher in the hierarchy to reduce misunderstandings and miscommunication. Every member of an organization should understand to whom the person must report. This principle also allows for a "gangplank" (i.e., horizontal communication between different departments to save time). The next person in the chain of command should be made aware of horizontal communi-cations.

Answer 34

C. Performance testing The process of "thinking aloud" is used for performance testing.

Answer 35

A. Sign a Service Level Agreement (SLA) outlining requirements. Before committing to a cloud service provider, the organization should sign a Service Level Agreement (SLA) that outlines requirements, including the need to adhere to HIPAA Security Rules and ensure privacy of PHI, because the ultimate legal responsibility lies with the healthcare organization that owns the data. The SLA should make clear administrative controls and the types of physical and technical security utilized, as well as where data may be stored, as data that are stored overseas are

Answer 36

B. Competent According to Benner's stages of clinical competence, a nurse who has 2-3 years of experience and the ability to master new situations but who needs extra planning time and may lack flexibility is competent. The 5 stages are (1) novice (little experience and rule-governed), (2) advanced beginner (some experience with new situations), (3) competent (see above), (4) proficient (thinks holistically and relies on experience, adaptable), and (5) expert (has a wealth of experience and acts intuitively).

Answer 37

D. Assumptions 61. D: The XY theory (McGregor, 1960) theorizes that workers are managed according to conflicting assumptions: X: Workers are unmotivated, resistive to change, unintelligent, and do not care about the organization; furthermore, they dislike work. Y: Workers are basically creative and can exercise ingenuity

Answer 38

B. PDCA (plan, do, check, act) When utilizing the FOCUS (find, organize, clarify, uncover, start) model of performance improvement, FOCUS is usually combined with PDCA (plan, do check, act) to create a 9-step process because FOCUS is not complete by itself. FOCUS is used primarily to identify problems in an organization, organize a response, clarify the solution to the problems, and start the change process. The FOCUS model does not include the steps necessary to find solutions to the problems, so PDCA, a method of continuous quality improvement, helps to solve specific problems.

Answer 39

B. To identify errors The primary reason for conducting end-user testing is to identify errors. Testing is carried out by end users to ensure that the computer system functions correctly and meets the organization's needs. Analysis may include asking end users to carry out specific tests, interviews with users, questionnaires regarding usability, comparative testing with users comparing work on two different systems, direct observation (over-the-shoulder), and indirect observation (audio/video feeds). Computer-generated data may be evaluated for accuracy and errors.

Answer 40

A. Criminal/civil penalties for violations of HIPAA rules The Health Information Technology for Economic and Clinical Health (HITECH) Act under the Enforcement Interim Rule provides criminal/civil penalties for violations of HIPAA rules. HITECH outlines 4 levels of violations and corresponding penalties, which cannot exceed $1.5 million for all violations of the same provision. Lack of awareness of the rules and regulations is not considered a defense or protection from penalties. HITECH establishes the Health IT Policy Committee, which makes recommendations regarding implementation of a national health IT infrastructure.

Answer 41

B. AND, OR, and NOT If the informatics nurse is utilizing Boolean logic for a query, the three operators are AND, OR, and NOT, and they are case sensitive and must be capitalized. Two symbols-quotes (" ") and parentheses ()—are also used. The operators can narrow results (AND) because sources with only one term are eliminated, expand results (OR) because sources with either term are returned, or exclude results (NOT). The operator NOT must always be preceded by AND (Liver AND cirrhosis AND NOT alcohol

Answer 42

D. Provide clinical decision support Artificial intelligence (AI), a machine simulation of human intelligence, is increasingly used as part of clinical decision support and to provide imaging analysis but will likely have expanded uses in the near future. Al is not currently used to pre-scribe treatments, only to recommend, and it does not have the ability to resolve ethical issues. Al may be part of a robotic sys-tem, but the surgeon is still in control, so Al does not autonomously carry out surgical procedures.

Answer 43

B. Have less volume than standard computers. Small form factor ("footprint") (SFF) computers typically have less volume than standard computers so that they take up less desk space. Because of their smaller size, SFF computers may have fewer expansion slots, but usually the same features are available in this format. The shape of the computer may differ from other computers as well, with some cube-shaped, book-shaped, and box-shaped. Because there is no industry standard for SFF computers, they vary widely according to manufacturer.

Answer 44

A. CMS Incentives for "meaningful use" of EHRs are provided by CMS. The American Recovery and Reinvestment Act (ARRA) and its Health Information Technology Act (HITECH) provision allocated $19 billion dollars for a 5-year period for incentives for hospitals and ambulatory care centers, beginning in 2011, and authorized the CMS to provide the incentives to hospitals and eligible providers. Five criteria for meaningful use include (1) improve healthcare quality and reduce disparities, (2) engage both patients and families, (3) improve coordination of care, (4) improve population and public health, and (5) ensure PHI is secure and private.

