CHAPTER 24-Nursing Informatics

CHAPTER 24 – INTERNET TOOLS FOR ADVANCED NURSING PRACTICE BASIC AND ADVANCED INTERNET SEARCH METHODS • Strategies in Internet Search Methods  Name precisely the information being sought.  Use a search string (one or more search terms) rather than a single word to increase the preciseness of a search.  Enhance search strings by Boolean or natural language methods. Use the Boolean terms: AND, OR, or NOT. AND – is used when search terms or strings need to be added together. OR – is used when equivalent terms or synonyms are used to capture the information required. • METASEARCH – represents a process similar to parallel, federated, broadcast, or cross database searches. Two metasearch providers: 1. NLM Gateway (http://gateway.nlm.nih.gov/gw/Cmd) 2. Ithaki (http://www.ithaki.net/indexu.htm) INTERNET-AVAILABLE CLINICAL PRACTICE TOOLS - This structured approach to clinical information database development is clinically useful, helps clinicians organize their own knowledge databases, and facilitates ready access to needed information. Y ASSESSMENT -refers to the systematic collection of data needed to arrive at one or more diagnoses. -includes forms, miscellaneous screening tools, risk assessment instrument, and information of the manifestation of signs and symptoms.     http://www.hospitalsoup.com/public/nursingassess2001.pdf - example of a comprehensive nursing assess form. http://www.niaaa.nih.gov – resource information on alcoholism http://www.state.vt.us/health/abuse.htm - domestic abuse assessment tool http://www.ctclearinghouse.org/ - multiple assessment and screening hyperlinks

GOVERNMENT DOMAINS:  www.fda.gov – Food and drug Administration  www.pubmed.gov – NLM Pubmed database EDUCATIONAL DOMAINS:  http://medicine.iupui.edu/flockhart.htm - P450 Drug Interaction table  http://nhlbisupport.com/bmi/bmicalc.htm - body mass index calculator  http://www.yourcancerrisk.harvard.edu – cancer risk tools  http://hin.nhlbi.nih.gov/atpiii/calculator.asp?usertype=prof – coronary heart disease risk calculator

http://www.umm.edu/healthcalculators/ - health risk calculators for 24 health conditions.  NLM MEDLINE Y DIAGNOSIS -from the Greek word, “Dia” means through and “gnosis” means knowledge. -is dependent on the knowledge base of the person diagnosing.  • • New Threats to Health – include mass trauma, biologic and biochemical warfare agents, and emerging infectious diseases. Mass Trauma Preparedness and Response – mass trauma hyperlinks, featured on the CDC Emergency Preparedness and Response webpages include coping with a traumatic event, a primer for clinicians on dealing with explosions and blast injuries; fact sheets for injuries and mass trauma; possible research studies; and rapid assessment of injuries. Bioterrorism Agents/Diseases – the CDC Emergency Preparedness and Response webpages present information on approximately 30 diseases. Photographic images and/or video presentations facilitate clinical decision making related to infectious agents that may be used for bioterrorism purposes. Chemical Agents – the CDC Emergency Preparedness and Response webpages hyperlink information to more than 70 chemical agents. Recent Outbreaks and Incidents – the Emergency Preparedness and Response page also includes information on outbreaks, e.g., severe acute respiratory syndrome (SARS), West Nile Virus, monkey pox, and mad cow disease; this site also includes information on incidents, e.g., wild fires, winter storms and power outages. Bioterrorism Information Available through Academic Health Science Centers  http://www.bioterrorism.uab.edu/ - bioterrorism education  http://www.gmu.edu/centers/biodfense/ - biodefense  http://bioterrorism.slu.edu/ - Bioterrorism and Emerging Infections  http://www.upmc-biosecurity.org/ - Biosecurity

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DISEASE DIAGNOSIS  http://www.cms.hhs.gov/medlearn/icd9code.asp - International Classification of Disease  www.cdc.gov – disease directories  http://cancer-web.ncl.ac.uk/omd - online medical dictionary  http://noah-health.org – A-Z index of health information of uncommon illnesses.  http://www.cdc.gov/genomics/default.htm - information on genomics and disease prevention. HUMAN RESPONSE TO ILLNESS/HEALTH DIAGNOSES  http://www.aorn.org/research/pnds.htm - perioperative nursing data set

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Nanda.org – listing nursing diagnoses http://www.nlinks.org/research_main.phtml - evidence-based nursing diagnoses

METHODS OF CONTRIBUTING TO TERMINOLOGY REVISION AND DEVELOPMENT  http://nlinks.org/cac_introduction.phtml - network for Language in Nursing Knowledge System

THE INTERNATIONAL CLASSIFICATION OF FUNCTONING, DISABILITY, AND HEALTH (ICF) - standardized nursing diagnosis terminologies do not encompass the entire field. As a result, subsets from the ICD are used, especially in the provision of primary care services by advanced practice nurses. Another terminology of interest to nursing practice is the ICF. - consist of four domains: body functions, body structures, activity and participation, and environmental factors. -I CF may assist nursing terminology developers in generating revised and new diagnose. It may also serve as a tool facilitating collaboration among leaders in the field of nursing diagnosis classifications. - Kearney and Pryor (22004) found it to be a useful conceptual framework for practice, education, and research. - Lehman (2003) concluded that it provides a useful framework in researching health conditions, body structures and function, activity and participation, and environmental influences on patients with idiopathic intracranial hypertension.  http://www3.who.int/icf/onlinebrowser/icf.cfm - ICF browser

