Healthcare Technology & Informatics

Technology & Informatics

• Informatics is the science encompassing information and computer science, focusing on the management and retrieval of information.
• Technology collects, manages and analyzes information.
• Healthcare utilizes informatics to improve decision-making, enhance efficiency, support patient care, ensure data accuracy, facilitate communication, enable evidence-based medicine, and support public health and research.
• Electronic Health Records provide timely access to client information, improve care coordination, maximize efficiency and client safety.
• Electronic prescriptions offer convenience, lower costs, and enhance safety for healthcare providers, clients, and pharmacies.
• Time-consuming data entry and complex interfaces are challenges to electronic charting/documentation

EHR Challenges

• Alert Fatigue stems from excessive notifications.
• Communication issues can arise from different systems.
• Costs and maintenance can disrupt processes.
• Data breaches and compliance are risks to Privacy and Security.
• EHR systems can cognitively overload clinicians and contribute to User Burnout.
• A significant amount of training is needed to learn EHR Systems.
• EHR systems have limited flexibility to tailor workflows.

Remote Patient Monitoring

• Remote patient monitoring is a form of telehealth that tracks client info aiding in the transfer of data to healthcare providers.

Benefits of Remote Patient Monitoring

• Real-time falls reduced with detection
• Gait and activity observed
• Sleep is assessed
• Clients able to manage their health
• Secured data easily accessible
• Unexpected readings can be highlighted
• Health providers are alerted as needed for unexpected readings
• Increased patient to health care provider connection

Information Technology

• Real-time data sharing and access from IT improves care coordination
• IT promotes telemedicine, automates tasks and decreases paperwork, increasing productivity.
• IT lowers administrative costs and improves workflow efficiency.
• Greater provider collaboration and patient engagement results from IT
• Predictable analysis and evident based decision making is enhanced

IT & Patient Safety

• Computerized Physician Order Entry (CPOE) and decision support systems help reduce prescription errors.
• Automated alerts and wearable devices improve patient monitoring and outcomes.
• IT prevents redundancies, unnecessary tests, and ensures standardized documentation.
• Barcoding systems ensures correct treatments and reduces misidentification risks.
• Encryption and access control protect sensitive patient data.
• Efficiency, patient safety and error prevention are increased through automation and data sharing of IT systems.

Reproduction: Breast Self-Examination (BSE)

• The American Cancer Society (ACS) does not recommend clinical breast exams for average-risk clients at any age.
• Breast self-exams are recommended by ACS when clients are at high risk with little evidence to support these detecting cancer in those regularly getting mammograms
• Average-risk clients are not having a personal or family history of breast cancer, genetic mutations (BRCA gene), or exposure to chest radiation prior to age 30.

BSE Frequency & Method

• BSE should be done monthly at the same time.
• Women who menstruate, should conduct a BSE a few days after menstruation ends which is typically when breasts are least swollen or tender
• Postmenopausal women can choose a fixed day of the month.
• In visual examination, look in the mirror with straight shoulders and arms on hips
• The visual exam is when and changes in size, shape, symmetry, dimpling, puckering, or nipple changes are assessed.
• In manual examination while lying down, pads of fingers are used to check for lumps or abnormalities by covering the whole breast area, including the underarm, with a pattern such as circular, vertical, or wedge-shaped while varying pressure.
• The manual examination can be done standing or in the shower after the previous steps.
• Soapy skin in the shower can make it easier to feel lumps.

BSE - Normal vs. Abnormal Findings

• Normal breasts exhibit slight asymmetry with uniform texture and no lumps.
• Lumpy breasts can also occur due to the menstrual cycle
• Abnormal breasts include new lumps, thickening zones, skin changes (dimpling or puckering), nipple discharge non-milk related, redness, or swelling.
• Any abnormalities require further investigation by a healthcare provider.

Testicular Self-Exam Frequency & Method

• A testicular self-exam should be done monthly.
• Men ages 15-35 are at highest risk of testicular cancer.
• Conduct the exam with both hands, after a warm bath or shower to relax the scrotal skin.
• Gently roll each testicle between the thumb and fingers.
• Check for any changes in size or shape, lumps, or bumps.
• The testicle should smoothly transition to the epididymis, a soft tube structure located at the back.

Testicular Self-Exam - Normal vs. Abnormal Findings

• Testicles should be smooth and firm, but not hard.
• One slightly larger testicle is normal.
• Any testicle lumps, swelling, changes in size, shape, and consistency are abnormal.
• Abnormal findings should be discussed immediately.

