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ACNP Review > Risk Assessment & Issues, Trends, Helath Policy > Flashcards

Risk Assessment & Issues, Trends, Helath Policy Flashcards

1
Q

Adolescent (11-19y) ages for PE

A

3 visits: 11-14y, 15-17y, 18-21y

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2
Q

Pap smear with GC and Chlamydia screen

A

3 yrs after vag intercourse, no later than 21y

Annually until 30y

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3
Q

Syphilis screen for male and female

A

At sexual activity, PRN or with pap smear

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4
Q

Mammography

A

Every 1-2y for 40-49y; annually for 50-74y or as long as in good health

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5
Q

Total Chol and HDL (or full fasting panel)

A

Starting @ 20y; every 5 yrs unless chol >200 mg/dl

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6
Q

Td

A

every 10 years

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7
Q

HPV vaccine

A

Gardasil (11-26y) and Cervarix (10-25y)

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8
Q

DRE and PSA

A

DRE @ 40y and PSA @ 40y if AA or Fam Hx of Prostate CA. All males 50y must have DRE/PSA

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9
Q

ECG

A

At 40y for baseline or with Carddiac RF

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10
Q

Tonometry

A

Glaucoma screening Annually after 40y

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11
Q

Normal IOP

A

10-20 mm Hg

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12
Q

Open angle glaucoma

A

20-30mm Hg

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13
Q

Closed angle

A

> 30 mm Hg with pain

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14
Q

Elderly PE

A

every 2 yr

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15
Q

Elderly pap

A

may discontinue at age 65-70 after 3 recent normal consecutive results

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16
Q

Elder ECG

A

every 2 yrs with cardiac RF

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17
Q

Colorectal CA screen

A

start at age 50

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18
Q

Fleible sigmoidoscopy

A

q 5 yrs

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19
Q

Colonoscopy

A

q 10 yrs

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20
Q

Td substitute 1 dose for Tdap

A

not indicated > or equal to 65 y

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21
Q

Pneumococcal vaccine

A

Once at 65y

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22
Q

Pneumococcal vaccine: what bacteria?

A

Streptococcus pneumoniae

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23
Q

Strep pneumonniae

A

CAP (I/P & O/P), meningitis, sinusitis, OM

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24
Q

Incidence

A

frequency

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25
Q

prevalence

A

proportion

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26
Q

Primary prevention

A

immunization, safety, weight loss, exercise

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27
Q

secondary prevention

A

screening

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28
Q

tertiary prevention

A

rehab

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29
Q

Passive immunity

A

gamma globulin injection and mother to fetus

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30
Q

Pneumococcal vaccine repeated after5 yrs after initial vacc for which populations?

A

Chronic RF, immunosuppression, long term steroid users, and if pt was vaccinated > or equal to 5 yrs previously and was < 65 yr of age at time of initial vacc

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31
Q

Hep A considered for:

A

military personnel, travelers to endemic areas, and men who have sex with men

32
Q

Hep B given to:

A

All healthcare workers and high risk sexually active adults

33
Q

Advanced directive

A

regarding medical tx

34
Q

Healthcare directive

A

type of adv directive that may or may not include a living will or specifications regarding POA

35
Q

Living will

A

specifies life prolonging measures. Often include granting of POA who articulates pt’s adv directive

36
Q

HIPAA title I

37
Q

HIPAA title II

A

privacy and confidentiality

38
Q

PSQIA: Patient Safety and Quality Improvement Act

A

Pat safety work product in protection when reporting medical errors

39
Q

HP 2020 Goals

A
  1. Increase the quality and years of healthy life

2. Eliminate health disparities among Americans

40
Q

Medicare part A

A

I/P: hospital, rehab, phys therapy

41
Q

Medicare Part B

A

supplement $: physician visits, medical equipment, labs

NP’s receive 85% of physician reimbursement

42
Q

Medicare Part C / Medicare Advantage

A

A+B=C

Choose HMO, PPO

43
Q

Medicare part D

A

limited drug coverage

44
Q

NP services billed Med B

A
  1. diagnosis
  2. therapy
  3. surgery consultation
  4. care plan oversight
45
Q

