Issues, Trends, and Health Policy Part II Flashcards
Established Rapport and Professional Therapeutic Relationship
- Non- _____ approach
- Mutual trust
- Professional boundaries
- Confidentiality
- Cultural competency
a. Respect
b. Spiritual needs
judgmental
Therapeutic Communication
- Listen more than ___
- “Tell me…”
- Never, “____?”
- Focus on feelings!
a. Mad, Sad, Glad, Afraid, Ashamed - Do not mince words; no _____
a. “I am concerned about alcoholism.”
b. “I’m sorry but, she died.”
- talk
- Why
- euphemisms
Crisis Intervention.
- Ensure safety/boundaries
a. Call _____ if necessary - Establish trust/rapport
Security
Crisis/Acute Grief Therapeutic Communication_
- Acknowledge ______
- Offer self
feelings
- ____ _____: Written statement of a patient’s intent regarding medical treatment.
a. The Patient Self-Determination Act of 1990 requires
that all patients entering a hospital should be
advised of their right to execute an advance
directive.
Advance Directive
- ____ _____: Type of advance directive that may (or may not-) include a living will and/or specifications regarding durable power of attorney in one or two separate doctmaents
Healthcare Directive
- ___ ____: Written compilation of statements in document format that specifies which life-prolonging measures one does and does not want to be taken if he/she becomes incapacitated
Living Will
a. In the United States, most states recognize living wills as long as the will is specific enough and addresses the problem at ____.
hand
b. ____ ___ often include granting durable power of attorney to a significant other to act as a proxy/agent/attorney-in-fact of the patient in making healthcare decisions should the patient become incapacitated. Essentially, the proxy is responsible for articulating the patient’s advance directive.
Living wills
c. ____ ___ ____ must usually be in writing before it will be honored by most institutions such as hospitals, banks, etc.
Power of attorney
- Title ____ of HIPAA protects health insurance coverage for workers and their families when they change or lose their jobs [(i.e., Comprehensive Omnibus Reconciliation Act (COBRA)]
1
- Title ___ of HIPAA, known as the Administrative Simplification (AS) provisions, requires the establishment of national standards for electronic health care transactions and national identifiers for providers, health insurance plans, and employers.
II
c) __________ provisions of the Patient Safety Rule,
which protect identifiable information being used to
analyze patient safety events and improve patient
safety
Confidentiality
a. The Office for Civil ____ enforces the HIPAA, which protects the:
a) Privacy of individually identifiable health information
Rights
b) HIPAA _____ _____, which sets national standards for
the security of electronic protected health information
Security Rule
- Health ____ (health insurance companies, HMOs, company health plans, and certain government programs that pay for health care, such as Medicare and Medicaid)
Plans
- Most Health Care Providers (especially those who use ______ billing to health insurers)
electronic
- Health Care __________ (those that process nonstandard health information data received receive from another entity into a standard such as standard electronic formats)
Clearinghouses
Examples of HIPAA Protected Information
1. _______ information in the medical record
Written
Examples of HIPAA Protected Information
2. ________ among healthcare providers about
one’s care or treatment
Conversations
Examples of HIPAA Protected Information
3. Patient information stored in a health insurer’s
_______ system
computer
Examples of HIPAA Protected Information
4. Patient _______ information stored at a clinic
billing
Examples of HIPAA Protected Information
5. Most ___ health-related information about a patient
all
Examples of HIPAA Protected Information
6. A patient’s health information cannot be used or
shared without written permission unless this law
allows it. For example, without a patient’s written
authorization, a provider generally cannot:
a. Disclose information to one’s ______
b. Use or share a patient’s information for marketing
or advertising purposes
c. Share private notes about a patient’s health care
employer
Examples of HIPAA Protected Information
6. A patient’s health information cannot be used or
shared without written permission unless this law
allows it. For example, without a patient’s written
authorization, a provider generally cannot:
b. Use or share a patient’s information for ______
or advertising purposes
marketing
Examples of HIPAA Protected Information
6. A patient’s health information cannot be used or
shared without written permission unless this law
allows it. For example, without a patient’s written
authorization, a provider generally cannot:
c. Share private _____ about a patient’s health care
notes
The Privacy Rule: Patients’ Rights
1. See or receive a ____ of their health records
copy
The Privacy Rule: Patients’ Rights
2. Have corrections _______ to their health information
added
The Privacy Rule: Patients’ Rights
3. Receive a ______ that tells the patient how their health information may be used and shared
notice
The Privacy Rule: Patients’ Rights
4. Decide if they want to give permission before their health information can be used or shared for certain purposes, such as for ________
marketing
The Privacy Rule: Patients’ Rights
5. Receive a report _______ when and why their health information was shared for certain purposes
outlining
The Privacy Rule: Patients’ Rights
6. File ______ with one’s healthcare provider, health insurer, and/or the U.S government if their rights are being denied or if their health information is not being protected
complaints
Situations for Which Health Information is Allowed to be Viewed/Shared:
1. To ensure _____ treatment and coordination of care
proper
Situations for Which Health Information is Allowed to be Viewed/Shared:
2. To pay for healthcare ______ (e.g., physicians, NPs,
hospitals, etc.)
