Legal And Ethical Flashcards
What grade level should all health care material be written at
No higher than 6th to 8th grade
Who lays out accreditation guidelines
Joint commission
Who clays out National Patient SAfety Goals and areas of concern for health care professionals in accredited institutions
Joint Comission
What are institutional Bylaws
Rules laid out by the institution that may provide further qualifications and restrictions on the role of healthcare staff
What pain assessment tool is best for nonverbal or foreign speaking patients
Wan baker FACES scale
Explain CPOT
Critical Care Pain Observation Tool
Facial expressions, body movements, muscle tension, compliance to vent
0-8
Explain CAM ICU
Confusion assessment
Mental Status change, inattention, disorganized thinking, altered LOC
Preformed daily
Explain the Katz index of ADLs
Assess the progression of an illness and need for care
Assess Bathing, dressing, toileting, transferring, continence, and feeding
Explain the Get up and GO test
Fall risk measurement
1-5 5being severely abnormal
>3 indicates a risk for falls
Absolute contraindication to balloon pump
AI
Who is Tai Chi particularity useful for
Parkinson’s
Does healing touch involve touching the patient
No
Differentiate the beginning, experienced, and specialist in nursing informatics
Beginner: Computer literacy, information management, ability to use patient care tech
Experienced: Skilled in information managment and new trends in specific area of practice
Specialist: Advanced information preparation, assist other nurses, conduct research and theory development
What is Benchmarking and its four core principals, benefits, and examples
Comparison and measurement of a healthcare organizations services against other health care agencies
Benefits: Share best practices, understand where you rank
Principals: maintain quality, customer satisfaction, safety, improvement
What is required for magnet status
A formalized systemic peer review nursing practice
Explain the FIFE model
Feelings
Ideas
Functioning
Expectations
A tool to improve patient and NP communication
Advanced directive
Written statement of a patients intent regarding medical treatment
Patient Self Determination Act
Requires all patients entering a hospital to be advised of their right to execute an advanced directive
Healthcare Directive
Type of advanced directive that may include a living will or specify a durable power of attorney
Living will
Compilation of statements that specify which life prolonging measures one does or does not want if he or she becomes incapacitated
Durable power of attorney
Also called a health care proxy
Responsible for articulating the patients advanced directive
What came out of title I HIPPA
Health insurance coverage for workers and families when they change jobs (COBRA) Consolidated Omnibus Budget Reconciliation Act
What came out of Title II of HIPPA
Administrative simplification provisions and confidentiality
Who is allowed to view the patient health record
With a patients family, friends, relatives, or others that the PATIENT IDENTIFIES as being involved with their healthcare or billing
Duty to Warn
Supersedes right of confidentiality if a patients condition may harm themselves or others
When initiating change where is it best to start
Local then progress outward
What is treated first medical or psych conditions
Medical
What is the strongest method to evaluate teaching
Return demonstration
What is a tertiary facility
Full range of services
What are the 3 Le Fort skull fractures
1: floating palate
2: Floating maxilla
3: Floating face
What is the most powerful data collected from a patient.
Subjective
What are the two main goals of Health People 2030
Increase quality and years of life
Eliminate health disparities
What are the 6 mandated reporting diagnoses
Gonorrhea, Chlamydia, Syphilis, HIV, TB, Covid-19 b
The American Nurses Association Nursing: A social policy statement
Described collaboration where everyone shares power, goals, responsibilities
Social Services vs Psych services
Psych is mental health diagnosis and management
Social: All social needs
PT vs OT
PT strength
OT Speech and fine motor skills
Palliative care
Improve quality of life in those facing life threatening illness
palliative care can coincide with treatment
Who sets the standard for reimbursement and cutting costs
Medicare
Differentiate between Problem focused, expanded problem focused, detailed, and comprehensive physical exam
Problem focused: exam affected site only
Expanded problem focused: exam of faceted site and other related body systems
Detailed: an extended exam of the affected site or organs and other related organs
Comprehensive: Everything
Differentiate Medicare A, B, C, and D
A: Inpatient, skilled nursing, home health, and hospice
B: NP services, outpatient, patient has copay
C: A and B can receive all care through one the the provider organizations
D: Drugs, patient has copay
How much does Medicare reimburse the NP
85% of physician fee
What is incident to billing
Allows the practice to be reimbursed 100%. Can be billed under physician provider number. Not allowed in hospital setting
Who is Medicaid for
Low income families and individuals
What does case management do
Mobilize, monitor, and control resources that a patient uses during a course of an illness to balance quality and cost
What is quality assurance/improvement/continuous
A process of monitoring, evaluating, reviewing, and improving the quality of care.