Math: Intake & Output

• Conversions should be checked in the conversions manual.
• Continuous irrigation is not factored intake and output.
• Oral liquids are temperature stable and include beverages such as juice, water, ice chips, coffee, or tea.
• Additional intake examples include milk, gelatin, broths, ice cream, frozen treats, or nutrition supplements such as Boost or Ensure, not pudding, custard, yogurt, oatmeal, and cream of wheat.
• IV fluids are always considered intake as a bolus or in an infusion.

Caring and Communication: Therapeutic Communication

• Techniques such as listening enable inter-client communication.
• Discussing topics with clients using an empathetic tone rather than an impatient or critical one reduces stress and encourages honesty in disclosures.
• Nursing promotes therapeutic communication through listening skills, empathy, and a professional relationship to provide holistic and patient-centered care.
• Therapeutic communication includes using silence, engaging in active listening, asking open-ended questions, accepting, giving recognition, restating, summarizing, and reflecting.
• Nurse-client teamwork builds through these elements.

Nurse strategies to enhance communication

Active Listening:

• Focused attention is key to clarity and comprehension. Empathy:
• Show support and validate emotional states. Body Language:
• Adopt open behaviors, facial expressions, and appropriate interpersonal space. Clarity and Simplicity:
• Summaries should avoid complex language. Open-Ended Questions:
• Encourage clients to describe their experiences. Cultural Competence:
• Adapt communication strategies to encompass diverse backgrounds. Feedback:
• Understanding of content needs confirmation through questions. Building Rapport:
• Personalization makes conversations welcoming. Maintain Professionalism:
• Display appropriate attitudes and practices Technology:
• Promote care plans through portals and telemedicine Encouraging Participation:
• Promote decision making through teach back methods

Barriers to Communication

• Differences in language, culture, hearing, and cognition are barriers to communication.
• These are overcome with qualified medical interpretrs and and assistive devices, such as hearing aids or eyeglasses.
• The use of an interpreter is required for any health care facility that receives any amount of federal funding.
• Some general actions healthcare workers utilize are being respectful, providing supportive body language.
• Nurses should confirm understanding.
• Provide a comfortable, quiet, and calm environment.
• It may simply take waiting for medications or recreational drug use to dissipate.

Utilizing Silence

• Silence gives both the nurse and client a chance to absorb the conversation and determine what should be discussed next.
• Using silence encourages the client to disclose more information, reduces the physical space between the nurse and client, and focuses on a topic area to learn more.

Communication and Vision loss

• Self identify when with a patient, to remove surprise or uncertainty.
• Verbally inform patient should you be leaving.
• Patient should be supported physically whenever walking or sitting.
• Use clock descriptions when informing the location of objects.
• For example, "10 feet to the left" or "The door is at 10 o'clock.".
• Supplies of audio information should remain available.
• Provide read access to medical data effectively and accurately.

Communicating with Patients with Hearing Loss

• In order to support communication, noises and distractions should be minimized.
• Hearing aids should be assured for charge and operational readiness.
• Tap or shake client so that they are able hear you.
• Speaking or shouting as compensation are not useful techniques.
• Speaking should be directed to facing the client, speaking clearly, and avoiding distractions (hands/objects) at the face.
• Understand that only 30% of speaking is understood, so repeating or rephrasing is useful.
• A sign language interpreter may be useful and needed.
• Speak to the person, not the interpreter.
• Allow the interpreter time to speak.
• Check that the interpreter is properly qualified.

Nutrition: Minerals

• Iron helps carry oxygen and is found in organ and red meats, green leafy vegetables, and iron-fortified foods.

Vitamins

• Any vitamin except Vit. A,D,E,K are water soluble
• Water soluble vitamins should are carried to the tissues of the body but are not stored in the body.
• Replenishment can occur because sweat and urine easily eliminate them.
• Vitamin C (ascorbic acid)-Promotes iron absorption, wound healing, bone formation, and immune function.
• Vitamin B1 (thiamine)-Converts nutrients to energy.
• Vitamin B2 (riboflavin)-Aids energy production and fat metabolism.
• Vitamin B3 (niacin)-
• Vitamin B5 (pantothenic)
• Vitamin B6 (pyridoxine)
• Vitamin B7 (biotin)
• Vitamin B9 (folate)-Necessary for proper cell division
• Vitamin B12 (cobalamin)-Aids red blood cell formation, as well as proper nervous system and brain function

Calculating Body Mass Index

• Weight in pounds and height in inches determine BMI.
• Calculations: weight first divided by height, result is divided by height again, final number is multiplied by 703.

