Informatics for Transforming Nursing Care (D029)

Correct answer A. Informatics Innovator

Explanation:

A Level 4 competency in nursing informatics corresponds to the role of an Informatics Innovator. Nurses at this level lead advancements in healthcare technology, develop innovative informatics solutions, and contribute to research and policy development. They go beyond using existing informatics tools by designing and implementing new ways to enhance healthcare data management and improve patient outcomes.

Why other options are wrong:

B. Beginning Nurse A beginner nurse has foundational informatics skills, such as using electronic health records (EHRs) and retrieving patient data but does not engage in developing new informatics solutions or research. This level corresponds to Level 1 in the informatics competency model.

C. Experienced Nurse An experienced nurse (Level 2) uses informatics tools effectively in patient care but does not develop or innovate new informatics solutions. They may analyze and apply data but do not lead advancements in the field.

D. Informatics Nurse Specialist This role, typically at Level 3, involves in-depth knowledge of informatics and the ability to analyze and implement technology solutions, but it does not reach the advanced innovation level of a Level 4 Informatics Innovator.

Correct answer A. Nursing Outcomes Classification (NOC)

Explanation:

The Nursing Outcomes Classification (NOC) is specifically designed to measure and compare nursing care outcomes across different healthcare settings. It provides standardized outcome measures that help assess the effectiveness of nursing interventions and track patient progress. By using NOC, nurses can evaluate patient responses to care and contribute to evidence-based practice.

Why other options are wrong:

B. Nursing Interventions Classification (NIC).

NIC is focused on standardizing nursing interventions rather than outcomes. It categorizes the treatments that nurses perform and helps ensure consistency in nursing care but does not specifically measure or compare patient outcomes.

C. Clinical Care Classification (CCC).

CCC is designed for use in electronic health records to standardize nursing diagnoses, interventions, and outcomes. While it supports documentation and communication in healthcare settings, it is not primarily focused on comparing nursing care outcomes across different settings.

D. Nursing Management Minimum Data Set (NMMDS).

NMMDS is a dataset that focuses on nursing administration and management, including staffing, resource allocation, and workload. It is not designed for measuring and comparing nursing care outcomes.

Correct answer C. Obtaining a client's oxygen saturation

Explanation:

Obtaining a client's oxygen saturation requires informatics because it involves the use of digital monitoring technology. Pulse oximeters provide real-time data that can be integrated into electronic health records (EHRs), allowing for continuous monitoring and clinical decision-making. Informatics plays a key role in collecting, analyzing, and sharing this data.

Why other options are wrong:

A. Obtaining a 24-hr urine test

While lab results may be documented in an electronic health record, collecting a 24-hour urine test is a manual process that does not primarily involve informatics. The analysis may involve laboratory systems, but the act of collecting the sample does not.

B. Auscultating a client's bowel sounds

Auscultation is a manual assessment technique that does not require informatics. The nurse listens to bowel sounds using a stethoscope, and while findings may be documented electronically, the task itself does not rely on informatics.

D. Performing a dressing change on a wound

Dressing changes are hands-on nursing procedures that do not require informatics. While electronic documentation of wound care is common, the actual task does not depend on healthcare informatics.

Correct answer D. Providing a calendar marked with the times each day at which the patient should take the medication.

Explanation:

A calendar with marked medication times is an effective tool to promote adherence because it serves as a visual reminder, reinforcing the importance of proper timing. Older adults may struggle with remembering schedules, and a written reference can help them independently manage their medication regimen correctly. This intervention also supports patient autonomy while reducing the risk of adverse drug effects due to improper spacing of doses.

Why other options are wrong:

A. Enlisting a neighbor to check the patient each day for medication compliance.

While a neighbor might help, it is not a reliable or sustainable intervention. The neighbor may not always be available, and the patient may feel a loss of independence. A self-managed strategy, like a calendar, encourages personal responsibility.

B. Setting an audible alarm to prompt the patient to remember to take the medication.

An audible alarm may help some patients but is not as effective as a written schedule. If the patient misunderstands the correct timing, an alarm alone will not clarify when each dose should be taken. Additionally, the patient may forget to set or adjust the alarm appropriately.

C. Having a home health nurse administer the drug three times a day.

Home health visits should be reserved for patients with severe cognitive impairments or complex medical needs. This option is impractical for a patient who is otherwise capable of self-administering medication with proper guidance.

Correct answer A. Bar-code medication administrations

Explanation:

Bar-code medication administration (BCMA) is a technology used to reduce medication errors by ensuring that the right patient receives the right medication at the right dose and time. It requires scanning both the patient's wristband and the medication barcode, thereby minimizing human error and improving medication safety.

