ch 1 hospitals and nursing careers Flashcards
hospitals
hospitals provide
- emergency care, surgery, nursing care, x-ray procedures and treatments, and lab testing
- respiratory, physical, occupational, and speech therapies
- care to people of ALL AGES
- care for people having babies, surgery, physical and mental health problems, and broken bones
- care to diagnose and treat medical problems
- care for person who are dying
- can be in patient (patient is admitted) or out-patient care (also known as ambulatory which means patients are not admitted)
hospital patients
acute illness
a sudden illness from which person is expected to recover
hospital patients
chronic illness
- an ongoing illness that is slow or gradual in onset and has no known cure
- can be controlled and complications prevented with proper treatment
hospital patients
terminal illness
- an illness or injury from which person will not likely recover
- person with a terminal illness will die
hospital patients
hospital stays can last
- less than 24 hours
- days, weeks, or months
long term care centers
long term care centers are designed to meet the needs of persons who
cannot care for themselves but DO NOT NEED HOSPITAL CARE
long term care centers
long term care centers provide
- medical
- nursing
- dietary
- recreational
- rehabilitative
- social services
long term care centers
persons in long term care centers are
RESIDENTS
long term care centers
long term care centers is the resident’s
temporary or permanent home
long term care centers
in long term care centers care needs range from
simple to complex
long term care centers
residents include
- persons who are older with chronic diseases, poor nutrition, or poor health
- person who are disabled from birth defects, accidents, or diseases
- persons discharged from hospitals while still recovering from illness, surgery, or an injurt
- some residents recover and return home
- others need nursing care until death
long term care center
Long term care centers meet the needs of
- alert, oriented persons
- confused and disoriented persons
- persons needing complete care
- short- term residents
- persons needing respite care
- life-long residents
- mentally ill persons
- terminally ill persons
long term care center
Alert, oriented persons know
- who they are
- where they are
- what year it is
- what time of day it is
- disability levels affects the amount of care needed
long term care centers
Confused and disoriented persons are
- mildly to severely confused and disoriented
- some problems are temporary; others are permanent
long term care centers
Persons needing complete care are
Very disabled, confused, or disoriented persons
long term care centers
Short-term residents need to recover from
- acute illness
- surgery
- fractures
- other injuries
long term care centers
Persons needing respite care go to nursing homes for
- Short stays
- the caregiver can go on a trip, tend to business, or simply rest
long term care centers
Life-long residents may have a
- disability that occurred before the age of 22 (a developmental disability)
- impairments may be physical, intellectual or both
long term care centers
With mentally ill persons
Behavior and function are affected
long term care centers
Terminally ill persons may need
- Hospice care
- some are alert and oriented
- others are comatose
long term care center residents
Board and care homes provide
- A room
- meals
- laundry
- and supervision
- a safe setting is provided BUT NOT 24 HOUR NURSING CARE
long term care center residents
Assisted living residencies (ALRs) provide
- housing
- personal care
- support services
- health care
- social activities in a home like setting
- mobility is often required
- stable health is required
- ALRs must follow state laws and rules
long term care center residents
Residents can usually
Dress themselves and meet grooming and elimination needs with little help
long term care center residents
Some board and care homes are for
Older people
Others are for people with certain problems
long term care center residents
ALR residents need help with some
Daily activities
long term care center residents
Many residents have problems with
Thinking
Reasoning
And judgment
long term care center residents
The resident can leave the building in an
Emergency
long term care center residents
Residents have
24 hour supervision
3 meals a day
long term care center residents
Services are added or reduced as the persons
Needs change
long term care center residents
nursing centers (nursing facilities, nursing homes) provide health care services to persons who need
regular or continous care
long term care center residents
nursing center requires what kind of nurses
licensed nurses are required
long term care center residents
skilled nursing facilities (SNFs) provide
complex care for severe health problems
long term care center residents
some nursing centers and hospitals provide
subacute care
long term care center residents
a hospice is an agency or program for persons who are
dying
* the focus is on comfort not cure
long term care center residents
alzheimer’s units (dementia care units) are designed for persons with
alzeimer’s disease and other dementias
long term care center residents
in SNfs what is provided
- medical
- nursing
- dietary
- recreation
- rehabilitation
- social services
long term care center residents
many people are admitted to SNFs from
hospitals
* some stay for a short time to recover or for rehabilitation
* others never go home
long term care center residents
subacute care is what kind of care
complex medical care or rehabilitation when hospital care is no longer needed
long term care center residents
persons receiving subacute care are often called
patients
long term care center residents
in a hospice what needs are met for the persons
- physical
- emotional
- social
- spiritual needs of the person and family are met
long term care center residents
hospice care is provided by
- hospitals
- nursing centers
- home care agencies
long term care center residents
pesons with alzheimer’s disease suffer increasing
memory loss and confusion
hospital and nursing center organization
a hospital has a governing body called the
board of trustees or board of directors
* an administrator manages the agency
* directors or department heads manage certain areas
* board makes policies
hospital and nursing center organization
nursing centers are owned by an
- individual
- corporation
- county health department
- each center has an administrator
- department directors report to the administrator
hospital and nursing center organization
hospitals and nursing centers must follow what kind of laws and rules
local, state, and federal laws and rules
hospital and nursing center organization
the health team involves
the many health care workers whose skills and knowledge focus on the person’s total care
in nursing centers it is called the interdisciplinary health care team
hospital and nursing center organization
the health team
- the goal is to provide quality care
- the person is the focus of care
- an RN leads this team
hospital and nursing center organization: nursing service
the director of nursing (DON) is responsible for the
entire nursing staff and the care given
