x Nursing 108 Flashcards

Question

RUG (Resource Utilization Group)

Answer 1

categories used to determine prospective papyment for nursing home clients each RUG represents group of residents who reauire similar daily care and similar cost (i.e. nursing home)

Answer 2

system for financing and orgaznizing delivery of health care inwhich costs are contained by controlling provision of services (HMOs)

Answer 3

-1st to offer managed care | -

Answer 4

- 1st to offer managed care - 1st to provide payment for care aimed at prevention - basic/supplemental health services - keep subscribers health to reduce costs - co pays, in network etc

Answer 5

- higher premiums, more choices - group of providers forms a company with health care agency to an insurance company or employer at discounted rates - physician can belong to more than one PPO

Answer 6

healthcare plan allow payment of flat fee for each patient covered. HMO or Managed Care will pay fixed amount of money for its members to health care provider. -Provider bear some or all risk.

Answer 7

Medicare, Affordable Care Act - more than 40 P4P programs exist. largest and longest California Pay for P program. - provide financial incentives to clinicians or better health outcomes.

Answer 8

Amendment to SSA Title XIX, establishing national and state health insurance program for elderly - requires enrollment to have hospital state of at least 3 consecutive days. - Insurance for hospital care, extended care, home health care. - updates in 1993

Answer 9

- healthcare for people on welfare and low income. | - any age covered by supplemental security benefits

Answer 10

1. Expand access to Insurance Coverage: by 2015, 16.9 mill more americans were covered by health insurance 2. Improve Quality and System Performance 3. Promote Health Workforce Development 4. Curb Rising Health Care Costs 5. Increase Consumer Insurance Protections 6. Emphasize Prevention and Wellness

Answer 11

``` .Public Health .Home Health Care .School-based Services .Community Health Centers .Physicians' Office/General Clinic .Occupational Health Clinics .Hopitals .Long Term Care Fac .Retirement/Assisted Living ```

Answer 12

functional nursing. an organizational mode for assigning nursing personnel that is task- and activity-oriented, using auxiliary health workers trained in a variety of skills. Each person is assigned specific functions performed for all patients in a given unit, and all report to the head nurse.

Answer 13

Team nursing is a model in which a group of healthcare professionals, including nurses, care for a group of patients in the acute care or inpatient setting. Acute care, also known as critical care, is when nurses help patients confronting life-threatening issues.

Answer 14

-everyone develops skills -nursing leadership inspires others -

Answer 15

1. Laissez-faire 2. Democratic 3. Authoritarian

Answer 16

permissive, nondirective, passive .allow group to determine own goals .little planning and decision making .can lead to frustration re no direction

Answer 17

supportive, participative, transformational .goals shared by group .moderate freedom, moderate control and hi leader activity .style works best when members have equal status .this style require Trust, Collaboration, confidence and autonomy

Answer 18

controlling, directive, autocratic . final decision with leader. . works best in emergency situations

Answer 19

a leadership style that has been developed and studied by Kenneth Blanchard and Paul Hersey. Situational leadership refers to when the leader or manager of an organization must adjust his style to fit the development level of the followers he is trying to influence.

Answer 20

S1. Directing (hi directive, lo supportive) S2. Coaching (hi direc, hi support) S3. Supporting (Hi support, lo direct) S4. Delegating (lo support, lo directive)

Answer 21

1. Hi Relationship - Lo Risk: consider group feelings, may sacrifice task for group 2. Hi Task - Lo Relationship: authoritarian, little regard for group, leaders use various forms of punishment 3. Lo Task - Lo Relationship: worst type leader, laissez-faire 4. Hi task - Hi relationship: best type leader, collaborate, get things done

Answer 22

SITUATIONAL: no one approach works in all situations, leaders adjust style to situation TRANSFORMATIONAL: leaders need t inspire excitement and commitment in group

Answer 23

Theory X leaders maintain control, direct employees because they believe motivation is result of reward/ punish. leader perception is employees dislike work, must threat or coerce X yuck

Answer 24

Theory Y leaders remove obstacles because believe that employees have self control and discipline to perform and receive reward from involvement in their work. leader perception is most people want to do well Y uplift

Answer 25

``` .Establish trust .Acknowledge good work .Show respect .Promote sense of direction .promote higher level of performance .resolve conflict . foster cooperation .reinforce goals . develop staff strengths .motivate personnel ```

Answer 26

.must gain clinical skill before moving to mgmt .if promoted from within, social aspects to negotiate .critical for new mgr to clearly establish professional boundaries and prioritize career in prof envt. .those who require acceptance by friends have diff in transition from RN to Nurse Mgmt.