Services that do NOT meet medicare’s definition of ‘physician services’

A
  1. Regular PE
  2. Health maintenance screening
  3. Counseling for well patients
46
Q

QA/QI/CPI

A

mgmt. process of monitoring, evaluating, continuous review and improving the quality in providing healthcare. Based on CQI: improvement based on continued monitoring structure, process, and outcome.

47
Q

Structures

A

inputs into care: resources, equipment, or numbers & qualifications of staff

48
Q

processes of care

A

Assessments, planning, performing treatments and managing complications

49
Q

outcomes

A

complications, adv reactions, short term results of treatment and long term results of pt health and functioning

50
Q

Critical path

A

contains key pt care activities and their time frames which are needed for a specific DRG

51
Q

Care map

A

newer version of critical path and is a blue print for planning and managing care delivered by all disciplines plus a section for common problems for pts of a sp case type. Monitoring of OUTCOMES is a very imp goal

52
Q

Root cause analysis

A

part of dev. CULTURE OF SAFETY. Asks ‘why?’ at each level of cause and effect. Process that is as impartial as possible

53
Q

Sentinel Events

A

unexpected events: death, serious physical or psychological injury or risk there of. Not all medical errors result in sentinel events and vice versa

54
Q

Scope of practice

A

delineated by state Nurse Practice Act. Key elements: collaboration and coordination of care, research based clinical practice, clinical leadership, family assessment, and discharge planning

55
Q

Standards of Advanced practice

A

delinieated by ANA to measure QUALITY of practice, service or education

56
Q

Credentials

A

establish MINIMAL levels of acceptable performance

57
Q

Licensure

A

rules/regs set by governamental body (state board of nursing)

58
Q

Certification

A

est meeting certain STANDARDS in a particular profession which signify MASTERY of sp knowledge/skills

59
Q

Credentialing and Privileging

A

granted by Hospital Credentialing Committee (comprised of phys) Privileges granted in part or full

60
Q

Medical futility

A

interventions that are unlikely to provide benefit to pt

61
Q

Quantitative futility

A

likelihood that intervention will benefit pt is extremely poor

62
Q

Qualititative futility

A

the quality of intervention will benefit pt is extremely poor

63
Q

Decisional capability

A

ability to understand
reason
differentiate good and bad
communicate

64
Q

Informed consent

A

discussing all of the benefits and risks. Consent is assumed if pt’s condition is life threatening

65
Q

right to refuse care

A

any, some or all of care can be refused as ong as pt has decisional capability

66
Q

nonmalficence

A

duty to do no harm

67
Q

utiliarianism

A

the right act produces the greates good for the majority

68
Q

beneficence

A

duty to prevent harm and promote good

69
Q

fidelity

A

faithfulness

70
Q

autonomy

A

respect ind thoughts and actions

71
Q

Role development of NP est?

A

1960s d/t phys shortage in pediatrics

72
Q

First NP program, where?

A

Univeristy of Colorado Health Sciences Center

73
Q

4 roles of NP

A

Expert:

  1. Clinician
  2. Consultant/Collaborator
  3. Educator
  4. Researcher
74
Q

Nonexperimental research:

A

2 broad categories:

  1. Descriptive - describes situation, experiences, and phenomena as they exist
  2. Ex post facto (in the past) or correlational - examines relationships among variables
75
Q

Cross sectional

A

find relationships between variables at a SPECIFIC POINT IN TIME; “surveys’

76
Q

Cohort

A

compares a part outcome in groups of indiviuals who are alike in many ways but differ by a certain characteristic

77
Q

longitudinal

A

taking multiple measures over an extended period of time to find relationships between variables

ACNP Review (12 decks)

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