Exam 1: Module 4 Flashcards
Factors affecting delivery of health care
- What are the changing demographics of healthcare
- Are ther more young adults or old?
- life expectancy?
- What is rising and increasing?
Inc. proportion of older adults
- life expectancy increasing
- Rising BMI resulting in increased rates of chronic disease
Social determinants of health
- what are the 5 key areas for SDOH?
- ecomonic stability
- Education access and quality
- Social and community context
- Healthcare access and quality
- Neighborhood and build environment
adverse childhood experiences and resiliency
- what are determinants of health for a child?
- childhood trauma
advances in technology
- how does this effect delivery of health care
- information managment systems improved
- advances in surpical techniques
- use of telemedicine has extended patient access
Delivery models study
- staffing issues
- staff qualifiation
- patient-nurse ratio
What does this all relate to?
Factors affecting delivery of health care
__% have basic or below basic levels of health literacy?
36%
What is important for health literacy?
Process, understand basic health information and services to make appropriate health decisions
What are the 3 common models of healthcare?
-Can the framworks overlap?
managed care
case managmenet
patient-focused care
- yes, they can overlap
Describe managed care?
- is it cost effective, high-quality or is it expensive and low quality?
- what is it designed to do?
- what is the goal of healthcare reform?
it is cost-effective and high-quality
- designed to improve outcomes for groups of patients
- goal is to focus on cost-containment with improved access and quality of services for everyone
What are the 2 primary managed care models?
HMO and PPO
case managment is the __________ process with ______________ teams led by case manager
collaborative; multidisciplinary
case management is a _________ for health care that helps to control ____ of care and maintaining _______ of care
framework;cost;quality
case mnagement is led by the _______
nurse
case management ________ the patient to experience ___________ of care regardless of the location where care. is provided
enables; continuity
What is patient-focused care
healthcare organize around expressed physical, emotional needs of the patient
- Patients and families integral to decisions about helathcare delivery
for patient-focused care, is it gnerally understoof that patients and families are integrated in the decision process regarding healthcare delivery?
Yes
Patient focused care still allows ________ of the patient
autonomy
once again, what are the 5 social determinants of health
(every exam shows health needs)
Economic Stability
Education Access and Quality
Social and Community Context
Healthcare Access and Quality
Neighborhood and Built Environment
people who are unemployed, self-employed, small company employers face challenges accessing healthcare resulting in
poorer health outcomes
can failure to recieve immunizations result in comunity outbreaks?
yes
the ACA signed by Obama was designed to…
remedy some disparities in access to health insurance coverage and other related problems
Current data shows that sizable disparities continue to provide _________ to equitable healthcare to all americans
obstacle
lack of usual source of care results in what 3 things
- results in fragmented care
- Poorer health outcomes
- Increased Cost
what is the value-based purchasing-medicare program?
It pays incentives to hospitals that demonstrate quality care
Medicare uses a prospective ________ _____ based on diagnosis-relates groups
payment plan
What is the nurses rolw in the setting of:
- Clinics; primary care practices?
- provide and imrpove patient care through clinic management,
- participation in care during visits
- an care management for patients with complex or chonic health conditions
take note: primary care that a community health nurse would implement - outreach to community members to update immunizations
What is the nurses role in the setting of:
- Home health care
- assess patients
- develop treatment plans
- provide care
- collaborate
- monitor health changed and progress
What is the nurses rolw in the setting of:
- long-term care facilities; nursing homes; silled care
(same as home health)
- assess patients
- develop Tx plans
- provide care,
- collaborate
- monitor health changes and progress
What is the nurses rolw in the setting of:
Telehealth
How about worksite wellness programs?
