Chapters 1-6 12 Flashcards
A health care provider was trained in ______ health care skills, rather than for specific illnesses or conditions
general
Charlatans use to offer ineffective ______ in exchange for money
cures
The _____ was the primary site for patient care
home
Health care professionals have to undergo intensive ____ _____
Large facilities provide _____ patient care
educational preparation
on-site
The family doctor is now called a ______ _____ and is supported by a team of specialist
general practitioner
A _____ approach is now used: focuses on the care of the whole person–physically and emotionally
holistic
All health care organizations have a purpose or _____
mission
Acute care settings
Probably the best known type of health care organization
People who receive the services there are called ____
hospital
patients
A patient who has to stay at the hospital for one or more nights receives _____ _____
inpatient care
A patient who goes home the same day receives _____ _____
outpatient care
Also called a skilled nursing unit or a skilled nursing facility
Provides care for a patient who has partially recovered but still requires skilled health care
sub-acute care units
The care provided in a sub-acute unit often focuses on _____
rehabilitation
For people who are unable to care for themselves at home, yet do not need to be hospitalized
long term care facilities
Long term care facilities often becomes the person’s ____, either temporarily or permanently
home
People being cared for in long term care facilities are called _____
residents
For people needing limited help such as:
medications
transportation
meals
housekeeping
assisted living facilities
Provide skilled care in a person’s home
People receiving care in this type of setting are called ____
Available for people of all ages with any number of medical needs
home health care agencies
clients
People can receive services when they know that they have 3 to 6 months to live
Focus: to relieve pain and to provide emotional and spiritual support
Services are provided for both the dying person and the family
hospice organizations
_____ care can be delivered in the home, a nursing home, hospital or hospice house or center
hospice
Within each facility, care of patients or residents is provided by a _____ _____ _____, made up of many people with different types of knowledge and skill levels
health care team
Structure of health care organizations are usually governed by a ____ _____ _____
Has divisions in charge of certain aspects of the organization’s function
An _____ or chief of executive officer (CEO) is the link between the board and the organization
board of trustees
administrator
Nursing services is headed by a ____ or ____
Care of patients or residents is provided by a ____ ____ _____
director of nursing (DON) or chief nursing officer (CNO)
health care team
The ____ or ____ is the primary focus of the health care teams efforts
patient or resident
The primary government agency responsible for protecting this nation’s health
United States Department of Health and Human Services
DHHS
An in-depth investigation of long term care facilities initiated by the DHHS in response to complaints of neglect and abuse from people who had family members in long term care facilities resulted in a law known as the _____ ____ _____ _____ of 1987
Omnibus Budget Reconciliation Act of 1987
OBRA
Sets national standards for all types of health care organizations and officially recognizes organizations that meet standards
The Joint Commission (JCAHO)
An actual inspection and evaluation of a health care organization or facility
survey
Statements that identify the standards that were not met, as well as the survey teams findings that indicate how the facility failed to meet the standards
Must be addressed in a formal written statement that outlines how each deficiency will be corrected
deficiency citations
A facility that does not regain compliance status may face serious penalties, such as:
loss of accreditation status
substantial fines
an inability to qualify for Medicare or Medicaid payments
an admissions ban
closure
Government and private regulations make sure that:
providers of health care are properly ____ and ____
health care facilities meet standards of ____ and ____
all products used in the delivery of health care are safe
quality health care is available to everyone
trained and competent
cleanliness and quality
Regulating agencies:
Government: ____
Private: _____
United States Department of Health and Human Services (DHHS)
The Joint Commission
Government agency that is responsible for protecting the health and safety of American workers by enforcing standards and providing education to improve conditions in the workplace
Occupational Safety and Health Administration (OSHA)
Assures the organization is meeting specifically stated standards of care
accreditation
Health care facilities that comply with the standards set by The Joint Commission are allowed to display the ____ ____ _____ _____ of _____
