DISCUSSION TEMPLATE
DISCUSSION QUESTIONS
There is need to use references for all your discussions but not necessary when responding to other students’ discussions. The references must be three years old. See the template for appropriate in-text citation for APA guidelines. A total of one reference is needed plus your text book.
Your discussion must be two paragraphs long with three sentences in each paragraph.
EXAMPLE
Please provide example here that pertains to this DQ
REFERENCES
Use two references including textbook. Inappropriate citation of references can result in lower discussion grade.
SAMPLE
DQ INITIAL RESPONSE
Provide an example based on your professional experiences of how network security is managed in your organization
Stewart (2013) stated Network Security is to ensure the information in both equipment and programming advancements. It oversees get to and shields from the assortment of dangers and prevents them from entering to our network. Network Security layer executes strategies and controls. By this Network Security, the Authorized clients just access network assets, and malevolent clients will be obstructed from conveying dangers to our network (Stewart, 2013).
Network security begins with various sorts of Authentications, with a username and a secret key – this named as one-factor verification. While two-factor confirmation, we can add some more assurance to one-factor verification like a security token or 'dongle', an ATM card, or a cell phone (Stenfelt, Kopplin, & Mattsson, 2016). What's more, three-factor confirmation, we can add some more assurance to the two-factor validation like a unique finger impression or retinal sweep.
EXAMPLE
We had one little import pass on business where every last one of the PCs is connected through LAN. Each time it is essential to store the information and secure the information so yet to the right uses similar utilizations can see and take that data. We ensure our entire structures by playing out the running with advances and making our entire framework protected and secure.
VPN's are used to set up an encoded relationship over a framework while using the Internet as its transmission medium. It's unassuming. As opposed to acquainting additional equipment and organizations with making a sheltered relationship between one place and another, a VPN uses the Internet, which is starting from now set up.
REFERENCES
J. Michael Stewart (2013), Network Security, Firewalls, and VPNs, Second Edition - Virtual Lab
Access (LMS Integration), 2nd Edition
ISBN(s): 9781284163117, N/A, 1284163113.
Stenfelt, J., Kopplin, D., & Mattsson, H. (2016). U.S. Patent No. 9,380,460. Washington, DC:
U.S. Patent and Trademark Office.
Directions: Reading chapter 1-4. PDF attached
This Reflection-in-Action Entry should be at least 200 words in length
utilize APA 6th Edition. Discuss and reflect on the topic in terms of:
a. How the content and assignments met the course objective(s)? Course name: nursing- in.
DISCUSSION TEMPLATEDISCUSSION QUESTIONS There is need to .docx
1. DISCUSSION TEMPLATE
DISCUSSION QUESTIONS
There is need to use references for all your discussions but not
necessary when responding to other students’ discussions. The
references must be three years old. See the template for
appropriate in-text citation for APA guidelines. A total of one
reference is needed plus your text book.
Your discussion must be two paragraphs long with three
sentences in each paragraph.
EXAMPLE
Please provide example here that pertains to this DQ
REFERENCES
Use two references including textbook. Inappropriate citation
of references can result in lower discussion grade.
SAMPLE
DQ INITIAL RESPONSE
Provide an example based on your professional experiences of
how network security is managed in your organization
Stewart (2013) stated Network Security is to ensure the
information in both equipment and programming advancements.
It oversees get to and shields from the assortment of dangers
and prevents them from entering to our network. Network
Security layer executes strategies and controls. By this Network
Security, the Authorized clients just access network assets, and
malevolent clients will be obstructed from conveying dangers to
our network (Stewart, 2013).
Network security begins with various sorts of Authentications,
with a username and a secret key – this named as one-factor
verification. While two-factor confirmation, we can add some
more assurance to one-factor verification like a security token
or 'dongle', an ATM card, or a cell phone (Stenfelt, Kopplin, &
2. Mattsson, 2016). What's more, three-factor confirmation, we
can add some more assurance to the two-factor validation like a
unique finger impression or retinal sweep.
EXAMPLE
We had one little import pass on business where every last one
of the PCs is connected through LAN. Each time it is essential
to store the information and secure the information so yet to the
right uses similar utilizations can see and take that data. We
ensure our entire structures by playing out the running with
advances and making our entire framework protected and
secure.
VPN's are used to set up an encoded relationship over a
framework while using the Internet as its transmission medium.
It's unassuming. As opposed to acquainting additional
equipment and organizations with making a sheltered
relationship between one place and another, a VPN uses the
Internet, which is starting from now set up.
REFERENCES
J. Michael Stewart (2013), Network Security, Firewalls, and
VPNs, Second Edition - Virtual Lab
Access (LMS Integration), 2nd Edition
ISBN(s): 9781284163117, N/A, 1284163113.
Stenfelt, J., Kopplin, D., & Mattsson, H. (2016). U.S. Patent
No. 9,380,460. Washington, DC:
U.S. Patent and Trademark Office.
Directions: Reading chapter 1-4. PDF attached
This Reflection-in-Action Entry should be at least 200 words in
length
utilize APA 6th Edition. Discuss and reflect on the topic in
terms of:
a. How the content and assignments met the course objective(s)?
Course name: nursing- innovation in patient care technology
and information manageme
b. Provide examples of actual or potential applications of the
3. course week’s course concepts.
c. Successes or challenges that you had for the week in terms of
the course content
Here is the grading rubric:
Criteria
Timeliness
Reflective Assignment submitted on time
Content
Fully responds to all questions in prompt and answers each
completely.
Accuracy
Entries contain accurate information and properly cited
references
Integration Of
Knowledge
Demonstrates that the author fully understands and has applied
concepts
learned in the course at a superior level. Concepts are integrated
into the writer’s own insights. The writer provides concluding
remarks
that show analysis and synthesis of ideas.
