Exam 2 Flashcards
Employers, professional organizations, nonprofit health care organizations, for profit corporations that deliver, insure or fund health care services
Members of the private health sector
Lobbying to improve community health care is an example of this nurse role
Advocacy
Tool used to gather information following environmental exposure
IPREPARE
I—Investigate potential exposures
P—Present work
R—Residence
E—Environmental concerns
P—Past work
A—Activities
R—Referrals and resources
E—Educate
Term refers to the rate at which a new event occurs over a specified period of time
Incidence rate
one way in which case manager assists clients in discharge planning is?
coordinate of health care needs
what is the epidemiological model that de-emphasizes the agent in explaining disease, but provides for multifactorial causes that transverse various pathways
web of causation
clients over 65 y/o with ESRD and those with a disability, ALS
people eligible for medicare
clients whom are pregnant, disabled, low income elderly
those eligible for medicaid
provisions of the affordable care act include?
-expands coverage for low income families
-coverage up to 26 if in school
-coverage for birth control
-removal of pre existing clause
-expansion of preventive care
this report stated the nurses should practice to the full extent of their education
future of nursing
what component of medicare covers prescription drugs
part D
what component of medicare covers inpatient hospital stays
part A (hospital insurance)
the predominant type of payment for healthcare prior to the 1930s
fee for service
first line or point of access medical care controlled by providers and focused on the individual
primary care
respecting and understanding values and beliefs of a certain culture group
cultural competence
connections b/t people and their environment
the built environment
what component of Medicare covers outpatient provider appointments (additional purchase, monthly fee)
part B
this air pollutant causes worsening respiratory symptoms, frequent asthma related medication use, decrease lung function recurrent health care utilization and increased mortality
particulate matter
drinking water is monitored by which governmental agency
EPA
this causes an estimated 21,000 lung cancer deaths in the US yearly and is the 2nd leading cause of lung cancer after active smoking
radon exposure
assessment, communication, and management are all part of ?
core environmental health competencies
most important factor in socioeconomic status
education
method of healthcare delivery designed to reduce unnecessary use of services, improve cost and ensure quality
managed care
what disease is growing in prevalence in developed nations
cardiovascular disease
essential services that support a healthy life
primary health care
federal organization that works to improve SAFETY & QUALITY of the healthcare system
Agency for Healthcare Research and Quality (AHRQ)
this term is the proportion of a population who have specific characteristic in a given time period
prevalence rate
funding for federal health related service is through ?
DHHS (department of health and human services)
**2nd largest federal department/ 2nd largest funding
a person’s way of perceiving, evaluating, and behaving within his/her world. Determines his/her values, beliefs, practices
culture
approval of new drugs is regulated by which level of government
federal government
primary focus of case management in the community setting is on what type of client ?
high cost, high need
care delivered through coordinated interdisciplinary team that is cost effective and client centered
medical home
term refers to the measurement of the number of deaths that occur within population over a specific period of time
crude rate
form of primary prevention that could reduce communication disease worldwide
immunizations
the first nursing epidemiologist to collect and analyze data about health services to improve public health
Florence Nightingale
most personal health services are provided by?
private sector
Leininger’s culture universal’s general theme
there is a commonality of values and norms in all cultures
understanding personal culture values and beliefs is important at what time ?
when providing care for clients with different cultural background
this model explains infectious disease by examining the host, agent, and environment
epidemiology triangle
what disease is growing in prevalence in developing nations
infectious disease
inpatient discharge planning begins when?
upon admission
which group is more likely to experience health disparities in the US
minorities and lower socioeconomic class
largest health threat faced by developing nations
population growth
information critical for the community case manager to have should include
community resources
level of government responsible for financing of healthcare services
state government
public health refers to?
efforts organized by society to protect, promote, and restore people’s health
what are the 3 levels of government
state, local, federal
what agency responds to health emergencies?
center for disease control (CDC)
a bill starts with what?
an idea!