Y TREATMENT -the term “treatment” is used here in lieu of interventions and nursing actions, because it expresses more precisely the broad clinical management focus of this section. NURSING TREATMENT  www.sabacare.com – Home Health Care Classification  http://www.nursing.uiwo.edu/centers/cncce/nic/index.htm - Nursing Intervention Classification  http://www.aorn.org.research/pnds.htm - Perioperative nursing data set CALCULATORS  http://www.martindalecenter.com/Calculators1B_4_Nut.html Martindale’s Calculators Online Part I:Nutrition -

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http://www.manuelsweb.com/nrs_calculators.htm - Nursing Calculators for Drug Administration http://www_users.med.cornell.edu/-spon/picu/calc/medcalc.htm Medical calculators

DRUG MANAGEMENT  www.dea.gov – Drug Enforcement Agency  http://www.fda.gov/medwatch/safety/vaers1.pdf - Vaccine Event Reporting System  www.nida.nih.gov – National Institute on Drug Abuse  www.medscape.com – Medscape  www.rxlist.com – Rxlist

Adverse

EVIDENCE-BASED PRACTICE GUIDELINES  http://www.cdc.gov/std/treatment - Sexually Transmitted Diseases Treatment  www.ngc.gov – National Guidelines Clearinghouse  http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm - Diagnosis and Management for Asthma  http://www.nhbli.nih.gov/guidelines/cholesterol/index.htm - evaluation and treatment of high blood cholesterol in adults  http://www.nhbli.nih.gov/guidelines/hypertension/index.htm - High blood pressure Guidelines PRACTICE AND TREATMENT GUIDELINES: PROFESSIONAL ORGANIZATION SITES -many of the professional association or societies include clinical practice guidelines or recommendations.  http://www.diabetes.org/fot-health-professionals-and-scientists/cpr.jsp American Diabetes Association  http://www.diabetes.org/for-health-professionals-and-scientists/cpr.jsp American cancer Society Guidelines for Screening, Surveillance, and Early Detection of Adenomatous Polyps and Colorectal Cancer  http://www.aafp.org/x132.xml - American Academy of Family Physicians Y OUTCOMES -outcomes measurement is a tradition within nursing practice. -categories of patient outcomes: • Patient safety • Nursing outcomes • Nursing home and home healthcare setting outcomes • Health plan outcomes • Short form health survey PATIENT SAFETY  http://www.webmm.ahrq.gov – presentation and discussion of medical errors.

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http://www.ihi.org/ihi - Institute for Healthcare Improvement

NURSING OUTCOMES  http://www.nursing.uiowa.edu/centers/cncce - Information of NOC NURSING HOME AND HOME HEALTHCARE SETTING OUTCOMES -related to nursing outcomes are those measures that evaluate the quality of care within nursing homes and home healthcare setting.  www.cms.hhs.gov – Centers for Medicare and Medicaid  OASIS (outcomes assessment information set – measures are used to evaluate quality within home healthcare settings. HEALTH PLAN OUTCOMES  http://www.ncqa.org/Programs/HEIDIS/index.htm - HEDIS ( health plan employer data and information set OFFICE TOOLS: Online Healthcare Record Audit and Patient Satisfaction Forms -First, both the quality of the health care record and patient satisfaction reflect upon the quality of the care provided, a healthcare outcome. -Second, patient satisfaction variables provide clinicians with criteria to evaluate their own performance and that of the office in which they are practicing.  http://www.geomedics.com/downloads/pss4.rtf - Patient Satisfaction Form

SHORT FORM HEALTH SURVEY  http://www.outcomes-trust.org – Medical Outcomes Trust  http://www.sf-36.org - SF-36.org OUTCOMES MEASUREMENT: INTERNET-AVAILABLE BIOSTATISTICAL AND ANALYTICAL TOOLS  http://www.cdc.gov/hiv/software/ez-text.htm – Qualitative data creation, management and analysis software  http://www.cdc.gov/hiv/software/answr/howto.htm - Qualitative database software  http://www.cdc.gov/epiinfo/ - Epidemiologic analysis software

eCLINICALOG ( http://www.eclinicalog.org ) , A Web-Based Clinical Encounter Database - Part of an educational strategy, initially designed to build data entry, analysis, and synthesis skills in nurse practitioner students. - Started out as a paper and pencil format - First version was a spiral-bound, legal-sized, two-page grid of boxes that student filled in.

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Second, addressed issues of retrievability, familiarity, availability, student acceptance, curricular congruence and contribution to the discipline Consist of three categories: • Patient • Program • Demographic Guides students through an informatics skill building and refinement process and assists professional development.