Writing Style, Formatting and Conventions
3 or more references are used to support opinions and justify
recommendations. Excellent writing with no grammar, APA or
spelling errors
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v
Jeanne Sewell, an associate professor of nursing at Georgia
College & State
University in Milledgeville, Georgia, is board certified as an
informatics nurse
specialist. Her credentials include a postgraduate certificate in
nursing infor-
matics from Duke University, a Master of Science in Nursing at
the University
of Maryland at Baltimore, a Bachelor of Science in Nursing at
Georgia Regents
University–Medical College of Georgia, and a nursing diploma
from Georgia
Baptist School of Nursing, now Georgia Baptist College of
Nursing at Mercer
University.
Jeanne’s expertise is nursing informatics, nursing education,
and the
scholarship of teaching and learning. She has received several
teaching
awards, including the Georgia College & State University 2015
Scholarship
of Teaching and Learning Award. She teaches traditional face-
to-face classes,
8. as well as blended and online classes, across the nursing
curriculum in the
following programs: baccalaureate in nursing, RN-BSN, master
of science in
nursing, and doctor of nursing practice. She has served as a
consultant in nursing education and as a
speaker at statewide, national, and international conferences.
Jeanne has clinical nursing experience in a variety of settings,
including nursing administration, out-
patient care, critical care, medical-surgical care, and pediatric
nursing. Her interest in nursing informat-
ics began in the early 1980s as she was completing graduate
studies, when different clinical information
systems began integration.
About the Author
vi
Contributors to the Fifth Edition
Omega Finney, MSN, RN-BC
Informaticist
Piedmont Healthcare
Atlanta, Georgia
Karen Frith, PhD, RN, NEA-BC
Professor and Associate Dean, Undergraduate
Programs
College of Nursing, The University of Alabama in
Huntsville
Huntsville, Alabama
9. Linda Q. Thede, PhD, RN-BC
Professor Emerita of Nursing
Kent State University
Kent, Ohio
Contributors
Contributors to the Fourth Edition
Deborah Ariosto, PhD, MSN, RN
Director, Patient Care Informatics
Vanderbilt University Medical Center
Nashville, Tennessee
Pamela J. Correll, RN, MS
Nursing Informatics Consultant
Maine Center for Disease Control and Prevention
Public Health Nursing Program
Bangor, Maine
Karen Frith, PhD, RN, NEA-BC
Professor and Associate Dean, Undergraduate
Programs
College of Nursing, The University of Alabama in
Huntsville
Huntsville, Alabama
Judy Hornbeck, MHSA, BSN, RN
Highland, Illinois
For a list of the contributors to the Student and Instructor
Resources accompanying this book, please visit http://
thepoint.lww.com/sewell5e.
vii
10. Reviewers
Kerry Allen, MSN
Associate Professor
Southern Adventist University
Collegedale, Tennessee
Kim Amer, PhD, RN
Associate Professor
DePaul University
Chicago, Illinois
Mary Boylston, MSN, EdD
Professor
Eastern University
St. Davids, Pennsylvania
Elizabeth Carlson, PhD
Associate Professor and Systems Leadership DNP
Program Director
Rush University, College of Nursing
Chicago, Illinois
Laura Clayton, PhD, RN, CNE
Assistant Professor of Nursing Education
Shepherd University
Shepherdstown, West Virginia
Prudence Dalrymple, PhD, MS in Informatics
Research and Teaching Professor
Drexel University
Philadelphia, Pennsylvania
Jeff Dowdy, MLIS
Graduate Librarian
Ina Dillard Russell Library, Georgia College &
State University
11. Milledgeville, Georgia
Tresa Dusaj, PhD(c)
Assistant Professor
Monmouth University
West Long Branch, New Jersey
Robert Elshaw, MSN, RN-BC, ANCC Board
Certified Informatics Nurse
Adjunct Faculty
Ursuline College
Pepper Pike, Ohio
Willy Fahlman, BScN, MEd, EdD
Sociology Faculty
Athabasca University
Athabasca, Alberta
Mary Fairbanks, MS, DNP, RN, PHN
Associate Professor
Bemidji State University
Bemidji, Minnesota
Matthew Gaines, AAS
Technical Support Tech
Division on Information Technology, Georgia
College & State University
Milledgeville, Georgia
Debbie Greene, PhD, RN, CNE
Associate Professor and Assistant Director for
Undergraduate Nursing Programs
School of Nursing, Georgia College & State
University
Milledgeville, Georgia
12. Janis Hayden, EdD, MSN, RN
Professor
St. Francis Medical Center, College of Nursing
Peoria, Illinois
viii Reviewers
Arlene Holowaychuk, RN, MSN, CNE
Assistant Professor, Preceptor Coordinator
Bon Secours Memorial College of Nursing
Richmond, Virginia
Michelle Hornack, MSN, BSN
Assistant Professor of Nursing
Graceland University
Independence, Missouri
Janice Jones, PhD, RN, CNS
Clinical Professor
University at Buffalo
Buffalo, New York
Rebecca Koeniger-Donahue, PhD, APRN
Professor of Practice
Simmons College
Boston, Massachusetts
Elizabeth Kostas-Polston, PhD, APRN,
WHNP-BC, FAANP
Assistant Professor
University of South Florida
Tampa, Florida
Anne Krouse, PhD
13. Professor
Widener University
Chester, Pennsylvania
Katherine Leigh, DNP, RN
Assistant Professor
Troy University
Dothan, Alabama
Barry Lung, MSN, RN-BC
Informaticist
Byron, Georgia
Rosemary Macy, PhD, RN, CNE, CHSE
Associate Professor
Boise State University
Boise, Idaho
Patricia Martin, MSN
Associate Professor
West Kentucky Community and Technical College
Paducah, Kentucky
Priscilla Okunji, RN-BC, PhD
Nursing Faculty
Howard University
Washington, District of Columbia
Jill Pence, MSN, BSN, RN, CNE
Assistant Professor
Samford University
Birmingham, Alabama
Rorey Pritchard, EdS, MSN, RN-BC,
CNOR, CNE
Clinical Assistant Professor
14. University of Wisconsin, Eau Claire
Eau Claire, Wisconsin
Leandro Resurreccion, BSZ, BSN, MSN, EdD
Professor of Nursing
Oakton Community College
Des Plaines, Illinois
Luis M. Cabret Rios, RN, MSN, APRN,
FNP-BC, DNP(s)
Nursing Instructor
Turabo University
Gurabo, Puerto Rico
Nicole Robert, MSN, RN
Faculty Mentor
Thomas Edison State College
Zachary, Louisiana
Lisa Shaffer, MS, MBA
Adjunct Instructor
Galen College of Nursing
Cincinnati, Ohio
Bonnie Stegman, PhD, MSN, RN
Assistant Professor of Nursing and Coordinator
of the BSN Online Completion Program
Maryville University, St. Louis
St. Louis, Missouri
Sharon Stoten, DNP
Assistant Professor
Indiana University East, School of Nursing
Richmond, Indiana
15. Reviewers ix
Debra Sullivan, PhD, MSN
Assistant Professor
Middle Tennessee State University
Murfreesboro, Tennessee
Jeanne Tucker, PhD, MSN, RN, HSAD, CHES
Assistant Professor of Nursing
Patty Hanks Shelton School of Nursing
Abilene, Texas
Laureen Turner, MSN, DNP
Instructor
University of San Francisco
San Francisco, California
Denyce Watties-Daniels, MSN
Assistant Professor
Coppin State University
Baltimore, Maryland
Bonnie K. Webster, MS, RN, BC
Assistant Professor
University of Texas, Medical Branch in Galveston,
School of Nursing
Galveston, Texas
Kathleen Williams, MSN, RN-BC (Informatics)
Assistant Professor
Charleston Southern University
North Charleston, South Carolina
Ronda Yoder, PhD, ARNP
Nursing Faculty
16. Pensacola Christian College
Pensacola, Florida
For a list of the reviewers of the Test Generator questions
accompanying this book, please visit http://thepoint.lww.