Joint Commission’s Gold Seal of Approval
Comprised of representatives of various accrediting agencies, inspects and evaluates the organization and actual facility
survey team
A report containing any identified deficiencies
written summary
Insurance purchased at group rates by an employer or corporation
group insurance
Health care provider has to prove that a person’s medical condition meets certain criteria before starting
treatment
Precertification (preapproval) process
Arrange contracts with various health care providers
managed care system
Health care providers contract with an insurance company to accept a standard payment
Preferred provider organization (PPO)
Contract with health care providers to provide health care services for a prepaid fee
Health maintenance organization (HMO)
Federally funded by Social Security, administered by Center for Medicare and Medicaid Services (CMMS)
People who are 65 or older are eligible
medicare
A report required for each resident that received Medicare
Asses the degree of assistance that each resident needs and helps to ensure that the resident receives quality care that is directed to his or her specific needs
minimum data set (MDS)
Payment is specified according to the diagnosis
diagnosis-related groups (DRG’s)
Due to the DRG system, patients are discharged ____ and ____
sooner and sicker
Designed to help people with low income to pay for health care
Federally funded and state regulated plan
Reimbursements are given only to facilities approved by the state agency
Medicaid
British nurse who is credited with making nursing into the profession it is today (1820-1910)
Florence Nightingale
____ _____ _____ _____ requirements for certification:
competency evaluation
principle of reciprocity
registry
continuing education
Omnibus Budget Reconciliation Act (OBRA)
Nursing assistant training ends with a ____ ____,
which involves a written test of 75 multiple choice questions and a skills test
competency evaluation
The principle of ____ means your certification as a nursing assistant may be valid in states other than where you originally trained
reciprocity
OBRA requires every state to maintain a ____, an official database of the people who have successfully completed the nursing assistant training program
registry
The ____ contains:
- full name, including maiden name and married name
- last known home address
- date competency evaluation was passed
- reported incidents of resident abuse or neglect, or theft of resident property
registry
- assist nurses in giving care to patients and residents
- meet the basic physical needs of patients and residents
- meet the emotional needs of patients and residents
- act as observer and communicator
These are responsibilities of a _____ _____
nursing assistant
The nursing team consists of: ____, _____, and _____
licensed practical nurse (LPN) or licensed vocational nurse (LVN)
registered nurse (RN)
nursing assistant
The difference between a LPN and RN is _____
the level of training
Licensed nurse who supervises the nursing assistants and may supervise another nurse
charge nurse
Sometimes called a nurse manager or head nurse, is usually an RN who is in charge of a particular floor or section, supervises the charge nurse and has 24 hr day responsibility of the floor
unit manager
May have same responsibilities as a unit manager, but the duties are limited to that shift
shift supervisor
RN who directs all of the nurse care within the facility, responsible for the overall operation of the entire nursing department
Director of Nursing (DON)
Person that is responsible for developing and delivering in-service education
Coordinator (of director) of In-Service Education or Staff Development
Nurse that is responsible for tracking data that reflect quality of care issues, like incidents or accidents
Quality Assurance (QA) or Quality Improvement (QI)
RN responsible for the assessment process that is used to complete the Minimum Data Set (MDS)
Registered Nurse Assessment Coordinator (RNAC)
RN who has completed additional training for licensure in advanced practice, are able to do some tasks that doctors do
Certified Registered Nurse Practitioner (CRNP)
RN that is assigned several patients or residents and is responsible for planning and carrying out all aspects of care for those people
primary nursing
Each member of the nursing team carries out the same task for all patients and residents
functional (modular) nursing
A team leader, determines all of the nursing needs for the patients or residents assigned to the team and assigns task according to each team members skills
team nursing
Nursing care is designed around the needs of the patient or resident and works to meet the person’s needs
patient-centered or patient-focused care
- describes the range of task the assistant is legally permitted to do
- restricts task assistant is allowed to do
- defines the responsibilities of a nursing assistant
