Practice Issues, Trends, and Health Policy Flashcards Preview

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Flashcards in Practice Issues, Trends, and Health Policy Deck (55):
1

Living Will

Written compilation of statements in document format that specifies which life-prolonging measures one does and does not want to be taken if he/she becomes incapacitated

2

Which office did HIPAA come out of?

Office of Civil Rights
This means it's a right.

3

PSQIA

Patient Safety and Quality Improvement Act:
1. Establishes a voluntary reporting system to enhance the data available to assess and resolve patient safety and health care quality issues

2. Includes privilege and confidentiality protections for patients

3. AHRQ lists patient safety organizations, which are external experts established by the Patient Safety Act to collect and analyze patient safety information

4

Duty to Warn v. Confidentiality

1. Duty to warn supersedes the right to confidentiality if a patient's condition may endanger others. Must warn the "others" who are in danger, and not just authorities, etc.

2. Duty to protect a patient from harming him/herself supersedes the right to confidentiality

5

Reason Healthy People 2020 was established

1. Increase quality and years of healthy life
2. Eliminate health disparities among Americans
(Exam LOVES Healthy People 2020)

6

Mandatory Reporting

1. Criminal acts and injury from a dangerous weapon
2. Certain STDs
3. Animal Bites
4. Suspected or actual child or elder abuse

7

5 STDs that need to be reported

1. Gonorrhea
2. Chlamydia
3. Syphilis
4. HIV
5. TB

8

Collaborative Practice

1. Exists to enhance the quality of care and improve pt outcomes
2. A "true partnership" in which all players have and desire power, share common goals, and recognize/accept separate ares of responsibility and activity

9

5 categories of 3rd party Payers

1. Medicare
2. Medicaid
3. Commercial indemnity insurers
4. Commercial management organizations (Insurance)
5. Businesses or schools wanting health services for employees or students

10

Medicare A

Inpatient hospitalization, home health services and/or hospice associated with the inpatient event

11

Medicare B

Outpatient services
Lab/diagnostics
Medical equipment
Some home health

12

Medicare C

If a patient is entitled to parts A and B, they may choose to receive their services through a Part C provider organization (Insurance company)

13

Medicare D

Limited prescription drug coverage

14

Services that do not meet Medicare's def. of phys services

1. Regular physical exams (annual exams)
2. Health maintenance screenings
3. Counseling for well patients
(All of these are changing under ACA, but that won't be on our exam yet)

15

Deming's 3 components of continued quality improvement (CQI)

Structures
Processes
Outcomes

16

Structures

Inputs into care such as resources, equipment, or numbers and qualifications of staff

17

Processes

Includes assessments, planning, performing treatments, and managing complications

18

Outcomes

Includes complications, adverse events, short term results of treatment and long term results of patient health and functioning

19

Root Cause Analysis

A tool for identifying prevention strategies to ensure safety

20

RCA involves and incorporates

Inter-disciplinary experts from the frontline services
Those who are the most familiar with the situation
Identifying changes that need to be made to systems
Impartiality

21

To be thorough, RCA must include:

1. Determination of human and other factors
2. Determination of related processes and systems
3. Analysis of underlying cause
4. Identification of risks and their potential contributions
5. Determination of areas of potential improvement

22

To be credible, a RCA must include:

1. Participation by the leadership of the organization and those most closely involved
2. Be internally consistent
3. Include consideration of relevant literature
4. Use the facts and ask, "So what?" to determine all possible consequences of a fact
5. Include 5 Whys

23

LACE

Licensure
Accreditation
Certification
Education

24

Scope of Practice

1. Based on legal allowances in each state, according to and delineated by individual State Nurse Practice Acts
2. Provides guidelines for nursing practice

25

Standards of Advanced Practice

Delineated by the ANA as authoritative statements by which to measure quality of practice, service, or education

26

Prescriptive Authority

The ability and extent of the NP's ability to prescribe medications to patients is dependent on state nurse practice acts

27

Determination of patient abandonment

1. Did the NP accept the patient assignment?
2. Did the NP provide reasonable notice before terminating the NP-patient relationship?
3. Were reasonable arrangements made to continue patient care when the adequate notification was given?

28

Medical Futility

Does the intervention have any reasonable prospect of helping this patient?

29

Quantitative Futility

Where the likelihood that an intervention will benefit the patient at all is extremely poor.

30

Qualitative Futility

Where the quality of the benefit an intervention will produce is extremely poor.

31

Danforth Amendment, 1991

Patient has the right to refuse care

32

Nonmaleficence

The duty to do no harm

33

Utilitarianism

The right act is the one that produces the greatest good for the greatest number

34

Beneficence

The duty to prevent harm and promote good

35

Justice

The duty to be fair

36

Fidelity

The duty to be faithful

37

Veracity

The duty to be truthful

38

Autonomy

The duty to respect an individual's thoughts and actions

39

Advanced Directives

Written statement of a patient's intent regarding medical treatment

40

2 Doctors that pioneered the NP programs

Loretta Ford
Henry Silver

41

First NP program: Type and year

Pediatric
1964

42

Cross-sectional Study

Study that examines a population with a very similar attribute but differs in one specific variable is designed to find relationships between variables at a specific point in time or "surveys."

43

Longitudinal Study

Involves taking multiple measures of a group/population over an extended period of time to find relationships between variables

44

Experimental Research

Includes experimental manipulation of variables utilizing randomization and a control group to test the effects of an intervention or experiment

45

Quasi-experimental Research

Involves manipulation of variables, but lacks a comparison group or randomization

46

Confidence Interval

An interval, with limits at either end, with a specified probability of including the parameter being estimated

47

Standard Deviation

Indicates the average amount of deviation of values form the mean

48

Percentage of the sample that falls within one SD from the mean

66%

49

Percentage of the sample that falls within 2 SD of the mean

95%

50

Level of significance

The probability level of which the results of statistical analyses are judged to indicate a statistically significant differences between groups

51

T-test

Statistical test to evaluate the differences in means between two groups

52

Reliability

The consistency of a measurement, or the degree to which an instrument measures the same way over time with the same subjects

53

Validity

The degree to which a variable measures whether negligence has occurred

54

Negligence

Failure of an individual to do what a reasonable person would do, resulting in injury to the patient

55

Malpractice

Failure of a professional to render services with the degree of care, diligence, and precaution that another member of the same profession under similar circumstances would render to prevent injury to someone else.