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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
NPs are reimbursed how by medicare
receive 85% of physician reimbursement
26
medicare C
A+B = C pts with a and b are eligible to receive health acer through one of the provider organizations
27
this portion of medicare covers drugs
medicare D - monty premium required
28
to qualify to be a medicare provider NP must have what
hold state license be certified by recognized national certifying body hold at least MSN degree
29
these benefits vary from state to state
medicaid
30
a management process of monitoring, evaluating, continuous review, and improving the quality in providing health care
quality assurance (QA)/QI/continuous process improvement (CPI)
31
quality assurance
process for evaluating the care of patients using established standard of care to ensure quality
32
FIFE
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
33
QSEN initiative
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
34
six key competencies of QSEN
patient centered care teamwork and collaboration EBP QI safety informatics
35
pt is having diarrhea as side effect of tube feedings - how do you manage
decrease osmolality of tube feeding
36
strongest method to evaluate teaching is what
returned demonstration
37
what qualifies a pt for hospice
terminal dx with < 6 months to live and only receive comfort measures
38
pt needs helps with ADLS what needs to be consulted
SNF
39
case management
mobilize, monitor, and control resources that a pt uses during a course of an illness while balancing quality and cost
40
which two forms of medicare require pt to pay something
B and D
41
CQI
continuous process improvement quality can be improved by continually monitoring structure, process and outcome standards
42
components of monitoring for CQI
care quality care appropriateness effectiveness of care cost of care self - regulation peer review
43
6 key copentenczies of QSEN
patient centered care teamwork and collaboration EBP QI safety informatics
44
a tool for identifying prevention strategies to ensure safety
root cause analysis
45
scope of practice
based on state delineated by individual state nurse practice act of each state BON varies state to state
46
state practice acts
authorize BON in each state to establish statutory authority for licensure of RN
47
credentials
encompass required education, licensure and certification tp practice as a nurse practitioner minimal level of performance
48
what mandates accountability
credentials
49
credentialing is necessary to
ensure that safe health care is provided by qualified individuals cosplay with federal and state laws relating to APN
50
established that a person is qualified to perform in professional role
licensure granted by governmental regulatory body ie state BON
51
establishes that a person has met standards that signify mastery of knowledge/skills
certification
52
the most common method of documentation
incident reports part of risk management
53
satisfaction surveys
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
two kinds of medical futility
quantitative qualitative
55
quantitative futility
where the likelihood that intervention will benefit the patient is extremely poor - the number
56
qualitative futility
where the quality of benefit an intervention will proceed is extremely poor
57
medical futility
refers to interventions that are unlikely to produce any significant benefit to patient
58
components of competence
ability to understand, reason, differentiate good and bad and communicate
59
nonmaleficence
duty to do no harm
60
utilitarianism
right act is the one that produces the greatest good for the greatest number - triage/mass casualty
61
beneficence
duty to prevent harm and promote good
62
justice
duty to be fair
63
fidelity
duty to be faithful
64
veracity
duty to be truthful
65
autonomy
duty to respect an individuals thoughts and actions
66
4 distinct roles of NP
clinician consultant/collaborator educator researcher
67
types of nonexperiemental research
descriptive ex post facto or correlational research cross sectional cohort longitudinal
68
descriptive research
non experimental aims to describe situations, experiences, and phenomena as they exist
69
ex post facto
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
cross sectional
non experimental observational study that examines a population with a very similar attribute but differs in one specific variable (such as age)
71
cohort
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
longitudinal
non experimental taking multiple measures of a group/population over an extended period of time to find relationships between variables
73
experimental study
manipulation of variables utilizing randomization and a control group to test the effects of an intervention or experiment
74
quasi-experimental
involves manipulation of variable but lacks a comparison group or randomization
75
qualitative
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
what is a potential problem of quantitative research
researcher bias
77
PICOT
framework to answer a clinical-based question P = patient I = intervention C= comparison o=outcome t= timing
78
type 1 error
"false postive" incorrectly rejecting true null hypothesis
79
type 2 error
"false negative" failing to reject null hypothesis which if false
80
difference between meta-analysis vs. meta synthesis
meta-analysis - quantitive study vs. meta synthesis qualitative
81
confidence interval
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
standard deviation
average amount of deviation from the mean 68% of sample falls within one SD of mean
83
level of significance
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
p< .05
experimental and control groups are considered to be significantly different 95% chance what you are seeing is not due to chance
85
t-test
statistical test to evaluate the difference in means
86
reliability
consistency of test to measure the same way over time
87
validity
degree to which a variable measures what it is intended to measures -valid to ask
88
liability
legal responsibility for actions that fail to meet the standard of care resulting gin actual or potential harm
89
negligence
failure of person to do what a reasonable person would do - resulting in injury
90
malpractice
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
assult
threat of harm ex: shaking first in the air
92
battery
actual harm to a patient can be done on unconscious person, but assault cannot
93
defamation
communication that can someone to suffer a damaged reputation - libel or slander
94
libel
type of defamation that is written
95
slander
type of defamation that is spoken
96
sensitivity
true postive a test identifies those that are positive have the disease
97
specificty
true negative test identifies those that do not have disease test negative
98
incidence
frequency in which disease appears
99
prevalence
proportion of population that is affected by disease ( %)
100
primary prevention
prevents development of disease es: immunizations/vacinations
101
primordial prevention
in childhood healthy diet, regular exercise
102
secondary prevention
screening early identification - Pap smear screen, prostate cancer screen, cholesterol screen
103
tertiary prevention
rehab and restore health cardiac rehab, PT after stroke
104
CLAS
culturally and linguistically appropriate services eliminate racial/ethinic health disparities and improve health
105
standard 5 CLAS
must offer and provide language assistance services
106
standard 5 CLAS
must offer and provide language assistance services
107
standard 6 CLAS
must provide verbal offers and written notices (in their preferred language) informing them of their rights for language services
108
standard 7 CLAS
must assure competence of language assistance - family/friends should not be the interpreter (except upon request by pt)

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