Health Care Flashcards
______________identification of and discrimination between physical and psychological signs and symptoms essentially to effective execution and management of the nursing regimen.
Diagnosis
________ prevention consists of health promotion and illness
PRIMARY PREVENTION
examples of PRIMARY PREVENTION
mamagram
Colonoscopy
flu clinical
education
what PREVENTION is your primary care provider?
secondary
________ prevention is diagnosis and treatment
SECONDARY PREVENTION
(call doctors/np/surgery/ prescription )
____________ prevention consists of rehabilitation, health
restoration, palliative care.
TERTIARY PREVENTION
NURSING ROLES (3)
caregiver
manager of care
member of the profession
TCAB
Transforming Care at the Bedside
Focus on
safer, more reliable inpatient care
* more focused on the patient
* increase the vitality of the work environment and satisfaction of front-line
nurses
* TEAMSteps
* From Military
* “patient safety is a team sport”
TEAMSteps
- From Military
- “patient safety is a team sport”
- Promotes:
- Team Leadership
- Situation monitoring
- Mutual support
- Communication
(QSEN)
Quality & Safety Education for Nurses
(KSA)
Knowledge, skills & attitudes to improve quality and safety
of healthcare systems
* 6 competencies:
* Patient centered care
* Teamwork and collaboration
* Evidence-based practice
* Quality improvement
* Informatics
* Safety
National Patient Safety Goals
2023
Improve accuracy of patient identification
CONSOLIDATED OMNIBUS BUDGET RECONCILATION ACT
(COBRA)
gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances such as voluntary or involuntary job loss.
Health Insurance Portability and Accountability Act (HIPAA) 1996
Protected Health Information
* Identifies an individual
* Contains health information
* Need to know basis only
* Do I need this information to do my job?
Part 2 of Cobra
Part 2 (must provide care for patient regardless if they can afford it)
* Receiving care in a hospital
* 250 yard rule
* Must provide services in emergency
* Treatment of emergencies
* Regardless of insurance or ability to pay
* Obstetric patient with contractions = emergency
* Transferring patients
* Only when stable
* If care needed not available
Part 1 of Cobra
Part 1
* Change in insurance
* Right to choose to continue group health benefits
The Health Information Technology for
Economic and Clinical Health Act
(HITECH)
- part of the American Recovery
and Reinvestment Act of 2009 - Includes HIPAA compliance
with technology - Civil and criminal penalties
PAYMENT SOURCES (6)
- MEDICARE
- MEDICAID
- SSI
- PRIVATE INSURANCE
-CANADA - COBRA
- MILITARY/ VA
Government issued payments ?
Government-funded programs are paid for with revenue from federal, state, and local taxes on the citizenry. Programs include Medicare, Medicaid, and children’s, specialty, and categorical programs.
Consumers
Aware, savy
Advances in technology
Testing, early diagnosis
Early diagnosis
Less costly
COMPUTERS and digital
information
EHR: meaningful use
MANAGED CARE
* HMO, POS, PPO
POS : can choose whether they want to use in-network or out-of-network providers. The member will pay higher costs for using out-of-network providers, except in an emergency situation
HMO: To offer all necessary medical benefits to members of the HMO while still holding costs to a minimum
PPO: managed care plan in which providers are paid by the PPO on a fee-for-fee service
- negotiated fee schedule between the PPO and the doctors
- PPO members not required to use PPO providers, but there is a financial incentive to do so
Focus of PPOs
- focus on good health care once you’re sick, not on wellness
- some annual exams not covered
CLINICAL PATHWAYS
map strategy for assessing, implementing, and evaluating the cost-effectiveness of patient care. These pathways reflect relatively standardized predictions of patients’ progress for a specific diagnosis or procedure.
Case management
LOS –
Length of Stay
DRG –
Diagnosis related group
Integrative Therapies
AIDET in practice
Acknowledge, introduce, duration, explanation and thank you.
Acute care is defined
“treat active sudden, often unexpected, urgent or emergent episodes of injury and illness that can lead to death or disability without rapid intervention.”