com/sewell5e.
x
Preface
Advancements in computer technology and the
Internet have made the use of informatics per-
vasive in our society worldwide. Simply stated,
informatics is the use of computers to dis-
cover, manipulate, and understand information.
Informatics is required to achieve the nursing
transformation mentioned by the 2010 Institute
of Medicine (IOM) report, The Future of Nursing,
which includes enabling nurses to be full partners
in redesigning healthcare in the United States
and to engage in effective workforce planning and
policymaking (Committee on the Robert Wood
Johnson Foundation Initiative on the Future of
Nursing at the Institute of Medicine, Robert Wood
Johnson Foundation, & IOM, 2011).
The first edition of this textbook, Computers
in Nursing, which was published in 1999, was one
of the first textbooks to address core informatics
competencies for all nurses. Each edition, includ-
ing this fifth edition, was designed to capture the
innovative advancements in nursing informatics
core competencies and applications and to teach
students how informatics should be integrated
17. into practice. This edition focuses on the best of the
fourth edition, such as office computing software,
interoperability, consumer informatics, telehealth,
and clinical information systems, plus new topics
that have entered the field since the last edition,
such as social media use guidelines, software and
hardware developments, and updates on mean-
ingful use. Each chapter now includes a Quality
and Safety Education for Nurses (QSEN) scenario
designed to stimulate critical thinking. The book’s
companion webpage at http://thepoint.lww.com/
sewell5e includes many resources for students—
for example, a sample database and spreadsheets,
as well information on APA templates and e-mail
signatures—along with a wealth of resources
for instructors (see the “Additional Resources”
section later in this preface for more informa-
tion). The goal was to make it all interesting—and
yes, thought-provoking—to you, the reader. For
example, QSEN scenarios, as well as application
and competencies critical thinking exercises, align
with each chapter’s objectives. In the decade and a
half since the first edition published, nursing and
the entire healthcare arena have come to recognize
the importance of informatics.
The major accrediting organizations for nurs-
ing, American Association of Colleges of Nursing
(AACN) and the National League for Nursing
(NLN), have identified informatics as an essential
competency for all nurses, ranging from the begin-
ning practitioner to the doctor of nursing practice
(DNP), doctor of philosophy (PhD), and doctor of
nursing science (DNSc) (AACN, 1996, 2006, 2008,
2010, 2011; NLN, 2008, 2015). A call for nurs-
18. ing education to adopt informatics competencies
for all levels of education came from the TIGER
Initiative, aimed at using informatics for improv-
ing practice with evidence-based information (The
TIGER Initiative Foundation, 2014).
Evidence-based decision making using infor-
matics tools should be implemented in healthcare
redesign as well as in improvements in data collec-
tion and information infrastructure. The textbook
includes information on how to discover schol-
arly journal articles and websites with healthcare
information for evidence-based decision making.
The learner is introduced to Medline/PubMed,
from the U.S. National Library of Medicine, a free
library available to users worldwide. Clearly, there
is agreement that informatics is an essential tool
to address the need to provide evidence-based
care with improved outcomes for individuals and
populations.
http://thepoint.lww.com/sewell5e
http://thepoint.lww.com/sewell5e
Preface xi
AUDIENCE
The information in this textbook is what every
nurse should know. Besides providing information
for anyone who is just beginning to learn about
nursing informatics, the book is designed for use
either as a text for a course in nursing informat-
ics or with a curriculum in which informatics is a
vertical strand. Here is a unit-by-unit breakdown
of how the material could be used:
19. JJ Unit I, Informatics Basics, and Unit II, Computer
Applications for Your Professional Career, pro-
vide background information that would be
useful in undergraduate and graduate introduc-
tory courses, or as an introduction to comput-
ers and information management.
JJ Unit III, Information Competency, would be
useful at any point in a curriculum.
JJ Unit IV, The Evolving Healthcare Paradigm, and
Unit V, Healthcare Informatics, provide infor-
mation that would be useful at more advanced
levels.
JJ Unit VI, Computer Uses in Healthcare Beyond
Clinical Informatics, can be used as a whole or
its individual chapters matched with a course.
International Council of Nurses, the Healthcare
Information and Management Systems Society
(HIMSS) TIGER Initiative, and two United States
nursing accrediting bodies provide direction for
incorporating nursing informatics as a core com-
petency into all levels of education programs.
