Care Coordination Flashcards

1
Q

Care coordination

A

The deliberate organization of patient care activities between two or more participants involved in a patient’s care to facilitate the appropriate delivery of health care services

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2
Q

Who is involved in coordination care of the patient

A

PT,OT, dietary , pastoral care , case management , social worker , womb care , etc

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3
Q

What is the biggest thing about care coordination

A

They want us to do it
We should do it on every pt
It has to be deliberate if it is going to work.

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4
Q

Case manager

A

Care coordinates
Works with helping funding and what the patient needs outside of the hospital

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5
Q

Quality improvement

A

Put into place so we can make continuous improvement

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6
Q

What should be set into place for quality improvement

A

A standard such as we want zero falls.

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7
Q

What happens when we do not meet standard for quality improvement

A

What happened? And how are we going to improve it

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8
Q

What do we need in order for quality improvement to work

A

Buy in from everyone

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9
Q

What is quality improvement based on

A

EBP so if someone comes in with DKA with have DKA protocol ( insulin drip, fluids and sugar checks)

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10
Q

Continuous quality care

A

Promoting teamwork , focus on EBP and having buy in …

This shows if we are improving and increasing knowledge such as acccucheck once a year

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11
Q

Care should be

A

Safe
Effective
Patient centered
Equitable
Efficient
Timely

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12
Q

Equitable

A

Your care doesn’t change based on how much money someone has

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13
Q

Efficient

A

Avoiding wast so we can save money
( we have to save $ in order to give $)

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14
Q

Timely

A

How long were you in the ER with chest pain
How long were you in the ER with s/s of stroke

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15
Q

HCAPS

A

Monitor the hospital
Selective
Evaluate the hospital by a set of standards

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16
Q

What is the issue with HCAHPS

A

They add stuff such as pain management that is our of our control like in sickle cell patients

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17
Q

How can a nurse improve her communication?

A

Sit on the bed and talk to the pt
Be at eye level
Give pt time ( 30 sec)

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18
Q

Development of standards types

A

Outcome standards
Process standards
Structure standards

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19
Q

Outcome standards

A

Focuses on the results from the care given
For example- zero pt with CAUDI or infections ( because i did oral care pt did not get pneumonia ).

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20
Q

Process standards

A

Related to care delivery
For ex - we have 1 hr window to give medication .. if med is due at 0900 we can give it as early as 8 or 10

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21
Q

Structure standards

A

Related to the organization
Ex- so we have nurse manager on every unit or case manager or a case manager every 2 units

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22
Q

Outcome audits

A

Determined by the quality nursing care you did. As a result of direct care of pt .. this is where our nursing comes into play ( we have no pressure ulcers becuase we turn pt q4 or we dont have pneumonia because we do oral care q4)

Nursing sensitive and from direct care
Where our fall rates come in , CAUDI , and audits to make sure we are documenting effectively

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23
Q

Pt discharge delays

A

It’s important to work as a team to avoid this .. and to avoid med errors

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24
Q

Care variation

A

When we dont do what we are suppose to do .. why we have protocols to help us not have care variation

25
Q

How can we avoid medical errors

A

Encouraging nurses to get as much sleep as possible
Double check your self
7 rights
Listen to your gut

26
Q

How did we improve communication with providers and the lab

A

The lab has a 2 hour window to call about critical lab results

27
Q

Magnet hospital

A

They follow protocoal and have less errors
We get money from the government and there is better pt outcomes
Lots of education

28
Q

Who makes less errors

A

More educated nurse- BSN

29
Q

Quality GAP

A

Difference in performance ( care we give) between top performing agency (magnet) and national average

30
Q

Risk management

A

When we deal with ethical issues and this is our back up

31
Q

Risk identification

A

As nurses it is our job to identify any potential risk
For ex - telling everyone a med looks like another med

CDC Identifying something such CAUDI as when pt gets UTI that they didnt have before so that is causing the UTI

32
Q

Risk treatment

A

The treatment would be that a policy or procedure set into place for the that would determine do you even need a foley?
Not every pt needs a foley
They have to meet the criteria of “this is why the pt needs a foley”

33
Q

Risk evaluation

A

Did it lower UTI rate by using that protocol ?

34
Q

Sentinel events

A

Something that results in death or permanent harm
Or even severe temporary harm that requires life saving intervention to keep the pt stable

35
Q

What’s the easiest way as a nurse to have quality improvement

A

Joining some kind of shared governance committee until you are experienced
And where ever you end up at get certified there

36
Q

Clinical practice guidlines

A

Is why and how we get our protocols
Step by step process
Protocols are to make sure sentinel events do not happen

37
Q

Root cause analysis

A

Ask WHY* to get to the root cause

38
Q

National pt safety goals

A

Identify pt correctly
Improve staff communication
Med safety
Alarm safety
Prevent infection
Identify pt safety risk
Prevent mistakes in surgery

39
Q

How can we avoid transfusion , chemotherapy or med errors ?

A

Identify the pt correctly

40
Q

In what way have we improved communication with staff

A

Lab calling in for critical lab values and within two hours

Have to report critical test results as well as diagnostic results

41
Q

How can we use medicine safety

A

Using the 7 rights
Labeling our meds
Or using dispensing tray w room #
Pull them out at bedside
Use a med bag and label w room #
PINCH drugs
STAR method

42
Q

PINCH drugs

A

Potassium
Insulin
Narcan
Narcotics
Chemo
Heparin

43
Q

STAR method and when we use it

A

Stop think act and review

For med vials that look alike and sound alike drugs

44
Q

How can we use alarm safety

A

Silence them effectively dont let them keep going
Avoid alarm fatigue

45
Q

How can we prevent infection

A

Washing hands for 20 seconds - sing happy birthday song
Know when to use hand sanitizer and when to wash your hands
Use green cap
Scrub the hub
Alcohol based hand sanitizer
Protocol to prevent CAUDI

46
Q

When do you wash your hands

A

Handling a pt with CDIFF

47
Q

Identify pt safety risk - how can we do this?

A

Assess for risk of suicide ideation
Do you have a plan? Etc

48
Q

How can we prevent mistakes in surgery

A

Time out- right pt , consent, procedure, body part
Marking the body part where the surgery will take place

49
Q

Are we allowed to sign consent

A

We can’t give the consent - if it is blood product yes..
The physician has to do that.

50
Q

5 steps of risk management process

A

Identifying potential risk
Analyzing risk
Risk evaluation
Treating the risk
Monitoring and reviewing the risk

51
Q

Fall risk

A

Non skid socks
Gown
Bracelet
3 side rails up
Make sure bed alarm is on to prevent future falls

52
Q

If pt falls

A

Assess the pt
Vitals
Call the charge nurse and physician
Document

53
Q

Most common sentinel event

A

Falls
Performing procedures on wrong pt
Unintended retention of foreign objects

54
Q

Difference between versed and fentanyl

A

Versed stores up in the tissue and effects BP so it takes a while to fix

Fentanyl does not

55
Q

Incident report

A

Encouraged to fill out for accidental mistakes so we can learn and grow from it

56
Q

Nursing services organization

A

Insurance that covers 6 million per pt
$100 a yr

57
Q

What is important to note when a case manager question comes up

A

Ask what’s going on and what works for the pt
Get more info “ tell me more”
Open ended questions to ask the pt

58
Q

Poor processes can cause

A

Preventable mistakes, wrong surgery , medication errors

59
Q

HCAPS is measured by

A

Communication with doc
Communication w nurse
Responsiveness of hospital staff
Pain management
Communication w meds
Discharge info
Cleanliness of environment
Quietness of hospital environment ( heal when sleep)