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practice issues Flashcards

1
Q

a former pt of an NP is writing blog posts, sending emails and accusatory statements about NP practice - what form of defamation is this

A

libel

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2
Q

MRT

A

multidisciplinary response teams
rapid response
institutional disaster

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3
Q

CPOT

A

critical care pain observation tool
assessed pain in critical care
1. facial expression
2. body movements
3. muscle tension
4. compliance with vent OR vocalization
score 0-8

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4
Q

four features of CAM-ICU

A

confusion assessment method for ICU
1. acute onset of mental status changes
2. inattention
3. disorganized thinking
4. altered LOC
conducted daily at least

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5
Q

which alternative therapy my be used with Parkinsons

A

tai chi

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6
Q

goals of technology in nursing

A

enhance scope of practice & EVP , make practice knowledge-driven

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7
Q

benchmarking

A

comparison and measurement of a healthcare organizations services against other national healthcare organizations

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8
Q

four core principles of benchmarking

A

maintaining quality
improving customer satisfaction
improving patient safety
continuous improvement

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9
Q

what score indicates riks of falling with get up and go test

A

> 3 indicating risk of falling

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10
Q

5 components of establishing rapport

A

nonjudgmental approach
mutual trust
professional boundaries
confidentiality
culture competency

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11
Q

what makes up culture competency

A

respect
spiritual needs

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12
Q

a written statement of patients intent regarding medical treatment is what

A

advance directive

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13
Q

title I of HIPPAA

A

protects health insurance coverage when loose job (COBRA)

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14
Q

who enforces HIPPA

A

office of Civil Rights (OCR)

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15
Q

how do you start any change

A

begin at the most local level - begin at hospital then community then region then state then national

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16
Q

goals of healthy people 2030

A

increase quality and years of healthy life
eliminate health disparities among americans

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17
Q

reporting statues

A

criminal acts and injury from dangerous weapon (police)
Department of Health: gonorrhea, chlamydia, syphilis, HIV, TB, COVID
animal bites (animal control)
suspected or actual child/elder abuse (police via social service)

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18
Q

sets the standard for reimbursement and cutting costs

A

medicare

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19
Q

problem focused exam

A

limited exam of affected body area or organ system

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20
Q

expand problem focused

A

limited exam of affected body area/organ system and any other symptomatic or related body area/organ system

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21
Q

detailed exam

A

extended exam of affected body area/organ and another symptomatic or related body area/organ

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22
Q

comprehensive exam

A

general multi- system exam or compete exam of single organ system and other symptomatic or related body area

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23
Q

this portion of medicare covers inpatietn/hospitalization and related services with inpatient event

A

medicare A

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24
Q

medicare B

A

covers physician services, outpatient hospital services, lab/diagnostic procedures, medical equipment and home health
part bath pays NPs and clinical nurse specialists

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25
Q

NPs are reimbursed how by medicare

A

receive 85% of physician reimbursement

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26
Q

medicare C

A

A+B = C
pts with a and b are eligible to receive health acer through one of the provider organizations

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27
Q

this portion of medicare covers drugs

A

medicare D - monty premium required

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28
Q

to qualify to be a medicare provider NP must have what

A

hold state license
be certified by recognized national certifying body
hold at least MSN degree

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29
Q

these benefits vary from state to state

A

medicaid

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30
Q

a management process of monitoring, evaluating, continuous review, and improving the quality in providing health care

A

quality assurance (QA)/QI/continuous process improvement (CPI)

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31
Q

quality assurance

A

process for evaluating the care of patients using established standard of care to ensure quality

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32
Q

FIFE

A

model to use when interviewing pt about condition

Feelings - fears/concerns regarding condition
Ideas- pts understanding of nature/cause of condition
Functioning- how the quality of life is effected
Expectations - what the pt thinks/hopes might happen with course of treatment

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33
Q

QSEN initiative

A

quality and safety education for nurses initiative - providing future nurses with knowledge, skills and attitude necessary to ensure continuous improvement in quality and safety in respective healthcare systems

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34
Q

six key competencies of QSEN

A

patient centered care
teamwork and collaboration
EBP
QI
safety
informatics

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35
Q

pt is having diarrhea as side effect of tube feedings - how do you manage

A

decrease osmolality of tube feeding

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36
Q

strongest method to evaluate teaching is what

A

returned demonstration

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37
Q

what qualifies a pt for hospice

A

terminal dx with < 6 months to live and only receive comfort measures

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38
Q

pt needs helps with ADLS what needs to be consulted

A

SNF

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39
Q

case management

A

mobilize, monitor, and control resources that a pt uses during a course of an illness while balancing quality and cost

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40
Q

which two forms of medicare require pt to pay something

A

B and D

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41
Q

CQI

A

continuous process improvement
quality can be improved by continually monitoring structure, process and outcome standards

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42
Q

components of monitoring for CQI

A

care quality
care appropriateness
effectiveness of care
cost of care
self - regulation
peer review

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43
Q

6 key copentenczies of QSEN

A

patient centered care
teamwork and collaboration
EBP
QI
safety
informatics

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44
Q

a tool for identifying prevention strategies to ensure safety

A

root cause analysis

45
Q

scope of practice

A

based on state
delineated by individual state nurse practice act of each state BON
varies state to state

46
Q

state practice acts

A

authorize BON in each state to establish statutory authority for licensure of RN

47
Q

credentials

A

encompass required education, licensure and certification tp practice as a nurse practitioner
minimal level of performance

48
Q

what mandates accountability

A

credentials

49
Q

credentialing is necessary to

A

ensure that safe health care is provided by qualified individuals
cosplay with federal and state laws relating to APN

