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Nursing Fundamentals > Healtch Care Delivery > Flashcards

Healtch Care Delivery Flashcards

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1
Q

Health Resources and Services Administration (HRSA)

A

provides health related info; administers programs concerned with health care for the homeless, people with HIV and AIDS, organ transplants, rural health care and employee occupational health

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2
Q

Food and Drug Administration (FDA)

A

Protect the public from unsafe drugs, foods and cosmetics

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3
Q

Centers for Disease Control and Prevention (CDC)

A

Prevent the transmission of communicable diseases

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4
Q

National Institutes of Health (NIH)

A

Conduct research and education related to specific illnesses

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5
Q

Substance Abuse and Mental Health Services Administration (SAMHSA)

A

Improve quality and availability of substance prevention, alcohol and drug addiction treatment, and mental health services

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6
Q

Agency for Toxic Substances and Disease Registry (ATSDR)

A

Maintain registry of certain diseases; provide information on toxic agents; conduct mortality and morbidity studies on defined population groups

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7
Q

Indian Health Service (IHS)

A

Provide health care services to Native Americans, including health promotion, disease prevention, alcoholism prevention, substance abuse prevention, suicide prevention, nutrition, and maternal-child health care

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8
Q

Agency for Healthcare Research and Quality (AHRQ)

A

Primary source of federal support for research related to quality and safety of health care delivery

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9
Q

Nursing Roles- caregiver

A

traditional and most essential role; functions as nurturer; provides direct care; is supportive; demostrates clinical proficiency; promotes comfort of pt

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10
Q

Nursing Roles- teacher

A

provides information; serves as a counselor; seeks to empower pt for self-care; encourages compliance with prescribed therapy; promotes healthy lifestyle; interprets information

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11
Q

Nursing Roles- advocate

A

protects the pt; provides explanations in pts language; acts as a change agent; supports pts decision

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12
Q

Nursing Roles- manager

A

makes decisions; coordinates activites of others; allocates resources; evaluates care and personnel; serves as a leader; takes initiative

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13
Q

Nursing Roles- expert

A

advanced practice clinician; conducts research; teaches in schools of nursing; develops theory; contributes to professional literature; provides testimony at government hearings and in court

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14
Q

Nursing Roles- case manager

A

tracks pts progress through the health care system; coordinates care to ensure continuity

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15
Q

Nursing Roles- team member

A

collaborates with others; possesses highly skilled communication methods; perfoms therapuetic measures to assist with respiration

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16
Q

Professional Roles- RN

A

procides care to individuals who are unable to care for themselves; with a holistic approach, nurses assist pts to cope with illness or disability; addresses the needs of the pt (individual, family, community); emphasizes health promotion

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17
Q

Professional Roles- APRN

A

diagnoses primamry health care problems; prescribes therapuetic modalities; promotes continuity of care; may specialize in a variety of areas

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18
Q

Professional Roles- MD

A

makes medical diagnosis and prescribes therapeutic modalities; performs medical procedures; may specialize in a variety of areas

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19
Q

Professional Roles- PA

A

provides medical services under the supervision of a physician

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20
Q

Professional Roles- unlicensed assistive personnel

A

assists in provision of pt care activites under the direction of the RN; may include CNA, personal care assistant, nursing assistant, orderly or certified phlebotomist

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21
Q

Independent Practive

A

fee-for-service; consumer choice of provider; disease-oriented philosophy

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22
Q

Health Maintenance Organizations (HMO)

A

fee is preset and prepaid; provide services to a group of enrolled personls; service is provision limited

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23
Q

Preferred Provider Organizations (PPO)

A

fees are preset and prepaid; networks of providers that give discounts to sponsoring organization; members are not mandated to select a specific primary care provider but must use a provider in the network

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24
Q

Exlusive Provider Organizations (EPO)

A

plans pay no benefit if member is treated oustide the network; usually regulated by state insurance laws

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25
Q

Medicare

A

established in 1965; individuals over 65; does not pay for all health care expenses (ie prescriptions); long term care and catastrophic illnesses are not covered; modivied in 1972 to include those with disabilites and end stage renal disease; run by federal government

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26
Q

Medicaid

A

shraed between federal and state; each state can modify who is elligible; reimburses NPs and CNMs if the state has authorized the APRN to provide services specified under the Centers for Medicaid Services (CMS)

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27
Q

State Children’s Health Insurance Program (SCHIP)

A

established in 1997 as part of the Balanced Budgent Act; nurses play essential advocacy role to parents of economically disadvantaged children; each state makes decisions about it’s financing

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28
Q

Levels of Care- Primary

A

promotes wellness and prevents illness or disability; society has begun to engage in health-promoting behaviors

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29
Q

Levels of Care- Secondary

A

acute treatment centers; most health care services are secondary; screening and diagnosis

30
Q

Levels of Care- Tertiary

A

restoring an individual to the state that existed before the development of illness (optimal level of self-care)

31
Q

Nursing Roles in- hospitals

A

caregiver, client educator, provides ongoing assessment, coordinates care and collaborates with other health care providers, maintains client safety, initiates discharge plans, variety of areas to specialize in

32
Q

Nursing Roles in- extended care

A

caregiver, educator, advocate, provides care directed at meeting basic needs, provides teaching and counseling, pland and coordinates care, administers medications, treatments and other therapeutic modalities