Answer 45

A. User executes the wrong sequence of steps in inputting data An example of a low-level error in inputting of data is when the user executes the wrong sequence of steps. This type of error usually results in some type of alarm or hard stop of the program until corrected, so the error can usually be corrected fairly easily. A moderate-level error includes inputting data that are incompatible with the computer system. High-level errors include being unable to make a decision about the correct action or being unable to correctly interpret outcomes data.

Answer 46

C. Strategize: consider needs and future direction Vendor analysis is carried out in a number of phases: Strategize: Consider organizational needs, the reason for vendor analysis, and future needs. This process must be done without bias. • Define: Determine technical requirements, conduct market research, develop a list of vendors, and send requests for information (RFIs) and requests for proposals (RFPs). Identify: Review the RFIs/RFPs, and narrow the list of vendors. Evaluate: Focus on the remaining vendors with demonstrations, site visits, reference calls, and due diligence. Partner: Enter into a contractual agreement with the selected vendors).

Answer 47

D. Work-around In a hospital that uses a barcode scanning for medications, one nurse has made copies of patients' wristbands and stached them h the top of the edicating the This probably represents one around, a ho put to the prover ethods are common with barcode scanning because barcode bracelets may become soiled, may be lost, and may be difficult to read, increasing the amount of time needed to pass medications.

Answer 48

C. Data table When utilizing SAS Enterprise guide to query a database, if the derived data are to be saved permanently, the correct format is the data table format. The data are saved and not updated until a query is rerun to gain additional information. With the data view format, the data are continually updated each time the results are opened and historical data are not saved. The report format is especially formatted so that it can be presented with options including HTML, PDF, text, or RTF but tasks cannot be completed for results in this format.

Answer 49

B. NANDA-I NANDA-I (NANDA International): used for standardized classification of nursing diagnoses according to a multiaxial tax-ontonomy of classes.

Answer 50

D. Reducing the redundancy of data In a relational database, normalization refers to reducing the redundancy of data so that data are stored in one place and not multiple places within the database and errors in data are removed. Thus, normalization is a method of cleaning and sim-plifying. Three common forms of normalization are (1) first normal form (1NF), (2) second normal form (2NF), and (3) third normal form (3NF). Each form of normalization has more stringent requirements than the previous form.

Answer 51

B. Before orders are written In an EHR with CPOE and CDS, allergy alerts should be triggered before orders are written and they should be automat-ed. Alerts that occur after orders are written are more likely to be ignored or overridden. Additional alerts, including hard stops, should occur if orders for contraindicated drugs or drugs to which the patient is allergic are ordered despite the original alert. The alerts should be carefully evaluated because excessive alerts may result in "alert fatigue" to the point that clinicians begin to ignore them.

Answer 52

C. The database contains errors. Data are classified as "dirty" when the database contains errors that render the data inaccurate. This compromises the data integrity. Dirty data may result from human errors in entering data (such as misspelling a name or incorrectly entering an ID number). Dirty data may also result from viruses, worms, or other bugs installed into a system. Hackers may enter a system and alter or remove data. Hardware and software may fail, corrupting or destroying data.

Answer 53

A. Template CMS provides templates, standardized structures with suggested clinical data elements, so that organizations can collect data and document patient procedures and clinical workflow more accurately. The use of templates helps to reduce risks. Templates can be integrated into existing EHRs and can be customized as needed because, although they provide a framework or blueprint for services, all sections of a template may not apply to the patient services provided by a healthcare organization.

Answer 54

B. Satisfying the needs of the customers With Total Quality Management (QM), the primary focus is on satisfying the needs of the customers. The organization conducts various assessments (surveys, interviews, focus groups) to determine customer needs and engages the entire organization at all levels in the improvement process with teamwork and participation encouraged. Measurement is central to TQM's processes, so criteria are identified through brainstorming and other methods, and quality improvement is measured. For TQM to be successful, it must be supported by top management.

Answer 55

C. Manages patients using the organization's computer information system Of the four levels of practicing nurses (beginning, experienced, informatics nurse specialist, and informatics innovator) related to informatics, the expectation of a beginning nurse regarding knowledge is the ability to manage patients using the organization's computer information system. Other expected knowledge includes a basic comprehension about how the computer and internet functions and the understanding of how to use the computer to carry out required tasks, such as sending and receiving emails and doing internet searches for information.

Answer 56

A. Usability Nonfunctional testing is associated with factors that improve the experience of the user but do not relate to actual func-tionality. Usability testing is one form of nonfunctional testing. Usability testing involves assessing the ease and efficiency of use, tolerance for errors, satisfaction with use, and successful use for the intended task. Usability testing can validate design decisions, indicate problems with use (such as unclear navigation or directions), and help develop user-friendly design deci-sions.

