M 5 Health Policy Flashcards by Josh Kotov

OSHA responsibilities

Work environment free of harm
Determine compliance with safety standards
Investigate safety events

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Creating a workplace that is free of danger is the responsibility of the

employer

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OSHA work employee rights

File safety complaint
Receive hazard training
Receive safety equipment
Report injury

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OSHA information rights of the employee

Request records of work related injury
See results of tests taken to fine hazards

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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

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If you file an OSHA complaint the employer can not

retaliate

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When to file and OSHA complaint
Signed complaints =

ASAP
Onsite inspections

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How to file OSHA complaints

Online
Fax
Email
Call

Visit local office

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BON members

6 nurses
3 school of nursing faculty
4 representatives of the public

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4 main jobs of BON

Licensure
School approval
Enforcement
Information

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BOCN Licensure involves

Evaluation (testing)
Renewal (every 2 years by birth month)
Issue (in different states)
Disciplinary action (suspension, revocation)

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Endorcement

Issuance of license without examination after determination of standards

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To be endorsed you must

Have graduate from nursing school
Taken school exams
Taken US NCLEX within last 4 years

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Requirements for maintaining license

Good character
Continued competence
No criminal record
Compliance with state provisions

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Determination of school approval by BON based on

Compliance with BON requirements
Program resources
Passing rate of at least 80%

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Classroom to clinical hours ratio

1 to 3

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Nursing practice act does what

Determines nursing titles
Sets qualification for licensure
Sets scope of practice
Sets consequences for not following law

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Mission of the HHS
Health and Human Services

Improve well being by
Providing effective health and human services

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What HHS region is Texas in

region 6

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Types of HHS programs

SNAP
Head start
Dietary and physical activity guidelines
Center of Medicare and Medicaid

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Who certifies hospitals for government funding

CMS
Center for medicare/medicaid services

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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