Health Care Flashcards
(44 cards)
______________identification of and discrimination between physical and psychological signs and symptoms essentially to effective execution and management of the nursing regimen.
Diagnosis
________ prevention consists of health promotion and illness
PRIMARY PREVENTION
examples of PRIMARY PREVENTION
mamagram
Colonoscopy
flu clinical
education
what PREVENTION is your primary care provider?
secondary
________ prevention is diagnosis and treatment
SECONDARY PREVENTION
(call doctors/np/surgery/ prescription )
____________ prevention consists of rehabilitation, health
restoration, palliative care.
TERTIARY PREVENTION
NURSING ROLES (3)
caregiver
manager of care
member of the profession
TCAB
Transforming Care at the Bedside
Focus on
safer, more reliable inpatient care
* more focused on the patient
* increase the vitality of the work environment and satisfaction of front-line
nurses
* TEAMSteps
* From Military
* “patient safety is a team sport”
TEAMSteps
- From Military
- “patient safety is a team sport”
- Promotes:
- Team Leadership
- Situation monitoring
- Mutual support
- Communication
(QSEN)
Quality & Safety Education for Nurses
(KSA)
Knowledge, skills & attitudes to improve quality and safety
of healthcare systems
* 6 competencies:
* Patient centered care
* Teamwork and collaboration
* Evidence-based practice
* Quality improvement
* Informatics
* Safety
National Patient Safety Goals
2023
Improve accuracy of patient identification
CONSOLIDATED OMNIBUS BUDGET RECONCILATION ACT
(COBRA)
gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances such as voluntary or involuntary job loss.
Health Insurance Portability and Accountability Act (HIPAA) 1996
Protected Health Information
* Identifies an individual
* Contains health information
* Need to know basis only
* Do I need this information to do my job?
Part 2 of Cobra
Part 2 (must provide care for patient regardless if they can afford it)
* Receiving care in a hospital
* 250 yard rule
* Must provide services in emergency
* Treatment of emergencies
* Regardless of insurance or ability to pay
* Obstetric patient with contractions = emergency
* Transferring patients
* Only when stable
* If care needed not available
Part 1 of Cobra
Part 1
* Change in insurance
* Right to choose to continue group health benefits
The Health Information Technology for
Economic and Clinical Health Act
(HITECH)
- part of the American Recovery
and Reinvestment Act of 2009 - Includes HIPAA compliance
with technology - Civil and criminal penalties
PAYMENT SOURCES (6)
- MEDICARE
- MEDICAID
- SSI
- PRIVATE INSURANCE
-CANADA - COBRA
- MILITARY/ VA
Government issued payments ?
Government-funded programs are paid for with revenue from federal, state, and local taxes on the citizenry. Programs include Medicare, Medicaid, and children’s, specialty, and categorical programs.
Consumers
Aware, savy
Advances in technology
Testing, early diagnosis
Early diagnosis
Less costly
COMPUTERS and digital
information
EHR: meaningful use
MANAGED CARE
* HMO, POS, PPO
POS : can choose whether they want to use in-network or out-of-network providers. The member will pay higher costs for using out-of-network providers, except in an emergency situation
HMO: To offer all necessary medical benefits to members of the HMO while still holding costs to a minimum
PPO: managed care plan in which providers are paid by the PPO on a fee-for-fee service
- negotiated fee schedule between the PPO and the doctors
- PPO members not required to use PPO providers, but there is a financial incentive to do so
Focus of PPOs
- focus on good health care once you’re sick, not on wellness
- some annual exams not covered
CLINICAL PATHWAYS
map strategy for assessing, implementing, and evaluating the cost-effectiveness of patient care. These pathways reflect relatively standardized predictions of patients’ progress for a specific diagnosis or procedure.