quiz two Flashcards
Affordable Care Act:
- Law enacted in 2010 to improve health care quality while lowering cost and expanding eligibility for the Medicaid program to include all adults with low incomes below a certain level of the federal poverty level
- Also concerned with disease prevention. Clients are encouraged to sign up for insurance and seek preventative care before they become ill so that they can stay healthy.
- Provides coverage for Americans who previously were unable to obtain insurance coverage due to preexisting conditions.
happens from an outside organization that assures they have policies and procedures in place to maintain the quality of services and the safety of clients
accreditation
is a sign to the public and other organizations that the organization is committed to quality and that the organization has high standards of practice
accreditation
○ A nonprofit organization that accredits health care organizations in multiple types of health care settings (inpatient hospitals to pharmacies)
○ Sends experienced surveyors who are experts in their respective field to perform the visits.
○ Visits often consist of documentation and policy review, observations, and interviews with administration and staff members to ensure quality and safe client care and identify areas for improvement.
○ Accreditation is not valid after three years
○ Monitors state legislative and regulatory changes and updates its standards accordingly
The organizations must be able to explain to TJC surveyors how they meet the elements of each standard either through discussion, by demonstration in chart review, or through written procedures and policies.
the joint commission
○ Organization that focuses on improving the quality of health care through the development of evidence-based standards for care.
National Committee for Quality Assurance
An organization that supports nurses to improve client care through education, certifications, and professional designations. Developed magnet status
American Nurses Credentialing Center
national accreditation agency concerned with continuous quality improvement of nursing programs across the academic spectrum. Nursing programs must provide a systemic self-assessment of the program addressing institutional support and the accreditation standards for quality nursing education.
NLN commission for Nursing Education Accreditation
an adverse event that should never occur, usually results in client’s death or harm that is determined to be permanent or severe. Examples include administering wrong blood types, infant death, surgical procedure performed on incorrect limb. These events are reported to TJC to improve systems-related issues and to improve client safety and quality of care.
Sentinel Events
uses broad range of standardized questions to measure and compare client satisfaction between healthcare facilitates. Is administered randomly to clients 48 hours to six weeks after discharge. Scores are publicly reported to ensure transparency.
Hospital Consumer Assessment of Healthcare Providers and Systems
popular survey tool to measure health care delivery and client satisfaction in acute care agencies. Has metrics on access to care, wait times, client interactions with the health care team, and the visit itself. Is emailed to every client at the conclusion of their visit.
The press ganey
government health care coverage for a client who is age 65 or older or with disabilities or any age with end stage renal disease or amyotrophic lateral sclerosi
Medicare
(hospital insurance) hospitalization, skilled nursing facilities, some hospice care, some health care
Part a of medicare
(medical insurance) doctor’s services, physical therapy, occupational therapy, some health care
part b of medicare
(advantage plan) selected coverage that can include Medicare parts A B and D
part c of medicare
(medication coverage) extra coverage to lower costs of prescription medications
part d of medicare
government health care coverage for a client who must meet eligibility requirements based on the client’s income in relation to the poverty level. Income eligibility varies from state to state
medicaid
benefit of employment for many people. Employer chooses the coverage and individuals still face out of pocket expenses.
employer sponsored health insurance
a fixed amount of money a client must pay before health insurance begins to cover, calculated annually
Deductible
physician or NP or PA that can screen the client and treat them for routine illness, promote wellness, and prevent disease. May also refer to specialist.
primary care facility
a fixed amount a consumer pays for health care typically at the time of the care or services are received.
copay
focuses on preventive services, caring for clients before admission to facility. The work is don’t on a population. Goal is to education the community to eat better, exercise, and partake in preventive care measures.
community care facility
requires treatment in an emergency department or an overnight stay. Brief short admission to treat and stabilize episode.
acute care facility
for clients who do not need specific nursing skills but rather a place to live. May need some assistance with ADLS
long term care
long term or short term care like rehab. May also provide limited therapies like wound care and respiratory care treatments.
skilled nursing facility
specializes in clients who require hospitalization for long-term illnesses such as severe burns, trauma, or ventilation needs.
long term care hospital
provides services for clients who are mostly independent but choose to live in a community setting for assistance with some part of their daily life.
assisted living
provider has determined the individual has less than six months to live
hospice
provide services that help clients feel as comfortable as possible during their illness with the goal of promoting pain relief and overall comfort.
palliative care
provides care for the client to allow the caregiver a break from some responsibilities for short time vacations
respite
involve having a nurse or other health care providers come into the home and deliver services.
home care
advise about healthy foods choices and nutrition and weight management. Also recommend therapeutic diets to treat different medical conditions.
dietitian
coordinate care for the client. Collaborate with health care team and client to ensure the treatment plan meets client’s needs and provides quality care that is cost-effective.
case manager
(NP) RN who completed advances education in a specialty and passes the associated certification exam
advanced practice registered nurse
in most states they work under the RN or other care provider and is responsible for providing basic care, gathering data, about clients condition, providing treatments, administering meds.