which entity has higher authority
(county court, state Supreme Court, state circuit court, Supreme Court)
Supreme Court
what does the nursing profession need to promote nursing’s policy agenda?
leaders with a vision for change
which model is used to determine if a common environmental factors exist? also determines if differences in living environment influence disease development
person-place-time model
In 2022, the journal science reported that a study of women in Finland indicated that having sons shortened the life spans of mother by about 34 weeks per son, but that daughters helped to lengthen the mother’s lives. data came from church records from the period 1640 to 1870… what type of study does this describe?
retrospective
what mnemonic is used to help organize documentation after an environmental exposure?
iprepare
I—Investigate potential exposures
P—Present work
R—Residence
E—Environmental concerns
P—Past work
A—Activities
R—Referrals and resources
E—Educate
what does DRG stand for?
diagnostic related groups
what does medicare part A provide?
hospital insurance
DRGs (diagnostic related groups) categorize patients by
according to similarity of diagnoses
(also based on procedure, age, gender)
with a prospective payment system, the amount of money that will be paid for health services is decided:
before the care is provided
(costs according to diagnosis)
anyone who is bilingual and willing can be used as a medical interpreter, T or F
false
it’s important for the nurse case manager to have ..
knowledge of available resources
in the epi triangle what is the cause of disease or the causative organism
agent
what protects health care privacy?
HIPPA
the nursing shortage is:
a health care crisis
nurse may have political roles as
change agents, lobbyist, public office
states are responsible for:
the finance and delivery of health services
components of the health care system are:
private subsystem and public subsystem
which of the following are part of the private health care system? (CDC, March of Dimes, USDHHS, FEMA)
March of Dimes
the US constitution mandates what?
the promotion of general welfare of its citizens
quality care is designed to:
contribute to the betterment of populations
the current US health care system is:
fragmented and uncoordinated
most services to group or individuals occur at which level (state, federal, national, local)
local level
which is a federal level subsystem? (managed care organization, non profit hospital, state health dept., Kroger minute clinic)
State Health Dept
the high cost of health care may be attributed to:
societal beliefs
this describes a government step to stop constantly rising costs
reimbursement based on diagnosis versus treatment
who is medicare for?
for individuals over 65
the federal government mandates services, but the state may…
exceed federal mandates
what has been a powerful and cost effective resource for preventing many infectious diseases?
immunizations
a major step for health care reform in 2010 was:
the Affordable Care Act
the role of public health nurse in economic may be as:
an advocate
environmental areas of concern may include:
the built environment
which of the following is an environmental concern world-wide
clean water
acronym used for environmental discovery is:
IPREPARE
I—Investigate potential exposures
P—Present work
R—Residence
E—Environmental concerns
P—Past work
A—Activities
R—Referrals and resources
E—Educate
environmental health effects may be immediate, long-term, and ?
inter-generational
what new science did Florence nightingale use in the Crimean war? (infection control, physics, statistics, or anthropology)
statistics
3 components of epidemiological triangle
host, agent, environment
which is an example of incidence rate?
115 of 145 students had ever had ice cream evoked headache
9 of 72 students had a headache
25% of the cautious group reported having weekly headaches
20 ice cream evoked headaches per 730 people per minute
20 ice cream evoked headaches per 730 people per minute
this is the number of new cases of a condition during a specific time
incidence
this is the number of births in a population
crude birth rate
this shows interaction between biological and sociobehavioral determinant of health
web of causation
this is the number of people with a disease in a particular population
prevalence
prevalence vs incidence
prevalence = this is the number of people with a disease in a particular population
incidence = this is the number of new cases of a condition during a specific time
when does discharge planning begin
time of admission
the first practicing nurse epidemiologist was who?
