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What does informatics
Mean for Nursing
Use of artificial intelligence or
decision making systems for use of
nursing process
Use of computer based scheduling
package to allocate staff in a hospital Use of computers for patient education
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What does informatics
Mean for Nursing
(Contd.) Use of computer decisions and how those
decisions are made
Use of computer assisted learning inNursing Education
For Hospital Information System
ResearchInformation nurses use inmaking patient care decisions and howthose decisions are made
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INTEGRATING
INFORMATICS
MULTI SYSTEMS APPROACH
FINANCIAL FLOW
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INTEGRATING INFORMATICSMULTI SYSTEMS APPROACH
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COMMUNICATION FLOW
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MANAGEMENT FLOW
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MEDICAL FLOW
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COMPARISON OF NURSING PROCESS TO CLASSICSYSTEM DEVELOPMENT LIFE CYCLE
OBSERVE REQUIREMENTS DEFINITION
NUR- ASSESS ANALYSIS
SING DIAGNOSEPRO-
CESSPLAN PRELIMINARY DESIGN
DETAIL DESIGN
IMPLEMENT CODING
TESTING
EVALUATE IMPLEMENTATION
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MAJOR PHASES IN SYSTEM
DEVELOPMENT
PLANNING SYSTEM DESIGN
PROGRAMMING SYSTEM CODE
IMPLEMENTATION SYSTEM IN USE
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PLANNING PROCESS
P ------------ STRATEGIC PLANNING INSTITUTIONOBJECTIVES
L
A ANALYSIS DETAILED
REQUIREMENTS
N
N
I
N
G --------- DESIGN USER INTERFACE
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NURSING DATA ELEMENTS
EXAMPLES OF DATA SETS
PATIENT DEMOGRAPHICS
AGE AND DATE OF BIRTH SEX
RESIDENCE
LANGUAGE
RELIGION
OCCUPATION
EDUCATION LEVEL
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NURSING DATA ELEMENTS
(Contd.)
CARE ITEMS
NURSING DIAGNOSIS
NURSING INTERVENTIONS
CIENT OUTCOMES
NURSING INTENSITY
SERVICE ITEMS MAIN NURSE PROVIDER
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NURSING DATA ELEMENTS
(Contd.)
MAIN DOCTOR
ADMISSION DATE AND HOUR
LENGTH OF STAY
DISCHARGE DATE AND HOUR
MAIN PATIENT SERVICE
RESPONSIBILITY FOR PAYMENT
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NANDA-NURSING MINIMUM
DATA SET ELEMENTS
NURSING ELEMENTS PATIENT DEMOGRAPHIC SERVICE
ELEMENTS ELEMENTS
NURSING DIAGNOSIS PERSONAL IDENTIFICATION SERVICE AGENCY
NUMBER
NURSING INTERVENTION DATE OF BIRTH PATIENT HEALTH
RECORD NUMBER
NUMBER OF MAIN RN
EPISODE
NURSING OUTCOME SEX ADMISSION OR
ENCOUNTER DATE
INTENSITY OF NURSING CARE RACE AND ETHNICITY DISCHARGE OR
TERMINATION DATE
DISPOSITION OFPATIENT
EXPECTED PAYOR OFBILL
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DRAFT UNIFORM DATA SET
INDIVIDUAL LEVEL-PATIENT DATA
DEMOGRAPHIC CLINICAL ITEMS SERVICE ITEMS
PERSONAL IDENTIFICATION MEDICAL ITEMS PROVIDER
IDENTIFICATION
ADMISSION DATE
DATE OF BIRTH SURGICAL DIAGNOSIS DISCHARGE DATE
EPISODE OF CARE
RELIGION LENGTH OF CARE
LENGTH OF STAY
SEX NO. OF HOSPITAL
ADMISSIONS
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DRAFT UNIFORM DATA SET
INDIVIDUAL LEVEL-PATIENT DATA (Contd.)
