Risk Assessment & Issues, Trends, Helath Policy Flashcards
(77 cards)
1
Q
Adolescent (11-19y) ages for PE
A
3 visits: 11-14y, 15-17y, 18-21y
2
Q
Pap smear with GC and Chlamydia screen
A
3 yrs after vag intercourse, no later than 21y
Annually until 30y
3
Q
Syphilis screen for male and female
A
At sexual activity, PRN or with pap smear
4
Q
Mammography
A
Every 1-2y for 40-49y; annually for 50-74y or as long as in good health
5
Q
Total Chol and HDL (or full fasting panel)
A
Starting @ 20y; every 5 yrs unless chol >200 mg/dl
6
Q
Td
A
every 10 years
7
Q
HPV vaccine
A
Gardasil (11-26y) and Cervarix (10-25y)
8
Q
DRE and PSA
A
DRE @ 40y and PSA @ 40y if AA or Fam Hx of Prostate CA. All males 50y must have DRE/PSA
9
Q
ECG
A
At 40y for baseline or with Carddiac RF
10
Q
Tonometry
A
Glaucoma screening Annually after 40y
11
Q
Normal IOP
A
10-20 mm Hg
12
Q
Open angle glaucoma
A
20-30mm Hg
13
Q
Closed angle
A
> 30 mm Hg with pain
14
Q
Elderly PE
A
every 2 yr
15
Q
Elderly pap
A
may discontinue at age 65-70 after 3 recent normal consecutive results
16
Q
Elder ECG
A
every 2 yrs with cardiac RF
17
Q
Colorectal CA screen
A
start at age 50
18
Q
Fleible sigmoidoscopy
A
q 5 yrs
19
Q
Colonoscopy
A
q 10 yrs
20
Q
Td substitute 1 dose for Tdap
A
not indicated > or equal to 65 y
21
Q
Pneumococcal vaccine
A
Once at 65y
22
Q
Pneumococcal vaccine: what bacteria?
A
Streptococcus pneumoniae
23
Q
Strep pneumonniae
A
CAP (I/P & O/P), meningitis, sinusitis, OM
24
Q
Incidence
A
frequency
25
prevalence
proportion
26
Primary prevention
immunization, safety, weight loss, exercise
27
secondary prevention
screening
28
tertiary prevention
rehab
29
Passive immunity
gamma globulin injection and mother to fetus
30
Pneumococcal vaccine repeated after5 yrs after initial vacc for which populations?
Chronic RF, immunosuppression, long term steroid users, and if pt was vaccinated > or equal to 5 yrs previously and was < 65 yr of age at time of initial vacc
31
Hep A considered for:
military personnel, travelers to endemic areas, and men who have sex with men
32
Hep B given to:
All healthcare workers and high risk sexually active adults
33
Advanced directive
regarding medical tx
34
Healthcare directive
type of adv directive that may or may not include a living will or specifications regarding POA
35
Living will
specifies life prolonging measures. Often include granting of POA who articulates pt's adv directive
36
HIPAA title I
COBRA
37
HIPAA title II
privacy and confidentiality
38
PSQIA: Patient Safety and Quality Improvement Act
Pat safety work product in protection when reporting medical errors
39
HP 2020 Goals
1. Increase the quality and years of healthy life
| 2. Eliminate health disparities among Americans
40
Medicare part A
I/P: hospital, rehab, phys therapy
41
Medicare Part B
supplement $: physician visits, medical equipment, labs
| NP's receive 85% of physician reimbursement
42
Medicare Part C / Medicare Advantage
A+B=C
| Choose HMO, PPO
43
Medicare part D
limited drug coverage
44
NP services billed Med B
1. diagnosis
2. therapy
3. surgery consultation
4. care plan oversight
45
Services that do NOT meet medicare's definition of 'physician services'
1. Regular PE
2. Health maintenance screening
3. Counseling for well patients
46
QA/QI/CPI
mgmt. process of monitoring, evaluating, continuous review and improving the quality in providing healthcare. Based on CQI: improvement based on continued monitoring structure, process, and outcome.
47
Structures
inputs into care: resources, equipment, or numbers & qualifications of staff
48
processes of care
Assessments, planning, performing treatments and managing complications
49
outcomes
complications, adv reactions, short term results of treatment and long term results of pt health and functioning
50
Critical path
contains key pt care activities and their time frames which are needed for a specific DRG
51
Care map
newer version of critical path and is a blue print for planning and managing care delivered by all disciplines plus a section for common problems for pts of a sp case type. Monitoring of OUTCOMES is a very imp goal
52
Root cause analysis
part of dev. CULTURE OF SAFETY. Asks 'why?' at each level of cause and effect. Process that is as impartial as possible
53
Sentinel Events
unexpected events: death, serious physical or psychological injury or risk there of. Not all medical errors result in sentinel events and vice versa
54
Scope of practice
delineated by state Nurse Practice Act. Key elements: collaboration and coordination of care, research based clinical practice, clinical leadership, family assessment, and discharge planning
55
Standards of Advanced practice
delinieated by ANA to measure QUALITY of practice, service or education
56
Credentials
establish MINIMAL levels of acceptable performance
57
Licensure
rules/regs set by governamental body (state board of nursing)
58
Certification
est meeting certain STANDARDS in a particular profession which signify MASTERY of sp knowledge/skills
59
Credentialing and Privileging
granted by Hospital Credentialing Committee (comprised of phys) Privileges granted in part or full
60
Medical futility
interventions that are unlikely to provide benefit to pt
61
Quantitative futility
likelihood that intervention will benefit pt is extremely poor
62
Qualititative futility
the quality of intervention will benefit pt is extremely poor
63
Decisional capability
ability to understand
reason
differentiate good and bad
communicate
64
Informed consent
discussing all of the benefits and risks. Consent is assumed if pt's condition is life threatening
65
right to refuse care
any, some or all of care can be refused as ong as pt has decisional capability
66
nonmalficence
duty to do no harm
67
utiliarianism
the right act produces the greates good for the majority
68
beneficence
duty to prevent harm and promote good
69
fidelity
faithfulness
70
autonomy
respect ind thoughts and actions
71
Role development of NP est?
1960s d/t phys shortage in pediatrics
72
First NP program, where?
Univeristy of Colorado Health Sciences Center
73
4 roles of NP
Expert:
1. Clinician
2. Consultant/Collaborator
3. Educator
4. Researcher
74
Nonexperimental research:
2 broad categories:
1. Descriptive - describes situation, experiences, and phenomena as they exist
2. Ex post facto (in the past) or correlational - examines relationships among variables
75
Cross sectional
find relationships between variables at a SPECIFIC POINT IN TIME; "surveys'
76
Cohort
compares a part outcome in groups of indiviuals who are alike in many ways but differ by a certain characteristic
77
longitudinal
taking multiple measures over an extended period of time to find relationships between variables