licensed practical nurse
completed 4-year program in naturopathic medical school. Work as complementary health practitioners who specialize in treating clients by prescribing more natural methods. May recommend changes in lifestyle, herbs, dietary supplements, and manipulative therapy.
naturopathic physician
provide car in multiple settings assisting clients to either recover or develop new skills to maintain daily living and return to work. Educate clients on adaptive equipment as needed to perform ADLS
OT
work with paramedics to administer care and stabilize clients who have emergency medical situations. Transport clients to acute care settings and hand off communication to treatment team of providers.
emergency medical technician
prepare and dispense medications prescribed by provides, double-check for interactions with other meds, and educate clients on how to take meds. May make recommendations regarding meds and dosing.
pharmacist
provide services to client to assist in their recovery from injury or illness. Help improve their movement and alleviate pain.
physical therpaist
diagnose and treat illness, prescribe medications and therapies as needed, and interpret diagnostic testing. They can educate clients on disease and diet and make referrals to specialists as required.
physician
work under the direction and supervision of a physician. Can still treat, diagnose, and prescribe meds, laboratory and other diagnostic test/treatments.
PA
treat clients who have chronic or acute diseases of the lung such as chronic obstructive lung disease and pneumonia as well as clients who had lung surgery. Can conduct diagnostic testing of the lungs and educate clients on respiratory medications.
respiratory therpist
assess clients, provide and evaluate care based on that assessment, and collaborate with the interprofessional health care team to meet the clients needs. Also provide education, administer meds, perform treatments, and operate various medical equipment.
registered nurse
collaborate with the interprofessional health care team to help fine solutions to client challenges and advocate for resources to resolve issues. Clinical ones can diagnose, treat, and provide psychotherapy services. Also play a role in discharge planning solutions.
social worker
work in many settings and evaluate/treat clients from various age groups who have speech or swallowing impairments that could be related to cognitive or social communication conditions. Teach clients how to make sounds and methods to improve vocab and strengthen the muscles used for swallowing.
speech language pathologist
usually nurses’ aides who assist the health care team. Assist clients with ADLS and can obtain vital signs and fluid intake and output measurements.
assistive personnel
provides continued health insurance coverage for a limited amount of time when an employee loses their job or has their hours cut to were they are no longer eligible.
Consolidated Omnibus Budget Reconciliation Act:
the law that governs the scope and standard of nursing practice
nursing practice act
legislation to protect insurance coverage and private information of clients
health insurance protability and accountability act
promote the use of information technology in health care settings in a meaningful way
Health Information Technology for Economic and Clinical Health Act:
passed to prevent “patient dumping” or the practice of one health care organization moving a client based on the client’s inability to pay or lack of insurance coverage
Emergency Medical Treatment and Active Labor Act
requires all health care organizations to inform clients of their rights to make decisions regarding their care and to indicate whether the client has made an advanced directive
Patient Self-Determination Act:
controlled substances have the potential for abuse and are regulated based on pharmacologic effects and the history, current pattern, and significance of abuse. Regulates substances that have potential for abuse by placing them in one of five schedules.
controlled substance act
ensures that individuals with mental illness receive coverage equal to those with medical illness or need for surgical intervention, addresses insurance plans requiring that insurers provide reasonable coverage
Mental Health Parity and Addiction Equity Act
requires group health plans to pay for 48-hour hospital stay or 96-hour stay in the case of a C section, beginning at the time of delivery
Newborns’ and Mothers Health Protection Act
prohibits discrimination against individuals living with a physical or mental impairment that substantially hinders life activities. Provides equal opportunities
Americans with Disabilities Act
prohibits another person from revoking the consent of an organ donor after death
uniform anatomical gift act
provides for regulation and oversight of long-term care facilities in an effort to protect residents. Specific care standards that forbid the use of chemical restraints
Omnibus Reconciliation Act
the process of enabling people to increase control over and improve their health
health promotion
population-based and individual based interventions for primary and secondary prevention, aiming to minimize the burden of disease and associated risk factors.
disease prevention
behavior’s and actions that can affect a client’s risk for developing a disease. Ex. Tobacco use, eating poorly, alcohol
modifiable risk factor
risk factors that cannot be changed. Ex. Age, gender, race, family history
non modifiable risk factor
act of intervening before negative health effects occur. Ex. Vaccinations and staying away from risky behaviors
primary level of prevention
early screening to detect a disease process before it progresses. Ex. Blood pressure measurement, mammograms, pap smears
secondary level of prevention
controlling the chronic effects of a health issue that has already occurred and on restoring the individual to optimal functioning. Ex. Education about self care, rehabilitation like PT or OT.
tertiary level of prevention
protecting clients from the excessive use of medical interventions that can cause more harm than good. Ex. A client that has no risk factors and no symptoms may not benefit from treatment.
quaternary level of prevention
what does pathway to excellence focus on
-turnover
-workplace engagment
-productivity
-teamwork
-job satisfaction
who accredits nursing programs
-NLN national league of nurses
-accreditation commission of education
-american association of collegiate nursing