scope of practice
To give another person permission to perform that task on your behalf
delegate
The National Council of State Boards of Nursing (NCSBN) has developed guidelines called the ____ ____ _____ _____
- the right task
- the right circumstances
- the right person
- the right direction
- the right supervision
five rights of delegation
- administering meds and O2
- receiving verbal orders from doctor
- diagnosing illness and prescribing meds
- supervising other CNA’s
- sterile task
- inserting or removing tubes
These are task that a CNA should ____ do
not
- person with experience and skill in a specific role
- person engaged in a specific occupation for pay
- person who has credentials, obtained through education and training enabling licensing or certification to practice certain professions
professional
- having a professional attitude
- possessing a positive attitude
- committed to doing your best
- sense of pride as result of setting high standards
- obtaining satisfaction from work done
professionalism
- your attitude toward your work
- remember that a strong ___ ____ is what separates an average employee from a great employee
- allows growth
work ethics
- punctuality
- reliability
- accountability
- conscientiousness
- honesty
- cooperativeness
- empathy
- life-long learner
characteristics of work ethics
Side of ourselves that we display to the world, communicating outwardly how we feel about things
attitude
____ and _____ go together hand and hand
professionalism and strong work ethics
Being able to imagine what it would feel like to be in another persons situation
empathy
- prevent emotional burn out
- keep your emotions in check
emotional health
- prevent the spread of infection
- maintain a professional appearance
personal hygiene
A brief document that gives a possible employer general information about you and your education and work experience
resume
It is against the law for an employer to ask a candidate questions about race, religion, marital status, ect….
Equal Employment Opportunity Commission (EEOC)
A list of three or four people who would be willing to talk to a potential employer about your abilities
reference list
Person that handles the hiring
human resources department (HR)
A chance for a potential employer to meet you personally and learn more about you
interview
The practice of designing equipment and work task to conform to the capacity of the worker
ergonomics
Manual lifting, turning, and repositioning of patients put health care workers at increased risk for _____
musculoskeletal disorders
Musculoskeletal disorders include:
- muscles strains and tears
- ligament sprains
- joint and tension inflammation
- pinched nerve
- herniated discs in the spinal column
Performing the same action over and over again places physical stress on the body, actions are:
- lifting
- pushing
- pulling
- stooping
- bending
- moving
The basic components of good body mechanics are
the ABC’s:
- alignment
- balance
- coordinated movement
Simply good posture, ensures that no excess strain is placed on the joints and muscles
alignment
The back is held in a _____ position with the natural curvature of the lower back intact
neutral
Stability produced by the even distribution of weight
balance
Improve your _____ by:
- increasing your base of support by spreading your feet further apart
- bringing your center of gravity (torso) closer to your base of support (feet) by bending at the knees and hips so that your torso is closer to your feet
balance
Involves using the weight of your body to help with movement
coordinated body movement
When you have to move a patient from the bed to a chair,
- bend your knees and hold the person close to the center of your body
- use your muscles in your ____ and ____ to lift and move the person
thighs and hips
A series of steps followed in a particular order:
-protects patients, residents, and nursing assistant
procedure
Actions followed before performing any procedure
pre-procedure actions
The Getting Ready steps:
-WEAVERS
- wash
- equipment
- announce
- verify
- explain
- respect
- safety
Actions that are routinely performed at the end of each procedure
post-procedure actions
Finish up steps:
A L S O W D
- alignment
- light
- safety
- open
- wash
- document
-Multiple duties
-emergency situations
-unnoticed wet floors
-helping a very weak person
-attempting to prevent a fall
Are factors that increase _____
a risk for falling
Form of communicating information about chemicals to employees
Safety Data Sheet (SDS)
Summarizes the following information:
- what the chemical is made from
- which exposures may be dangerous
- what to do if an exposure occurs
- how to clean up spills
Safety Data Sheet (SDS)
____ mishaps can occur due to:
- frayed wires
- loose plugs
- unsafe electrical appliances
electrical
A way of returning stray electrical current to the outlet so that the risk of electrical shock is reduced
grounded
For a fire to occur 3 elements must be present:
- fuel
- heat
- O2
Common sources of ____ include:
- cloth
- cooking oil, gasoline
- the building itself
fuel
Common sources of ____ include:
- electrical spark
- lighted smoking material
- candles
- heated elements
- stove
heat
Common sources of ____ include:
- present air
- O2
oxygen
The general actions that are taken in the event of a fire emergency are known as the ____ fire response plan
RACE
R- remove
A- activate
C- contain
E- extinguish or evacuate
Type of fire fueled by wood, paper, cloth, dried leaves and grass
Extinguished by water and removing heat
Type A
Type of fire fueled by petroleum, cooking, grease
Extinguished by sprinkling baking powder, put a lid on pan and remove from heat
Type B
Type of fire fueled by electric short circuit, electric sparks
Extinguished by using a fire extinguisher
Type C
When using a fire extinguisher remember the word PASS:
Pull
Aim
Squeeze
Spray
A sudden, unexpected event that causes injury to many people, major damage to property, or both
disaster
Violet acts (including physical assaults and threats of assaults) directed toward persons at work or on duty Includes acts of terrorism
workplace violence
-society’s laws
-governing authority
-personal ethical code
-moral sense
-values installed by family
-spiritual beliefs
Are factors that influence ____
behavior
Revision of Patients’ Bill of Rights by American Hospital Association
12 points in the Patient Care Partnership
Patients’ rights and responsibilities in the bill
Patients’ Rights
Guidelines as part of the Omnibus Budget (OBRA)
16 points in the residents rights
-set legal and ethical standards
-creates atmosphere of open communication
-protects residents
Residents’ Rights
Advocacy
Ombudsman
OBRA requirements
Are concerns for ____
long-term care
Process of making a plea or providing support on another’s behalf
advocacy
A person from the state or local Office on Aging who regularly visits residents in long term care facilities to check on their welfare
ombudsman
____ requires nursing homes to post information notifying residents of their right to file an complaint
OBRA
The ability to make thoughtful decisions based on an understanding of the risks and benefits related to a decision
decision making capacity
Documents that allow a person to make his or her wishes concerning health care known to family, friends, and health care providers
-preserve the patient’s right to make informed health care related decisions
advanced directives
The authority to make health care decisions is transferred to a health care agent in times when the patients decision making abilities are impaired
durable power of attorney for health care
Allows the patient to make known their wishes concerning end of life medical treatment
living will
Rules are made by a controlling authority such as the state or federal government
laws
Concerned with the relationship between individuals
civil law
Concerned with the relationship between an individual and society
criminal law
Legal action taken against a person for breaking the law
litigation
Responsibility of an individual to act within the confines of the law
liability
When a civil law is violated a ____ or wrong is committed
tort
Without intent to cause harm
unintentional tort
A person who commits unintentional tort is considered ____
negligent
Negligence committed by people licensed to practice their profession is called _____
malpractice
with intent to cause harm, includes:
- defamation
- assault
- battery
- fraud
- false imprisonment
- invasion of privacy
- larceny
intentional tort
Making untrue statements, slander or libel
defamation
stealing
larceny
Threatening or attempting to touch a person without consent
Can be based on angry statement or gesture
assault
Touching a person without consent
battery
Deception that could cause harm
Misrepresents professional qualities
fraud
Confining another person against their will
Improper use of restraints
false imprisonment
Violating another persons right to keep certain information and aspects of self away from others
invasion of privacy
Keeping information to self
confidentiality
Federal privacy regulations
Involves both at work and away from work
Health Insurance Portability and Accountability Act
HIPAA 1996
Repetitive and deliberate infliction of injury on another person
Actively doing something failing to do something
abuse
Moral principles or standards that govern conduct
ethics
Code stated by the American Nurses Association
professional ethics
Type of ethics that are derived from values
personal
A cherished belief or principle
value
Do good for those in your care
beneficence
Avoid harming those in your care, use kindness and gentleness
nonmaleficence
Treat people fairly and equally
justice
Act with integrity to earn others trust
fidelity
Respect a person rights and personal preference
autonomy
- treat patients and residents with respect for their individual needs and values
- respect the patients right to choice in regards to their care