Body Mass Index - Categories

• Underweight = less than 18.5
• Normal = 18.5-24.9
• Overweight = 25-29.9
• Obese = 30 and above

Diet Interventions for Swallowing disorders

• Thickening liquid is one strategy.
• Other interventions are NPO (nothing by mouth), and soft to pureed foods.
• Dietary changes may be short termed.

Dysphagia Interventions

• Clear Liquid Diet-limits amount of calories and nutrients.
• Full liquid diet-contains only fluids, foods that are liquids, and foods that are liquids at room temperature
• It should be only utilized only for a period of days.
• Reduces the digestive system's strain.

Function of Fats

• Provide energy.
• Support vitamin absorption.
• Help with cholesterol level analysis.

Potassium

• Proper nerve transmission is partially maintained by potassium.
• Fluid balance inside the cell is partially maintained by potassium
• Appropriate muscular capacity is partially maintained by potassium

Treating Potassium Deficiency

• Potassium can be supplemented with oranges, dried fruits, tomatoes, avocados, dried peas, meats, broccoli, bananas, dairy products, whole grains, and potatoes.

Promoting Safe Movement

• Calcium ions mediate nerve impulses, cellular signaling, and muscular constriction.
• A working diagnosis involves bone density assessment which may result in osteoporosis and other fractures.
• Nerve transmission for the release of neurotransmitters occurs as does the regulation of metabolic pathways.
• Proper use of ergonomics makes products fit the worker's demands.
• Items aligned for fit makes workflows improve, discomfort becomes less of a factor through careful modification,

Safe Ergonomics

• Stand as close as possible when reaching.
• Muscles and back should both be normal.
• Head and shoulders needs to be maintained.
• When squatting, the hips should bow slightly
• Turns should involve full body motion.

Ergonomic Workflows

• Ergonomics in the workplace help with dangerous/ hazardous conditions.
• Workflows are intended for employees.
• Well considered features enable a better product relationship

Postures

• Twisting, extending, and bending can all increase the risk for injuries.
• Bringing the individual the nurse is tending to as close as possible may be useful here.
• Being as straightforward as possible when engaging is more useful, and twisting or bending intensifies the force.
• Lifting should involve legs as the quadricep is the strongest muscle, as opposed to the back.

Range of Motion

• ROM manipulation in many different varieties determines muscular health.
• Motion can occur in all different directions
• The functions and flexibility, improvement of posture, reduce stiffness, and low risks can come with improvements of ROM.

Mobility Changes with Aging

Changes include:

• Sarcopenia, or loss of muscle
• Osteoporosis, reduction of Bone Density
• Osteoarthritis or joint stiffness
• Balance Issues Cardiovauscular and respiratory declines reduce endurance, while vision and hearing impairments affect coordination.
• Neurological changes slow motor control, and postural shifts lead to altered gait. -Psychological factors like fear of falling or depression can also contribute to reduced activity

Crutch Usage

• Strong side supports stair rail
• Move arm with stair, and crutches to weak side for support
• Move solid leg before moving, followed by crutches and weaker leg next.
• Always move with side that has rail first
• Do the opposite with stair descent.

Evidence-Based Decision Making in Nursing

• When considering sources of info, use proper evidence
• Who/what made the resource?
• Look toward .com as commercial, and .net as internet source
• What are their qualifications?
• Look to certifications or other affiliations
• What agenda may exist?
• Always look for factual and accurate information.

Self Management Interventions

• Wellness is a process
• Actions are determined by personal choices and how they lead to holistic impacts
• Spirituality
• Mental Health or Mindfulness
• Physical or Environmental Aspects

Physical Interventions

• Exercise regularly for 150 minutes a week.
• Balanced diets with fruits, vegetables, and grains.
• Sleep between 7-9 hrs regularly.
• Routine screening checkups are also useful, as is managing hydration.

Mental Interventions

Approaches that benefit patients

• Mindfulness and meditation supports regulation and anxiety control. -Therapy approaches challenges negative thoughts.
• Social support, as is connection to some larger group, helps prevent isolation.
• Creative Activities offer emotional support.
• Small goals offer realistic purpose.
• Screening time should be limited

Spiritual goals

• Promote services such as prayer, meditation, or general attendance.
• Connect with nature.
• Get involved with outreach such as Volunteering.
• Practice gratitude.
• Maintain mindfulness in all actions.
• Seek a spiritual leader.