Answer 57

C. Contributory negligence Contributory negligence involves the injured party/patient contributing to his or her own harm. Contributory negligence is a consideration in malpractice actions. In this case, the patient did not follow through with diagnostic tests that may have indicated increased risk of a myocardial infarction, so the physician did not have adequate information. Other types of negligence include negligent conduct in which an individual fails to provide reasonable care based on standards and expertise, gross negligence in which an individual willfully provides inadequate or substandard care, and comparative negligence in which the percentage of negligence is attributed to each individual involved.

Answer 58

D. Embed it into electronic nursing documentation. The best method to ensure that nurses follow an evidence-based practice is to embed it into electronic nursing docu-mentation. Embedding may include alerts, pop-up boxes with clinical information, and adding interaction, which increases staff engagement. Any information should include references so that the nurses can do follow-up research. When possible, nurses should be rewarded in some way for participation, such as with continuing education credits, a certificate of comple-tion, or time off.

Answer 59

D. Aggregate Aggregate data includes pharmacy transactions, required reports, demographic information, financial information, hazard and safety practices, and most things not included in the clinical record. Medical/clinical data includes patient-specific information regarding the patient, diagnosis, treatment, laboratory findings, consultations, care plans, physician orders, and information related to informed consent and advance directives. The medical record should include records of all procedures, discharge summary, and emergency care records. Knowledge based data includes methods to ensure that staff is provided training, support, research, library services, or other access to information, and good practice guidelines. Comparison data includes internal comparisons or external comparisons to benchmarks or best-practice guidelines.

Answer 60

B. ONC The governmental agency that has established certification requirements for the exchange of data electronically is the ONC (Office of the National Coordinator for Health Information Technology), which is part of the US Department of Health and Human Services and was mandated by the HITECH Act to coordinate national implementation of health information technology and data exchange. Data interfaces should be HL7 compatible, and data must be sent using secure encryption.

Answer 61

D. Data mining Data mining is the analysis (often automatic) of large amounts of data to identify underlying or hidden patterns. The steps to data mining include detecting anomalies, identifying relationships, clustering, classifying, regressing, and summariz-ing. The effectiveness of data mining depends on many factors, such as hardware and software applications. Data mining may identify similar groupings in data, and these groups can then be further analyzed. Data mining may be applied to multiple patients' electronic health records to generate information about the need for further examination or interventions.

Answer 62

C. Appropriate for needs The contingency theory of organizational behavior (Fiedler, Vroom, Yetton) states that there is no one best method of organizing an organization because it is contingent on several factors; therefore, what works in one organization may not work in another. Leadership should be appropriate for the organizational needs, and different organizations require different styles of leadership. Contingency factors can include size, task complexity, environment (i.e., internal, external, market conditions), technology, organizational culture, employee characteristics, hierarchy, and strategies.

Answer 63

B. Evidence based research Clinical practice guidelines are recommendations that help healthcare providers make appropriate decisions regarding specific clinical situations. Clinical practice guidelines are based primarily on evidence-based research

Answer 64

C. Underline When highlighting text, underlining is more evident than italicizing and bolding because screens have different lighting and resolution. Text against a colored background, especially a deep color, is difficult to read. Colored fonts may be used sparingly to highlight different types of information. Using a variety of fonts and multiple sizes on one screen can be very distract-ing. Long paragraphs should be avoided and information broken into small chunks with adequate white space to rest the eyes.

Answer 65

D. Can be eliminated. When considering improvements to workflow processes, the first issue to address is whether steps in a process can be eliminated because the goal is to simplify while still maintaining the integrity of the process. Eliminating steps may result from purchasing new equipment, altering product design, or changing the environment (such as carrying out a process at point of care rather than in another area). In some cases, steps may be simplified by combining some steps with others or by changing the order of steps.

Answer 66

C. An astronomical value Rules applied to trending analysis: Astronomical value: Data point unrelated to other points indicates sentinel event or special cause variation Run (shift): ≥7 consecutive data points all above or all below the median (run chart) or mean (control chart) Trend: ≥7 consecutive data points in either ascending or descending order with ≥21 total data points or ≥6 with fewer than 21 total data points Cycle: Up and down variation forming a sawtooth pattern with 14 successive data points, suggestive of systemic effect on data; if the trend is related to common cause variation, the variation may be demonstrated with 4-11 successive data points

Answer 67

B. Make hasty decisions Groupthink (Whyte, Janis) theorizes that group members avoid conflict by reaching consensus without analysis, resulting in hasty decisions that may be ill-conceived. Members tend to censor their own ideas and pressure others to conform in order to maintain consensus and may assume that if people remain silent that they agree. Some members may take on the role of "mind guard" to protect the other members from opinions that do not conform. Members often think they are invincible and morally right, which can result in ethical or moral consequences for their poor decision making.

