- claims liability while employed - occurrence based

Professional Role Flashcards by Restore Hyperwellness Blaine

Hierarchy - Highest Level of Evidence

Meta-Analysis / Systematic Review

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Hierarchy - Middle Level of Evidence

Randomized Control Trials
Cohort Studies
Case Control Studies
Cross Sectional Studies

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Hierarchy - Lowest Level of Evidence

Editorials / Opinions: no real research

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Quasi-Experimental Design Versus Randomized Control Trial difference

Randomized control trial randomizes who gets the placebo and drug, whereas the quasi experimental study there is no randomization

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Validity of the Study

Accuracy of the results

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Reliability of the Study

Results of the study are repeatable

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Independent Variable

exist by themselves, what we can change and manipulate, when changed, will change the dependent variable

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Dependent Variable

What is being assessed with the affects

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Autosomal recessive

Both parent has to carry the gene and pass it on (inherited)

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What is social history?

relationship status
sexual
lives with?
education
employed
smoking
drug
alcohol
new stressors
social support
exercise
clean water
air conditioning

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Primary level of prevention

Before incident occurs

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Secondary level of prevention

Screening for early diagnosis

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Tertiary level of prevention

After illness/disease has already happened, it’s the treatment, or therapy (PT/OT)

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Infant mortality

infant deaths per 1000 live births
- leading cause is congenital malformations

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Erickson’s Pneumonic

Trust the Auto in Industry
Indentiy with Intimate
Geniuses with Integrity

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License

Can practice in the state

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Certification

board exam

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Credentials

process in order to be allowed to bill medicare/medicaid

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Liability Insurance

claims liability while employed
occurrence based

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Incident to billing

Physician has to be in the building to be able to bill for subsequent visits at 100%, but if anything new were to happen we bill at 85%

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Who Funds Medicare?
Who does it cover?

federal level funding
Older adults
Permanent disability
Chronic disease
ESRD for example

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Medicare Part A

Inpatient, hospice

Medicare Part B

Outpatient, equipment, diagnostics, second opinion, dialysis

Medicare Part C

Supplemental like dental/vision

Medicare Part D

Drug coverage and prescription drugs

Budget Reconciliation Act (1st in time)

medicare reimbursement that allows NPs to bill

Balanced Budget Act

required NPs to have NPI number to bill up to 85%

Who funds Medicaid What is it?

Funding by federal and state level Those who cannot afford it (lives below federal poverty level) $2,000 per month WIC various from state to state CHIP (children's health insurance program)

HITECH Act

- this mandated that we all move to electronic medical records in order to be paid - defined meaningful use of what is shared in electronic health records - clinical decision support - protection of health information

COBRA

- allows for patients have access to healthcare while unemployed (quit or fired) - for up to 18 months

Health Belief Model

- people will not change behaviors until the believe the are at risk and will have negative health consequences - perceived risks - susceptibility - belief of consequence - risk severity - benefits to action - self efficacy - cues to action

Stages of Change Model

Readiness to Make Change - pre-contemplation - contemplation -preparation - action - maintenance

Motivational Interviewing

Patient centered - discover own motivation and goals Therapeutic Communication Collaborative

Family Systems Theory

Family functions as one cohesive unit and each member plays a specific role

Lewin's Change Model

Unfreeze - before change occurs, figuring out how to be motivated to change Change Refreeze - ensures this change is permanent

Transitional Care Model

Prevent readmissions and exacerbation

Swiss Cheese Model

Risk analysis and management, focused on root cause analysis

Consensus Model

Allows APRN to practice at full authority of license

State Nursing Practice Act

determines legal right to practice as NP determines scope of practice

State Board of Nursing

Enforces state nursing practice act

Collaborative Agreements

MDs, DOs, dentists Not chiropractors

Power of Attorney

person can make decisions on behalf

Healthcare Power of Attorney

only decisions regarding healthcare can be made

Domestic Abuse

Report - learn about state's difference between elder, child Sensitive in approach Do not place blame Maintain privacy

Informed Consent

Consent by adult, mentally competent, after all risks and benefits have been discussed - if not 18 y.o. it is an asset b/c they cannot give consent

Collaborative

Works together

Consultive

Needs advice, unsure of treatment

Veracity

truth telling

Fidelity

loyalty

Autonomy

patient makes own decisions

Paternalism

trying to decide what is best for the patient

Beneficence

to do good

Non-malfesiance

do no harm - check drug allergies

Justice

everyone gets same level of care and respectful of cultural considerations