- Assess pateints from a distance
- monitor health status
- Interact to provide healthcare needs
- provide health education
- group wellness coaching sessions
- wellness programs
What is the nurses rolw in the setting of:
Alcohol and addiction rehab facilities
Assess stage of recovery and level of readiness for change; provide skilled care during detox
What is the nurses rolw in the setting of:
Outpaient clinics; community mental health centers
Provide Care management for patients with complex or chronic mental health conditions
What is the nurses rolw in the setting of:
Residential mental health and/or addiction tretment centers
Assess patients
- provide care including therapeuti communication
- monitor and discuss progress
What is a factor that has influenced the increased diversity in practice settings for nurses?
The shift of health care delivery into the community
What is the focus of community-based nursing practice?
Promoting and maintaining population health, preventing and minimizing disease progress
Example: A home health nurse visits a client who is discharged from the hospital with a diagnosis of CHF: The nurse will check the client’s vital signs, weight, medication/ diet adherence, do health assessment, draw blood etc.
What is this example called?
Community-Based Nursing
What type of nursing does planning and implementing immunizations services for communities?
Community health nursing
What typoe of nurse has teh intent to assist patients as they schedule follow up care, consults, and provide them with resources they require to ensure coordination of care?
Nurse Navigator
type of healthcare that reduces cost while maintaining high quality?
Managed Care
A collaboration of services to meet comprehensive health care needs
Case management
Delivery model that organizes healthcare around the expressed phyical and emotional needs of the patient
Patient-Focused
difference between emergency and disaster
emergency: sudden often unexpected event that threatens health or safety
Disaster: when public emergency escalates requiring assistance from agencies outside of the affected community
an infection that spreads rapidly in one or more specific locations
epidemic
Spreads rapidly around the world
Pandemic
community’s ability to rapidly meet increased demand for qualified personnel and resources, including healthcare resources, in event of disaster
Surge capacity
What is:
- occurs both before, after emergency occurs
- identifying otential hazards
- taking action to reduce likelihood ofoccurence
- minimizing effets of those that cannot be prevented
mitigation
occurs before emergency occurs
- risk assessed, plans developed to address risks
- these plans are developed at what 4 levels
Preparedness
- federal, regional, state, an local
what 3 agencies have preparedness for an emergency response?
federal emergency management agency
- department of homeland security
- CDC
What do public health nurses do for preparedness
- plan ahead of time in communities
- conduct training drills
- evaluate operational plans
- work with local stakeholders
For preparedness:
- should nurses be aware of their employers response plans?
- Should nurses have a sense of how their state, local communities will operate in an emergency?
- With what agency should nurses choose to become a disaster volunteer?
- Yes
- Yes
- American red cross
the implementation of emergency preparedness plans
emergency response
what phase of emergency includes:
- Nurses wel qualified to participate in risk assessment and planning after disaster
- Nurses can also educate pateints, communities about disaster preparedness
- Public health nurses:
- conduct rapid ongoing needs asessments after natural disaster
- work with community stakeholders to plan for long-term health concerns
- Participate in reconstruction of critical services
- Evuate long-term impact of disaster on community
Recovery
What agency is called upon to act and coordinate recovery efforts after major events.
Federal Emergency Management Agency (FEMA)
homeland security has developed federal guidelines called
Nstional incident management system (NIMS)
what are the 5 components of NIMS
- Planning
- Operations
- Logistics
- Administration and Finance
- Incident command system
Prioritizing patients for treatment based on severity of illness or injury and in light of supplies and resources available
Triage
Do nurses perform triage every day in emergency departments
Yes
most policies specified the triage team’s composition by profession
__% required a physician
__% required a nurse
__% called for the inclusion of an ethicist
89%
70%
33% (1/3)
What does SALT stand for (Triage)
Sort
Assess
Lifesaving Interventions
- Treatment/transport
order of triage categories
priority/color
1-red
2-yellow
3-green
4-black
What should we talk to children about (mitigation)
talk about the virus and community responses related to covid-19
Nurses role in disasters will vary based on:
- Type and location of…
- number of…
- available…
type and location of disaster
- # of victims
- Available personnel and supplies
