Exam #1 Flashcards
What is the Accountable Care Organization (ACO)?
This departs from the fee-for-service model so instead they offer incentives to provide integrated, well coordinated care to patients.
What is the meaning of Fee-for-Service?
Everything a provider does comes out as a fee
-Instead of doing the necessary and better care,, they’ll do more unnecessary care
HMO and copayments
This is a prepaid group managed care plan that gives its subscribers all the medical services one requires through an affricated group
Copayments: pay a little out of pocket or nothing at all
PPO’s
Pay healthcare providers to provide services for a lower fee in return to a prompt day
Prompt day= A fair and reasonable payment
Inpatient
Patients that stay at the hospital for treatment
Outpatient
Patients that receive outside care in their homes
-like a clinic
ACA is?
A law that aims to expand and improve health insurance coverage in the healthcare system
What is Medicare?
This is a plan for adults older than 65
They receive
–Hospital care, extended care and home health care
What is Medicaid?
A federally funded public assistance program for people of any age and low income
T/F: Preferred provider organizations (PPOs) are prepaid, group-managed care plans that allow subscribers to receive all medical services through a group of affiliated providers.
F
What is a Occupational therapists?
evaluate the patient’s functional level and teaching activities to promote self-care in activities of daily living. They assess the home for safety and provide adaptive equipment as necessary.
speech therapist is?
trained to help patients who are deaf or hard of hearing speak more clearly, to assist patients who have had a stroke to relearn how to speak, and to correct or modify a variety of speech disturbances in children and adults. Speech therapists also diagnose and treat swallowing problems in patients who have had a head injury or a stroke.
physical therapist
seeks to restore function or to prevent further disability in a patient after an injury or illness. PTs use various techniques to treat patients, including massage, heat, cold, water, sonar waves, exercises, and electrical stimulation. Most PTs are also educated in the use of psychological strategies to motivate patients.
Respiratory Therapist
A respiratory therapist (RT) is trained in techniques that improve pulmonary function and oxygenation. RTs may also be responsible for administering a variety of tests that measure lung function and for educating the patient about the use of various devices and machines prescribed by the health care provider.
What are ways quality and safety have improved? (p. 276-278)
What is the difference between primary, secondary, and tertiary health care? (p. 282)
Definition: This is the first point of contact for individuals with the health care system. It focuses on overall health maintenance and prevention of disease.
Services: Includes routine check-ups, immunizations, health education, and treatment for common illnesses and conditions. Primary care is often provided by general practitioners, family physicians, pediatricians, and internists.
Goals: To provide comprehensive, accessible, and continuous care that is patient-centered and preventive. Secondary Health Care:
Definition: This level provides more specialized services typically requiring referral from a primary care provider.
Services: Includes specialty care like cardiology, dermatology, and orthopedics, often involving diagnostic tests and more advanced procedures. Care is usually provided by specialists or through hospitals.
Goals: To address specific health issues that need specialized expertise and to provide a higher level of intervention compared to primary care.
Tertiary Health Care:
Definition: This is highly specialized medical care usually provided in specialized centers or teaching hospitals.
Services: Includes complex treatments and procedures such as surgeries, advanced diagnostics, and management of severe and complex conditions. It often involves a team of specialists and advanced technology.
Goals: To manage and treat rare or complex conditions that require high-level expertise and resources not available in primary or secondary care settings.
What is the difference between PPOs & HMOs? (p. 284)
HMOs are known for their provider networks and lower costs. They are also restrictive and don’t cover out-of-network care unless it’s an emergency. PPOs offer more flexibility and allow out-of-network care, but that type of care typically comes with a higher cost.
List health care settings that a nurse can work in? (pp. 288-292)
Acute Care Settings:
Hospitals: Including emergency departments, intensive care units (ICUs), and surgical units.
Urgent Care Centers:Providing immediate care for non-life-threatening conditions.
Critical Care Units: Specialized areas such as cardiac care units (CCUs) and neonatal intensive care units (NICUs).
Primary Care Settings:
Private Practice: Working with individual or group practices focusing on general health maintenance and disease prevention.
**Community Health Clinics: **Providing primary care services to underserved populations.
Public Health Departments: Focusing on community health, disease prevention, and health education.
Long-Term Care Settings:
Nursing Homes: Offering extended care for individuals with chronic illnesses or disabilities.
Assisted Living Facilities: Providing support with daily activities while allowing for greater independence.
Rehabilitation Centers: Assisting with recovery and rehabilitation from injuries or surgeries.
Home Health Care:
Home Health Agencies: Delivering care in patients’ homes, including wound care, medication management, and health monitoring.
Palliative and Hospice Care: Providing end-of-life care and support for terminally ill patients and their families.
Specialty Care Settings:
**Oncology Clinics: **Focusing on cancer care and treatment.
**Cardiology Clinics: **Specializing in heart conditions and diseases.
Diabetes Clinics: Managing and educating on diabetes care and prevention.
Educational and Research Settings:
Academic Institutions: Teaching and training nursing students and professionals.
Research Facilities: Conducting studies and clinical trials to advance nursing practice and health care knowledge.
Occupational Health Settings:
Corporate Wellness Programs: Providing health assessments and education in the workplace.
**Industrial Clinics: **Managing health and safety for employees in industrial settings.
Military and Correctional Facilities:
**Military Health Services: **Delivering care to service members and their families.
**Correctional Facilities: **Providing health care within prisons and jails.
Describe what role the hospitalist has in the healthcare team. (p. 296, Box 11-3)
A hospitalist specializes in managing the care of hospitalized patients, coordinating treatment, communicating with the healthcare team and families, and ensuring efficient and effective inpatient care.
