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Continuity of Care
Chapters 2,8, 9, 10 Freshman...CONCEPTS RNUR 131
| Continuity of care | Answers |
|---|---|
| Providing appropriate, uninterrupted care from one level of care | Continuity of care |
| Patient should be able to go from one facility to another without any changes in care | Continuity of care |
| Where pt is in hospital for more than 24 hours | Inpatient facilities for care |
| The pt enters and exits the facility in less than 23 hours | Outpatient facilietes for care |
| Hospital keeps pt for hours for observation | Outpatient facilites for care |
| Setting is *Unfamiliar to the nurse *Controlled by the pt | Home Care facilities for care |
| Nurse needs *Knowledge *Skill *Independence *Accountability *Creativity | Home Care facilites for care |
| Facility that the supervisor is on call, but you have to make the calls | Home Care facilities for care |
| What are the four roles of a home health care nurse? | *Provider of care * Coordinator of services *Educator *Advocate for pt |
| Facility where size and service varies | Hospital |
| Meet the varied needs of certain patient goups *children *rehab *psychiatric or drug dependency care *servere burn pts (it meets the pts needs of certain patient groups | Speciality hospitals |
| A hospital that provides general care | General hospitals |
| Surgical procedures *Diagnostic test *Medications *Physical Therapy *Counseling *Health education are in what type of setting? | Outpatient settings in hospitals |
| A non-profit institution that are financed by *state *local * *national *Tax based *Public Funds. Pts *Provided at no or low cost * | Public non-profit hospital (Truman) |
| May be for profit or non-profit and are operated by *communities *churches *coporations *charatitable organizations. Most pts have some type of personal insurance (HCA) | Private profit or non-profit hospitals |
| Located in *Hospitals (urgent care) *Shopping malls *Community agencies *Free standing service provided by a goup of healthcare providers who work together *CVS *Walk-in basis | Ambulatory care |
| Clinics provide *tecnical services (administer meds.) *Determine priority of care needs *Teaching about all aspects of care *Urgent care center (walk-in) | Ambulatory care |
| By appointment only | Doctor's office or clinic |
| Usually only provides emergency care | Day care centers |
| Staffed by nurses in *hospitals *independent agency *Crisis intervention centers. Provide *crisis centered *long-term counseling *outpatient care *Medications *hotlines. For *drugs *crisis *abuse *suicidal | Mental Health Centers *Crisis intervention centers |
| Major source of health assessment for children, health education, emergency care (emergency meds, breathing treatments, AED,,defib) | Schools |
| Large industries have own nurse and center *prevention of work related injuries *health assessments *screenings *health promotion *education | Occupational health centers |
| Located in living units *nurses/students are vounteer based *immunizing children *teaching preg. women * treat infection/illness/STD *provide info. on health promotion | Homeless shelters |
| Encouraging independent self-care for pt to return to normal life *chemical dependency *free-standing *assoc. w/ hospital *Multidisciplinary team | Rehabilitation Centers |
| Subacute care *assisted living *Long term *nursing homes *retirement centers *residential instutions for mentally/developmentally/physically disabled pts of all ages *aging in place...in appts are physically able *Intermediate RN on call *A.L. RN availab | Long term care facilities |
| This gives caregivers of homebound ill, disabled, elderly pts time away from responsibilites | Respite Care |
| Palliative/supportive care wervices *physical *psychological *social *spiritual care for dying (under 90 days to live | Hospice |
| Elder *Permanetly disabled *Catastropic care *Expensive Meds. *Federally funded (established national and state insurance programs) | Medicare |
| Low income *Blind *Disabled *Federally funded | Medicaid |
| This plan pays the hospital a fixed amount that is predetermined by the medical diagnosis or specific procedure rathern than by the actual cost of hospitalization and care | Diagnosis-related groups (DRG's) under Medicare |
| HMO *PPO *Private Insurance *Long-term care insurance | Group plans (financing) |
| Got a job you probably have | Group plan |
| Stay in network of providers | HMO |
| Pt has more choice may pay more out of pocket with health care | PPO |
| Blue Cross, Blue Shield not from job, you pay for it out of your own pocked | Private Insurance |
| Speciality insurance pays some of nursing home care. Relates to what you do | Long-term care |
| Health history *Physical assessment *Teaching *Referrals are all | Needed when admitting to outpatient |
| Pt information *ID bracelet *Prepare room *Health history (once in room) *Physical assessment *Inventory of belongings *Unit orientation | Needed when admitting a pt to Inpatient |
| Do we describe belongings like gold ring, diamond necklace, Gucci purse? | NO... document yellow ring clear stone brown purse |
| Take all belongings *Copy chart and send with patient *Report *Unstable pt you may have to go for a ride with them | Transfering the pt to another facility |
| Take belongings *Take all patient information *Report | Done on transfer within facility |
| Coordinate prior to discharge *Teach (meds.. calander, Precedures/treatments...dressing changes, restrictions), Diet, Referrals/follow up, Health promotion (Info on how to quit smoking, or weight management) | Dismissal from facility |
| Will insurance pay if a person refuses to sign AMA? | NO-not usually.. notify pt of this matter |
| Against medical advise at dismissal | AMA |
| A legal document that needs to be signed if pt wants to leave against medical advice. It releases physician and facility from liability and sometimes the pts signature needs to be witnesses (depending on facility) | Dismissal AMA release form |
| The joint commission (formerly JCAHO)m State boards of Nursing, Federal Drug Administration FDA | Health care regulatory agencies |