services
Situations for Which Health Information is Allowed to be Viewed/Shared:
3. With a patient’s family, relatives, friends, or others the
patient identifies as being _______ with their health
care or bill payment (unless the patient objects)
involved
Situations for Which Health Information is Allowed to be Viewed/Shared:
- To ensure _______ care given by healthcare providers
(e. g., physicians, NPs, nursing homes, etc.)
quality
Situations for Which Health Information is Allowed to be Viewed/Shared:
5. To protect the _____ of the public (e.g., reporting
disease outbreaks)
health
Situations for Which Health Information is Allowed to be Viewed/Shared:
6. To make required reports to the ______ (e.g., reporting
gunshot wounds)
police
Examples of Those NOT Required to Follow HIPAA
1. Life _____
insurers
Examples of Those NOT Required to Follow HIPAA
2. Employers
3. Workers compensation \_\_\_\_\_
4. Many schools and school districts
5. Many state agencies like child protective service
agencies
6. Many law enforcement agencies
7. Many municipal offices
8. Otherscarriers
Examples of Those NOT Required to Follow HIPAA
4. Many ____ and school districts
schools
Examples of Those NOT Required to Follow HIPAA
5. Many state agencies like ____ ____ ______
agencies
child protective service
Examples of Those NOT Required to Follow HIPAA
- Many ___ enforcement agencies
- Many municipal offices
- Others
law
Examples of Those NOT Required to Follow HIPAA
- Many _____ offices
- Others
municipal
The Patient Safety and Quality Improvement Act (PSQIA)
1. Establishes a ______ reporting system to enhance
the data available to assess and resolve patient
safety and health care quality issues.
voluntary
The Patient Safety and Quality Improvement Act (PSQIA)
2. PSQIA provides federal privilege and confidentiality
protections for patient safety information called
patient safety work product to encourage the
reporting and analysis of medical errors.
a. Patient safety work product includes information
collected and ____ during the reporting and
analysis of patient safety events.
created
The Patient Safety and Quality Improvement Act (PSQIA)
3. The confidentiality provisions should serve to
improve patient safety _______ by creating an
environment where providers may report and
examine patient safety events without fear of
increased liability risk. The aim is that greater
reporting and analysis of patient safety events will
yield increased data and better understanding of
patient safety events.
outcomes
- The Agency for Healthcare Research and Quality
(AHRQ) has additional responsibility for listing patient
safety organizations (PSOs), which are external experts
established by the ___ ____ ___ to collect and
analyze patient safety information.
Patient Safety Act
- The “duty to ____” supersedes the right to confidentiality if a patient’s condition may endanger others.
warn
- The duty to protect a patient from harming him/herself ___________ the right to confidentiality.
supersedes
____ ___ ______: Damaging one’s reputation as a result of information being shared without the patient’s permission
Invasion of Privacy
Invasion of Privacy:
a. The charge ______ be made if the information can
be shown to have been accurate, given in good faith,
and the receiver had a valid reason for obtaining the
information (e.g., a consulting practitioner has a right
to know specific patient information).
cannot
General Principles
1. When initiating any change, you always begin at the most local level and then progress _____ & _____. For example, you began at the hospital level, then the community, then the region, then the state, then national.
upward and outward
- In treating patients, medical conditions are always treated first before _______ conditions.
psychosocial
- Remember that the strongest method to evaluate teaching is returned demonstration. That is, “___ ____”, or “tell me what you understand based on what I just said”, grand rounds, etc.
show me
Le Fort 1: _____ ______
floating palate
Le Fort 3: ____ _____
floating face
Le Fort 2: ____ ____
floating maxilla
- Always ______ educate your patient regarding their condition who is reluctant to undergo diagnostic or procedures.
fully
- Do not delay a patient’s discharge from a hospital or acute care facility for primary care screening exams that are _____ absolutely necessary.
not
- Remember that the most powerful data collected from a patient is their _______ data, or data you observed as a nurse practitioner. Caution should be taken with the interpretation of family members, friends, and others.
subjective