* the DON is an RN
hospital and nursing center organization: nursing service
nurse supervisors and nurse managers oversee a
- work shift
- a nursing area
- or a certain function
hospital and nursing center organization: nursing service
nursing areas may charge nurses for
each shift
hospital and nursing center organization: nursing service
staff RNs report to the
charge nurse
hospital and nursing center organization: nursing service
LPNs/LVNs report to
staff RNs or to the charge nurse
hospital and nursing center organization: nursing service
Nurse aide (CNA) reports the
nurse supervising your work
hospital and nursing center organization: nursing service
functions include
- staff development
- restorative nursing
- infection control
- continous quality
hospital and nursing center organization: nursing service
the charge nurse is responsible for all
patient or resident care and for the actions of nursing staff during that shift
hospital and nursing center organization: nursing edu staff
plan and present educational programs (in-service programs) that meet
federal and state requirements
hospital and nursing center organization: nursing edu staff
provide new and changing
information
hospital and nursing center organization: nursing edu staff
instruct on the use of new
equipment
hospital and nursing center organization: nursing edu staff
review key policies and procedures on a
regular basis
hospital and nursing center organization: nursing edu staff
teach and train
nursing assistants
the nursing team: registered nurses
what do RNs do
- assess, make nursing diagnoses, plan, implement, evaluate nursing care
- develop care plans, provide care, and delegate nursing care and tasks to the nursing team
- evaluate how the care plans and nursing care affect each person
- teach persons how to improve health and independence
- teach the family
- carry out the doctor’s order or delegate them to other nursing team members
hospital and nursing center organization: nursing edu staff
conduct new employee
orientation programs
the nursing team
clinical nurse specialists or nurse practitioners have limited
diagnosing and prescribing functions
the nursing team
the nursing team involves
- RNs
- LPNs/ LVNs
- nursing assistants
the nursing team
all focus on the
- physical
- social
- emotional
- spiritual needs of the person and family
the nursing team
an RN has completed a
2-, 3-, or 4 year nursing program and has passed a licensing test
the nursing team
RNs DO NOT
diagnose or prescribe treatments or drugs
the nursing team
some RNs become
clinical nurse specialists or nurse practioners
the nursing team
licensed practical nurses (LPN) and licensed vocational nurses (LVN)
- are supervised by RNs, licensed doctors, and licensed dentists
- have fewer responsibilites and functions than RNs do
- need little supervision when the person’s condition is stable and care is simple
- assist RNs in caring for acutely ill persons and with complex procedures
- completed a 1 year nursing program and has passed a licensing test
- the title of licensed vocational nursee (LVN) is used in some states
the nursing team
the nursing assistants
- have passed a nursing assistant training and competency evaluation program (NATCEP)
- perform delegated nursing tasks under the supervision of a licensed nurse
nursing care patterns
the pattern used depends on how many
- persons need care
- the staff
- the cost
nursing care patterns
functional nursing
focuses on tasks and jobs
* each nursing team member has certain tasks and jobs to do
nursing care patterns
team nursing
involves a team of nursing staff led by an RN
* “team leader” delegated care, nursing tasks, and procedures to other nurses and to nursing assistants
* delegation is based on the person’s needs and teams member abilites
nursing care patterns
primary nursing
involves total care
* the RN (primary nurse) is responsible for the person’s total care
nursing care patterns
case management is like
primary nursing
* a case manager (an RN) coordinated a person’s care from admission through discharge and into the home setting
nursing care patterns
patient-focused care
involves moving services from departments to the bedside
* reduces the number of people caring for each person
paying for health care
private insurance
is bought by individuals and families
paying for health care
group insurance
is bought by groups or organizations for individuals
paying for health care
medicare
- is a federal health insurance program for persons 65 years of age or older and some younger people with certain disabilites
- part A pays for some hospital, SNF, hospice, and home care costs
- part B helps pay for doctors’ services, out-patient hospital care, physical and occupational therapists, some home care, and many other services
- part b is voluntary and pays a monthly premium
paying for health care
medicaid
- a health care payment program sponsored by the federal gov and operated by the states
- there is no insurance premium
- the amount paid covered services is limited
- people with low incomes usually qualify, some older, blind, and disable persons also qualify
paying for health care
prospective payment systems
- limit the amont paid by insurers, medicare, medicaid
- the amount paid for services is determined before giving care
- medicare severity-adjusted diagnosis-related groups (MS-DRGs) are for hospital costs
- resource utilzation groups (RUGs) and for SNF payments
- case mix groups (CMGs) are used for rehab centers
paying for health care
managed care
- deals with health care delivery and payment
- inserers contract with doctors and hospitals for reduced rates or discounts
- managed care limits: choice of where to go for health care and the care that docs provide
- many states require managed care for medicare and medicaid coverage
- the insured person uses docs and agencies providing the lower rates
- person pays for costs not covered by insurance
meeting standards
standards are set by the
federal and state governments and accrediting agenices
meeting standards
a survey team will
- review policies, procedures, and medical records
- interview staff, patients and residents, and families
- observe how care is given
- observe if dignity and privacy are promotes
- check for cleanliness and safety
- make sure the staff meets state requirements
- decide if agency meets the standards
meeting standards
standards relate to
agency policies and procedures, budget and finances, and quality of care
meeting standards
the joint commission is the
national accrediting and certifying agency that focuses on the quality improvement and patient safety
meeting standards
if problems are found
- the agency is given time usually 60 days at most to correct the problem
- the agency can be fined for uncorrected or serious problems
- the agency can lose its license, certification, or accreditation
meeting standards
your role involves
- providing quality care
- protecting the person’s rights
- providing for the person’s and your own safety
- helping keep the agency clean and safe
- conducting yourself in a professional manner
- having good work ethics
- following agency policies and procedures
- answering questions honestl and completely