33
Q

Nursing roles in- home health

A

educator, caregiver, provides skilled nursing care, coordinates health promotion activities

34
Q

Nursing roles in- hospice

A

caregiver, counselor, advocate, plans and coordinates care, promotes comfort measures, provides pain control, supports families

35
Q

Nursing roles in- outpatient setting

A

check vital signs, assist with diagnostic tests, prepares client for examination, provides teaching and counseling, performs physical

36
Q

Nursing roles in- schools

A

caregiver, educator, advocate, coordinates health promotion and disease prevention activities, treats minor illnesses, provides health education

37
Q

Nursing roles in- industrial clinics

A

caregiver, educator, coordinates health promotion activities, provides educaiton for safety, proved urgent care as needed, maintains health records, conducts ongoing screenings, provides preventative services

38
Q

Nursing roles in- managed care organizations

A

caregiver, educator, case manager, uses triage to determine the most appropriate intervention for clients

39
Q

Nursing roles in- community nursing centers

A

caregiver, treats client’s responsibilites to health problems, promotes health and wellness

40
Q

Nursing roles in- rural primary care hospitals (RPCH)

A

caregiver, educator, advocate, performs assessments and provides emergency care

41
Q

Quality Assurance

A

the traditional approach to quality management in which monitoring and evaluation focuses on individual performance, deviation from standards and problem solvine

42
Q

Continuous Quality Improvement

A

approach to quality management in which scientific, data-driven approaches are used to study work processes that lead to long term system improvement

43
Q

Total Quality Management

A

method of management and system operation used to achieve CQI. TQM promotes and organizational culture that supports customer need, empowers emplyees to work as a team, emphasizes self development, and requires a new leadership style in which emplyees are viewd as resources

44
Q

Leadership

A

must create a people-oriented culture

45
Q

Team/teamwork

A

a group who works together to achieve a common goal; demonstrates commitment, cooperation and communication

46
Q

Tools to measure quality

A

audits, peer review, benchmarking (comparing to the competition), clinical pathways

47
Q

The nurse is reviewing the nursing agenda for health care reform. Which is a basic premise of this agenda?

A

there must be plans to decrease the cost of health care

48
Q

the nurse realized that which of the following factors will probably shape reform of the health care delivery system?

A

aging of the population

49
Q

a client tells the nurse that he receieves health care services from the private sector. This sector of the health care delivery service includes….

A

independent providers who are reimbursed on a fee for the service basis

50
Q

a client has a health insurance plan that has a capitated rate. Capitated rates in HMO’s means….

A

a preset flat rate per member is paid to a provider whether the member uses the service or not

51
Q

the nurse talks with every assigned client to ensure satisfaction with the care received. Which of the following could be a cause for client dissatisfaction?

A

delayed pain medication

52
Q

A client is admitted to a rehab facility to recovery from surgery for hip fx. This facility is considered:

A

tertiary

53
Q

A prescribing practitioner who is reimbursed directly by an insurance company for services provided is being reimbured by which method?

A

Fee for service

54
Q

Which of the following is one reason why a nursing shortage is imminent?

A

Declining number of nursing faculty

55
Q

Which group spurred the movement toward cost containment of health care?

A

the business sector

56
Q

Which health sercive is promoted through primary care?

A

teaching

57
Q

Which agency is responsible for administering the Medicare and Medicaid programs?

A

CMS

58
Q

If a health care organization fails to adhere to quality standards for care, which of the following can occur?

A

denial of payment for services

59
Q

Which factor places the quality of hospital care at risk when hospitals restructure?

A

Replacing RNs with UAPs

60
Q

One dimension of an organizations cultrue is atmosphere. Which characteristic is an example of the atmosphere in a high performing organization?

A

open and nonthreatening

61
Q

What is the percentage goal recommended by Healthy People 2010 for preschool children in this couintry to be immunized?

A

10%

62
Q

In Nursing’s Agenda for Health Care Reform, a cornerstone of this proposal is that…

A

all citizens must have access to health care services

63
Q

What statement would be accurate about nurse practitioner versus prescribing practitioner care?

A

NP’s can independently diagnose and treat common acute illnesses and injuries

64
Q

Which action is the nurse manager’s responsibility in quality improvement?

A

lead by example

65
Q

A client has had a total hip replacement and is transferred to a facility for restorative care. This facility would be…

A

a long term extended care facility

66
Q

According to the CMS, “never events” will not be reimbursed with payment to hospitals. Which occurence is an example of a never event?

A

A client falls out of bed and breaks her wrist

67
Q

A client asks the nurse, “exactly what is an HMO?”. The nurses response should incllude which of the following?

A

HMO’s are groups of federally financed insurance companies; HMOs were established to control the costs of health care delivery; HMOs were intended to emphasize prevention rather than treatment of chronic conditions

68
Q

WHen working with a person from a vulnerable population, it is important for the nurse to do which of the following?

A

learn about the person’s specific cultural practices

69
Q

The nurse who is working in a rehabilitation facility is providing which level of care?

A

tertiary

70
Q

Which of the following nursing actions will adversely affect customer satisfaction of hospitalized clients?

A

implementing a routine schedule for every client

Nursing Fundamentals (10 decks)

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