Answer 27

The Quality and Safety Education for Nurses (QSEN) project addresses the challenge of preparing future nurses with the knowledge, skills, and attitudes (KSAs) necessary to continuously improve the quality and safety of the healthcare systems within which they work. ``` 6 Competencies .Patient Centered Care .Teamwork and Collaboration. .Evidence-Based Practice. .Quality Improvement. .Safety. .Informatics. ```

Answer 28

Head RN assigns tasks to staff members for all pts on unit. .intro in 1930s .allowed for care of more pts .Pros: all members utilized .Cons: pts don't have single nurse. nurses don't own 1 pt, multiple for one task.

Answer 29

team provides care for a group of pts. .intro 1950s after WWII .RN heads team of licensed and unlicensed, each using their skills, coordinated by team leader .Cons: leader must have good leadership skills, communication, delegation and conflict resolution mgmt

Answer 30

one RN rsponsible for all care for group of pats 24/7 and directs care coor by other health care providers. .popular in 80s .great continuity of care .Pros: hi job satisfaction, lo complication rate, better pt outcome .Cons: $$$$$

Answer 31

.Sr partner and Jr partner, work together with group of pts. RN/LPN, RN/CNA, Experience RN/novice RN Pro: lo $ Con: success rely on commitment of members .Care Pairs: RN/CNA

Answer 32

.used in early 20th cent when nurses did home care . Total Pt Care, one RN responsible for a pt for a period of time. .intro attending RN (ARN). 5x8hr shift per wk. to build relationship w pts and caregivers .Pro: pt care continuity, autonomy of RN .Con: $$$$$$

Answer 33

Civility .based on recognition that all human beings are important .basics of nursing .be civil to all promotes emotional health and create pos atmosphere for healing . helps develop empathy for others and key to underpinning of emotional intelligence

Answer 34

awareness of both thoughts and feelings of others using behavioral cues. EI skills correlate with professionalism and expert practice

Answer 35

1. correctly ID emotions in self and others 2. use emotions to reason (think/feel) 3. understand emotions 4. managing emotions

Answer 36

.Self awareness .self mgmt .social awareness .relationship mgmt

Answer 37

aka Horizontal Violence. btwn nurses, usually new grads. "Nurse's eat their young"

Answer 38

.Determine if both parties aware of conflict | .Assess

Answer 39

1. Accommodation 2. Avoidance 3. Competition 4. Compromise 5. Collaboration

Answer 40

YES RNs remain accountable for delegated task LPNS can NOT delegate.

Answer 41

.Assess the client .Know staff availability . Know the job description . Educate staff member. UAP should be educated and observed doing task delegated

Answer 42

``` . right task .right circumstances . right person . right direction /communication .right supervision and eval ```

Answer 43

10 questions. 1. laws in place supporting rules of delegation? 2. task w/in scope of ln, rn or new grad? 3. assess of client needs? 4. UAP, LPN, new grad competent? 5. ability of caregiver match needs of client? 6. task done w/out nursing judgement? 7. result predictable? 8. easy directions? 9. task done w/out repeat assessment? 10. supervision available?

Answer 44

comm among health profs and impact patient care.

Answer 45

an evidenced-based system aiming to improve teamwork and communication skills w goal of optimizing pt outcomes and improving pt quality and care by implementing evidence based practice. focus on planning, staff pd, putting EPB into practice sustain and spread improvements re teamwork

Answer 46

. Clear Communications . Positive approach . Active listening

Answer 47

https://www.youtube.com/watch?v=Z3pR-pzutZE addresses the challenge of preparing future nurses with the knowledge, skills, and attitudes (KSAs) necessary to continuously improve the quality and safety of the healthcare systems within which they work. ``` Quality and Safety competencies? .Patient Centered Care. .Teamwork and Collaboration. .Evidence-Based Practice. .Quality Improvement. .Safety. .Informatics. ```

Answer 48

.function properly within nursing and inter-professional teams fostering open comm, mtual respect, shared decision making for quality patient care. .value contributions of othrs .fx within own scope of practice .act w integrity, consistency, respect for diff views .value diff styles of comm

Answer 49

-systemic process for improving pt care thru discover of new info

Answer 50

. discovering most efficient /cost effective approach to nursing . clarify/expand body of knowledge unique to nursing . can be use to shape health policy in direct client care w/in org and at local, state, federal lev . understand/address cultural issues in nursing care

Answer 51

. provide practicing nurses w best evidence based data . resolve probs in clinical setting . achieve excellence in care delivery . promote effective nursing interventions .assist w efficient and effective decision making .reduce variations in nursing care

Answer 52