Why other options are wrong:

B. Standardized terminology in nursing technology.

While standardized terminology enhances communication and documentation accuracy, it does not directly prevent medication errors at the point of administration.

C. Interoperability.

Interoperability refers to the ability of different health information systems to communicate and exchange data. While it improves access to patient information, it does not specifically target medication errors.

D. Data mining and dissemination.

Data mining helps analyze trends and identify medication errors retrospectively, but it does not actively prevent errors at the time of medication administration.

Correct answer C. It is illegal for me to give out your protected health information to your friend.

Explanation:

Under the Health Insurance Portability and Accountability Act (HIPAA), a client’s medical records and personal health information (PHI) are protected. Healthcare professionals cannot disclose PHI to unauthorized individuals, including friends, unless the client provides written consent. This response correctly explains that it is illegal for the nurse to share the client’s health information with a friend without proper authorization.

Why other options are wrong:

A. It is illegal for your friend to request access to your medical file, even if you consent to it.

This statement is incorrect because a client can grant access to their medical records by providing written consent. If the proper release forms are completed, a friend or other designated individual may view the client’s health information.

B. Your friend cannot see your protected health information because it is our manager's policy.

While hospital policies often align with HIPAA regulations, the reason for denying access is based on federal law, not simply a manager’s policy. Stating that it is a managerial decision does not fully explain the legal protections surrounding patient confidentiality.

D. Your friend must have a doctor's order to view your health record.

A doctor’s order is not required for someone to access a patient’s medical records. Instead, the patient must provide explicit written consent authorizing the release of their health information to another person. A healthcare provider does not have the authority to approve such access without the patient’s permission.

Correct answer A. The client's room number

Explanation:

Client identification should always use two unique identifiers, such as the client’s name, birth date, or medical record number, to prevent medication errors. Using the client’s room number is unsafe because room assignments can change, and multiple clients may be in the same room. The charge nurse must intervene to ensure that the newly licensed nurse follows proper patient identification protocols.

Why other options are wrong:

B. The client's telephone number.

A client's telephone number is an acceptable identifier because it is unique to the individual and can be used alongside another identifier to verify the correct patient.

C. The client's birth date.

The client’s birth date is a commonly used and reliable patient identifier. It helps ensure that medication is administered to the correct client when combined with another identifier, such as the medical record number.

D. The client's medical record number.

The medical record number is a unique identifier specific to each client. It is one of the safest and most recommended ways to confirm a patient’s identity before administering medication.

Correct answer D. Assessment, Diagnosis, Outcome Identification, Planning, Implementation, and Evaluation

Explanation:

The Standards of Practice for an Informatics Nurse align with the Nursing Process, which includes:

Assessment: Gathering and analyzing data

Diagnosis: Identifying issues related to health informatics and nursing care

Outcome Identification: Defining measurable outcomes for patient care and system improvements

Planning: Developing strategies and interventions to achieve outcomes

Implementation: Applying informatics solutions to support nursing care

Evaluation: Assessing the effectiveness of interventions and making necessary adjustments

These standards guide evidence-based practice and decision-making in the field of Nursing Informatics.

Why other options are wrong:

A. Assessment, Problem, Expected Outcome, Interventions, and Actual Outcomes.

This structure lacks Outcome Identification and Evaluation, which are crucial steps in the nursing process and informatics practice.

B. Care Component, Assessment, Diagnosis, Implementation, and Outcomes.

The phrase "Care Component" is not a standard part of the Nursing Process or the ANA Standards of Practice for Informatics Nurses.

C. Assessment, Diagnosis, Goal, Planning, Intervention Actions, and Actual Outcomes.

While similar, this version replaces "Outcome Identification" with "Goal" and "Evaluation" with "Actual Outcomes", which do not fully capture the systematic review and revision process required in informatics nursing.

Correct answer A. I will trust any website that has positive reviews about ostomy products.

Explanation:

A website's positive reviews do not guarantee the accuracy or reliability of its medical information. Reviews are often subjective, influenced by marketing, and may not be medically valid. Reliable resources should come from medical organizations, healthcare professionals, or government agencies.

Why other options are wrong:

B. I will look for websites that are affiliated with reputable medical organizations.

This is a good practice because reputable medical organizations, such as the American Cancer Society or Mayo Clinic, provide evidence-based information.

C. I will check if the website provides references for the information presented. 

Checking references ensures that the content is supported by credible sources, such as peer-reviewed journals.

D. I will verify the author's credentials before accepting the information.

Evaluating the author's qualifications helps determine whether the information is coming from a healthcare professional or an unverified source.