| Medicaid, Medicare Managed Care Organization (MCO), Medicaid are funded through | Federal |
| Hospice is a service at the ____ level | Continuing |
| Immunizations are | Prevention |
| School-based screenings are at the ____ level | Primary |
| ICU is at the _____ level | Secondary |
| Regional cancer center is at the ______ level | Tertiary |
| Home health care is at the ____ level | Restorative |
| Why were DRG's put implemented by the federal government? | Increasing healthcare costs |
| Care that is given by many providers | Fragmentation of care |
| Part A is paid for by Federal government *Part B is covered by a monthy permium or supplemental insurance policy | Medicare |
| This program started out with the elderly, expanded to the disabled, then DRG's, and in 1988 catastrophic care costs | Medicare |
| An organized, high-quality, cost-effective system of healthcare that influences the selection and use of healthcare services | Managed care |
| The process of coordinating an individual's healthcare for the purpose of maximizing positive outcomes and containing costs | Case management |
| Essential healthcare based on practical, scientifically sound, and socially acceptable methods and technology, made universally accessible through the community's full participation and at a cost the community can afford | Primary healthcare |
| Make health assessments, Performing technical procedures, and providing health education is the typical role of the nurse in the | Primary care center |
| This care is a type of care provided for caregivers of homebound ill, disabled, or elderly patients | Respite |
| AA is and example of what type of care | Voluntary |
| Not-for-profit community agencies financed by private donations, grants, or fundraisers | Voluntary agencies |
| What is the difference in an occupational health nurse and Occupational therapist? | Occupational health nurse=work setting; Occupational therapist=licensed to assist physically challenged patients to adapt to limitations |
| Make health assessments, assist physician, and provide health education | Primary care offices; Doctor's office |
| Would a physician assistant work in an ambulatory care center? | Yes, they may run them |
| Surgical procedures, diagnostic tests, medications, physical therapy, counseling and health education can all be done during _______ care | outpatient |
| Predetermined payment to hospital if procedures is more than that hospital absorbs costs, but if less, then hospital profits | DRG's diagnosis related groups in medicare |
| Professionals from different fields can make an | Interdisciplinary team |
| Coordinating future care for the patient is the responsibility of the _____ at discharge | Nurse |
| The process of planning for continuity of care as the patient moves from the acute care setting to care at home | Discharge planning |
| The coordination of services provided to patients before they enter a healthcare setting, during the time they are in the setting, and after they leave the setting | Continuity of care |
| Verify the patient going home on the | Physicians order |
| What do you need do with medications before discharge | Name, dosage, purpose, effect, times taken, stated verbally and in WRITING |
| Assess the pt's need for nursing care related to admission | 5 guidelines when admitting and discharging pts from hospital (JCAHO) |
| Include consideration of biophysical, psychosocial, enironmental, self-care, educational, and discharge planning factors | 5 guidelines when admitting and discharging pts from hospital (JCAHO) |
| Involve the patient and family in care as appropriate | 5 guidelines when admitting and discharging pts from hospital (JCAHO) |
| Nursing staff members should collaborate, as appropriate, with physicians an members of other clinical disciplines to make decisions regarding the pt's needs for nursing care | 5 guidelines when admitting and discharging pts from hospital (JCAHO) |
| Assess need for continuing care in preparation for discharge, and document referrals for such care in the patient's medical record | 5 guidelines when admitting and discharging pts from hospital (JCAHO) |
| When discharging a pt that had miscarrage | health database, personal data (feelings, coping), emotional supports available |
| belongings, chart, kardex, care plan, medications correctly labeled for new room, notify other departments, new floor give report about pt to new nurse | Transfer in hospital |
| belongings, perscriptions and appt. cards for return visits to physician's office may be sent, discharged from hospital setting, copyof chart to ____ facility along with a detailed assessment and care plan | Transfer to a long-term care facility |
| check discharge order, instructions, equipment and supplies, financial arrangements. ASSIST pt to dress and pack belongings; check written for future services, transport pt to car and assist, record and complete discharge summary | Discharge from a healthcare setting |
| Position bed to highest level, arrange furniture in room for easy access to bed, open bed (fold back linens), assemble equipment and supplies, make sure they are working properly, adjuct physical enviornment of room | Pt admitted on a STRETCHER and is recieving oxygen (bed higher) |
| Eligibility requirements: Doctor must make plan of care for the pt home, home agency must be _____ certified, Intermittent skilled nursing care or physical, speech, or occupational therapy must be needed, and pt must be home bound for | Medicare |
| Wash hands before removing supplies, clean supplies before putting them back into the bag, hand washing before access, place on a liner before setting it down | Bag technique |
| Focuses on high quality cost effective care | MANAGED CARE |
| What should be done when transferring from acute care to home care? | Make referrals to appropriate agencies |
| It centers on individuals and families with acute and chronic illness needs | Community-based care |
| Information on how the clients information will be disclosed is required by _______ to be given to the client | HIPAA |
Created by:
Cinderelle
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