ORGANIZATION AND STRUCTURE
In this fifth edition, the six units were redesigned to
improve the organization and flow of the content.
Unit I, Informatics Basics, introduces readers
to new guidelines for use of electronic communi-
cation with social and professional networking.
Chapter 1 (Introduction to Nursing Informatics:
Managing Healthcare Information) provides an
20. overview of nursing informatics, including the
differences between computers and informatics,
the rationale for having basic informatics skills,
and the need to be computer fluent and infor-
mation literate. Chapters 2 (Essential Computer
and Software Concepts) and 3 (Basic Computer
Networking Concepts) cover essential computer
and software concepts, as well as information
related to how computers network and communi-
cate. Nurses often use computers without know-
ing the terminology and the possibilities and
limitations of information technology. Chapter 4
(Social and Professional Networking) examines
guidelines for use of social and professional net-
working media. Ethical and legal implications for
use of social networking sites are discussed.
Unit II, Computer Applications for Your Profes-
sional Career, provides information on the recent
versions of office software, including Google Drive,
Apache OpenOffice.org, and Microsoft Office. The
chapters include additional information to assist the
growing number of Mac users. Chapter 5 (Authoring
Scholarly Word Documents) demonstrates how to
use word processing software to format papers using
American Psychological Association writing style. It
also addresses the differences between writing a paper
for a class assignment and writing for publication.
Chapter 6 (Authoring Scholarly Slide Presentations)
emphasizes best practices for presentation design.
Chapter 7 (Mastering Spreadsheet Software to
Assess Quality Outcomes Using Numbers) addresses
best practices for designing worksheets and charts.
Chapter 8 (Databases: Creating Information from
Data) provides an explanation of how databases
21. work, including a short tutorial to assist students in
designing a simple database that addresses a nurs-
ing care issue. The database concepts discussed are
relative to any database, such as the digital library or
Internet search engines.
Unit III, Information Competency, includes
updated information on this topic. Chapter 9
(Information Literacy: A Road to Evidence-Based
Practice) includes information on use of the PICO
(patient/problem—intervention—comparison—
outcome) research approach, and it includes how
to evaluate health information found on the
Internet and how to analyze scholarly articles.
Chapter 10 (Finding Knowledge in the Digital
Library Haystack) reviews how to search digi-
tal libraries and use filters from PubMed, the
free National Library of Medicine digital library.
Chapter 11 (Mobile Computing) covers the latest
mobile computing devices and resources.
In Unit IV, The Evolving Healthcare Paradigm,
Chapters 12 (Informatics Benefits for the
http://OpenOffice.org
xii Preface
Consumer) and 13 (The Empowered Consumer)
address information for empowering healthcare
consumers, the importance of personal health
records, and challenges consumers face access-
ing and understanding health information.
Chapters 14 (Interoperability at the National
and the International Levels) and 15 (Nursing
22. Documentation in the Age of the Electronic Health
Record) discuss standards and terminology neces-
sary for interoperability and data abstraction from
electronic records using standardized terminology
for documenting the electronic health record.
Unit V, Healthcare Informatics, focuses on use
of informatics in the healthcare setting. Chapter
16 (Nursing Informatics: Theoretical Basis,
Education Program, and Profession) explores
informatics as a nursing specialty, including
information on the theory base for nursing infor-
matics, educational programs, and professional
organizations. Chapter 17 (Electronic Healthcare
Information Systems, Electronic Health Records,
and Meaningful Use) reviews the progress toward
implementation of the electronic health record
(EHR), as well as “meaningful use” and the
implications for improving healthcare delivery.
Chapter 18 (Design Considerations for Healthcare
Information Systems) provides an overview of
healthcare information systems, systems selec-
tion, and the systems life cycle, a process used to
plan and implement a computer system. Chapter
19 (Quality Measures and Specialized Electronic
Healthcare Information Systems) reviews infor-
mation on specialized electronic healthcare infor-
mation systems and quality measures to improve
care outcomes. Chapter 20 (Electronic Healthcare
System Issues) covers issues associated with the
use of information systems. When documenta-
tion moved from paper to electronic systems, new
problems emerged that nurses need to understand
in order to mitigate. Finally, Chapter 21 (Evolving
Trends in Telehealth) addresses exciting new
developments in telehealth, which allows supple-
23. mentation of face-to-face care with technology
that supports care delivery in the patient’s home,
emergency departments, and intensive care units.
Unit VI, Computer Uses in Healthcare Beyond
Clinical Informatics, includes the use of infor-
matics in other nursing settings. Chapter 22
(Educational Informatics: e-Learning) describes
the use of informatics in nursing education.
Chapter 23 (Informatics in Management and
Quality Improvement) covers management infor-
mation technology tools. Chapter 24 (Informatics
and Research) discusses the use of informatics for
nursing research. Chapter 25 (Legal and Ethical
Issues) addresses the legal and ethical challenges
that informatics introduces, encompassing data
breaches and copyright issues.
Information on the newest computer and soft-
ware features is included in the textbook appen-
dix. This overview may serve as a course lesson,
depending on the computer knowledge of the stu-
dents. Key terms in each of the book’s chapters are
defined in the glossary. Because nursing students
often identify information technology terminol-
ogy as new and challenging, the glossary terms
provide learning support.
In summary, the topics in this textbook address
informatics competencies and applications needed
by all nurses, now and in the near future. Nurses
with communication skills enhanced with the use
of technology, computer fluency, information lit-
eracy skills, and knowledge of informatics termi-
nology and clinical information systems can assist
24. in shaping nursing practice to improve patient
outcomes and to contribute to the scholarship of
nursing.
ADDITIONAL RESOURCES
Informatics and Nursing includes additional
resources for both instructors and students that
are available on the book’s companion website at
http://thepoint.lww.com/sewell5e.
Instructors
Approved adopting instructors will be given access
to the following additional resources:
JJ Ebook: Allows access to the book’s full text and
images online.
JJ PowerPoint Slides: Provide an easy way for you
to integrate the textbook with your students’
classroom experience through either slide
shows or handouts.
http://thepoint.lww.com/sewell5e
Preface xiii
JJ Case Studies: Bring the content to life through
real-world situations with these scenarios,
which can be used as class activities or group
assignments.