- hold confidential all information about a patient
- be guided by consideration for dignity of patients
- fulfill the obligation to provide competent care
code of ethics
Process of exchanging information that involves at least two people
communication
Tends to be deliberate, used to express a thought, with the intent of giving specific information to another person
verbal communication
More subtle, involves giving information through the use of facial expressions, gestures, and body language
-tone of voice can be considered a form
nonverbal communication
Is an indication that the message sent by the sender was received and understood by the receiver
feedback
_____ questions invite the person to say more
open ended
____ is perhaps the most universal of all languages
touch
Results from differences between people
conflict
Today the _____ remains a primary tool of communication
- use etiquette
- respect patient confidentiality
- know your facilities policy
telephone
Something that you noticed about a patient typically related to a change in physical and mental condition
observation
Information that cannot be objectively measured or assessed
subjective data (symptom)
Information that you obtain directly though measurements or by using one of your five senses
objective data (sign)
Spoken exchange of information between health care team workers
reporting
Communicating information about a patient to other health care team members in written form
- medical record
- kardex
recording (charting)
Legal document that contains:
- persons current condition
- measures taken for diagnosis and treatment
- persons response to treatment
medical record
_____ records contain:
- admission sheet
- med history
- nursing history
- physicians order sheet
- medication administration record
- physicians progress notes
- narrative nurses notes
- graphic sheet
- miscellaneous documents
medical
A persons medical record can be maintained by:
entering data into a _____ in response to prompts
computer
Computer information system Advantages: -record easily and quickly -information can be uploaded quickly -information can be recorded at bed side -doctor orders immediately sent to appropriate departments
electronic health record (EHR)
A card file containing condensed versions of each patients medical record
- summary of pts current diagnosis
- diagnostic tests and treatments ordered by the doctor
- information about routine care measures
kardex
Plan that directs the efforts of the health care team members who are responsible for carrying out the doctors orders
interdisciplinary care plan
Nursing team develops a care plan for each pt
nursing care plan
The communication method that is used to develop the nursing care plan
nursing process
Nursing assistants play a key role in ____ and ____ the nursing care plan
implementing and evaluating
Steps in the ____:
- assessment
- diagnosis
- planning
- implementation
- evaluation
nursing process
A condition characterized by a rapid onset and a relatively short recovery time, unexpected
acute illness
A condition that is ongoing
chronic illness
Illness or condition from which recovery is not expected
terminal illness
- grouped according to age
- grouped according to illness or condition
- grouped according to special needs
grouping
Changes that occur physically are known as ____
growth
Changes that occur psychologically or socially are known as ____
development
- 20 to 40 years
- typically enjoy stable, supporting friendships and good health
young adult
- 40 to 65 years
- at the height of career
- become caretakers
- start to show signs of aging
- chronic illness may occur
middle adulthood
- 65 to 75 years
- physical signs of aging and the development of chronic illnesses become more prevalent
- strength diminishes
later adulthood
- 75 years and beyond
- primary task is preparing for ones own death
- must adjust to failing health
- enjoy sharing wisdom to the young
older adulthood
Defined as something that is essential for a persons physical and mental health
need
Famous American psychologist defined what he thought to be the basic human needs
Abraham Maslow (1908-1970)
Maslow’s pyramid, called ____ reflects Maslow’s belief that the more basic, lower level needs must be met, at least to some degree, before the higher level needs can be met
Maslow’s hierarchy of human needs
- physiologic needs
- safety and security
- love and belonging needs
- self-esteem needs
- self-actualization needs (highest level)
Maslow’s hierarchy of human needs
Made up of the beliefs (including religious or spiritual beliefs) values and traditions that are customary to a group of people
culture
A persons spiritual beliefs
religion
-getting satisfaction and comfort from the way we live
-everyone has different idea
-everyone will decide what they do and do not want
-holistic approach
-must respect his or her wishes
-provide information to help client or resident to make
decision
quality of life