Florence Nightingale
this is a higher burden of mortality experienced by one population
health disparity
what does regular medicare not cover?
dental, eyes, hearing benefits
medicare advantage plans are also known as what part of medicare?
optional gap coverage
part C (dental, hearing, vision)
medicare part B covers which expenses ?
outpatient care
a key component of a “fee for service” plan :
provider was in control of what they charged
this is an area in which it’s difficult to buy fresh food
food desert
being conscious of one’s own culturally shaped values and beliefs is called what?
cultural awareness
this agency of health & human services works to control and prevent disease and responds to health emergencies?
(CDC) center for disease controls
a woman stands very close to the nurse when asking about her husband’s condition. the culturally competent nurse knows:
spatial acceptances differ around cultures
this type of study looks back in time to compare those w/ a disease to those who don’t have the disease
retrospective
components of the private healthcare subsystem include
personal care services from for-profit and not-for-profit entities
in the public health arena, the state provides what governance?
health codes and licensing of healthcare personnel
this critical issue in healthcare delivery includes consume rights, accountability, and reduction in errors
quality care
this the the structural characteristics and type of area one lives in can greatly affect one’s health.
the built environment
host factors or intrinsic factors that influence susceptibility to an agent include:
personal behaviors such as hygiene, tobacco use, recreation diet
and genetic predisposition
this is reimbursement for Medicare services determined by diagnoses, age, gender, complications
prospective reimbursement
what new science did florence nightingale use in the Crimean War
statistics
John Snow’s map of a London neighborhood with locations of cholera cases surrounding a water pump is an example of:
web of causation
what part of medicare is the advantage plan that covers dental, hearing, vision costs for a premium with deductible?
part C (medicare advantage plan)
optional gap coverage
transitional care management by the case manager involves what?
care coordination for 30 days after discharge from a hospital
follow up face to face visit w/ provider
one factor that influences healthcare cost is
lifestyle and health behaviors
the practice of international nurses has been..
bettered by global communication and technology
this is the study of the distribution and determinants of health and disease in human populations
epidemiology
formula for crude rate
Number of births / Total population
X 100,000
births divided by total pop then multiply 100,000
causality screening surveillance
Causality: establish the cause-and-effect relationship (smoking & lung cancer)
Screening: Identify risk factors or presence od disease in their earliest stages to minimize impact
Surveillance: This is the long-term monitoring of disease for change or for collection of data in the community or population. You would want to identify trends and implement interventions as appropriate.
descriptive vs analytic epidemiology
descriptive - Focuses on the amount and distribution of health and health problems within a population
analytic - Investigates the causes of disease by determining why a disease rate is lower in one population group than in another (uses observational/experimental studies like RCTs)
sensitivity vs specificity
Sensitivity = how well a test identifies a person WITH the disease (High sensitivity is good for screening because you have low false positives) ***Rules out a disease !
Specificity = How well a test identifies a person WITHOUT the disease (very few false positive results) High specificity is good for screening you have low false negatives ***rules IN a disease
3 branches
Executive branch- Administers and enforces laws through regulatory agencies.
Legislative branch- Enacts the statutory laws that are the basis for governance & Prohibited from interfering with the courts’ final judgements.
Judicial branch- Provided protection against oppressive governance and against professional malpractices, fraud, and abuse.
***sovereign power = independent & supreme authority of the nation or state
state gov vs federal gov
state: Directly involved in healthcare policy, legislation, and regulation. Also decides and provides financing for healthcare.
federal: Influences health policy, directly and indirectly through financing of healthcare for many groups (Medicare, Medicaid, etc)
what is an exemplar and has led the way in establishing the medical home concept to ensure efficient, quality care
Kaiser Permanente (Public health policy)
what is the largest source of federal funding of nursing education
The health resources and service administration (HRSA)
private subsystem vs public health
private- focus on the individual: personal care (non profit & profit)
public- focus on populations: prevention of disease/illness (federal, state, local)
The nurse who was responsible for organizing relief efforts for soldiers during the U.S. Civil War and who was the founder of the American Red Cross was
Clara Barton
The case manager reviews the chart of a patient to determine appropriateness and timeliness of medical care while the patient is in the hospital. This funcIon of case management is referred
to as
utilization review.