``` .Ask .Acquire .Appraise .Apply .Assess ```

Answer 53

.best available evidence?

Answer 54

.Phenomenology (interviews to know person) .Ethnography . case studies (investigation of culture) . life histories (learn about pt life to understand their illness better)

Answer 55

primarily exploratory research. It is used to gain an understanding of underlying reasons, opinions, and motivations. It provides insights into the problem or helps to develop ideas or hypotheses for potential quantitative research

Answer 56

study in which items can be counted, measured and statistics can be used to analyze.

Answer 57

. Randomized Controlled Trial aka double blind randomized controlled trial (giver nor receiver know if they have med or placebo) . Longitudinal Study (study sample people across time) . Descriptive studies (naturally data, i.e. deaths, births etc . Methodological Research, collective term for structured process of conducting research

Answer 58

a systematic view of phenomena by designing specific relationship among concepts or purposes of describing, explaining, predicting, and /or prescribing.

Answer 59

``` .understand, organize, analyze pt data .make decisions .plan pt care .predict outcomes of care .eval pt outcomes ```

Answer 60

a MODEL or pattern of shared assumptions about reality

Answer 61

. Client - receiver of nursing care . Nursing - inter btwn nurse, pt and envt . Health - degree of well being .Envt - surroundings other than people and inanimate thing that can affect client.

Answer 62

. Descriptive, describe phenomenon, event, situation or relationship . Prescriptive, addresses nursing interventions . Development, outlines process of growth/develop of humans from beginning to end of life . Systems, learns how the parts of the whole work.

Answer 63

Interpersonal relations model. .Goal to develop interpersonal interaction between nurse and client. .Focus on person/client, envt, health

Answer 64

Definition of Nursing .Goal to help client gain independence as rapidly as possible .Patient is whole, complete independent being w 14 fundamental needs (breath, eat, drink, eliminate, move and maintain posture, sleep/rest, dress/undress, maintain body temp, keep clean, avoid danger, communicate, worship, work, play, learn . Health is being able to perform these tasks unaided.

Answer 65

Cultural Care Diversity and University Theory Goal to provide nursing care based on understanding and respecting clients culture. .Care is essence of dominant, distinctive and unifying feature of nursing.

Answer 66

Self-Care Theory Goal to care or and help client attain self-care 5 methods of helping 1. acting or doing good 2. guiding 3. teaching 4. supporting 5. provide envt promoting ind abilities to meet current and future demands

Answer 67

Science of Unitary Human Beings .Goal to help client achieve max level of wellness .nursing is use of intellect and knowledge to interact w pts and promote health patterns of living in harmony

Answer 68

Adaptation Model . Goal to identify types of demands placed on client and client's adaptation to them .main task to maintain integrity in face of envt stimulus ``` 4 Adaptive Models .Physiologic .self concept .role function .interdependence ```

Answer 69

Philosophy and Science of Nursing goal to promote health, restore clients to health and prevent illness . Caring central to nursing threatened by tasks and tech. . Caring is universal phenomenon only effective when practiced interpersonally

Answer 70

Theory of Goal Attainment Goal to use interaction w client to help client attain goal of recovery and health.

Answer 71

Health Care Systems Model Goal to prevent client stress, reduce existing stress, prevent new problems

Answer 72

Environmental Theory .goal to manipulate envt to allow bodies reparative process . focus on nursing and pt/envt relationship. . 5 envt factors (pure water, fresh air, sunlight, cleanliness, efficient drainage)

Answer 73

Behavioral System Model .goal to foster correct behavioral function in client to prevent illness as well as during and following illness. 7 subsystems: Attachment, affiliative, dependency, achievement, aggressive, eliminative, sexual.

Answer 74

Conservation Model Goal to promote adaptaion and maintain wholeness using principles of conservation . nurse accomplishes goal of model thru conservation of energy, structure and personal and social intergrity

Answer 75

