CHAPTER 16 – Dependability of Nursing Informatics System CHAPTER 17- Nursing Minimum Data Set CHAPTER 18- Theories Models and Frameworks SUBMITTED BY: Cabanalan, Romar C. Ladjarani, Sandra H. Maulana, Dayang Almira H. Sharif Masdal, Sarah P. Musa, Shiedjian A. BSN-IIB SUBMITTED TO: Mr. Roderick P. Go Nursing Informatics Professor DATE SUBMITTED: May 10, 2013 CHAPTER 16 Dependability of Nursing Informatics System Dependable System is the measure of the reliability, integrity and performance of the system. It is defines as trustworthiness of a computing system which allows reliance to be justifiably placed on the service it delivers. It is the collective term used to describe the availability performance and its influencing factors: reliability performance, maintainability performance and maintenance support performance. In nursing informatics, dependability is the measure of the effectiveness of the health care delivery, quality of service and quality of care through the use of health information system. It encompasses the reliability, integrity, confidentiality and security of the data, information and the process. Factors that affects dependability of systems A. Error In the health care information system, it is the discrepancy between actual results and behavior from the expected or the reference condition or expected performance. In hospitals and clinics, data error or inaccuracy of the information is resulted when an incorrect reading is registered in the measuring equipment, the measuring device is malfunctioning unnoticeably, mishandling of data, incorrect reading of data (honest mistake), the computer system does not properly process the data, a potential bug is existing in the program, the data process by the computer program overflows, incorrect processing of tables and indexes, etc. Hour Systolic Diastolic H-01 140 110 H-02 145 110 H-03 140 115 H-04 140 110 H-05 135 100 H-06 140 95 H-07 135 95 H-08 135 100 H-09 130 105 H-10 140 110 H-11 110 160 H-12 135 100 H-13 140 100 H-14 145 100 H-15 145 95 Based on the historical pattern, systolic reading is greater than diastolic reading. A diastolic reading of 160 mmHg which is more than the systolic reading of 110 mmHg is an indication that there is an error in reading the data. B. Fault Sometimes due to computer bug which is considered a defect in the system. The presence of a fault in health information system may or may not lead to a failure BSA (m ) Height (cm) Weight (kg) 1.45484 152 50 1.88569 213 60 0.76000 180 52 1.68762 117 58 160006 165 56 1..1276 162 51 1.49276 171 47 Converting the table into chart, we can evidently see that there is an error in the results. Based on our knowledge, if the height and/or weight is increase there is corresponding increase in the body surface area (BSA), on the contrary, point number 14 of the figure shown below, gives an opposite results. We can say that is an error in processing the data and not the inputting of the data, since the height and weight is correct. C. Failure It is a condition in which the system performs unnecessarily or the function is contrary to its specification or the expected condition. An error may not necessarily cause a failure; however a persistent fault can have an impact that mitigates a failure condition. Example is a problem in the network occurs resulting to unavailability of the communication system. This common problem should be anticipated; as such preventive measures and contingency plan should be incorporated in the planning and implementation of the health information. CHAPTER 17 Nursing Minimum Data Set Health Information technology offers a large number of benefits to the nurses and healthcare providers as well as the patients and consumers such as the quality and effectiveness of healthcare delivery and service. Migration from the paper-based to electronic/computer health records minimizes irregularities in the workflow process and decision making process. To accurately and consistently document, accumulate, combined, translate, and retrieve health information data, fields, data set, and data elements must have an equivalent vocabularies and/ or terminologies within the healthcare record before it stores in the database. The Nursing Minimum Data Set (NMDS) provides a formal structure for electronic healthcare data elements and components to support nursing care in all settings. What is Minimum Data Set? The minimum data set providers the specific reference information for the user such as the drug uses, dosage requirement, and direction for use, active ingredients, dates, and other relevant information. The Nursing Minimum Data Set/Elements The Nursing Minimum Data Set (NMDS) is categorization scheme for the standardization of collection, integration, storage, classification, retrieval and reporting of essential nursing data. The collected data will essentially provide an accurate description of nursing decision, nursing diagnose, nursing care, nursing resources, nursing services, etc. used when providing patient care. The Nursing Minimum Data Set endeavors the standardization of the aggregated of essential nursing data. Drug Fact Active Ingredients Purpose Uses Warnings Directions Other Information Inactive Ingredients Other Information Questions/ Comments? The Nursing Minimum Data Set (NMDS) encompasses three categorical scheme or elements which includes the following: Nursing Care Elements Nursing Diagnosis Nursing Intervention Nursing Outcome Nursing Care Intensity Patient Demographic Elements Personal Identification Date of Birth Sex Nationality Residence Service Elements Unique facility or agency number elements Unique patient health record number Unique number of principle Registered Nurse Episode admission Discharge or termination date Disposition of patient Expected payer for medical bill CHAPTER 18 Theories Models and Frameworks Informatics System in Health Care Industry Information system is collective term referring to a system of data records and activities that processes and translate the data to information in an automated process. The processing of data involves the use of computer systems and specialized software that manipulates the information- processing activities of the organization. Computer- based information systems are in the field of information technology. Thus, the discipline of nursing informatics is related to the processing of the data of patients records into information which are supported by information systems. Information Systems in the Hospital Transaction processing Information System Operation System Individual Patient record Hospital Information System Nursing Information System Pharmacy Health System Preservation of Healthcare Quality Theory in Nursing Informatics In the Philippines, many organizations such as Department Of Health are trying to educate and inform the public about health care quality. The purpose of implementing quality health care is to offer expert advice and suggest noteworthy approaches to solve medical problems, illnesses, sickness, ailment, disorder and complaints. Notwithstanding the readiness of the solution, the solution typically involves a multitude of strategies including regulatory forms, financial incentives, independent oversight and patient education. HEALTH INFORMATION TECHNOLOGY (HIT) Article 8 section 11 of the 1987 constitution of the Philippines States the “the state shall adopt an integrated and comprehensive approach to health development which small endeavor to make essential goods, health and other social services available to all people.” Health Informatics Paradigm Shift Basic Steps to properly implement the nursing information system in the Hospital: Stage 1 3 Translate Data into Information (with 2 statistical processes) Collecting and 1 Analyzing the Data Commencing the Project STAGE 2 health care provider are provided simultaneously. 6 Project Evaluation 5 Support from the Client 4 Dissemination of Information Defining Component of Nursing Informatics Data It simply exists and has no significance beyond its existence. It can exist in any form, usable or not. It does not have meaning of itself. In computer parlance, a spreadsheet generally starts out by holding data. Information, often in the form of facts or figures obtained from experiments or surveys, used as a basis for making calculations or drawing conclusions. Information, for example, numbers, text, images, and sounds, in a form that is suitable for storage in or processing by a computer. Information It is a date that has been given meaning by way of relational connection. In computer parlance, a relational database makes information from the data stored within it. Definite knowledge acquired or supplied about something or somebody. The collected facts and data about a particular subject. A telephone service that supplies telephone numbers to the public on request. The communication of facts and knowledge. Computer data that has been organized and presented in a systematic fashion to clarify the underlying meaning A formal accusation of a crime brought by a prosecutor, as opposed to an indictment brought by a grand jury. Knowledge It is the appropriate collection of information, such that its intent is to be useful. Knowledge is a deterministic process. When someone "memorizes" information (as less aspiring test bound students often do), then they have amassed knowledge. General awareness or possession of information, facts, ideas, truths, or principles. Clear awareness or explicit information, for example,