Care Coordination

Question 1

What did care coordination models first emerge to do?

Answer 1

to manage home and community-based services

Question 2

What do care coordination models typically address for children and teens?

Answer 2

School-based services

Question 3

What do care coordination models typically address for adults?

Answer 3

School-based services or other traditional vocational programs when returning to work

Question 4

What do care coordination models typically address for elderly individuals or financially disadvantaged families?

Answer 4

1. utility assistance programs

2. Housing needs that range from finding a home to making the home arrangement safe and accessible

Question 5

What do state programs involve?

Answer 5

1. support the local organizations

2. facilitation of transportation, insurance, and disability-related services

Question 6

In a social model at what level is leadership and organization responsibility organized?

Answer 6

the local or state level

Question 7

What are the area agencies on aging designated as in a social model?

Answer 7

it is Designated as coordinators and administrators of care coordination programs that can then be standardized at some level across a state

Question 8

What are county social service agencies?

Answer 8

They assume care coordination responsibilities and are often able to serve as a single entity for multiple funding resources such as waiver services, block grants, state-funded services, and Medicaid

Question 9

What are the duties of Medical Oriented Models of care?

Answer 9

1. Coordinate medical services
2. Financing Medical models
3. Managed Care

Question 10

Give some examples of medical-oriented models of care

Answer 10

1. pharmacist-supported models focused on medication management
2. Self-management programs designed to empower patients to actively manage their own health needs
3. Models more common in practice and with a stronger evidence base include disease management programs that supplement primary care for ambulatory-based conditions such as heart failure or diabetes
4. Care management models that collaborate with primary care to support patients in navigating available services

Question 11

What are integrated models?

Answer 11

1. committed to the integration of healthcare, social support, and community clinical and nonclinical services are still evolving.
2. Offer significant promise for supporting holistic, patient-centered, family-focused care
3. building bridges between services and settings is fraught with barriers

Question 12

What barriers can occur with integrated models?

Answer 12

1. most challenges stem from having the different service types financed from different sources
2. Coordination is only further complicated by the scope of authority for managing the different services and the level of involvement of each agency or organization
3. Can be difficult to determine the setting in which the coordination should reside
4. Could be difficult to determine the relationship or nature of the partnership that should exist between agencies and service organizations

Question 13

Give an example of an integrated model of care

Answer 13

Program for All-Inclusive Care for the Elderly (PACE)

Question 14

Why is PACE a fully integrated model of care?

Answer 14

1. The PACE program is provider-based and integrates both acute and long-term healthcare and social services
2. Working in contract with Medicare and Medicaid, the program is designed to support people age 55 and older who qualify for admission to a nursing home but prefer to continue residing in the community

Question 15

What are the 5 key attributes of care coordination?

Answer 15

1. an interprofessional team of personnel that includes the patient
2. a proactive plan of care
3. A targeted set of purposeful activities
4. Proactive follow-up
5. communication

Question 16

What are the critical differences between care coordination and collaboration?

Answer 16

1. coordination initiated by nurse
2. collaboration may be initiated by the client or family
3. collaboration requires direct interaction
4. coordination may/may not involve direct client care

Question 17

What is the nurse’s role in care coordination?

Answer 17

1. advocate for the client
2. coordinate all aspects of care
3. identify actual/potential problems
4. implement a plan with the assistance of the care team
5. Update plan as needed
6. Contact client after discharge and coordinate care to avoid readmission

Question 18

What are some barriers to effective care coordination?

Answer 18

1. client NONADHERENCE to the care plan
2. limited access to resources
3. deficient knowledge

Question 19

What are the nursing interventions to barriers for care coordination?

Answer 19

1. assess, address reasons for client nonadherence
2. incorporate resource availability into care plan
3. assess, address knowledge deficits

Question 20

What may be needed in order to support those in the greatest need of care?