Answer 68

D. SNOMED-CT Systematic Nomenclature of Medicine Clinical Terms (SNOMED-CT) is a multidisciplinary terminology that allows terminology from one classification system to be mapped to concepts from another, such as NANDA, NIC, and NOC. SNOMED-CT contains diagnoses, interventions, and outcomes. Other multidisciplinary terminologies are the Alternate Billing Codes (ABC), used for alternative and complementary treatments, and Logical Observations identifiers, Names, and Codes (LOINC), which includes outcomes and assessments and is used for laboratory results.

Answer 69

A. Entity-relationship diagram An entity-relationship diagram (ERD) is a specific type of flowchart that visually represents the relationship between different entities and their attributes within a system. Entities can include objects (including people) and concepts, while attributes are characteristics of an entity. For example, an entity may be a nurse, and an attribute may be an identification number or name. The ERD demonstrates the type and number of relationships between entities. ERDs are often used during design of a database system.

Answer 70

A. Integrity The three primary concerns regarding secure network information are (1) confidentiality, (2) availability, and (3) integrity. An organization needs a clear confidentiality policy to ensure the privacy of data and to prevent accidental disclosures, such as may occur with badly placed monitors or shoulder surfing. Availability includes having an acceptable use policy and protecting hardware, such as keyboards from spills. Integrity is exemplified by trust that a system can be trusted to provide accurate infor-mation.

Answer 71

D. Labeler code The National Drug Code (NDC) used for barcoding of medications is recommended by the FDA for use on all inpatient medications and vaccines, applied at the unit dose to decrease the risks of medication errors. An NDC is a code of 10 or 11 digits divided into 3 sections: ... Labeler code (4-5 digits): Assigned by the FDA and represents the manufacturer, re-packager, or distributer Product code (3-4 digits): Assigned by the labeler and describes the medication, strength, and dose Package code (1-2 digits): Assigned by the labeler and describes the package form and size

Answer 72

C. Patient scheduling The financial processes that a healthcare organization uses to manage administrative and clinical processes comprises the revenue cycle. The revenue cycle represents a business transaction in healthcare and begins when the patient is scheduled and terminates with receipt of payment and reconciliation of all charges. Managing the revenue cycle requires the collection of appropriate data, verification of eligibility, accurate documentation, appropriate coding, prompt billing, collections procedures, dispute resolution, and payment posting procedures.

Answer 73

D. Apply to user's needs. Relevant data refers to data that apply to users' needs; therefore, the determination as to whether data are relevant is relatively subjective, depending on whether the data meets the specific needs of a user at a specific time. Timely data are available when needed. Flexible data can be used for various purposes; for example, data about supplies may be accessed and utilized by various departments to obtain supplies and by others to determine budgetary or ordering needs. Reliable data provides reliable

Answer 74

B. A bibliographic database If assisting a team with meta-analysis, the informatics nurse should advise the team to begin with a bibliographic data-base, such as MedlinePlus (free access), Cumulative Index to Nursing and Allied Health (CINAHL) (subscription access), or Cochrane Library (subscription access). Meta-analysis applies statistical methods to evaluate the results of multiple studies on a related topic. Once a list of articles is obtained, further sources may be gleaned from the reference list for each article. Addi-tionally, information may be gained from unpublished works, such as conference presentations.

Answer 75

B. LAN The network that connects the departments in an organization is likely a LAN (local-area network). Many LANs nowadays are Wi-Fi-based: WLANs (wireless local area networks). Larger networks, such as in a city or an area of a city are MANs (met-ropolitan area networks). A network that encompasses a much larger area, such as a country, is a WAN (wide area network).

Answer 76

B. Written email Email is usually the most effective means of communicating with large numbers of individuals because communication can be sent very rapidly and can be secure. Emails can be sent from almost anywhere and are asynchronous, so the sender and receiver do not need to be available at the same time. Additionally, emails have attachment support, so documents, videos, and images can be sent. Emails also provide a record of communication, which may be important for legal or accountability purpos-es.

Answer 77

B. Provide honest information about the reasons for the changes and how the changes will affect staff. When instituting changes, the best approach is to provide honest information about the reasons for changes and how staff will be affected. Resistance to change is common for many people, so coordinating collaborative processes requires anticipating resistance and taking steps to achieve cooperation. Resistance often relates to concerns about job loss, increased responsibilities, and general denial or lack of understanding and frustration. The nurse should be empathetic and patient, allowing people to express their opinions and encouraging their participation.

Answer 78

D. Failure, Mode, and Effects Analysis (FMEA) A method that can be used prior to utilizing a new process in order to identify and correct problems in the process is Failure, Mode, and Effects Analysis (FMEA). FMEA is a 12-step process that begins with describing the process in detail and developing a team that creates a flow chart listing each step in a process. Then, they brainstorm each step to determine potential causes for failure and potential adverse outcomes, which are rated according to severity, occurrence, and detection, and a risk priority number is assigned. The team then brainstorms methods to reduce potential failures and identify performance measures.

