Practice Issues; Ethical and Legal Principles; Issues, Trends And Health Policy Flashcards
What are the 3 principles of instruction?
Mentoring/ coaching- instructing patients on disease management, medication management
Role modeling- NP instruct patient in healthy behavior or giving examples of other patient’s good behavior
Counseling
** mentoring/ coaching is similar to counseling
What is health literacy? what is average reading level? what level should health information be written at?
the degree to which individuals have the capacity to obtain, process and understand basic health care information and services necessary to make appropriate health care decisions
**single best predictor of one’s health status
Average American adult- 8th grade reading level
Health information should be no higher than 6th-8th grade reading level, (preferably 5th grade reading level)
What are goals in acute/ critical care laid out by the Joint Commission?
- proper ID of patients and relevant health data (blood types)
- proper staff communication
- safe use of medications: labeling, proper care when treating patients on anticoagulants, proper knowledge and patient counseling on medication, maintain list of medications and check for possible interactions
- ensure alarms are audible and responded to in a timely manner
- Infection prevention: hand hygiene, treatment of resistant infections; using guidelines for prevention of CLABSI, CAUTI, surgical infection
- prevention of mistakes in surgery- mark surgical area, timeout process every time.
What are institutional bylaws?
rules laid out by institution that provide further qualifications, and restrictions on the role of healthcare staff- duties, responsibility and privileges of AGACNPs.
Describe resource utilization or healthcare utilization- what are elements/ measures of healthcare utilization in acute care?
How consumers use health care resources and services.
How patients interact with healthcare providers
Length of stay, causes for readmission, causes for hospitalization, preventable hospitalizations, long-term care use, emergency room vs primary care clinic utilization
What are elements of “Meaningful Use” with respect to EMR technology utilization?
NPs can use EMR data to….
Improve quality, efficiency, safety
reduce healthcare disparities
engage patients and family members in course of care- MyChart is great example of this
Improve care coordination
Maintain HIPAA- patient privacy and safety of PHI (personal health information)
What are ways to establish rapport and professional therapeutic relationships? (5)
- non-judgmental approach
- mutual trust
- professional boundaries
- confidentiality
- cultural competency- respect, spiritual needs.
What legislation enforced that all patients should be informed of their right to execute an advanced directive?
Patient Self-Determination Act of 1990
What does HIPAA stand for? what are the elements of title I and II of the HIPAA legislation?
Health Insurance Portability and Accountability Act
Title I: COBRA: protects health insurance coverage for workers and families when they change or lose their jobs– (comprehensive omnibus reconciliation act)
Title II: **HIPAA THAT WE’RE FAMILIAR WITH: Administration simplification provisions- requires establishment of national standards for electronic health care transactions and national identifiers for providers, health insurance plans and employers- Office for Civil Rights, under HIPAA, protects individual identifiable health information, sets standards for EMR security, and the Patient Safety Rule- protect identifiable information being used to analyze patient safety events
Which types of businesses are required to follow HIPAA?
- “health plans” aka- health insurance companies, government insurance programs
- health care providers
- health care clearinghouses- process nonstandard health information data received from another entity
What is included under The Privacy Rule: Patients’ Rights
A patient is allowed to…
- receive a copy of health records, view health records
- have corrections added to health information
- receive information on how their health information is being used or shared
- decide if they want to give permission for sharing PHI for external purposes, such as marketing
- file complaint if rights are being denied or violated
What is the Patient Safety and Quality Improvement Act PSQIA?
federal privilege and confidentiality protections for PHI- encourages the reporting and analysis of medical errors
Maxillofacial injuries:
What are the Severe Le Fort fractures of the skull- 1, 2, 3
Le Fort 1: Floating palate
Le Fort 2: Floating maxilla
Le Fort 3: Floating face
what diseases require mandatory reporting?
STDs: chlamydia, syphilis, gonorrhea
HIV, TB
what are other categories of mandatory reporting?
animal bites- contact animal control
child or elder abuse suspected
is there mandatory reporting for domestic violence
no, state specific if mandatory reporting required
what is Medicare A coverage?
inpatient/ hospitalization, SNFs, home health services, hospice
what is Medicare B coverage?
physician services, outpatient hospital services, laboratory and diagnostic procedures, medical equipment, some home health services
supplemental medical insurance- have to pay premium
Medicare pays 80% of bill, patient pays 20%
what is Medicare C
A+B= C Medicare Advantage (prior Medicare+choice) patients with A and B, are eligible to receive all of health care services through one of the provider organizations under part C: HMOs, PPOs
what is Medicare D?
Limited prescription drug coverage: offered by insurance and other private companies; approved by Medicare
monthly premium, co-pay on each prescription
penalty may be applicable if not enrolled when first eligible
is incident to billing applicable in hospital setting?
no, NP must bill under their NPI number
what is SPO CQI
Continuous Quality Improvement
SPO: Structures- inputs into care such as resources, equipment, numbers and qualifications
Processes: assessments, planning, performing
Outcomes: complications, adverse events, short term results of treatments, long-term results of patient health and functioning
what is QSEN? what are 6 key competencies
Quality and Safety Education for Nurses initiative- provide nurses with knowledge, skills and attitude
- Patient centered care
- teamwork and collaboration
- EBP
- QI
- Safety
- Informatics
what are CQI steps, as outlined by Joint Commission?
- Quality planning
- Delineate scope of care
- Establish thresholds for evaluation related to indicators
- Collect and organize data
- Evaluate care when thresholds are reached
- Take action to improve care
- Assess effectiveness of action and document improvement
- Communicate relevant information