Answer 20

Care coordination may need to be reserved for those individuals particularly vulnerable to fragmented, uncoordinated care on a chronic basis and at the highest risk of negative health outcomes

Question 21

What population is at the least in need of care coordination?

Answer 21

the general population

Question 22

What population is in a medium need of care coordination?

Answer 22

People with complex conditions or life situations elevating the likelihood of negative outcomes

Question 23

What population is in high need of care coordination?

Answer 23

Frail and vulnerable children and adults

Question 24

What is an emergency?

Answer 24

1. sudden, unforeseen events that threaten health or safety

2. Public emergency necessitating assistance from outside affected community

Question 25

What is a disaster?

Answer 25

1. little or no warning
2. Initially overwhelm available personnel and emergency services
3. combined threat to life, public health, or the environment

Question 26

What is a pandemic?

Answer 26

Infection that spreads rapidly around the world

Question 27

What is emergency preparedness?

Answer 27

plans to prevent, respond to, and recover from emergencies

Question 28

What is surge capacity?

Answer 28

Ability to rapidly meet increased demand for qualified personnel and resources

Question 29

What are the four phases of emergency responses?

Answer 29

1. mitigation
2. preparedness
3. emergency response
4. recovery

Question 30

What occurs during the mitigation phase of emergency responses?

Answer 30

1. occurs both before and after an emergency occurs
2. Warning systems and insurance
3. agencies and communities identify potential hazards and take measures to prevent and minimize emergency
4. Communities implement their emergency operations plans
5. Key nursing activity: the anticipation of needed resources and policies to assist nurses and other professionals in implementing effective disaster response

Question 31

What occurs during the Preparedness phase of emergency responses?

Answer 31

1. happens before an emergency occurs
2. Nurses gain understanding of expected roles in emergency
3. Having comprehensive disaster plan in place that coordinated effectors among many people, agencies, and levels of government
4. Planning committees exist on all levels
5. Develop emergency plan

Question 32

What occurs during the emergency response phase?

Answer 32

1. implementation of preparedness plans
2. coordinated response to meet needs of individuals in the community affected by an emergency
3. occurs during and immediately after an emergency, simultaneous with the community’s assessment of immediate disaster effects
4. Nurses should follow the disaster plan of their agencies, communities, and local emergency management agency
5. Protocols and standards of care are in place to guide the practice of all nurses
6. Victims triaged and treated as soon as possible
7. Search and rescue operations, shelter for survivors, repairing utility infrastructures

Question 33

What occurs during the recovery phase?

Answer 33

1. Designed to return the community to normal or create new and safer normals
2. Rebuilding, reemployment, repair, reconstitution of government operations
3. Work is never complete
4. Nurses may suggest ideas for responding to disaster victims more effectively and efficiently
   5 Mock disaster drills show areas of the plan that need strengthening

Question 34

What do state divisions of emergency management typically deal with?

Answer 34

State divisions of emergency management act as the local emergency management agency

Question 35

What does the US Department of Homeland Security typically do with regards to emergencies?

Answer 35

mandates that the federal guidelines of the National Incident Management System be followed

Question 36

What do Local Governments typically do with regards to emergencies?

Answer 36

Primarily responsible for emergency management and response (Local Emergency Management Agency, or LERT)

Question 37

What is CERT and What does it do?

Answer 37

Community Emergency Response Team Program:

1. Training available for interested individuals
2. Presents citizens the facts about what to expect following a major disaster in terms of immediate service
3. gives the message about citizens’ responsibility for mitigation and preparedness
4. Trains citizens in needed lifesaving skills
5. Organizes teams so they are an extension of first responder services

Question 38

What is COCA and what do they do?

Answer 38

Clinician Outreach Communication Activity Program:

1. Provides timely, accurate, and credible information to clinicians related to emergency preparedness and response and emerging public health threats
2. COCA fosters partnerships with national clinician organizations to strengthen information-sharing networks before, during, and after a public health emergency

Question 39

What is triaging?