Quality and Safety Education for Nurses (QSEN)
Initiative aimed at providing future nurse with the knowledge, skills, and attitude necessary to ensure continuous improvement in quality and safety
QI steps are outlined by who
Joint Comssion
Critical Path
Key patient care activities and time frames for these activities which are needed fora specific case type or diagnosis
Care Map
Blueprint for managing care delivered by all disciplines
Monitoring outcomes
Root cause analysis
Identify prevention strategies to ensure safety
Asking Why
Sentinel Event
Unexpected occurrences involving death or serious physical or psych injury or risk of
What is the NP scope determined by
Individual state board nurse practice acts
Who dictates the level of prescriptive authority
State board of nursing
Who dictates that an NP can prescribe
DEA
What does credentialing encompass
Required education, licensure, and certification to practice
MINIMAL levels of acceptable performance
What does licensure establish
Person is qualified to perform in a particular professional role
Granted by State board of nursing
What is certification
Person has met certain standard s in a partifcular profession signifying mastery
AACN
ANCC
What is credentialing granted by
Hospital credentialing committee
Quantitative vs Qualitative futility
Quantitative: # of interventions unlikely to produce benefit
Qualitative: Quality of life will not improve with interventions
Nonmaleficence
Do no harm
Utilitarianism
The right act is the one that produces the greatest good for the greatest number of people
Beneficence
The duty to prevent harm and promote good
Justice
The duty to be fair
Fidelity
The duty to be faithful
Veracity
The duty to be truthful
When did NP role develop
1960s in pediatrics
Non experimental vs experimental design
NE: usually includes two broad descriptive categories of research no actual experiment
EL Includes manipulation of a variable and utilizes randomization and a control group
What is an Ex post facto design
In the past correlational research, examines relationship amongst variables
Cross sectional
Observational study that examines a population with a very similar attribute but differs in one specific variable “surveys”
Cohort
Observational study the can be retrospective or prospective that compares a particular outcome in groups of individuals who are alike but differ in a particular characteristic
Longitudinal
Multiple measurements of a group over an extended period of time
Quasi experimental
Manipulation of variables but lacks a comparison group or randomization
Qualitative
Open ended quaestions
6 levels of evidence hierarchy starting from the highest
1: Meta analysis of RCTs, 2. RCTs, 3. Quasi-experimental, 4. Qualitative cohort, 5. Case controlled, 6. Editorial
PICOT
Framework to answer a clinical based question: Patient, Intervention, Comparison, Outcome, Timing
Type one vs Type two research error
Type 1: false positive, Type 2: False negative
Meta anaylsis vs Meta synthesis
MA: quantitative MS: Qualitative
Confidence interval
A interval that specifies that probability. A small probability interval implies a very precise range of values
Standard deviation
Average amount of deviation of values from the mean
Level of significance
Dictates statistical significance between two groups. The probability of false rejection of the null hypothesis. p<0.05 means the experimental and the control group are statically different
Perfect correlation e
A measure that dictates correlation between two variables. +1 means a positive correlation
T-Test
Test to evaluate the difference in means between two groups
Reliability vs validity
R: consistency. V: accuracy
Liability
Responsibility that in NP has for actions that fail to meet the standard of care
Negligence
Failure of an individual to do what a reasonable person would do
Malpractice
Failure of a profession to render services to the degree that another member of the same profession in similar circumstances would do.
Assault vs battery
A: creation of apprehension or threat, B: striking of a person
Libel vs slander
L: Written defamation. S: verbal defamation
Sensitivity vs specificity
Sensitivity: True positive. Specificity: true negative
Incidence vs prevalence
I: frequency. P: proportion
Primordial, Primary, Secondary, and Teritiary prevention
Primordial: begins in childhood, prevent risk factors. Primary: modifying risk factors (immunizations/vaccines), Secondary: early identification and treatment. Tertiary: Rehab
What is the Goal of Culturally and Linguistic Appropriate Services (CLAS)
Eliminate racial and ethnic health disparities and improve health for all American s
What incidences demand reporting
HIV, COVID, syphilis, chlamydia, TB, Gun shot wounds, animal bites
What kind of visits does Medicare not cover
Well visits not related to a specific disease
Screenings are what kind of prevention
Secondary
What does Medicaid pay?
After 3rd party or other insurance
What does incident to billing cover
Only basic services like height and weight
When ending a patient interaction what is not required
Referral to another provider