DEMOGRAPHIC CLINICAL ITEMS SERVICE ITEMS
LOCATION OF RESIDENCE REASON FOR DISCHARGEDISCHARGE DISPOSITION
EXPECTED PAYOR
UNIT OF SERVICE-VISIT
UNIT OF SERVICE-HOUR
UNIT OF SERVICE PERDISCIPLINE
NO. OF DAYS PER LEVELOF HOSPICE CARE
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THE OMAHA SYSTEM
It is a research-based, comprehensive
taxonomy that consist of the Problem
Classification Scheme, the InterventionScheme, and the Problem Rating Scale for
Outcomes
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THE OMAHA SYSTEM
(Contd.) It is based on the dynamic, interactive nature of
the nursing or problem solving process, the
clinician-client relationship, and concepts ofdiagnostic reasoning, clinical judgement, and
quality improvement.
It follows taxonomic or classification principles, it
consists of terms and codes arranged from generalto specific.
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THE OMAHA SYSTEM
(Contd.)
The goal of this system was to develop a
taxonomy that would provide a useful guidefor practice, a method for documentation,
and a framework for information
management
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PROBLEM CLASSIFICATION
SCHEME It is a comprehensive client-focused
taxonomy that describes clients health
related concerns and problems. It consists of four levels: domains,
problems, modifiers, and signs/symptoms.
The domains are Environmental,Psychosocial, Physiological, and HealthRelated Behaviours.
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PROBLEM CLASSIFICATION
SCHEME (Contd.) Client problems, the second level of the Scheme,
are the 40 nursing diagnoses that represent matters
of difficulty and concern to the client. Two sets of modifiers appear at the third level of
the Scheme and are used in conjunction with
problems. The user identifies a problem as either
an individual or family problem and as either ahealth promotion, potential, or actual problem.
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PROBLEM CLASSIFICATION
SCHEME (Contd.) Using two modifiers with a problem increases
applicability across the health-illness continuum
and adds specificity to the problem. The fourth level of the Scheme involves a cluster
of signs and symptoms specific to each problem.
For eg: signs and symptoms for the problem,
Income, include uninsured medical expenses anddifficulty buying medicines or other supplies.
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INTERVENTION SCHEME
The terms, codes, and definitions of the Scheme
are designed to help users identify and document
both plans and interventions for clients specificproblems or nursing diagnoses.
The four categories in the first level of the scheme
are Health Teaching, Guidance, and Counseling;
Treatments and Procedures; Case Management ;and Surveillance.
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INTERVENTION SCHEME (Contd.)
The second level of the scheme is analphabetical listing of 62 targets
Targets are defined as objects of healthrelated interventions or activities, andfurther describe problems-specificintervention categories
The third level of the Intervention Schemeis designed for client-specific information
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PROBLEMS RATING SCALE FOR
OUTCOMES It is a comprehensive framework designed to
measure clients health related changes
It is a 5-point, ordinal scale comprised ofKnowledge, Behavior, and Status subscales
Status is the condition of the client, in relation toobjective and subjective defining characteristics
For eg. for problems such as Grief andCirculation, the user would identify and documentbaseline Knowledge, Behavior, and Status ratingsduring the first home visit, hospital shift, or clinic
encounter
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NURSING INFORMATION
SYSTEM (NIS)EVALUATED ON THE AVAILABILTY
OF FOLLOWING
A CARE PLAN
A NURSING WORK SHEET
AN ASSESSMENT DOCUMENT
A DISCHARGE PLANNING GUIDE FOR
A SPECIFIC PATIENT
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NURSING INFORMATION (NIS)
(Contd.) A QUALITY ASSURANCE RECORD
A NURSE CHARTING RECORD
IS THE CHARTING SYSTEM FLEXIBLE TOADAPT TO DIFFERENT APPROACHES(SOAP)
IS THE CARE PLANNING SYSTEM
FLEXIBLE TO ADAPT TO DIFFERENTAPPROACHES (DIAGNOSIS ORIENTEDPROBLEM ORIENTED)
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NURSING INFORMATION (NIS)
(Contd.) Are physician orders automatically loaded into the
NIS application and available in the care plan,nursing worksheet, assessment report, and
discharge planning record without any redundantentry?
Spend a minimum 1 hour on the patient care unit
Go to at least two patient care areas. See whetherthe system is fully operational on more than oneunit
Meet nursing officer and gain feedback