Importance of Diet and Nutrition

• Reducing impact of stress by strengthening the immune system and lowering blood pressure, improving overall health.
• Complex carbohydrates stimulate production of serotonin, increasing well being and stabilizing sugar.
• Good carbohydrate sources are whole grains, oatmeal, and lentils.
• Oranges as vitamin C helps hormone levels
• Omega 3 fatty acids are found in fish, avocados, seeds and nuts.
• Black tea assists faster trauma recovery. -Water should also be consumed regularly and should never be skipped.
• Limit alcohol consumption.

Physical Benefits for Anxiety

• Routine exercise routines
• Cardio, yoga, and pilates are good
• Self-care involves positive reinforcement across mental and physical planes.
• Snack preparation, stress reduction programs, and self-regulating through sleep all promote good health.

Components of Professionalism

Accountability:

• Actions should be reliable Competence: -Knowledge should be regularly assessed Ethical Practice: -Rights and ideals for clients Compassion and Empathy: -Kindness and respect should be shown Communication: -Practices should be clear. Collaboration and Teamwork: -Working together is important Integrity: -Honesty is key Respect: -Treating client will courtesy is essential. Self-Regulation and Discipline: time/ stress are managed Leadership:
• Demonstrating leadership qualities and advocating for high standards of practice. Commitment to Quality and Safety: -High levels of patient care is the intent Advocacy: Supporting -Patients' rights and desires are to be honored. Appearance and Behavior: -Actions should be positive.

Professional Responsibility

Responsibility is an obligation to perform work, duties, or tasks involving strong judgement skills.

• Reliability, support, and following through indicate strength.
• It's important to give all people the same effective, knowledgable, and considerate support no matter their background.
• Differences in diagnoses should also never change healthcare practices.

Care Coordination

• Working with a group allows the delivery of expansive practices which improves communication and collaboration. Important factors here are
• Informing everyone of the plan
• Approaching all plans as client centered
• Enabling continuous transitions

Core Tenets of Nursing

• Assess and act.
• Work together and enable seamless transitions.
• The core goal here includes enabling the client's health

Nursing Process Steps

• Assessment
• Analysis
• Implement
• Plan
• Evalulate

Assessments

• Information such as symptoms, history, and environment all are included to determine a diagnosis.

Objective and Subjective data

• The patient is central to generating solutions to nursing issues and prioritizing any diagnosis.

5 rights of delegation

The five rights of delegation include: Proper Skill Sound Environment: -Client has consistent symptoms Qualified Personnel: -Competence to safely and reliably to complete the duties Guidance: -Directions must allow safe care Coordination: -All support workers together.

Abnormal Readings

When coming to quick thinking and analysis, you need to engage in more than simple thought.

• Quick, precise reasoning helps determine patient conditions

Interventions

The next steps include getting support to improve standards of care This is measured out by making sure the client and their requirements always get met

Code Of Ethics

The Code refers to obligations that ought to direct the professional conduct of nurses in their practice. All licensed practical nurses and registered nurses need to meet those objectives.

Ethical Goals

The overall scope of the document emphasizes care, well being, and the health needs of the world. The ICN focuses on responsilibites of the nurse, with changing technology and justice.

Health Promotion

• Primary
• Decrease development of medical conditions by changing behaviors or exposures
• Vaccinations
• Banning harmful substances
• Secondary
• Detect disease before it occurs with symptoms or complications
• Blood pressure, cholesterol tests
• Cancer screenings
• Tertiary
• Chronic effects of health issues restored, improve health capacity
• Education of self-care, rehabilitation of effects to improve quality of life

Diversity

• Etic: Outsider view
• Emic: Insider view

Social Determinants of Health

• Economic
• Includes employment, housing, and food security
• Education
• Encompasses graduation and early education
• Healthcare
• Covers insurance and related health
• Neighborhood and Built Environment:
• Includes affordable resources and safety
• Social and Community Encompasses social support, discrimination, community engagement, incarceration, and workplace conditions.

Bias

These biases can alter healthcare effectiveness. Bias erodes the reliability, affecting patient safety.

Reducing Misinformation

Effective support that does not lead to emotional impact can help Patient requirements should also remain top priority.