Answer 39

Prioritizing clients for treatment based on severity of illness or injury and in light of supplies and resources available

Question 40

What are the factors of reverse triage?

Answer 40

1. most severely injured and ill victims that require greatest resources treated last
2. Allows the greatest number of victims to receive medical attention
3. Simple color classification system used to prioritize clients
4. Recommended that emergency medical personnel be assigned to triage

Question 41

What does a black triage tag mean?

Answer 41

1. victim unlikely to survive given the severity of injuries, level of available care, or both
2. palliative care and pain relief should be provided

Question 42

What does a red triage tag mean?

Answer 42

1. victim can be helped by immediate intervention and transport
2. requires medical attention within minutes for survival (up to 60)
3. Includes Compromises to patient’s Airway, Breathing, and Circulation

Question 43

What does a yellow Triage color mean?

Answer 43

1. Victim’s transport can be delayed
2. includes serious and potentially life-threatening injuries, but status not expected to deteriorate significantly over several hours

Question 44

What does a green triage color tag mean?

Answer 44

1. victim with relatively minor injuries
2. status unlikely to deteriorate over days
3. May be able to assist in own care: “Walking Wounded”

Question 45

What is the hot zone of a disaster?

Answer 45

1. initial site of the incident

2. Only personnel with appropriate protective equipment allowed in the hot zone

Question 46

What is the warm zone of a disaster?

Answer 46

1. decontamination zone

2. Located at least 300 feet from the outer edge of the hot zone

Question 47

What is the cold zone of a disaster?

Answer 47

Where decontaminated victims are triaged and treated

Question 48

What is bioterrorism?

Answer 48

1. deliberate release of virus, bacteria, other microbes used to cause illness and death in people, animals, or plants`
2. One purpose is to cause fear and panic

Question 49

What are the primary agents of bioterrorism?

Answer 49

1. Anthrax
2. Botulism (Clostridium Botulinum)
3. Yersinia pestis (Plague)
4. Viral hemorrhagic fevers
5. Variola major (smallpox)
6. Francisella tularensis (tularemia)

Question 50

What is the only treatment currently available for bioterrorism?

Answer 50

Inhalation of anthrax treated with ciprofloxacin 400 mg IV every 12 hours

Question 51

What is the Strategic National Stockpile?

Answer 51

1. program designed to ensure immediate availability of essential medical materials to a community in the event of a large-scale chemical and biological attack
2. Managed jointly by the CDC and Department of Homeland Security
3. Consists of large quantities of antibiotics, vaccines, and client support supplies
4. the First component is a preassembled push package
5. The second component is a vendor-managed inventory package

Question 52

What is the Preassembled push Package?

Answer 52

1. designed to meet community’s needs in case of undetermined threat
2. Stored in locations to enable delivery within 12 hours after attack

Question 53

What is the Vendor-managed inventory package?

Answer 53

1. shipped once the threat has been clearly identified
2. Packages designed for arrival within 24-36 hours
3. Locations permit delivery within 12 hours after attack

Question 54

What members of the emergency medical services do nurses often come in contact with during an emergency?

Answer 54

1. EMR
2. EMT
3. Advanced EMT
4. Paramedic
5. Volunteers
6. Chaplains
7. Police/Firemen

Question 55

What personnel can provide basic life support?

Answer 55

1. Emergency medical responders (EMR’s)

2. Emergency medical technicians (EMT’s)

Question 56

What personnel can provide advanced life support?

Answer 56

1. Advanced EMT’s

2. Paramedics

Question 57

What is the role of the nurse in a disaster?

Answer 57

1. Must be able to perform under stressful conditions
2. Nurse expect to follow emergency preparedness plans
3. Nurse may be assigned triaging and assessing victims
4. Nurses as leaders in their communities in discussing emergency preparedness and contingency plans
5. nurses are never expected to jeopardize their own safety, the safety of family, or rescuers by responding to disasters