JJ Test Generator: Lets you put together exclusive
new tests from a bank to help you assess your
students’ understanding of the material. These
questions are formatted to match the NCLEX
25. (National Council Licensure Examination),
so that your students can have practice with
the question types covered in this important
examination.
JJ Suggested answers to the QSEN scenarios
found in the book.
JJ QSEN Map: Shows how the book content inte-
grates QSEN competencies.
JJ BSN Essentials Competencies Map: Shows
how the book content integrates American
Association of Colleges of Nursing (AACN)
Essentials of Baccalaureate Education for
Professional Nursing Practice competencies.
JJ TIGER Competencies Map: Shows how the book
content integrates Technology Informatics Guiding
Educational Reform (TIGER) competencies.
JJ Image Bank: Contains all the illustrations and
tables from the book in formats suitable for
printing and incorporating into PowerPoint
presentations and Internet sites.
JJ Strategies for Effective Teaching: Offer cre-
ative approaches for engaging students.
JJ Learning Management System Cartridges.
Students
Students who have purchased Informatics and
Nursing, fifth edition, have access to the following
additional resources:
JJ Journal Articles: One article per chapter offers
26. access to current research available in Wolters
Kluwer journals.
JJ Weblinks: These URLs point readers to helpful
online resources for each chapter.
JJ Acronyms: This list of abbreviations and their
spell outs demystifies the alphabet soup of the
informatics field.
JJ Additional Information and Examples: Users
can download digital versions of examples used
for the office software chapters, among others,
from thePoint.
JJ Plus a Spanish-English Audio Glossary, Nursing
Professional Roles and Responsibilities, and
Learning Objectives.
See the inside front cover of this text for more
details, including the passcode you will need to
gain access to the website.
REFERENCES
American Association of Colleges of Nursing. (1996). The
essentials of master’s education for advanced practice nurs-
ing. Retrieved from http://www.aacn.nche.edu/education-
resources/MasEssentials96.pdf
American Association of Colleges of Nursing. (2006). The
essentials
of doctoral education for advanced nursing practice. Retrieved
from http://www.aacn.nche.edu/publications/position/DNP
Essentials.pdf
27. American Association of Colleges of Nursing. (2008). The
essentials of baccalaureate education for professional
nursing practice. Retrieved from http://www.aacn.nche.
edu/education-resources/BaccEssentials08.pdf
American Association of Colleges of Nursing. (2010). The
research-focused doctoral program in nursing: Pathways
to excellence. Retrieved from http://www.aacn.nche.edu/
education-resources/PhDPosition.pdf
American Association of Colleges of Nursing. (2011). The
essentials of master’s education in nursing. Retrieved from
http://www.aacn.nche.edu/education-resources/Masters
Essentials11.pdf
Committee on the Robert Wood Johnson Foundation Initiative
on the Future of Nursing at the Institute of Medicine,
Robert Wood Johnson Foundation, & Institute of Medicine.
(2011). The future of nursing: Leading change, advancing
health.
Washington, DC: National Academies Press.
National League for Nursing. (2008). Preparing the next genera-
tion of nurses to practice in a technology-rich environment: An
informatics agenda. New York: NLN Press.
National League for Nursing. (2015). A vision for the chang-
ing faculty role: Preparing students for the technological
world of health care. Retrieved from http://www.nln.org/
docs/default-source/about/nln-vision-series-%28position-
statements%29/a-vision-for-the-changing-faculty-role-
preparing-students-for-the-technological-world-of-health-
care.pdf?sfvrsn=0
Technology Informatics Guiding Education Reform. (2014).
29. care.pdf?sfvrsn=0
http://www.nln.org/docs/default-source/about/nln-vision-series-
%28position-statements%29/a-vision-for-the-changing-faculty-
role-preparing-students-for-the-technological-world-of-health-
care.pdf?sfvrsn=0
http://www.thetigerinitiative.org/
http://www.thetigerinitiative.org/
xiv
Several colleagues contributed to this fifth
textbook edition. Jeff Dowdy shared his librarian
expertise for Chapter 10 edits on digital librar-
ies. Linda Thede, who has expertise with nursing
taxonomy, wrote the revisions for Chapter 15 on
nursing documentation. Barry Lung, a nursing
informatics expert and a recently retired infor-
matics consultant, provided his expertise for
Chapters 18, 19, and 20 edits on clinical informa-
tion systems. Omega Finney, who is certified as an
informatics nurse specialist and works as an infor-
matics nurse specialist at Piedmont Healthcare,
provided the updates for Chapter 16 on nursing
informatics. She also wrote the section in that
chapter titled A Day in the Life of an Informatics
Nurse Specialist. Omega is a recipient of an
Informatics Nurse of the Year award at Piedmont
Healthcare. Karen Frith, who is board certified as
an advanced nurse executive, wrote and updated
Chapters 23 and 24 on research and administra-
tive tools. Matthew Gaines, an information tech-
nology specialist, provided his technical support
expertise for the updated appendix on hardware
and software. In addition, the feedback from peer
30. reviewers, faculty, and students who have used the
textbook helped to guide the changes and updates.
Numerous others assisted in editing and rewrit-
ing, including Meredith Brittain, a Supervisory
Product Development Editor at Wolters Kluwer.
I appreciate the opportunity to have coauthored
the third and fourth editions of the textbook with
Linda Thede. Thanks also go to my husband, fac-
ulty colleagues, and friends for their support while
preparing this edition. Finally, I extend a special
thanks to my mother, Daisy Penny, for fostering
my love of nursing and nursing informatics.