Examples of acute care are
six
(1)trauma care and acute care surgery,
(2) emergency care,
(3) urgent care,
(4) short-term stabilization,
(5) prehospital care,
(6) critical care.
Long-term support services (LTSS) encompass
“human assistance, assistive technologies and devices, environmental modifications, care and service coordination” on a regular or intermittent basis (Nguyen, 2017). LTSS are provided in a variety of nonhospital settings, such as extended care facilities, ambulatory care centers, and home healthcare agencies.
Inpatient
refers to a client who has been admitted to a healthcare facility. The length of stay is limited to the amount of time that the client requires 24-hour care.
OUTpatient
refers to a client who receives treatment at a healthcare facility but does not stay overnight
Extended care facilities
provide long-term care and support that can range from a few months to a lifetime.
As the length of stay in hospitals has declined, extended care facilities can deliver services that were previously provided in hospitals.
Community health centers
Community-based centers that provide care for the community at large. Community health nurses provide services to at-risk populations and devise strategies to improve the health status of the surrounding community (e.g., school-based pregnancy reduction programs, healthcare for the homeless). Community care is provided to client groups at various sites, such as churches, schools, shelters, workplaces, and public clinics.
Primary care
is the first level of care that patients receive, and is focused on patient wellness and the prevention of severe health conditions. Primary care providers are typically patients’ first point of contact when they have medical concerns or needs.
Secondary services
are directed toward early diagnosis and treatment of illness, disease, and injury. Increasingly these services are being performed in surgery centers, offices, and outpatient centers. The trend away from the hospital is related to containing costs, increasing specialization of hospitals, and growing evidence that hospitals often harbor medication-resistant infections.
Tertiary services
refer to long-term rehabilitation services and care for the dying.
Physicians :
Nurse Practitioners :
Physician Assistants (PAs):
Registered Nurses (RNs)
Licensed Practical Nurses (LPNs)
Unlicensed Assistive Personnel (UAP)
are licensed as medical doctors (MDs) or doctors of osteopathy (DOs). Their primary role is to diagnose and treat disease and illness through medical and surgical services. A physician may work independently, as part of a medical group, as an employee of a health facility, or as hospitalists, who lead the medical team to coordinate care for inpatients.
(NPs) are independent practitioners with advanced education and training and are licensed to provide a broad range of medical and nursing care based on their specialty area. NPs engage in activities ranging from health promotion to caring for clients with acute or chronic healthcare problems. They can practice independently or in collaboration with a provider.
practice under the supervision of a physician to diagnose and prescribe treatments and medications to treat certain diseases and injuries. As an extension of the physician, nurses are permitted to follow a PA’s prescriptions, unless prohibited by your state’s nurse practice act or policies and procedures.
assess clients, administer treatments and medications, provide education, and modify nursing care plans based on client responses to treatment. They have the most direct contact with clients and provide holistic, continuous, and comprehensive nursing care.
(CANT ASSESS/monitor blood tranfusion)work under the supervision of the RN to provide noncomplex care, administer certain medications, and communicate client responses.
is a broad term that covers nursing assistants, aides, and technicians. UAPs provide custodial care under the direction of nurses and providers in a variety of settings
MediCARE
This act was designed to provide insurance for persons aged 65 years and older. It was later expanded to include younger people with permanent disabilities, such as end-stage renal disease, but provides only limited coverage for long-term care. Medicare is financed from a payroll tax levied on employers and employees and from premiums paid by Medicare subscribers (clients
Medicaid =
Provide access to healthcare services for individuals with low incomes and minimal resources. Medicaid is a joint federal and state program; therefore, the eligibility criteria for Medicaid and the range of medical services offered vary from state to state. Medicaid offers a fairly comprehensive set of benefits, including prescription drugs, skilled care, and long-term care.
Continuous quality improvement (CQI) programs
seeing how we did
used interchangeably with total quality management (TQM), focus on quality (excellent) care as an ongoing goal through an evaluation process that identifies problems, develops solutions, implements corrective plans, and evaluates its effectiveness. While CQI is a system approach, different methods are used at the unit level to promote quality improvement.