50
Q

established that a person is qualified to perform in professional role

A

licensure
granted by governmental regulatory body ie state BON

51
Q

establishes that a person has met standards that signify mastery of knowledge/skills

A

certification

52
Q

the most common method of documentation

A

incident reports
part of risk management

53
Q

satisfaction surveys

A

important form for identifying problems before developing into actual incidents or claims ; important to track and analyze just like incident reports
part of risk management

54
Q

two kinds of medical futility

A

quantitative
qualitative

55
Q

quantitative futility

A

where the likelihood that intervention will benefit the patient is extremely poor
- the number

56
Q

qualitative futility

A

where the quality of benefit an intervention will proceed is extremely poor

57
Q

medical futility

A

refers to interventions that are unlikely to produce any significant benefit to patient

58
Q

components of competence

A

ability to understand, reason, differentiate good and bad and communicate

59
Q

nonmaleficence

A

duty to do no harm

60
Q

utilitarianism

A

right act is the one that produces the greatest good for the greatest number - triage/mass casualty

61
Q

beneficence

A

duty to prevent harm and promote good

62
Q

justice

A

duty to be fair

63
Q

fidelity

A

duty to be faithful

64
Q

veracity

A

duty to be truthful

65
Q

autonomy

A

duty to respect an individuals thoughts and actions

66
Q

4 distinct roles of NP

A

clinician
consultant/collaborator
educator
researcher

67
Q

types of nonexperiemental research

A

descriptive
ex post facto or correlational research
cross sectional
cohort
longitudinal

68
Q

descriptive research

A

non experimental
aims to describe situations, experiences, and phenomena as they exist

69
Q

ex post facto

A

correlational research
examines relationships between variables
- looks into past to obtain correlation between two things - such as a chart review to compare sepsis rates on surgeons

70
Q

cross sectional

A

non experimental
observational study that examines a population with a very similar attribute but differs in one specific variable (such as age)

71
Q

cohort

A

non experimental or observational study
retrospective or prospective
compares a particular outcome (such as lung cancer) in groups of people who are alike in many ways but different by a certain characteristic (eg. female nurses who smoke compared to those that don’t)

72
Q

longitudinal

A

non experimental
taking multiple measures of a group/population over an extended period of time to find relationships between variables

73
Q

experimental study

A

manipulation of variables utilizing randomization and a control group to test the effects of an intervention or experiment

74
Q

quasi-experimental

A

involves manipulation of variable but lacks a comparison group or randomization

75
Q

qualitative

A

case studies
open-ended questions
field studies
obersvation
ethnographic studies
used to explore phenomena through detailed descriptions of people, events, situations or observed behavior

76
Q

what is a potential problem of quantitative research

A

researcher bias

77
Q

PICOT

A

framework to answer a clinical-based question

P = patient
I = intervention
C= comparison
o=outcome
t= timing

78
Q

type 1 error

A

“false postive”
incorrectly rejecting true null hypothesis

79
Q

type 2 error

A

“false negative”
failing to reject null hypothesis which if false

80
Q

difference between meta-analysis vs. meta synthesis

A

meta-analysis - quantitive study vs. meta synthesis qualitative

81
Q

confidence interval

A

smaller is better
an interval (3.2-3.8) of probability

pts with cancer have 3.2-3.8 episodes of nauseas every 24 hours

82
Q

standard deviation

A

average amount of deviation from the mean

68% of sample falls within one SD of mean

83
Q

level of significance

A

probability of which the results of analyses are judged to be statistically significant difference between two groups

  • the probability of false rejection of the null hypothesis in a statistical test
84
Q

p< .05

A

experimental and control groups are considered to be significantly different

95% chance what you are seeing is not due to chance

85
Q

t-test

A

statistical test to evaluate the difference in means

86
Q

reliability

A

consistency of test to measure the same way over time

87
Q

validity

A

degree to which a variable measures what it is intended to measures
-valid to ask

88
Q

liability

A

legal responsibility for actions that fail to meet the standard of care resulting gin actual or potential harm

89
Q

negligence

A

failure of person to do what a reasonable person would do - resulting in injury

90
Q

malpractice

A

failure to render services as another member of same profession would render

-professional misconduct
-unreasonable lack of sill
-illegal/immoral conduct
-other allegations resulting in harm to patient

91
Q

assult

A

threat of harm

ex: shaking first in the air

92
Q

battery

A

actual harm to a patient

can be done on unconscious person, but assault cannot

93
Q

defamation

A

communication that can someone to suffer a damaged reputation - libel or slander

94
Q

libel

A

type of defamation that is written

95
Q

slander

A

type of defamation that is spoken

96
Q

sensitivity

A

true postive
a test identifies those that are positive have the disease

97
Q

specificty

A

true negative
test identifies those that do not have disease test negative

98
Q

incidence

A

frequency in which disease appears

99
Q

prevalence

A

proportion of population that is affected by disease ( %)

100
Q

primary prevention

A

prevents development of disease
es: immunizations/vacinations

101
Q

primordial prevention

A

in childhood
healthy diet, regular exercise

102
Q

secondary prevention

A

screening
early identification
- Pap smear screen, prostate cancer screen, cholesterol screen

103
Q

tertiary prevention

A

rehab and restore health
cardiac rehab, PT after stroke

104
Q

CLAS

A

culturally and linguistically appropriate services
eliminate racial/ethinic health disparities and improve health

105
Q

standard 5 CLAS

A

must offer and provide language assistance services

106
Q

standard 5 CLAS

A

must offer and provide language assistance services

107
Q

standard 6 CLAS

A

must provide verbal offers and written notices (in their preferred language) informing them of their rights for language services

108
Q

standard 7 CLAS

A

must assure competence of language assistance - family/friends should not be the interpreter (except upon request by pt)

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