chronic ill test 1 Flashcards
nursing process
assessment, diagnosis, planning, intervention, evaluation
nursing management responsibilities
Staffing Employee satisfaction Safety and quality Customer satisfaction Budgeting
nursing management skills
strong ability to make clinical decisions, priority setting, Organizational skills, Use of resources, Time management, Team communication
car coordination includes
patient, provider, and care team
care coordination
Care coordination is a necessary foundation to achieving the “triple aim” of health reform
“triple aim” of health reform
- Improved patient experience of care (quality, access, and reliability).
- Improved population health.
- Per capita cost control.
what happens if care coordination isn’t involved
Increased cost Potential drug interactions Increased medical error Unnecessary duplication of tests and services Unnecessary patient and family distress
what is chronic illness defined as
Persisting longer than 6 months
Irreversible
Affects functioning in one or more systems
top chronic illnesses in the US
- Heart disease
- Cancer
- Chronic lung disease
- Stroke
- Alzheimer’s Disease
- Diabetes
- CKD
how many adults in the US have a chronic illness
6 in 10 adults in the US have a chronic disease
how many adults in the US have 2 or more chronic illness
4 in 10
cost of chronic disease
90% of the nation’s $3.3 trillion in annual health care expenditures are for people with chronic health conditions
causes of chronic disease
tobacco use, poor nutrition, lack of exercise, excessive alcohol use
1 complication of chronic disease
depression
other complications of chronic disease
spiritual distress, fear, anxiety, and powerlessness
spiritual patients and chronic illness
Spiritual patients are able to find meaning and purpose in life and are better able to cope with and accept their chronic illness
chronic illness management
1: Prevention of exacerbations - Imperative for patient’s to know the signs and symptoms of the onset of a crisis!
Carrying out prescribed treatment regimen
Controlling symptoms
CHF+ diuretics
Adjusting to changes in the course of disease
Prevent social isolation
management of Patient with COPD
maintenance medications are key + sick day plan
management of patient with CHF
daily monitoring of weight and sodium intake + medication compliance
8 phases of chronic illness
- onset
- stable
- acute
- comeback
- crisis
- unstable
- downward
- dying
phase 1 onset of chronic illness
Signs and symptoms are present
Disease diagnosed
phase 2 onset of chronic illness
Illness course and symptoms controlled by treatment regimen
Person maintains everyday activities
phase 3 onset of chronic illness
Active illness with severe and unrelieved symptoms or complications
Hospitalization may be required for management
phase 4 onset of chronic illness
Gradual return to an acceptable way of life
phase 5 onset of chronic illness
Life-threatening situation occurs
Emergency services are necessary
phase 6 onset of chronic illness
Unable to keep symptoms under control
Life becomes disrupted while patient works to regain stability
phase 7 onset of chronic illness
Gradual and progressive deterioration in physical or mental status
Continuous alterations in everyday life activities
phase 8 onset of chronic illness
Patient relinquishes everyday life interests and activities, let go, and die peacefully
Immediate weeks, days, hours preceding death
examples of community resources for chronic ill patients
School Government Non-profits Faith-based organizations All of these resources keep chronically ill patients supported, involved and active!
how are health systems involved in the chronic care model
Develop agreements that facilitate care coordination
Promote effective improvement strategies
Encourage open and systematic handling of errors and quality problems to improve care
Self-Management Support
Empower and prepare patients to manage their health care by Encouraging patients to set goals, identifying barriers and challenges, and monitoring their own conditions
Delivery System Design
Assure effective, efficient care and self-management support through Regular, proactive planned visits to maintain optimal health
decision Support
Promote care consistent with scientific data and patient preferences
Clinical Information Systems
Organize data to facilitate efficient and effective care
Upon initial diagnosis of a chronic illness, patient’s can experience the
5 stages of grief
5 stages of grief
- Denial
- Anger
- Bargaining
- Depression
- Acceptance
Some stages may be revisited, and others may not be experienced at all
transition between stages is an
ebb and flow, NOT a progression
life alterations during a chronic disease
Behavioral and emotional changes
Impact on body image
Impact on self-concept
Impact on family
life alteration reactions depend on
- The nature of the illness
- Patient’s attitude
- The reaction of others
- Variables of illness behavior