Health Policy, Informatics & Quality Improvements Flashcards
Methods designed to focus on HEALTH PROMOTION & ILLNESS PREVENTION
Primary prevention
The ability to read, understand, and act on health information, including such tasks as comprehending prescription labels, interpreting appointment slips, completing health insurance forms, and following instructions for diagnostic tests.
Health Literacy
The process of coordinating, facilitating, and following a clients use of an array of health and social services over time.
Case Management (CM)
Members of a nursing team who assume delegated aspects of basic client care such as bathing, assisting with feeding, and collecting specimens. CNA’s, hospital attendants, nurse techs, and orderlies.
UAP
Individuals who are with out any type of healthcare coverage.
Uninsured
Methods that focus on the diagnosis and treatment of the disease.
Secondary Prevention
A healthcare delivery system designed to provide cost-effective, high quality care for groups of clients from the time of their initial contact with the health system through the conclusion of their health problem
Managed Care
A delivery model that organizes health care around the expressed physical and emotional needs of the client
Client focused care
The delivery of individualized nursing care to a group of clients by a team led by a professional nurse
Team nursing
Individuals who healthcare coverage is insufficient to meet their needs
Undeinsured
Methods that focus on the restoration of health following an illness or accident and include rehabilitation and palliative services
Tertiary Prevention
A system of price control regulation that classifies client illnesses based on diagnosis and pays hospitals a predetermined sum for each specific diagnosis regardless of the actual cost of services, the length of stay, or the activity or complexity of the clients illness
DRG’s Diagnosis-related groups
A task oriented approach to care delivery used in situations of inadequate staffing or nursing shortages.
Functional Nursing
A model in which one nurse has 24/7 authority and responsibility for the care of an assigned group of clients.
Primary nursing
Primary prevention
Secondary prevention
Tertiary prevention
Types of Health Care Services
Focus on Health Promotion and Illness Prevention Healthy People 2020 updated q 10yrs -Childhood obesity/nutrition -physical activity across lifespan -dental/oral health -tobacco use/smoking cessation -health screening recommendations annually
Primary prevention
Focus on EARLY DISEASE DETECTION, TREATMENT
Prevent progression of disease
Early detection provided through screening
bi or tri annually
Secondary Prevention
Focus on RESTORING FUNCTION, DECREASING DISEASE-RELATED complications of already established disease
Includes rehabilitation and palliative care
Tertiary Prevention
Type of care delivered in?
- physicians offices
- hospital-based clinics
- community health centers
- public health services and organizations
- often the entry or gatekeeper for managed care
Primary Care delivered in~
Type of care delivered in ?
Hospitals
Outpatient surgical center
Specialists office
Secondary Care delivered in~
Types of care delivered in?
- Hospital
- Acute care facility
- Rehabilitation center
- Extended care facility
*Home health nurse, skilled nursing care, rehab
Tertiary care delivered in~
Changing demographics Advances in technology Health Literacy -lower health literacy -elder adults -lower socioeconomic status -lower education attainment
Factors affecting delivery of health care
Americans Disability Act
discrimination of anyone with a disability qualify
ADA of 1990
Promote awareness and discussion of healthcare issues in preparation for medical decisions @ the end of life
PSDA of 1991
patient self-determination act
documentation and reporting correctly and appropriately document data pertinent to the care of clients
Reporting
An unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof.
Sentinel event
Healthcare organization that accredits more than 20, 000 health care organizations and programs.
To Continuously improve healthcare for the public
The Joint Commission (TJC)
a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, knowledge and wisdom in nursing practice
supports consumers, patients, and other providers in their decision-making in all roles and settings.
This support is accomplished through the use of information structures, information process and information technology
Nursing Informatics (NI)
Study of care related and organization processes with the goal of developing and implementing a plan to improve health care services and better meet the needs of clients
Quality Improvement
Supports clinical decision making and scientifically based nursing practice
Informatics
Allergies, medical and surgical hx, prior diagnostic studies, consultations
Electronic Health Record
Identifies factors that led to sentinel events
Focus on systems, processes
Goal determine which organizational improvements are needed to decrease likelihood of such events reoccuring
Root Cause Analysis for Sentinel Event
Something happened that could of lead to harm
Sentinel Events
Electronic health records Clinical decisions support systems Bedside medication administration Computerized provider order entry (CPOE) Client surveillance Clinical data warehouse
Clinical information systems
Better access to information Enhanced quality of documentation Improved quality of care Increased productivity Improved communications Reduced errors Reduced hospital costs Use of common database
Some Advantages of Nursing Information Systems
Traditional nursing process
- based on traditional paper forms
- menu driven to capture essential information
- generates various reports, information
- documentation of discrete data
- standardized care plans that can be individualized
- documentation of routine aspects of care
- documentation of medication administration
Critical pathway approach
- Interdisciplinary protocols
- Nurse (provider) can select pathways
- should merge into one “master plan”
- Interaction with physician orders
- tracking of protocol variances
Two Approaches of Nursing Information Systems
Improved data integrity Increased productivity Improved quality of care Increased satisfaction for providers Universal data access Improves documentation
General Benefits of EHR (electronic health records)
An unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof. Serious injury specifically includes loss of limb or function. The phrase “or the risk thereof” includes any process variation for which a recurrence would carry a significant chance of a serious adverse outcome.
-Such events are called “sentinel” because they signal the need for immediate investigation and response.
The term “sentinel event” and “error” are not synonymous; not all sentinel events occur because of an error, and not all errors result in a sentinel event.
Sentinel Events
Safe Patient Handling and Back Safety
The single most important factor for reducing the risk of back injury among healthcare workers is to eliminate manual lifting of patients
PEEPS-Patient Environment Equipment Posture Safety
Total Assist-requires a lift to move
Partial Assist-Can sit on side of bed unassisted. Might need partial, total or ceiling lift
Gait Belt Assist- needs gait to transfer and ambulate
Independent-No fall precautions
4 levels of assistance
