Issues, Trends, and Health Policy Part 1 Flashcards
Instructing patients in how to successfully manage their own conditions
Mentoring/ coaching
Instructing patient s with asthma on how to manage exacerbations this is a form of _____/ _____
Mentoring/ coaching
Instructing patients with diabetes mellitus on how to control blood glucose via diet and exercise form of _____/_____
Mentoring/ coaching
Instructing patient through examples of health care processes in action this is ____ ____
role modeling
______ ______ may be done through NP instructing patient in healthy behavior or through role modeling examples in other patients
Role modeling
Principles of Instruction include:
a) Mentoring/ coaching
b) Role modeling
c) __________
Counseling
Instructing patients in how to reponsibly mangage medications, conditions, and courses of treatment
Counseling
The degree to which health care professionals have the capacity to obtain, process, and understand basic health care information and servisces nessarey to make aprrorpirate health care decisions
Health Literacy
____ ____: considered to be the single best predictor of one’e health status
Health literacy
Average adult in America reads at an _____- grade level
eighth
Medical/ health information literature should be written at no higher of a grade level than ___ to ___ grade.
6th to 8th
Legislative and Regulatory Processes:
1) Accreditation guidelines
a) Often laid out by the ____ _____
Joint commision
Joint Commission also lays out ___ _____ ____ Goals and area of concern for health care profssionals in accredited instiutions
Natioanl Patient safety
_____ ___ _____
a) Rules laid out by the institution that may provide further qualifications and restrictions on the rule of healthcare staff (e.g. the duties responsibility, and privilegess of AGACNPs)
Institutional by laws
How consumers use health care resources and services
Resource Utilization
How patients interact with health care providers
Resource Utilization
Special concerns in acute care
a) length of stay
b) Top reasons for hsopitalization
c) Preventable hoospitalization
d) Long- term care
e) Emergency room and primary care clinic utilizations
Resource Utilization
Tem of multiple helath care professionals across various disciplnes, assembles to deal with emergency situations
Multidisciplinary Response Team (MRTs)
___ ____ ___: deals with rapid deteriations in health, such as respiratory distress or caridac arrest
a) Physician/ AGACNP
b) Nurse
c) Respiratory therapist
d) Others per institutional protocol
Rapid Response Team
____ ______: a mass casualty event wihich MRTs frequently train to intervene
a) Pandemic
b) Terrorist attack/ mass shooting
c) Natural disaster
d) Large chemical exposures
e) Large fires/ explosions
Institutional disaster
Utilizing healthcare technology and databases to optimize course of treatment
Integrating Health Information Technology
___ _____ ___ (__): Integrated database that allow NPs real time access to paitnet health information
Electronic Medical Record (EMR)
_____ ______ (___): Using EMR technology to
a) Improve quality, efficiency, and safety
b) Reduce healthcare disparities
c) Engage patient’s and family members in course of care
d) Improve care coordination
e) Maintain privacy and safety of patient health information
Meaningful Use (MU)
____ _____ _____ is a management process of monitoring, evaluating, continuously reviewing, and improving both the quality of health care deliver and the health status of target populations
Quality Improvment (QI) Principles
_____ and _____ _____ for Nurses (QSEN) Initiative
a) An initiative aimed at providing future nurses with the knowledge, skills, and attitude necessary to ensure continuous improvement in quality and safely of their respective healthcare systems
Quality and Safety Education
Quality and Safety Education for Nurses Initiative
b) Identifies, funds, and promotes education across six key competencies
i) Pateint- centered care
ii) Teamwork and collaboration
iii) Evidence- based practice (EBP)
iv) _____
iiv) Safety
iiiv) Informatics
QI
Evaluating Safety Initiatives
a) Uses multi cause variable systems such as ____ cause analysis
root
Evaluating Safety Initiatives
b) Effective systems of evaluation should answer the following questions:
i) Are we providing _____ care?
ii) How safe was this care in the past?
iii) How safe will we be in the future?
iv) Can our process and health system reliably deliver safer care?
iiv) How can we be sure that we are getting better?
safe
Standardizing Assessment Tools
a) General
i) Patient _____ Questionnaire
aa) Used in primary care to screen for behavioral health systoms
bb) Assesses symptoms of depression, anxiety, trauma, and alcohol use
Stress
Depression
Patient _____ _____ (PHQ-9)
1) Most common screening tool for depression
2) Patient self-ranks 9 signs and symptoms over the last 2 weeks on a scale of 0 to 3, with 3 indicating nearly every day.