Answer 79

A. Psychotherapy notes According to HIPAA regulations, psychotherapy notes that are maintained separately from the medical record may be excluded from the designated record set. Patients or legal representatives have the right to access any elements of the designated record set, regardless of the form (i.e., paper or electronic). There is no legal right to access other records, such as requisitions for laboratory tests, duplicate records held by business associates, education records, audits, telephone messages, appointment logs, surgery logs, and notes that a covered entity records while meeting with an attorney regarding a pending lawsuit.

Answer 80

A. Operating system Operating system software is responsible for storage management. Operating software, which loads first when the computer is turned on, is the most critical, handling both hardware and software applications, and is responsible for a number of processes, including management of memory, devices, processors, application interface, and the user interface. Operating systems include Mac OS X, Unix, Linux, and Microsoft Windows. Current operating systems generally support multiple users and they can also multitask so that users can work in more than one application at a time.

Answer 81

B. Monthly Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a national standardized survey of patients' opinions of their hospital care. The survey asks 29 questions about aspects of the patient's experience of hospitaliza-tion. A random sample of adult patients must be surveyed each month within 48 hours to six weeks after discharge. Hospitals that are subject to the Inpatient Prospective Payment System (IPPS) must collect surveys and submit data in order to receive full reimbursement from CMS. Non-IPPS hospitals may voluntarily participate. Eleven HCAHPS measures are reported on the Hospital Compare website.

Answer 82

A.Understanding how the brain functions in order to develop computer processes Cognitive informatics focuses on understanding how the brain functions in order to develop computer processes. The field of informatics can help develop an understanding of the processes similar to those of the human brain, such as utilization of data and data storage, and the cognitive/neurological sciences can help to develop an understanding of how the computers may better process information. Cognitive informatics, then, applies knowledge gained from studying the human brain to computer applications, focusing on such factors as memory, thinking/reasoning, and learning.

Answer 83

C. Takes no further action If the CDS system recommends a therapy that the clinician ignores, the system generally takes no further action, as the CDS system only makes recommendations based on inputted data, but the clinician makes the final determination as to whether to follow the recommendation or not. CDS systems are composed of a base of knowledge, a program that utilizes this knowledge base in assessing patient-specific information, and a method of communicating the recommendations, such as through alerts.

Answer 84

B. Map the current workflow. In preparation for the workflow redesign required for the implementation of an EHR, the first step should be to map the current workflow at the macro, mini, and micro levels, focusing on areas that are likely to be most impacted by the implementa-tion. Examples of affected areas include patient admission and discharge, laboratory and medication orders, scheduling appointments, referrals, and billing for services.

Answer 85

A. Medications The Institute for Safe Medication Practices (ISMP) order set guidelines provide guidance for developing order sets for medications, both for paper-based and electronic order sets. Guidelines include checklists for format (layout, font, prompts, symbols, abbreviations), content (development, medications, exclusions, inclusions), approval and maintenance (criteria for review, changes, verification, and biannual review of listings), and specific criteria (IV/epidurals, electrolytes, compounded medications, chemotherapy, analgesics, pediatric medications, weight-based dosages, and medications for older adults).

Answer 86

B. The data moved from one system to another system are understood in the same way. Interoperability is the ability to transfer, share, and utilize information from one system to another. Aspects of interoperability include: Technical: the ability to move data freely from one system to another.

Answer 87

A. Gantt chart The best type of display to use to demonstrate and manage schedules and time estimates needed to complete a number of tasks associated with quality improvement projects is a Gantt chart, which is created after completion of a timeline. The chart may have the timeline represented in days, weeks, or months, depending on the overall duration of the project, on the horizontal axis across the top. The tasks are listed on the left on the vertical axis. Color-coded horizontal lines or bars are then drawn from the projected beginning date to ending date for each task.

Answer 88

A. Knowledge skills, and attitude. The Quality and Safety Education for Nurses (QSEN) project's informatics competency ("Use information and technology to communicate, manage knowledge, mitigate error, and support decision-making") includes the three elements of KSAs: • Knowledge: Ability to evaluate benefits and strengths and weaknesses, evaluate communication technologies, determine information essential to a patient care database, and demonstrate understanding of taxonomy and terminology. Skills: Participation, selection, implementation, promotion, and evaluation. Attitude: Values information/communication technologies, need for consensus and collaboration, and use of standardized terminologies.

Answer 89

B.Hospital census data for the state An example of aggregate data is hospital census data for the state. Aggregate data is derived from a compilation of data from different sources, so the data that is presented as a separate entity (census data) is derived from multiple more discrete data items, such as census reports from each hospital, city, and county. Other types of aggregate data include financial reports, demographic information, and summary reports. Aggregate data, by their nature, do not provide detailed information.

Answer 90

B. Data selection The first step to knowledge discovery in databases (KDD) is data selection. Other steps include pre-processing (assem-bling target data set and cleaning data of noise), transforming data, data mining, and interpreting results. KDD is a method to identify patterns and relationships in large amounts of data, such as the identification of risk factors or effectiveness of inter-ventions. KDD may utilize data perturbation, the hiding of confidential information (such as name) while maintaining the basic information in the database, and data mining.

