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Community ch 11

Community ch11 review

QuestionAnswer
T or F? Even though 47 million Americans have no health insurance, the United States spends more on healthcare than other industrialized nations where ALL citizens are insured. True (p193)
Why are costs so much in the United States? 1. 2. 3. 1. Excessive administrative costs 2. inflated prices 3. Inappropriate care
True or False? The United States focus on health care is is to prevent illness and promote health. False - Preventing illness and promoting health have often been given a lower priority financially in the United States.
True or False? Recent data suggests there is a decrease in the prevalence of chronic disability, earlier diagnosis and treatment of disease, and improved treatment of health problems in the U.S. True
____________ management is the development and coordination of care for a selected client and family. Case management
__________ management is the coordination of a plan or process to bring health services together as a common whole in a cost effective way. Care management
What is the chief role of a case manager? Advocates for resources needed by their clients.
What category of care is provided in places and spaces where people live most of their lives? Home Health Care
Who are likely candidates for Home healthcare? People facing an acute or chronic illness.
What wealthy Quaker philanthropist worked with Florence Nightingale to send trained nurses into the homes of the sick in Liverpool, England (1859)? William Rathbone
Who created the Henry Street Settlement in 1893 Lillian Wald
What insurance company first offered home care services as a benefit in 1909? Metropolitan Life
What university offered the first university course in public health nursing in 1910? Columbia
What year was medicare established? 1966
T or F? Cost containment in the health care industry drives home health care? True
T or F? Home care is part of a continuum of care where clients have the opportunity to live through the experiences of subacute, chronic, and end-of-life care. True
T or F? In the past 20 years, Medicare regulations served as the basis for Medicaid programs, as well as other health insurance protocols for payment or reimbursement. True
_______ care was introduced to encourage healthcare providers to hold costs down through streamlining services. Managed care
Types of Agencies: ________ agencies are generally established as not-for profit and is governed by a voluntary board of directors and community based advisory boards? Private/voluntary agencies
Types of Agencies: Type of agency that is congruent with hospital care as part of a continuum of care is a ________ ___________ agency Hospital based agencies.
Types of AGencies: _____________ agencies are those private agencies that plan to and want to make a profit. Proprietary agencies
Types of Agencies: __________ agencies are thos ethat are supported by public monies that often come from taxes (local, state, or federal). Official (or public) agencies
Lead paint screening for children, TB treatment and follow-up, well-child clinics, & water testing facilities are all examples of what type of agency? Public or official agency
Which of the two local hospitals below is a for profit hospital: Tennova or Covenant? Tennova is for profit Covenant is not for profit
What is the primary difference in medicare and medicaid? Medicare is a federal program and medicaid is a state program.
The program that receives Federal Funds for military personnel and their dependents for home health care services is called _____________ TRICARE
T or F? Home healthcare is regulated primarily by the local level of government. False - regulated by state and federal government.
Condition based on how difficult it is for a client to leave the home is called ______________ Homebound
Which of the following are criteria for eligibility under Medicare? a)Home bound b) plan of care c) skilled needs d) intermittent care needs e) necessity f) all of the above f) all of the above
A __________ of ___________ is an agency-generated written document that is guided by a lengthy assessment. Plan of care
_________ _________ refer to the needs of the client that are accomplished through professional abilities of registered nurses or home health aides. Skilled needs
What is the assessment called that is currently used in developing a plan of care by agencies in the U.S.? OASIS (Outcome and Assessment Information Set)
How is homebound determined? Based on how difficult it is for the client to leave home - "taxing effort"
How many days does Medicare specify for intermittent care needs? 60 days
T or F? Telehealth is a form of electronic communication to deliver chronic care, and specialty consultations. False. Telehealth is a form of electronic communication to deliver acute care, not chronic care, and specialty consultations.
What are the standards of care key elements listed in the Scope and Standards of Home Health Nursing Practice document? (hint - a delicious old pie) A (Assessment) D (Diagnosis) O (Outcome identification) P (Planning nurse interventions to the identified outcomes) I (Implementation or Interventions) E (Evaluate outcome accomplishments)
Term that refers to various members of the healthcare team that contribute to client management in the home Interdisciplinary collaboration
Which of the following groups generally receive care from home health agencies? a) Adults with acute or chronic illnesses b) Older adults c) Mothers and newborns d) Children and their parents e) all of the above e) all of the above
T or F? Telehealth is bound by law to not give electronic referrals to specialists. False - that is a large portion of what they do - offer referrals to specialists and help patients find health care providers in their area and for their needs.
In the Interdisciplinary care team, who are the "gatekeepers?" Nurses
What is a type of community-based care that combines quasi-indepenedent living with the availability of nursing care on site and through home visits? Assisted Living
T or F? Nurses make home visits to the homeless? True - they go to shelters to provide care
Faith community nursing can also be referred to as ____________ nursing. Parish nursing
What is the goal in terms of time after receving a referral until the initial visit is made? 24 hours
Where do referrals for home care agencies come from? Physicians or discharge planners from other healthcare institutions
T or F. A home care nurse should not use client sink areas in the home to wash their hands. True. This is to decrease cross-contamination
What are some things that are assessed during the home visit? 1. Risk of medication errors 2. Risk of falls 3. Risk of abuse and neglect
Of home care clients aged 65 and older, what percentage had possible medication errors? 30%. (of those that take 9 or more medications, 50% have had medication errors)
What kind of profile is crucial to review at each home visit? Medication profile. (Many pts have more than one doctor and multi RX).
What 3 herbal medications have adverse interactions with prescriptions? 1. Ginkgo biloba (anticonvulsants, antidepressants, anticoagulants) 2. Ginseng (digoxin, anticoagulants, antidepressants, and analgesics) 3. St. John's wort (chemotherapy, indinavir, cyclosporine, digoxin, and theophylline)
What is the most crucial part of terminating the initial visit in home care? 1. Making sure the client and their families know how to reach the home care nurse (any time day or night) and 2. that the emergency plan is understood by the client and family.
What is the most crucial part of the postvisit planning? Nurse establishes the outcome measures in planning an intervention for the pt.
What are the 5 phases of the home visit? 1. Initiating the visit 2. Preparation for visit 3. Equipment 4. Directions 5. Personal safety
Created by: agwharton