What do consumers want from their health care? (p. 297)
In addition to quality and affordability, convenience and personalization are key drivers of consumer choice and perception of their healthcare.
What are today’s healthcare primary foci? (p. 297)
Today’s healthcare primary foci include improving quality of care, enhancing patient safety, reducing costs, promoting preventive care, and integrating services to ensure a patient-centered approach.
What can nurses do to help health care reform? (p. 298)
Nurses can help health care reform by advocating for policy changes, participating in quality improvement initiatives, providing evidence-based care, and educating patients and communities about health and wellness.
What are the steps of the nursing process?
1.Assessment
2. Diagnosis
3. Planning
4. Implementation
5. Evaluation
A dad paints in evergreen
What is the nursing process?
A systematic way we can make clinically safe decisions for our patients.
What kind of practice is thoughtful person-centered practice?
focuses on the individual within multiple complicated contexts, including family and/or important others. Person-centered care is holistic, individualized, just, respectful, compassionate, coordinated, evidence-based, and developmentally appropriate.
What is clinical reasoning?
Refers to the ways of thinking about patient care issues (determining, preventing, and managing patient problems).
What are the types of problem solving?
Trial-and-error, scientific, and intuitive.
What type of problem solving may be chosen when approaching a rare medical condition, is not recommended, and is NOT a first line of problem solving? Ex. Trying to heal a cut on someone’s arm with baking soda.
Trial-and-error problem solving
What type of problem solving has a logical 7 step method and consists of problem identification, formulating a hypothesis, and gathering info needed to make a decision?
Scientific problem solving.
What type of problem solving comes with experience and is essentially one knowing what to do because they have seen and dealt with it before?
Intuitive problem solving.
What are the 10 guiding principles of person-centered care?
-All team members are considered caregivers.
-Care is based on continuous healing relationships.
-Care is customized and reflects patient needs, values, and choices.
-Knowledge and information are freely shared between and among patients, care partners, physicians, and other caregivers.
-Care is provided in a healing environment of comfort, peace, and support.
-Families and friends of the patient are considered an essential part of the care team.
-Patient safety is a visible priority.
-Transparency is rule in the care of the patient.
-All caregivers cooperate with one another through a common focus on the best interests and personal goals of the patient.
-The patient is the source of control for one’s care.
Describe the assessing step of the nursing process.
Collecting, validating, and communicating patient data.
Describe the diagnosing step of the nursing process.
Analyzing patient data to identify patient strengths and problems.
Describe the planning step of the nursing process.
Specifying patient outcomes and related nursing interventions. Plan with the patient.
Describe the planning step of the nursing process.
Specifying patient outcomes and related nursing interventions. Plan with the patient.
Describe the implementing step of the nursing process.
Carrying out the plan of care.
Describe the evaluating step of the nursing process.
Measuring extent to which the patient achieved outcomes.
Primary focus of healthcare
Health promotion
Health care outcomes by IOM
Safe, efficient , client centered, timely , equitable
Health care reform
Ensure were always informed on current topics, being involved in politics, participate in nursing associations , document out care, stronger voice, increasing education, provide care to people neglected, holistic care
Strategies to promote quality of care
Strategies to promote quality of care
How healthcare is paid for
out of pocket, individual private insurance, employer based insurance, government funding (medicare and medicaid)
Roles of health team members
Physician/Doctor:
Role: Diagnose and treat medical conditions, develop and oversee treatment plans, and provide overall medical care.
Specialties: Can include general practitioners, internists, surgeons, and specialists like cardiologists or oncologists.
Nurse:
Role: Provide direct patient care, administer medications, monitor patient progress, and educate patients and families. Nurses also coordinate care and advocate for patients’ needs.
Types: Includes registered nurses (RNs), nurse practitioners (NPs), and licensed practical nurses (LPNs).
Pharmacist:
Role: Dispense medications, provide medication counseling, monitor for drug interactions, and contribute to medication management and safety.
Physician Assistant (PA):
Role: Perform medical examinations, diagnose and treat illnesses, assist in surgeries, and prescribe medications under the supervision of a physician.
Social Worker:
Role: Assist patients and families with social, emotional, and financial challenges, coordinate community resources, and provide counseling and support services.
Occupational Therapist (OT):
Role: Help patients develop, recover, or maintain daily living and work skills through therapeutic activities and adaptive techniques.
Physical Therapist (PT):
Role: Work with patients to improve movement, strength, and physical function through exercise and rehabilitation therapies.
Speech-Language Pathologist (SLP):
Role: Assess and treat speech, language, and swallowing disorders to improve communication and functional abilities.
Dietitian/Nutritionist:
Role: Develop and implement nutrition plans, provide dietary counseling, and manage nutritional aspects of patient care, including special diets.
Clinical Psychologist:
Role: Provide psychological assessments, therapy, and counseling to support mental health and address behavioral issues.
Healthcare Administrator/Manager:
Role: Oversee healthcare facilities or departments, manage operations, ensure compliance with regulations, and implement policies to improve service delivery.
Medical Assistant:
Role: Support physicians by performing clinical tasks such as taking vital signs, preparing patients for exams, and handling administrative duties.
Why has health care become so complex?
as people live longer, they get more diseases and issues