Answer 91

B. Providing medical care from a distance through multiple technologies Telemedicine refers to provision of medical care from a distance through multiple technologies including, but not limited to, the telephone. Telemedicine may include distant consultations, such as through videoconferencing; remote monitoring, such as utilization of the cardiac monitor for cardiac assessment; sharing of medical information, such as through social media sites and wireless devices; and medical education, such as training or classes for clinical personnel, such as physicians and nurses. Telemedicine may be delivered through networks as well as the internet and

Answer 92

D. Bureaucratic leader When leading a team to facilitate change, an informatics nurse who follows the rules of the organization exactly and expects everyone else to do so is a bureaucratic leader. While the bureaucratic leader may be that desired by administration and may engender respect if the nurse carries out the leadership role competently, team members may not be motivated to participate or bring about change because they may feel that their input is not valued.

Answer 93

A. Generate a baseline backup of data. During the performance stage of data conversion and migration, it is critically important to generate a baseline of backup data. Stages of data conversion and migrations include the following: Planning: inventorying the system, reviewing the types and amounts of data and the source and destination formats, considering cost-effectiveness, developing a specific plan for conversion, performing mapping, and creating conversion scripts and specification documents Performance: generating a baseline backup of all data, extracting data, normalizing data, performing trial and test conversions, and completing data migration Validation: ensuring that data was converted accurately and completely and formatted correctly, eliminating duplicate data, and resolving problems

Answer 94

C. RFI When doing system analysis and gathering information, the first tool is often an RFI (request for information). RFIs are often sent to a number of vendors, outlining the information needed and providing an overview of the organization's plans for purchase. The RFI may include an RFP (request for proposal) as well as a an RFQ (request for a quote), although the RFP and RFQ may be sent after the information is received and reviewed as part of the elimination and selection process. The RFT (re-quest for tender) asks for pricing and information when contracting for a specific project.

Answer 95

D. Less shoulder surfing A primary security advantage of point-of-care documenting of the EHR as opposed to documenting in a central location (such as the nursing station) is less shoulder surfing is likely to occur. Shoulder surfing (a common cause of confidentiality compromise) occurs when someone watches the computer screen while another person is accessing records. Computer screens should be positioned so that they cannot be viewed by unauthorized personnel, and healthcare providers should always be on the alert when documenting to ensure that no one is watching the screen.

Answer 96

D. Waiting areas If nursing educators at a hospital want to set up computer stations for consumer/patient self-assessment and health education, the best placement in the facility is probably waiting areas throughout the hospital as this makes them available to the most individuals, and people in waiting areas often wait for prolonged periods and may welcome a distraction. Interactivity is an important element to include in any electronic presentation, and the subject matter should be presented in a simplified format that appeals to those with varying levels of health literacy.

Answer 97

D. 55% 121. D: Mehrabian developed the 7-38-55 rule of communication theory: 7%: Meaning is conveyed by the spoken word-what people hear or perceive. 38%: Meaning is conveyed by the speaker's tone of voice. 55%: Meaning is conveyed by the speaker's body language. For example, if a speaker stands while the receiver sits, the speaker is conveying authority. If the speaker's voice is loud, this can be considered aggressive. Meaning is also conveyed by the receiver's body language, such as by folding the arms as a protective mechanism when having a negative response.

Answer 98

D. Include all positive cases, taking into account variables, decreasing the number of false negatives. 122. D: Data should include all positive cases, taking into account variables, decreasing the number of false negatives. • Specificity: Data should include only those cases specific to the needs of the measurement and exclude those that may be similar but are a different population, decreasing the number of false positives. Stratification: Data should be classified according to subsets, taking variables into consideration. Validity: Data should measure the target adequately, so that the results have predictive value. Recordability: The tool/indicator should collect and measure the necessary data. Reliability: Results should be reproducible. Usability: The tool or indicator should be easy to utilize and understand.

Answer 99

D. Examine the ethical dilemma. Steps to the ETHICAL model of decision making include the following: Examine the ethical dilemma: Collect and consider the gathered information. Thoroughly understand the alternatives: List possible alternatives and their pros and cons. Hypothesize any ethical arguments: Consider moral principles. Investigate, compare, and evaluate the alternatives: Review facts and assumptions. Choose one of the alternatives: Recommend but challenge personal reasoning. Act: Make a plan to implement the chosen alternative. • Look and examine: Evaluate and consider the outcomes, and reevaluate as needed.

Answer 100

C. Response time analysis Response time analysis assesses the time it takes for a system to respond to a request, such as a database query. Response time analysis includes assessment of service time (i.e., the time needed to process a request), network latency (i.e., the time needed to traverse a network), queuing time (i.e., the wait time), and client-side processing (i.e., the time to receive a response in web-based applications). Response time analysis uses benchmarks for comparison and can help identify bottlenecks in a system.

