Lecture 3 - Roles, Education, and Values of Healthcare Professionals, ABX Stewardship Flashcards

1
Q

Differentiation must be balanced because _________

A

It can be counterproductive when activities of one functional unit must be coordinated with that of another

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2
Q

Integration

A

The degree to which harmony of effort exists among different units

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3
Q

Integration requires

A
  • Interaction
  • Sharing of information
  • Joint decision making about goals
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4
Q

______________ is a tool for integration

A

Cross-Understanding

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5
Q

What are the 5 professions that are the largest in number involved in interprofessional delivery of healthcare:

A
  1. Medicine
  2. Nursing
  3. Pharmacy
  4. Social work
  5. Healthcare administration
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6
Q

O*NET Occupational Interest:

Realistic

A

Frequently involve work activities that include practical, hands-on problems and solutions

(Often deal with plants, animals, and real-world materials like wood, tools, and machinery. Many of the occupations require work outside and do not involve a lot of paperwork)

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7
Q

O*NET Occupational Interest:

Investigative

A

Frequently involve working with ideas, and require an extensive amount of thinking

(These occupations can involve searching for facts and solving problems mentally)

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8
Q

O*NET Occupational Interest:

Artistic

A

Frequently involve working with forms, designs, and patients.

(They often require self-expression and the work can be done without following a clear set of rules)

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9
Q

O*NET Occupational Interest:

Social

A

Frequently involve working with, communicating with, and teaching people.

(These occupations often involve helping or providing service to others)

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10
Q

O*NET Occupational Interest:

Enterprising

A

Frequently involve starting up and carrying out projects.

(These occupations can involve leading people and making decisions. Sometimes they require risk taking and other deal with business)

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11
Q

O*NET Occupational Interest:

Conventional

A

Frequently involve following set procedures and routines

(These occupations can include working with data and details more than with ideas. Usually there is a clear line of authority to follow)

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12
Q

Role:

Physician

A
  • Diagnose illnesses, and prescribe and administer treatment for people suffering from disease
  • Examine patients, obtain medical history, order and interpret diagnostic tests, prescribe drugs, perform surgery, manage chronic disease
  • Obtained either an MD or DO degree
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13
Q

Education:

Physician

A

– Licensed on the state (as opposed to federal) level

• 3 USMLE exams plus USMLE CS plus intern year completion = medical license

– Most physicians are board certified-passed a test in their specialty (Needed for hospital privileges in some cases)

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14
Q

Values:

Physician

A
  1. Very independent
  2. Expect problems to have solutions
  3. Expect high social status
  4. Respect for scientific evidence
  5. Concerned about patient care > cost

Primary O*NET Interest: INVESTIGATIVE

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15
Q

Role:

Pharmacy

A
  • Distribute prescription drugs to individuals for the treatment of disease in response to a prescription
  • Advise patients, physicians, and other healthcare workers on the selection, dosages, interactions, and side effects of medications
  • Monitor the health and progress of the patients they provide medications to ensure they are using their medications safely and effectively
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16
Q

Education:

Pharmacy

A

• PharmD is a 4 year graduate doctoral degree
• Some pursue a 1-2 year residency after graduation
• After completing their degree, pharmacists must pass 2 exams to attain state licensure
– One in pharmacy skills and knowledge
– Another in law of the state issuing the license

17
Q

Values:

Pharmacy

A
  • Excellence in the choice and dosing of drugs to treat patients
  • Primary O*NET Interest: Investigative
18
Q

What are the two exams pharmacist must pass to attain state license?

A

– One in pharmacy skills and knowledge

– Another in law of the state issuing the license

19
Q

Antibiotic Resistance

Definition

A

A microorganism’s resistance to an antimicrobial drug that was once able to treat an infection by that microorganism

(One of the principal public health threats facing the world)

20
Q

What are three ways resistance genes can transfer?

A
  1. Plasmid transfer
  2. Transfer by viral delivery
  3. Transfer of free DNA
21
Q

What are the 6 characterizations of ONET

A
  1. Realistic
  2. Investigative
  3. Artistic
  4. Social
  5. Enterprising
  6. Conventional
22
Q

Profession top two interest:

Internist

A

Investigative

Social

23
Q

Profession top two interest:

Surgeon

A

Investigative

Realistic

24
Q

Profession top two interest:

Registered Nurse, Nurse Practitioner, Social worker

A

Social

Investigative

25
Q

Profession top two interest:

Pharmacist

A

Investigative

Conventional

26
Q

Profession top two interest:

Heathcare Administrators

A

Enterprising

Conventional

27
Q

Carbapenem Resistant Enterobacteriaceae

A

Gram negative bacteria that produce an enzyme called carbapenemase that confers resistance to carbapenem

(Includes the genera Klebsiella, Escherichia, and Enterobacter)

28
Q

T/F

CRE bacteria can asymptomatically infect/colonize patients

A

True

29
Q

Antibiotic Stewardship

A

Systematic measurement and coordinated interventions designed to promote the optimal use of antibiotics
(Includes choice, dosing , route, and duration)

Goal: optimize clinical outcomes while minimizing unintended consequences

30
Q

T/F
Starting in 2017, the Joint Commission has mandated that all hospitals and nursing care facilities have antibiotic stewardship programs

A

True

31
Q

Antibiotic Use Principles

5

A
  1. Empiric therapy - Start based on clinical evaluation
  2. Tailoring therapy - Change the antibiotics in response to clinical data like blood cultures
  3. Convert from IV to PO - Minimizes complications, saves money
  4. Use the shortest effective duration of therapy
  5. Monitor Pharmacokinetics (Ex: Vancomycin trough and dose adjusting)
32
Q

CDC Core Elements of ASP

A
  • Leadership Commitment: clear support from hospital leaders
  • Accountability: physician to lead the team and responsible for outcomes
  • Antibiotic Expertise: pharmacist
  • Action: intervene to ensure abx used correctly
  • Tracking: monitor abx use and track resistance
  • Reporting: create reports on abx use and distribute to hospital
  • Education: educate clinicians
33
Q

The action that the ASP can take; typically includes the following strategies (2)

A
  • Prospective Audit and Feedback (PAF): ASP staff review abx orders and provide recommendations to prescribers regarding optimization of abx use
  • Preauthorization: approval is required by an infectious disease specialist before an abx can be administered
34
Q

Microbiology Lab Function

A
  • Cultures, grows, and identifies organisms
  • Compiles antibiogram data (Summary of abx susceptibility data for bacterial isolates recovered by a the lab over a defined period of time)
  • Makes decisions on diagnostic tools to use
  • Susceptibility results are a useful tool for guiding abx use