Acknowledgments
xv
About the Author ............................................ v
Contributors ...................................................... vi
Reviewers ........................................................... vii
Preface ................................................................ x
Acknowledgments .........................................xiv
UNIT I: INFORMATICS BASICS
����������������������1
1� Introduction to Nursing Informatics:
Managing Healthcare Information ����������2
Informatics Introduction
������������������������� 3
Informatics Discipline
������������������������������ 5
31. Healthcare Informatics .......................... 5
Nursing Informatics ................................ 6
Forces Driving More Use of
Informatics in Healthcare ��������������������8
National Forces ....................................... 8
Nursing Forces ......................................... 8
Costs ..........................................................10
The Information Management
Tool: Computers
����������������������������������
11
Computers and Healthcare ������������������� 11
Early Healthcare Informatics
Systems ..................................................... 12
Progression of Information
Systems ..................................................... 12
Benefits of Informatics
���������������������������13
Benefits for Healthcare in
General ...................................................... 13
Benefits for the Nursing
Profession .................................................14
Skills Needed by All Nurses ������������������15
Computer Fluency ................................. 15
Information Literacy ..............................16
Summary
�����������������������������������
���������������17
Applications and Competencies ��������18
32. 2� Essential Computer and Software
Concepts
�����������������������������������
����������21
Operating Systems
���������������������������������22
Cloud Computing
�����������������������������������
22
Cloud Office Apps ................................ 23
Sharing Files in the Cloud ..................24
Advantages and Limitations of
Using the Cloud .....................................24
Software Program Copyright ��������������24
Open Source ...........................................24
Shareware ............................................... 25
Freeware .................................................. 25
Public-Domain Software ..................... 25
Commercial Software .......................... 25
Software Piracy ..................................... 25
Managing Digital Files
���������������������������26
Keyboard Shortcuts .............................26
Managing File Extensions ...................26
Saving a File as a Different
Type ..........................................................26
The Clipboard .........................................28
Disk and Data Encryption ...................28
Other Computer Features ��������������������28
Speech Recognition .............................28
33. Contents
xvi Contents
Sleep Mode .............................................29
Handling Minor Problems ...................29
Summary
�����������������������������������
������������� 30
Applications and
Competencies���������������������������
������������ 30
3� Basic Computer Networking
Concepts
�����������������������������������
��������� 32
A Historical Perspective of the
Internet
�����������������������������������
���������������33
Network Connections Essentials ��������34
Types of Networks ................................35
Network Connections ..........................35
Network Connection Speed ..............36
IP Addresses ........................................... 37
Domain Name System ......................... 37
The World Wide Web
����������������������������37
Web Browsers ........................................ 37
34. Troubleshooting an URL .....................38
Online Security
�����������������������������������
�����39
Computer Malware .............................. 40
Protection Against Malware ..............43
Hoaxes ......................................................44
Security Pitfalls ......................................45
Summary
�����������������������������������
��������������45
Applications and Competencies ������ 46
4� Social and Professional
Networking
�����������������������������������
�����48
E-mail
�����������������������������������
��������������������� 49
E-mail Signature ....................................49
Out-of-Office Replies ..........................50
Managing E-mail ....................................50
Spam .........................................................50
E-mail Etiquette ......................................51
Web 2�0
�����������������������������������
�����������������52
Social and Professional
Networking
�����������������������������������
35. ��������52
Networking Sites ...................................53
Blogs .........................................................54
Content Sharing ....................................56
Pros and Cons for Using Social
Media for Professional
Networking ............................................. 57
Safe Networking ....................................58
Collaborative Sharing and
Collective Intelligence
�����������������������58
Group Discussion Forums ..................59
Internet Telephone .............................. 60
Teleconferencing ...................................61
Cloud Office Suite Software ...............61
Podcasts ...................................................61
Social Bookmarking .............................62
Summary
�����������������������������������
��������������62
Applications and Competencies �������63
UNIT II: COMPUTER APPLICATIONS FOR
YOUR PROFESSIONAL CAREER
������������������ 65
5� Authoring Scholarly Word
Documents
�����������������������������������
������ 67
Steps for Writing a Scholarly
Paper
36. �����������������������������������
�������������������68
Step 1: Researching the Paper
Topic .........................................................68
Step 2: Choosing the Word
Processing Tool .....................................68
Step 3: Writing the Paper ...................69
The APA Paper Formatting
Requirements
�����������������������������������
�����71
Title Page .................................................. 71
Abstract and Keywords ....................... 71
Body of the Paper .................................. 71
References .............................................. 73
APA Template ........................................ 73
Special Considerations for
Scholarly Papers
���������������������������������74
Special Considerations for
Academic Papers ..................................74
Contents xvii
Special Considerations for
Journal Manuscripts ............................. 75
Other Word Processing Tools �������������76
Spelling and Grammar Check ...........76
Page Ruler ...............................................76
Format Painter .......................................76
Automatic Bullets and
37. Numbers ..................................................76
Find and Replace .................................. 77
Table of Contents ................................. 77
Footnotes and Endnotes .................... 77
Track Changes Tool .............................. 77
Collaboration ..........................................78
Mail Merge ...............................................78
Language Translation ..........................78
Learning New Word Processing
Skills
�����������������������������������
��������������������78
Summary
�����������������������������������
������������� 80
Applications and
Competencies���������������������������
������������ 80
6� Authoring Scholarly Slide
Presentations
�����������������������������������
�� 82
Using Electronic Slideshows in
Nursing
�����������������������������������
���������������83
Principles for All Presentations .........83
Computer Slide Models .......................85
Presentation Styles ...............................85
Presentation Software
���������������������������86
38. Compatibility of Software ..................87
Collaborating on Slideshow
Software Design ....................................87
Basics of Slide Creation
������������������������87
Views of the Slides ...............................87
Layers .......................................................88
Creating the Presentation
��������������������89
Storyboarding ........................................89
Content ....................................................89