Answer 101

A. Scan the medication barcode and check the patient's ID. Prior to being issued a unique identifier and password to access and enter data into an EHR, the staff member should have been trained and tested in the EHR system. While some self-study may be indicated, staff members should not be expected to learn on the job or teach themselves because EHR systems can be quite complex, and insufficient training increases the risk of errors. Training must be provided promptly for all new hires or staff members who indicate they need training.

Answer 102

A. Been trained and tested in the EHR system Prior to being issued a unique identifier and password to access and enter data into an EHR, the staff member should have been trained and tested in the EHR system. While some self-study may be indicated, staff members should not be expected to learn on the job or teach themselves because EHR systems can be quite complex, and insufficient training increases the risk of errors. Training must be provided promptly for all new hires or staff members who indicate they need training.

Answer 103

C. Academic databases Peer-reviewed journals are typically considered the gold standard for literature research; however, for an initial overview, journal topics may be too narrowly focused, so a better place to begin is an academic database, such as PubMed (health and biomedical sciences) and IEEE Xplore (technical literature). An academic database can link to journal articles and other types of information sources, providing many avenues of interest to follow. This can

Answer 104

B. Providing and sharing standards for exchange of electronic health information The primary goal of Health Level Seven (HL7) is providing and sharing standards for exchange of electronic health information (interoperability). HL7 is a nonprofit ANSI-accredited organization. Organizations must utilize the same standards if they are to share data, such as when a patient wants to transfer records from one hospital to another. HL7 is critical to the development of electronic health records. HL7 has a number of different trademarks that can be applied for to use with products and services. HL/ provides specifications but does not provide software.

Answer 105

B. Optimize safety and the safe use of EHRs. The Office of the National Coordinator for Health Information Technology's Safety Assurance Factors for EHR Resilience (SAFER) Guides provide assistance in optimizing safety and the safe use of EHRs. There are nine different guides available in three categories: Foundational guides: High Priority Practices and Organizational Responsibilities Infrastructure guides: Contingency Planning, System Configuration, and System Interfaces Clinical process guides: Patient Identification, Computerized Provider Order Entry with Decision Support, Test Results Reporting and Follow-up, and Clinician Communication

Answer 106

D. Determine the system response if a component fails. System testing that involves fault injection is done to determine the system response if a component fails. Faults are purposely introduced into the system to cause one or more components to fail, and then test cases or a series of actions are

Answer 107

D. The "think aloud" procedure Cognitive walkthrough is one method to assess the users' abilities to understand the model and its purpose, to produce the desired actions, and to determine if users understand which is the right action and whether they understand system feed-back. The "think aloud" procedure is used while participants utilize a product and carry out the steps in a process, noting any usability problems, including the ability to learn the process without formal training. Sessions may be audiotaped or videotaped for later evaluation.

Answer 108

B. A SWOT analysis As part of gathering data and conducting internal and external analysis for short-term strategic planning, the organization may derive insight from SWOT analysis: Strengths, Weaknesses, threats, & opportunities

Answer 109

D. Healthcare providers may not activate the alert The primary disadvantage to an alert that requires manual activation for viewing is that the healthcare providers may not activate the alert unless failing to do so results in a hard stop. However, if the information is critical or should be read in all circumstances, then the alert should be automated to save the user the extra step of activating the alarm. Alerts should be carefully designed so that they are meaningful because excessive alerts tend to be ignored or overridden.

Answer 110

D. Aggregate data Types of healthcare-associated data include the following: • Aggregate: pharmacy transactions, hazard and safety practices, financial information, and most things not included in the clinical record • Medical/clinical: all patient-specific medical records, including diagnoses, laboratory findings, physician orders, and informed consent Knowledge-based: training, support, research, library services, good practice guidelines, drug information databases, clinical decision support system, medical literature and journals, disease registries, coding resources, and medical calculators and tools Comparison: internal or external comparisons to benchmarks or best-practice guidelines

Answer 111

D. Active radio frequency identification (aRFI) The type of system that would be most efficient to track the movement of equipment and supplies through the hospital is active radio frequency identification (aRFI). With RFI, equipment contains embedded digital memory chips with codes unique to the piece of equipment. Sensors then receive signals from the chips. In passive RFI, signals are only transmitted when the chip is in close proximity to the sensor. However, in active RFI, continuous transmission of signals between the chip and the sensor occurs, allowing for more accurate tracking.

Answer 112

A. Community engagement Community engagement is the best method of promoting health equity because it allows the person to interact with key players who are involved in decision making in the community. Community engagement may include attending meetings of the governing body; serving on committees; engaging in volunteer work; hosting community forums; organizing cleanup drives and fundraisers; offering skills and expertise; and collaborating with schools, businesses, and organizations. Additionally, the person may engage in social media and join local groups on Nextdoor and/or Facebook.

