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Nursing Informatics:Trustworthy Systems and Patient SafetyBaker importantly introduces trust despite increasing risk. The author notes that “as HIT assumes a greater role in the provision of care and in healthcare decision-making, the nurse increasingly must trust HIT to provide timely access to accurate and complete information and support for decision-making while assuring that individual privacy is continuously protected (2015, pp. 146-147). Baker expands the discussion of trustworthy systems by addressing security and privacy. While privacy and security are sometimes used as synonyms, there are distinct differences. “Privacy is more than security and security is more than privacy” (Baker, 2015, p. 147). Privacy refers to the right of an individual to keep his or her health information private. Confidentiality refers to the duty of anyone entrusted with health information to keep that information private. Security deals with protection. Review the Nationwide Privacy and Security Framework (p. 147).Baker provides a detailed discussion of the HIT Trust Framework (pp. 149-159). The Trust Framework is represented in seven layers including Layer 7 Usability FeaturesSingle sign onIdentity federation Layer 6 Technical SafeguardsPerson and Entity Authentication Access Control Audit ControlsData IntegrityNon-repudiation EncryptionMalicious Software Protection Transmission SecurityLayer 5 Architecture SafeguardsScalability ReliabilitySafetyInteroperability AvailabilitySimplicity Process Isolation Layer 4 Operational SafeguardsSystem Activity Review Continuity of OperationsIncident Procedures SanctionsEvaluation Security Operations Management Awareness & Training Business AgreementsConfiguration Management Identity Management & Authorization Consent ManagementLayer 3 Physical SafeguardsFacilitiesSystem & NetworksElectronic MediaLayer 2 Policy Foundations Security Policy Privacy PolicySafety Policy Layer 1 Risk Management Security Risk AnalysisApplication & Data Criticality Analysis Privacy Risk Analysis Safety Risk AnalysisRisk Management StrategyBaker concludes the chapter noting, “Many of the safeguards included in the trust framework have been codified in HIPAA standards and implementation specifications. Building trustworthiness in HIT always begins with objective risk assessment, a continuous process that serves as the basis for developing and implementing a sound information assurance policy and physical, operational, architectural and technological safeguards to mitigate and manage risks to patient safety, individual privacy, care quality, financial stability, and public trust (2015, p. 159). Chapter 29 explores patient safety. Sengstack provides a succinct overview of national health IT safety initiatives. The chapter author identifies specific agencies their roles and responsibilities/or initiatives in patient safety. Sengstack identified the followingOffice of the National Coordinator for Health Information Technology – Safety Plan Agency for Health Research and Quality – Common FormatsFood and Drug AdministrationThe Institute for Safe Medication PracticesECRI InstituteLeapfrog GroupThe chapter author provides an introduction and overview to Health IT Safety Tools and Resources. The tools and resources include the following AHRQ’s Guide to Reducing Unintended Consequences of Electronic Health RecordsSAFER GuidesCPOE Design Checklist/Pick-List ChecklistThe Pick-List Checklist Sengstack concludes the chapter stating “Tools, knowledge, and resources offered in this chapter can help lay the found for a strong health IT strategic plan that can assist organizations as they strive to capture the full potential of their systems. Healthcare organizations need to ensure safety of their health IT systems. All stakeholders must become involved and increasingly transparent as they learn and share their safety lessons from the implementation and use of their IT” (2015, p. 427). Learning ObjectivesTo explain the critical role “trustworthiness” plays in healthcare quality and safetyTo explain the relationship among security, privacy, and trustTo propose adherence to fair information practice principles as essential to privacy and trustTo introduce and describe a trust framework comprising seven layers of protection essential for protecting sensitive and safety-critical health information and servicesDescribe the current state of the evidence in relation to health IT and patient safety Discuss the federal government’s involvement in assisting to improve patient safety using health ITDescribe at least three resources that organizations can use to evaluate the safety of their health ITActivities Read and reviewBaker, D. B. (2015). Chapter 10 Trustworthy systems for safe and private healthcare. In V. Saba & K. McCormick (Eds.), The essentials of nursing informatics (6th ed., pp. 145-160). McGraw-Hill. Sengstack, P. P. (2015). Chapter 29 Health information technology: Striving to improve patient safety. In V. Saba & K. McCormick (Eds.), The essentials of nursing informatics (6th ed., pp. 419-428). McGraw-Hill. Individual ActivityDiscussion Board ActivityWhat is the role of the nurse informatics specialist (INS), the nurse practitioner (NP), and the nurse leader in evaluating the safety and trustworthiness of HIT? What tools should be used in the evaluation? Name/list a minimum of 2 tools.Use the literature to support both your initial post and the post to another. You need to use a minimum of 2 references for each post for a total of 4 references. The initial post should be 250-500 words. The post to another student should be 150-250 words. Respectfully comment and provide feedback on the student’s post. Do you agree or disagree? Provide rationale. Use headings to organize the content. Grading Rubric ActivityPoints PossiblePoints EarnedCommentsWhat is the role of the nurse informatics specialist (INS), the nurse practitioner (NP), and the nurse leader in evaluating the safety and trustworthiness of HIT? What tools should be used in the evaluation? Name/list a minimum of 2 tools.The initial post should be 250-500 words.Use a minimum of 2 references40Respectfully comment and provide feedback on the student’s post. Do you agree or disagree? Provide rationale. The post to another student should be 150-250 words.Use a minimum of 2 references 35A minimum total of 4 references10APA 7 in the text references 1APA 7 Reference List 1APA style, use of headings, readability, grammar, spelling 13Total 100
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