Health Promotion Model .goal to promote optimum health thru lifestyle changes

Answer 76

Nursing Process ASSESSMENT (can not delegate primary, only secondary assessments) D PLANNING I Eval/Educate (LPNs can only reinforce, not teach) Collaboration (needs wound consult, dietary services etc)

Answer 77

the prevention of harm to patients. emphasis on a system of care delivery that .prevents errors .learns from errors that do occur .is built on culture of safety that involves health care professionals, organizations and patients.

Answer 78

Quality Improvement activities aimed at improving performance and is an approach to continuous study and improvement of processes of providing services to meet needs of indiv and others.

Answer 79

Quality Assurance refers to broad spectrum of evaluation activities aimed at ensuring compliance w minimum quality standards. Primary aim to demonstrate that a service or product fulfills or mets a set of requirements. QA -Focusing on "outcomes" CQI (continous quality improvement) -focus on "processes" and "outcomes"

Answer 80

ongoing effort to improve organizations approach to managing performance, motivating improvement and capturing lessons learned. GOAL: exceed expectations of client Process of doing, eval, improving, doing again, recycling 4 Basic Elements: 1. Teamwork 2. Include pt perspective 3. measure processes 4. insure adequate resources for implementation

Answer 81

seeks to fix the system to decrease chance of error.

Answer 82

optimal size 5-8 ppl. .should be diverse .include input from "end user", patient. .i.e. nurse, MD, therapist, med records, pharmacy, utilization review, community and pt rep.

Answer 83

PLAN: set goals, predict, plan data collection DO: test plan, document, reassess, revise STUDY: complete data analysis, review lessons, decide action ACT: implement, evaluate, decide next cycle

Answer 84

informal feedback. systematic review process, look at nurse's practice, used for rewards and punishment, only look at evidence affecting nurses's practice

Answer 85

outcome criteria or outcomes mgmt. includes clinical pathways, cost attainment, pt access to services, degree of clinical outcomes, variance from stated goals

Answer 86

records reviewed, measured according to criteria. collect pt outcomes to evaluate care.

Answer 87

determine whether patient’s care was appropriate and whether resources were appropriate.

Answer 88

formerly JCAHO, survey most hospitals and health care orgs for quality of care. satisfactory survey qualified institution to receive funding from medicaid/medicare

Answer 89

independent evaluating body. qualifies for Medicare funding

Answer 90

document only what was done, no subjective statement, conclusions or summaries.

Answer 91

An unexpected occurrence involving death or serious physical or psychological injury, or the risk of serious physical or psychological injury

Answer 92

```  Patient suicide  Operative/postoperative complication  Wrong-site surgery  Medication error  Delay in treatment  Patient fall  Patient death or injury in restraints  Assault, rape, or homicide  Transfusion error  Perinatal death/loss of function ```

Answer 93

Inadequate communication among healthcare | providers

Answer 94

Focuses on finding flaws and opportunities for improvement in the health care environment. RCAs are NOT used to evaluate the performance of individual health care providers

Answer 95

improving the quality of care provided to hospital patients and bringing value to stakeholders by focusing on the actual results

Answer 96

29 specific negative occurrences in healthcare that have serious adverse patient outcomes and are reportable events - blood incompatibility, stage 3 and 4 pressure ulcers, falls and trauma injuries, air embolism, foreign object retained after surgery, and surgery involving wrong site, wrong patient, or wrong procedure  Ventilator-associated pneumonia (VAP)  Iatrogenic pneumothorax (caused by a therapeutic intervention such as mechanical ventilation or tracheostomy)  Deep vein thrombosis/pulmonary embolism (when not related to orthopedic procedures)  Delirium in critically ill patients

Answer 97

Quality and Safety Education for Nursing Competency – Safety ◦ Minimizes risk of harm to patients and providers through both system effectiveness and individual performance

x Nursing 108 Flashcards

Transition to the Professional Nurse Role (121 cards)