Which model of care was developed to provide collaboraIve, quality-driven, safe, primary
care?
Patient-centered medical home
Which act, established in the 1940s, provided grants to states for the purpose of new construcIon of health care institutions?
The Hill-Burton Act
What is the correct process a bill must take before final approval by the president?
a bill must succeed through the two legislaIve bodies, the House of
Representatives and the Senate, and then be submitted for final approval by
the president.
Decisions on public policy are made by which part of the federal government?
LegislaIve, execuIve, or judicial branches of the government
A statement of a decision regarding a goal in health care and a plan for achieving that goal is called what?
health policy
Groups such as professional organizations, nonprofit health care organizaIons, and corporations that sponsor health care are/is called
the private sector.
The Health Resources and Services AdministraIon (HRSA) assists nursing workforce
development by
providing grants to provide for education and recruitment.
A person who acts as a representative for another person or organization before the
legislature is called a(n)
lobbyist.
Politcal action commitiees (PAC) are formed by professional organizatoons, business, or labor groups for the purpose of
attracting candidates who are sympathetic to particular health care issues.
In the United States today, where are most personal health care services provided?
The private sector
Which prospecIve payment method determined the amount of reimbursement that health care providers would receive for specific illnesses from Medicare?
Diagnosis-related groups
How would a community health nurse use ExecuIve Order 12898?
Recognize that it would help achieve environmental justice
In the 1850s, a researcher studied a cholera epidemic among people living in different secIons of London. The researcher who used epidemiologic methods to study the epidemic, and used rates as an epidemiologic tool was
John Snow
Assisting the family of a special needs child through the complex health care system is an example of what type of case management?
Patient-centered case management
4 types of analytic epidemiology
- Observational studies: (Descriptive purposes,
Etiology of disease,
No manipulation by investigator) - Cross-sectional studies:
aka prevalence or correlational studies,
Examine relationships between potential causal factors & disease at a specific time,
Impossible to make causal inferences
3.Retrospective studies:
Compare individuals with a particular condition or disease with those who do not have the disease,
Data collection extends back in time
- Prospective studies:
Monitor a group of disease-free individuals to determine if/when disease occurs,
Cohort shares a common experience within a defined time period,
Monitors cohort for disease development - Experimental design:
Aka Randomized Clinical Trial (RCT),
Subjects assigned to experimental or control group, Apply experimental methods to test treatment & prevention strategies,
Ethical considerations with human subject rights review, useful for investigating chronic disease prevention
types of health care plans
- indemnity plan (BCBS) , not very common anymore, paid all costs, free choice of provider/services, managed their own health care and became costly
-HMO (health maintenance organization), more comprehensive care, preventative care, specialty care is restricted
-PPO (preferred provider organization), more flexible than HMOs, negotiated rates and reimbursements, offered incentives within network
-POS (point of service), combine HMOs and PPOs, will be responsible for cost outside of network unless referred
-HDHP (high deductible health plans), lower premiums but higher up front cost, Health savings account
roles of public health nurse in economics of health care
researcher, educator, provider of care, advocate
When making health-related decisions, clients from different cultural backgrounds depend on relaIonships. One type of relaIonship involves the client seeking assistance from other members of the family and allowing a relaIve to make decisions about important health-related issues. This relaIonship is a(n)
lineal relationship
a community health nurse is caring for a family that includes husband, wife, children, and other blood relatives. what type of family is this
extended family
what consists of the connections among people, communities, and their surrounding environments that affect health behaviors, habits, interpersonal relationships,
Cultural values ,customs
the built environment
Founder of Healthy People initiative. Four key indicators of meeting their goals are: Quality of Life, health status, well-being, determinants of health and disparities.
USDHHS (U.S. Department of Health and Human Services)
nurse roles in political activities
-coalitions
-lobbyists
-political action committees
-campaigning
-voting strength
-public office