Health Questionnaire
PHQ-9
____ to ___ = Moderately severe depression
15 to 19
PHQ-9
____ to ___ = Minimal depression
1 to 4
PHQ-9
____ to ___ = Moderate depression
10 to 14
PHQ-9
___ to ___ = Mild depression
5 to 9
PHQ-9
____ to ___ = Severe depression
20 to 27
Anxiety Disorders
Generalized ____ ____-7 (GAD-7)
1) Self-administered screening tool that identifies whether a complete assessment for anxiety is indicated
Anxiety Disorder
Anxiety Disorders
Generalized Anxiety Disorder-7 (GAD-7)
2) Patient ranks ___ signs and symptoms over the last 2 weeks on a scale of 0 to 3, with 3 indicating nearly every day
7
Anxiety Disorders
Generalized Anxiety Disorder-7 (GAD-7)
b. ____ to ___ = Moderate anxiety
10 to 14
Anxiety Disorders
Generalized Anxiety Disorder-7 (GAD-7)
a. ___ to ___ = Mild anxiety
5 to 9
Anxiety Disorders
Generalized Anxiety Disorder-7 (GAD-7)
c. ___ to ___ = Severe anxiety
15 to 21
Anxiety Disorders
Generalized Anxiety Disorder-7 (GAD-7)
d. A total score > ____ indicates a probable diagnosis of generalized anxiety disorder
10
Drug and Alcohol Use
CAGE-AID
1) Self-report questionnaire designed to quickly assess whether an alcohol or drug assessment is needed
2) Answering “yes” to two or more questions warrants a complete assessment
a. C: Have you ever felt that you ought to ___ ___ on
your drinking or drug use?
cut down
Drug and Alcohol Use
CAGE-AID
1) Self-report questionnaire designed to quickly assess whether an alcohol or drug assessment is needed
2) Answering “yes” to two or more questions warrants a complete assessment
b. A: Have people _____ you by criticizing your
drinking or drug use?
annoyed
Drug and Alcohol Use
CAGE-AID
1) Self-report questionnaire designed to quickly assess whether an alcohol or drug assessment is needed
2) Answering “yes” to two or more questions warrants a complete assessment
c. G: Have you ever felt bad or ____ about your drinking
or drug use?
guilty
Drug and Alcohol Use
CAGE-AID
1) Self-report questionnaire designed to quickly assess whether an alcohol or drug assessment is needed
2) Answering “yes” to two or more questions warrants a complete assessment
d. E: Have you ___ had a drink or used drugs first thing
in the morning to steady your nerves or to get rid
of a hangover? (e.g., eye opener)
ever
Pain
a. ____ _____FACES Pain Rating Scale
i) Self-assessment tool
ii) Patient rates pain by choosing among six faces,
ranging in expression from smiling to crying
Wong-Baker
Pain
b. ____ _____ Scale
i) Assesses conscious state of a patient
Ramsay Sedation
Pain
b. Ramsay Sedation Scale
i) Assesses conscious state of a patient
ii) If awake:
Ramsey ___: responsive to commands only
3
Pain
b. Ramsay Sedation Scale
i) Assesses conscious state of a patient
ii) If awake:
Ramsey ___: anxious, agitated, restless
1
Pain
b. Ramsay Sedation Scale
i) Assesses conscious state of a patient
ii) If awake:
Ramsey ___: cooperative, oriented, tranquil
2
If asleep:
Ramsey ___: No response to light glabellar tap or loud auditory stimulus
6
If asleep:
Ramsey ___: Sluggish respnse to light glabellar tap or loud auditory stimulus
5
If asleep:
Ramsey ___: response to light glavellar tap or loud auditory stimulus
4
Brief Pain Inventory (BPI) short form
i) Assesses severity of pain and impact of pain on ______functions by asking patient to fill out survey
ii) Through self- report or interview, patient rates severity of pain and impact of pin on dilay function, as well as location of pain, pind medication, and amount of pain relief
daily
Brief Pain Inventory (BPI) short form
ii) Through self- report or interview, patient rates _____ of pain and impact of pain on daily function, as well as location of pain, pain medication, and amount of pain relief
severity
Richmand Agitation Sedation Scale (RASS)
a) A ___-point scale to assess levels of anxiety, agitation, and sedation
10
Richmand Agitation Sedation Scale (RASS)
a) A 10-point scale to assess levels of anxiety, agitation, and sedation
b) Scoring based on observable behavior in the following categories
___ combative
+4
Richmand Agitation Sedation Scale (RASS)
a) A 10-point scale to assess levels of anxiety, agitation, and sedation
b) Scoring based on observable behavior in the following categories
___ agitated
+2