Special Effects ........................................91
Speaker Notes ........................................93
Creating a Show that Allows
for Nonlinear Presentations ...............94
The Presentation
�����������������������������������
� 94
Handouts .................................................94
Transferring to the Web .....................94
The Oral Presentation ..........................94
Learning New Presentation Skills �������95
Summary
�����������������������������������
��������������95
Applications and Competencies �������97
7� Mastering Spreadsheet Software to
Assess Quality Outcomes Using
Numbers
�����������������������������������
39. ���������99
Uses of Spreadsheets in Nursing ������100
Tips for Better Spreadsheets ��������������101
Spreadsheets
�����������������������������������
������ 102
The Spreadsheet Window ................ 102
Spreadsheet Basics ............................ 102
Spreadsheet Power ............................ 104
Formulas ................................................ 104
Formatting Cells .................................. 105
Text to Columns .................................. 106
Freezing Rows and Columns ........... 106
Using Automatic Data Entry ............ 107
Data Validation .................................... 107
Forms ...................................................... 107
Formatting a Spreadsheet for
Use in a Database ............................... 107
Linking Cells and Worksheets
from Other Sources ............................ 108
Data Protection and Security .......... 108
Charts
�����������������������������������
�������������������108
Chart Basics .......................................... 108
Creating the Chart ................................113
Dashboards ............................................ 114
Pivot Tables and Pivot Charts .......... 114
Printing
�����������������������������������
������������������114
40. Learning New Spreadsheet Skills ������114
Summary
�����������������������������������
������������� 116
Applications and Competencies ������ 116
xviii Contents
8� Databases: Creating Information
From Data
�����������������������������������
������ 118
Uses of Databases in Nursing ������������� 119
Anatomy of Databases
������������������������ 120
Tables ..................................................... 120
Queries ................................................... 120
Forms ........................................................121
Reports ....................................................122
Database Concepts and
Terminology
�����������������������������������
���� 122
Database Models
����������������������������������
123
Flat Database ........................................123
Hierarchical Database .........................123
Network Model .....................................123
Relational Database Model .............. 124
Object-Oriented Model ..................... 126
41. Database Software
Solution
s ������������ 126
Creating a Simple Database �������������� 126
Saving Data in a Database ����������������� 129
Manipulating Data
��������������������������������130
Sorting .................................................... 130
Querying .................................................132
Secondary Data
Use����������������������������� 132
Discovering Knowledge in
Large Databases
������������������������������� 133
Data Mining ............................................133
Online Analytical Processing ........... 134
42. Structured Query Language ............ 134
Summary
�����������������������������������
������������ 134
Applications and Competencies ����� 135
UNIT III: INFORMATION COMPETENCY ��������137
9� Information Literacy: A Road to
Evidence-Based Practice
��������������������138
Information Literacy Competencies
for Nurses
�����������������������������������
�������� 139
Impact of the Healthcare
Professional’s Information
Literacy .................................................. 140
Teaching Information Literacy
Skills ........................................................ 140
Critical Thinking and Clinical
Reasoning ............................................... 141
Knowledge Generation ..................... 142
43. Knowledge Dissemination
Activities ................................................ 142
Information Technology Skills ����������� 142
Discovering and Evaluating Health
Information on the Internet ������������ 143
Website Source ................................... 143
Website Authority .............................. 143
Website Funding ................................. 143
Website Validity and Quality ........... 143
Website Privacy and Disclosure ..... 144
Nursing Information on the
Internet
�����������������������������������
������������� 145
Clinical Practice and Informatics .... 145
Scholarly Journal Articles ................. 148
Government and Not-for-Profit
Health and Disease Specialty
Organizations .........................................151
Professional Nursing
Organizations .........................................151
44. Laws, Rules, and Regulations ............151
Online Evidence-Based
Resources ................................................151
Summary
�����������������������������������
������������� 151
Applications and Competencies ����� 153
10� Finding Knowledge in the Digital
Library Haystack
�������������������������������� 155
Digital Library Basics
��������������������������� 156
Reference Management Software ���� 156
Library Guides and Tutorials ������������� 157
Subject Headings .................................157
Searching Using MeSH Terms ..........157
Using a Search Interface ................... 158
Bibliographic Databases Pertinent
to Nursing
�����������������������������������
45. �������� 159
CINAHL .................................................. 159
Contents xix
MEDLINE/PubMed .............................. 159
Cochrane Library .................................. 161
PsycINFO and PsycARTICLES.......... 161
Embarking on the Quest for
Knowledge
�����������������������������������
������ 162
Step 1: Questioning Practice:
Recognizing an Information
Need ........................................................ 162
Step 2: Searching for Appropriate
Evidence ................................................ 163
Step 3: Critically Analyzing the
Literature Findings ............................. 165
Step 4: Applying/Implementing
the Search Findings ........................... 166
Step 5: Evaluating the Result and
46. Effectiveness of Practice
Changes ..................................................167
Challenges to the Adoption of
Evidence-Based Nursing ����������������� 167
Summary
�����������������������������������
������������ 167
Applications and Competencies ����� 168
11� Mobile
Computing�����������������������������
�170
Mobile-Computing Basics ��������������������
171
History of Mobile Computing ������������� 171
Understanding Mobile Computer
Concepts
�����������������������������������
���������� 172
Smartphones and Tablet Devices
Defined ....................................................172
47. Wi-Fi Mobile Computer
Operating Systems ..............................172
Display .....................................................173
Battery .....................................................173
Memory ...................................................173
Data Entry ............................................. 174
Synchronization (Sync) ..................... 174
Connectivity.......................................... 174
Advantages and Disadvantages of
Using Mobile Devices in Nursing
and Nursing Education �������������������� 175
Use in Nursing Education ..................177
Use of Mobile Devices in
Clinical Practice ....................................177
Use of Mobile Devices in
Nursing Research .................................179
Use of Mobile Devices to Read
eBooks .................................................... 180
Use of Mobile Devices for Library
Searches ................................................ 180
Data Security Issues
������������������������������ 181
48. Future Trends
�����������������������������������
������ 181
Summary
�����������������������������������
������������ 182
Applications and Competencies ����� 182
UNIT IV: THE EVOLVING HEALTHCARE
PARADIGM
�����������������������������������
�������� 185
12� Informatics Benefits for the
Consumer
�����������������������������������
�������187
Implementing the Promise of the
Internet in Healthcare ����������������������
188
