NP in LTC Flashcards

Question

in what ways do we see an increased quality of care of residents from use of NPs in LTC?

Answer 1

- satisfaction of resident, families, physicians, NH staff - medication attention, i.e. frequency of visits, frequency/timing of medical orders - disease-specific quality indicators, i.e. CHF, HTN, incontinence - preventive health quality indicators, i.e. decubitus ulcers, diabetic foot care - end-of-life care, i.e. DNRs, feeding tubes, DNH

Answer 2

- identifying residents at high risk for readmission - modifying visit pattern to better manage high risk residents - improving communication between nurses and providers - improving communication between NH and acute care setting - providing support to residents and families to impact clinical decision-making - discussing advanced directives, code status, and hospice

Answer 3

- lower rates of depression, urinary incontinence, pressure ulcers, restraint use, and aggressive behaviors - residents had improvements in meeting personal goals - families had satisfaction with medical services - provide RESIDENT AND FAMILY-CENTERED CARE - enhanced quality of care - better relationships with residents and families with better information and emotional support - perception of improved availability and timeliness of care - perception of preventing unnecessary hospitalization

Answer 4

- NPs provide comparable care that is both substitutive and complementary to that provided by MDs in LTC - health screening rates were similar, although NPs had higher completion rates of advanced directives related to DNR orders

Answer 5

- in absence of physician oversight or supervision, NPs are safe providers and prescribers - often prove to be more cautious - spend more time with patient and less likely to prescribe medication as only therapy or intervention

Answer 6

- capitated $ paid for each NH enrollee - underlying premise: enhanced primary care = reduced hospitalization - intense management at NH by NP as well as use of intensive service days (ISD) which reimburses a facility for care for acutely ill residents vs. hospital

Answer 7

- reduction in acute care transfers | - mixed results on other clinical outcomes (functional status, falls, depression, preventive health, etc.)

Answer 8

- performed by MD - indicate reason for admission - complete medical and surgical hx - meds - physical exam - screening tools - functional assessment - risks assessments - advance directives - code status - complete assessment and plan - capacity for decision making - rehab potential

Answer 9

- within 30 days of admission - should incorporate additional data obtained (hospital records, lab data, consults, and other tests) - review and revise medical plan of care

Answer 10

- every 30 days for 1st 90 days and at least once every 60 days thereafter - most providers visit every 30 days - visits usually will alternate between NP and physician - considered timely if within 10 days of due date

Answer 11

- for illness or changes reported by nursing staff - focused HPI - exam - tx plan

Answer 12

- detailed assessment of of resident's current problems, - PE - chart review - staff interview - observation of care - documentation of visit - consent for care - communication of tx plan

Answer 13

- access to health care including selection of medical provider - privacy: visit should not occur in hallway or other public area, HIPAA - consent: residents have the right to know the results of the visit as well as implications for care; they have the right to refuse care - communication: findings, tx plan, referrals

Answer 14

- obtaining hx from a cognitively impaired resident - resident and staff routines that impact the timing of visits - possible facility barriers that impact tx plan

Answer 15

- provide timely, quality visits - reduce meds - reduce restraints - reduce need for hospitalization - address pain and recommend strategies - recommend strategies to improve function - be part of the team! - involve resident/family in decision-making - get involved in QI initiatives

NP in LTC Flashcards

(40 cards)