M 5 Health Policy Flashcards
OSHA responsibilities
Work environment free of harm
Determine compliance with safety standards
Investigate safety events
Creating a workplace that is free of danger is the responsibility of the
employer
OSHA work employee rights
File safety complaint
Receive hazard training
Receive safety equipment
Report injury
OSHA information rights of the employee
Request records of work related injury
See results of tests taken to fine hazards
OSHA employers must
Train staff about hazards
Keep accurate records
Post OSHA info
Inform OSHA within 8h of fatality
Inform OSHA within 24h of hospitalization
If you file an OSHA complaint the employer can not
retaliate
When to file and OSHA complaint
Signed complaints =
ASAP
Onsite inspections
How to file OSHA complaints
Online
Fax
Email
Call
Visit local office
BON members
6 nurses
3 school of nursing faculty
4 representatives of the public
4 main jobs of BON
Licensure
School approval
Enforcement
Information
BOCN Licensure involves
Evaluation (testing)
Renewal (every 2 years by birth month)
Issue (in different states)
Disciplinary action (suspension, revocation)
Endorcement
Issuance of license without examination after determination of standards
To be endorsed you must
Have graduate from nursing school
Taken school exams
Taken US NCLEX within last 4 years
Requirements for maintaining license
Good character
Continued competence
No criminal record
Compliance with state provisions
Determination of school approval by BON based on
Compliance with BON requirements
Program resources
Passing rate of at least 80%
Classroom to clinical hours ratio
1 to 3
Nursing practice act does what
Determines nursing titles
Sets qualification for licensure
Sets scope of practice
Sets consequences for not following law
Mission of the HHS
Health and Human Services
Improve well being by
Providing effective health and human services
What HHS region is Texas in
region 6
Types of HHS programs
SNAP
Head start
Dietary and physical activity guidelines
Center of Medicare and Medicaid
Who certifies hospitals for government funding
CMS
Center for medicare/medicaid services
What does the DHSR oversee
Division of Health service Regulation
Healthcare facilities
Emergency services
Adult care services
Jails
What does the DHSR oversee
Division of Health service Regulation
Healthcare facilities
Emergency services
Adult care services
Jails
Medicare
for pt 65 or older
pt with disabilities
End stage disease pts
Medicare A
Hospital insurance
(Hospital visits)
Medicare B
Medical insurance
(Primary care provider)
Medicare C
Combination of A and B
Medicare D
Drugs
Medicaid
For low income and children
Medicaid eligibility based on
Income
# of children
Pregnant women
Individuals with disability
Medicaid service
Inpatient
Outpatient
Lab
Radiology
Home health
Family planning
Fee for service reimbersement types
Case based
Charge based
Case based
Payer reimburses provider
Charge based
Payer pays based on official list of services
Prospective payment
Rates are established before services
Per procedure
Per diagnosis
Per day
Bundle
Pay per each procedure
Pay per diagnosis
Pay per fixed daily amount
Pay per all services for issue for however many providers
Medicare reimbursement methods for hospitals
Inpatient prospective payment system
Value based purchasing
Shared savings program
Inpatient prospective payment system principles
Based on inpatient diagnosis
Value based purchasing reimbursement principles
Best practices
Enhanced patient experience
Quality goals achieved
Shared payment program principles
provider lowers payments to patient
medicare lets provider keep different
Readmission penalties of medicare
Within 30 days of
HF
Pneumonia
MI
COPD
Heart surgery
Hip surgery
Knee surgery
Nosocomial infection penalties of medicare
deduction of 1%, if hospital is in top 25% of high nosocomial infection rates
APHA
American public health association
Provides healthcare reports
Promotes health/wellness
APHA values
Community
Science and EBP
Health equity
Prevention and wellness
APHA provides
Professional support
Access to latest reports
Networking
Discounts
Free APHA services
Development webinars
Continued edu
American nurses today journal
Importance of joining professional nursing organization like ANA or APHA
Knowledge is power
Stay informed
Promote healthy lifestyle
ACHC
Accreditation commission for healthcare
Official review process to meet regulatory standards
Nursing school program accreditation bodies
CCNE
ACEN
Benefits of being accredited
^ quality
^ community confidence
^ efficiency
^ competitive advantage
Transparency through external review
Accreditation process
Learn - review requirements
Prepare - complete application
Sustain - participate in process
Biggest accreditation body in US
TJC
TJC Acomplishments
First to mandate Quality Assurance programs
Started quarterly evaluations