Electronic Medical Record ............... 189
Electronic Health Record .................. 190
Personal Health Record .................... 190
50. Oral Communication .......................... 201
Written Communication .................. 202
Empowering the Healthcare
Consumer for Self-Management ... 203
Providing Supportive Systems ...... 208
xx Contents
Providing Web-Based Patient
Information
�����������������������������������
�����209
Creating a Web Page ......................... 210
Summary
�����������������������������������
������������� 211
Applications and
Competencies���������������������������
������������ 211
14� Interoperability at the National
and the International Levels ���������������214
51. Interoperability Defined����������������������
215
Types of Interoperability ��������������������
215
Standards
�����������������������������������
������������ 215
U�S� Efforts for Promoting
Interoperable Electronic Health
Records
�����������������������������������
������������ 217
Office of the National Coordinator
for Health Information
Technology ............................................217
Health IT Adoption Surveys ............. 219
U.S. Public Health Information
Network ................................................ 220
Unified Medical Language
System ................................................... 220
Effect of U.S. Efforts on Nursing
and Patient Care...................................221
52. International Standards
Organizations
�����������������������������������
� 221
International Organization for
Standardization ....................................221
International Electrical
Commission ..........................................222
ASTM International .............................222
Health Level Seven .............................222
International Classification of
Disease ...................................................223
International Classification of
Functioning, Disability,
and Health .............................................224
Digital Imaging and
Communications in Medicine ..........224
Comité Européen de
Normalisation .......................................224
International Health Terminology
Standards Development
Organisation .........................................225
Development of International
53. Standards ..............................................225
Billing Terminology
Standardization
�������������������������������� 225
International Classification of
Disease—Clinical Modification ........225
Medicare Severity Diagnosis-
Related Groups ....................................226
The Healthcare Common
Procedure Coding System ...............226
Outcome and Assessment
Information Set ....................................226
Summary
�����������������������������������
����������� 226
Applications and Competencies �����227
15� Nursing Documentation in the Age
of the Electronic Health Record ���������� 229
Nursing and Documentation ������������� 230
Types of Standardized
Terminologies
54. �����������������������������������
� 231
Natural Language ................................231
Linear Lists or Vocabularies .............232
Taxonomic Vocabularies ...................232
Combinational Vocabularies ............233
Ontologies .............................................234
Overview of Standardized
Healthcare Terminologies �������������� 234
Nursing-Related Standardized
Terminologies
�����������������������������������
235
Minimum Data Sets ............................235
Nursing-Focused Standardized
Terminologies .......................................236
Interdisciplinary Standardized
Terminologies .......................................237
Attempts to Make Terminologies
Interoperable
�����������������������������������
�� 241
55. Mapping ................................................. 241
Harmonization...................................... 241
Contents xxi
Linking .................................................... 241
Integration ............................................. 241
Benefits of Using Standardized
Terminologies
�����������������������������������
242
Increasing Quality of Care ................242
Decreasing Costs of Care .................242
Contributing to Evidence-Based
Practice and Clinical Decision
Systems ..................................................242
Communication in Healthcare .........243
Standardized Terminologies
Issues
�����������������������������������
��������������� 243
56. Interdisciplinary Healthcare �������������� 243
Summary
�����������������������������������
�����������244
Applications and Competencies ���� 245
UNIT V: HEALTHCARE INFORMATICS ���������247
16� Nursing Informatics: Theoretical
Basis, Education Program, and
Profession
�����������������������������������
����� 249
Theories That Lend Support to
Informatics�����������������������������
������������ 250
Nursing Informatics Theory ............ 250
Sociotechnical Theory and Social
Informatics ............................................252
Change Theories .................................252
General Systems Theory ...................254
Chaos Theory .......................................255
Cognitive Science ...............................256
57. Usability Theory ...................................256
Learning Theories ...............................257
Summary of Theories .........................257
Informatics in Educational
Preparation
�����������������������������������
������257
Informatics for All Nurses .................258
Nursing Informatics as a
Specialty
�����������������������������������
��������� 259
Florence Nightingale’s Role in
Nursing Informatics ........................... 260
Informatics Nurse Specialist
Certification ......................................... 260
Roles for Nurses in the Informatics
Specialty
�����������������������������������
���������260
Informatics Nurse ................................ 261
58. Informatics Nurse Specialist ............262
Informatics Organizations ����������������� 264
Multidisciplinary Groups .................. 264
Nursing Informatics Profession
Associations ..........................................265
Summary
�����������������������������������
����������� 266
Applications and Competencies ���� 266
17� Electronic Healthcare Information
Systems, Electronic Health Records,
and Meaningful Use
�������������������������� 268
EMR, EHR, ePHR, and Their
Relationships to Emerging
Clinical Information Systems �������� 269
Data Standards ................................... 269
The Need for EHRs
������������������������������� 271
Paper Records ......................................271
59. Weaknesses of Paper Records ........271
Electronic Records .............................272
The Electronic Record and
Meaningful Use
����������������������������������27
3
The Electronic Records Privacy
and Security: HIPAA Revisited ����� 276
Summary
�����������������������������������
������������277
Applications and Competencies �����277
18� Design Considerations for Healthcare
Information Systems
������������������������� 279
Workflow Redesign
���������������������������� 280
Technology Competencies ���������������� 281
Need for Interoperability ������������������� 282
60. Health IT System Cost–Benefits ������� 282
Project Management and the
Systems Life Cycle
�������������������������� 283
xxii Contents
Project Management ..........................283
Systems Life Cycle .............................283
Business Continuity Plan �������������������290
Summary
�����������������������������������
������������ 291
Applications and
Competencies���������������������������
����������� 291
19� Quality Measures and Specialized
Electronic Healthcare Information
Systems
61. �����������������������������������
�������� 293
Quality Measures for Health
Information Technology ����������������� 294
Physician Quality Reporting
System ................................................... 294
EHR Certification .................................295
HIT Research and Analysis
Reports ...................................................295
Specialty Healthcare
Information Systems �����������������������
295
Admission, Discharge, and
Transfer ..................................................295
Financial Systems .............................. 296
Clinical Information Systems ������������ 296
Ancillary Systems ................................297
Clinical Documentation .....................297
Computerized Provider Order
Entry ....................................................... 298
Medication Administration .............. 299
Managing Patient Flow