Answer 113

A. Attribute In a database, each field in a table is an attribute, with fields being columns and records being rows. A data file (collec-tions of different related records) comprises a table, which is also referred to as an entity. In each record, one field is the primary or key field, which contains the unique identifier for that particular record. A database contains one or more entities. The entity relationship diagram (one-to-one, one-to-many, or many-to-many) indicates the relationships that exist among the different entities.

Answer 114

C. CMS The governmental agency responsible for enforcing the electronic transactions and code sets for the Administrative Simplification provisions of HIPAA is the Centers for Medicare & Medicaid Services (CMS). CMS is not responsible for enforcing security or privacy regulations, which are enforced by the Office of Civil Rights.

Answer 115

B. Return on investment The profit margin in healthcare organizations are other quite narrow

Answer 116

B. Birthdate 140. B: In addition to name, birthdate is an acceptable unique identifier. Other unique identifiers include alphanumeric strings (such as those used for ID numbers) and social security numbers. A unique identifier should not be readily changeable (al-though names alone can be changed). Factors such as hair color (which is easily changeable) or age (which changes with time) are not reliable for identification. Additionally, gender is not sufficient as a unique identifier because gender may be fluid in some individuals, may be faked, and may not be obvious.

Answer 117

D. Ergonomic problem If during observational testing for the adaptation phase of an information system, the informatics nurse observes users taking notes of data to enter into the system later when they have more time, this suggests an ergonomic problem in dialoging with the system and requires further assessment to determine if the user interface is not adequately intuitive, if too many screen actions (scrolling, clicking) are required, or if the system responds too slowly.

Answer 118

A. Before going live A chart migration plan should be formulated before going live with an EHR to ensure that important patient data are not lost or are unavailable. The migration plan should outline the steps to transferring data from paper charts to the EHR, including the timeframe, who is responsible, and what data are to be transferred. Because of the changing nature of patients' conditions and census, much data must be transferred in a short period of time and this can pose numerous logistical prob-lems.

Answer 119

D. Dashboard 143. D: A dashboard is an easy-to-read and understand visual display that includes a number of different performance measures in one display, typically with charts, tables, or graphs, to aid understanding. Dashboards should be updated frequently so that the information is current. Dashboards are easily customizable and help provide broad involvement of all departments. Negative trends can easily be identified and targeted for improvement. Dashboards can also help with making informed decisions about necessary changes or use of resources.

Answer 120

D. Transferred intact When transferring data from one system to another free text data as well as coded data must be transferred intact and not truncated.

Answer 121

B. An alert to an alternate clinician If an alert regarding a patient's laboratory tests is forwarded to a clinician who does not respond during the three-hour window of specified time, the system should be set up to send an alert to an alternate clinician. The organization should also have a procedure in place for notifying clinicians about critical information that is in addition to the automated alerts generated.

Answer 122

D. System integration testing When interfacing a new cardiac monitoring system with the EHR, critical initial testing includes system integration testing, which tests whether or not the interface between software programs (such as cardiac monitoring and the EHR)

Answer 123

A. Allows user interaction with technology The human-technology interface (HTI) allows user interaction with technology, so HTI may include touch (as with touch screens), keyboards, light pens, barcodes, ID badges, or voice (for voice-activated devices or applications). HTIs vary widely according to the hardware and software involved and may include various levels of security. In some cases, there is virtually no security because the interaction may be activated by simply turning on a switch. In other cases, the interaction may be predicated on the use of a user name and password or other method of identification.

Answer 124

D. Facility/non-facility payment rates Place of service (POS) codes are used by Medicare to determine facility (F) or non-facility (NF) payment rates. POS codes have two digits and indicate the setting in which a service was provided. POS codes are used to ensure correct reimbursement, facilitate processing of claims, and collect data. POS codes include the following:

Answer 125

B. Dashboard A dashboard (also called a digital dashboard), like the dashboard in a car, is an easy to access and read computer program that integrates a variety of performance measures or key indicators into one display (usually with graphs or charts) to provide an overview of an organization. It might include data regarding patient satisfaction, infection rates, financial status, or any other measurement that is important to assess performance. The dashboard provides a running picture of the status of the department or organization at any point in time, and may be updated as desired, such as daily, weekly, or monthly. 150. A: The timing of health messages is important. People are more likely to respond when a threat is imminent. Therefore,

Answer 126

A. Before and at the beginning of flu season The timing of health messages is important. People are more likely to respond when a threat is imminent. Therefore, communicating about the need for the annual flu vaccine is best done immediately before and at the beginning of flu season in order to reduce risk. Messages at other times of the year are often ignored, and new flu vaccines may not be available yet. If the message is given only before flu season, people may not feel that the need is urgent, and if given in the middle of flu season, many people may already have contracted the flu.

ANCC Infomatics Practice Test 1 Flashcards

(150 cards)