MODULE 4- UNIT 1 THE HEALTH CARE DELIVERY SYSTEM

Question 1

What is the world health organization?

Answer 1

Health is a state of complete physical, mental and social well-being, not merely the absence of disease and infirmity

Question 2

What is healthcare?

Answer 2

Healthcare is the management of the resources of healing

Question 3

What is the delivery of healthcare?

Answer 3

The action or activities of supplying or providing services to maintain health, detect illness and cure those who are ill or injured

Question 4

What is the ANA

Answer 4

American Nurses Association

Question 5

What is the role/function of the ANA?

Answer 5

1. Basic care for all citizens
2. Health policies that support safe, effective, patient-centered, timely efficient, and fair care based on outcome research
3. Shift from illness and disease care to health promotion
4. Balance between high tech treatment and community-based and preventative services
5. Establish a single-payer system for financing healthcare

Question 6

What are some challenges in healthcare

Answer 6

1. Uninsured- more likey to skip or delay treatment for acture/chronic illnesses-die prematurely
2. Cost- reduce costs while maintiang high-quality care for patients
3. Access- improve access for all patients
4. Health- Encourage healthy behaviors
5. Services- Earlier discharges result in more patients needing nursing homes or home care
6. New millennium- Buisness orientation of health care results in a conflict of care and profit.

Question 7

True or false: What we document affects the patients care and insurance reimbursement.

Answer 7

Treu

Question 8

What is the IOM?

Answer 8

National academy of Medicene (institue of medicene)

1. Independent, non-profit, non-governmental organization that provides authoritative advise

Question 8

What is the vision of IOM

Answer 8

1. Access to quality care for all populations
2. Focus on wellness and disease prevention
3. Improve health outcomes
4. Promote compassionate care across the lifespan

Question 9

What is the IOM recommendation for Nurses?

Answer 9

1. Practice to the full extent of their training
2. Achieve high levels of edu.
3. Become full partners with physicians and other health care providers
4. Improve data collection and the information infrastructure

Question 10

What is the nations priorities partnership?

Answer 10

1. A group of 52 organizations, from a variety of health care disciplines

Question 11

True or false: Nurses need to be aware of finances and their patients funding in order to be advocates?

Answer 11

True

Question 12

What should we know about out of pocket patients?

Answer 12

1. Not covered by any type of insurance
2. Paid by the patient

Question 13

What should we know about private insurance?

Answer 13

1. Patient shares the cost of care through out-of-pocket expenses (deductible)
2. Insurance company contracts with health care providers
3. Premiums are paid to an insurance company

Question 14

What is employment-based private insurance?

Answer 14

1.Employer pays all or a portion of the costs (premiums)
2.Increasingly, employee and employer pay portions of the cost
3. Extend to spouse, dependents and children.

Question 15

What are some federal programs (public sources)?

Answer 15

1. Medicare- 65 years-old, disabled people
2. Medicaid- mothers and children, nursing home care
3. State children’s health insurance program (SCHIP)

Question 16

What are some charitable organizations?

Answer 16

1. United way
2. Salvation army
3. Red cross

Question 16

What are the purposes/functions of charitable organizations?

Answer 16

Provide important resources
1. Direct services
2. Cover costs for tradition health services

To groups like
1. children
2. families at or below the poverty level
3. Aged

To the extremely vulnerabe populations
1. Homeless, mentally ill, victims of violence.

Question 17

What are the traditional levels of healthcare: List 6.

Answer 17

1. Preventative
2. Primary
3. Secondary
4. Tertiary
5. Restorative
6. Continuing

Question 18

What is preventative/ primary care?

Answer 18

1. Health promotion and disease prevention
2. Primary care providers (may be the entry or gatekeeper for managed care)
   
   • Health and nutrition education
   • Immunizations
   • Occupational health programs

Question 19

Where would we send patients to get Preventative Care or primary care?

Answer 19

1. Physician offices
2. Nurse-managed clinics
3. schools
4. Community health centers
5. Parish and block nursing

Question 20

What is the focus of secondary care?

Answer 20

1. Early diagnosis
2. Treatment
3. Prevention of worsening of conditions
   -Disease
   -Illness
   -Injury

Question 21

Where would we send a patient needing secondary care?

Answer 21

1. Medical units
2. Surgical units
3. Mother/baby care
4. Ortho
5. Outpatient surgical centers or specialty care centers

Question 22

What is the focus of tertiary care?

Answer 22

1. Specialized patient populations

Question 23

Where might we send a patient needing tertiary care?

Answer 23

1. ICU's 2. Oncology centers 3. Burn centers 4. Psychiatric facilities 5. Rural hospitals (Critical access)

Question 24

What is Quaternary care?

Answer 24

1. The Term Quaternary care is sometimes used as an extension of tertiary care in reference to advanced levels of medicine which are highly specialized and not widely access. 2. Experimental medicine and some types of uncommon diagnostic surgical procedures are considered this. example - transplant centers Level IV NICU

Question 25

When does discharge planning start?

Answer 25

1. Starts at the time at admission and includes A) Health Edu/Med EDU B) Determining discharge destination C) Identifying post discharge needs D) Developing discharge instructions

Question 26

What are the benefits of discharge planning?

Answer 26

1. Fewer complications 2. Few readmissions 3. Improved outcomes

Question 27

What are some discharge barriers?

Answer 27

1. Ineffective communication -profession to profession -Professional to patient 2. Lack of clairty -Responsibility -Follow-up 3. Lack of resources -Rehab beds -Nursing home beds

Question 28

How can we reduce discharge barriers?

Answer 28

Communication

Question 29

What is the focus of restorative care?

Answer 29

1. Serves patients recovering from an acute or chronic illness/disability. Helps individuals regain maximal function and enhance quality of life

Question 30

What are types of restorative care?

Answer 30

1. SNF, REHABILITATION centers, Home health care

Question 31

Nursing centers or facilities are a type of continuing care... what is there focus?

Answer 31

1. Prolonged care of people-- disabled, functionally dependent, terminal disease

Question 32

Assisted living centers are a type of continuing care facility... what is there foucus?

Answer 32

1. long-term care setting-- provides a home-like environment, greater patient autonomy, no fee caps.

Question 33

What is the focus of respite care?

Answer 33

1. Short term relief for caregivers which can be provided at home, daycare, or institutions for overnight care. Trained volunteers enable caregivers to leave the home for errands or social time

Question 34

What is the focus of adult day care?

Answer 34

1. Provides a variety of health and social services to patients who live with family or alone 2. May or may not be associated with a hospital or nursing home

Question 35

What is the focus of hospice (palliative care)

Answer 35

1. Family-centered care that allows patients to live with comfort, independence, and dignity while easing the pains of terminal care 2. Focuses on symptom, not curative care 3. Provides respite care for caregivers

Question 36

What are the different team members in health care?

Answer 36

1. Practitioners, assistive, nursing, supportive, specialty, ancillary

Question 37

What are types of nursing interventions?

Answer 37

1. Direct care 2. Indirect care