Informatics Nursing Flashcards

Which change management model is most widely used to guide healthcare IT (EHR) implementation projects?

Answer: Lewin's Change Theory (Unfreeze-Change-Refreeze) or Kotter's 8-Step model

Lewin's Three-Step Change Theory and Kotter's 8-Step Change Model are the most widely applied change management frameworks in healthcare IT implementations.

A nurse uses the EHR to access medication history, allergy list, and recent labs from the patient's previous hospitalization at an affiliated facility. This is an example of:

Answer: Health Information Exchange (HIE) supporting longitudinal patient record access

Health Information Exchange (HIE) enables authorized clinicians to electronically access and share patient clinical information across different healthcare organizations.

A root cause analysis reveals a medication error where metformin was selected instead of metronidazole from a drop-down list due to adjacent placement of similar names. This is classified as:

Answer: Juxtaposition error (wrong-drug selection due to adjacent similar names)

Juxtaposition errors occur when two similar items are placed adjacent in an EHR list and the clinician selects the wrong item. This is a well-recognized EHR-specific error type.

Which federal law established the legal framework for protecting electronic health information privacy and security in the United States?

Answer: The Health Insurance Portability and Accountability Act (HIPAA) of 1996 with HITECH amendments

HIPAA (1996) established the foundational privacy and security framework for PHI. The HITECH Act (2009) significantly strengthened HIPAA by extending requirements to business associates and establishing the Breach Notification Rule.

Which approach uses automated queries to measure nursing documentation quality across thousands of records simultaneously?

Answer: Nursing sensitive quality indicators extracted via SQL from the EHR database

SQL queries on the EHR relational database enable automated extraction of structured data to measure documentation compliance and quality across entire patient populations — far more efficient than manual audits.

Which metric would best measure whether a newly implemented sepsis early warning algorithm in the EHR actually improves patient outcomes?

Answer: In-hospital mortality rate and time-to-antibiotics for patients with sepsis alerts

Clinical effectiveness of a sepsis alert system is best measured by patient outcome metrics — mortality rate and time-to-antibiotics. Alert firing rates and acknowledgment rates are process measures that do not directly confirm improved patient outcomes.