Community nursing
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| Purpose of Healthy People 2010 | Promoting health and preventing illness, disability, and premature death. Prevent illness of elderly and decrease infant mortality and low birth weight.
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| When did Healthy People come out? | It came out in 1979 from the Surgeon General. In 1980, the nation set goals for the next 10 years.
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| What are the 2 major goals of Healthy People 2010 | 1) increase quality and years of healthy life. 2) Eliminate health disparities that occur in gender, race, or ethnicity, education, income, disability, living in rural areas, or sexual orientation.
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| Healthy People, Health Indicators | Physical Activity, Overwt and obesity, tobacco use, substance use, responsible sexual behavior, mental health, injury and violence, environmental quality, immunization, access to health care.
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| Primary prevention is | prevention of initial occurrence of disease or injury
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| Primary prevention activities include: | Immunization, family planning, well child care, smoking cessation, hygiene teaching, fitness classes, alcohol/drug prevention, seat belts/car seats.
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| Secondary prevention is: | early identification of disease or disability with prompt intervention to prevent or limit disability
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| Secondary prevention activities include: | physical assessments, HTN screening, developmental screening, breast/testicular self-examination, hearing/vision screening, mammography, pregnancy testing
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| Tertiary prevention is: | assistance (after disease or disability has occurred) to halt further disease progress and to meet one's potential and maximize quality of life despite illness
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| Tertiary prevention activities include: | Teaching/counseling regarding lifestyle changes (Diet/exercise), stress management and home management, support groups, support for caretaker, meals on wheels, physical therapy, mental health counseling
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| Children's Bureau (foster care), US Public health services, and Red Cross Town & country (American Red Cross) occured in what year? | 1912
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| Division of Nursing occurred in what year? | 1944
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| Funds for hospital construction called Hospital Survey & Construction Act (Hill-Burton) occured in what year? | 1946
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| Medicare instituted to fund care for elderly in... | 1966
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| Medicaid instituted to fund care for the indigent in.. | 1967
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| Healthy people was first developed in... | 1980
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| What did Lillian Wald start? | founder of public health and school nursing.
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| Henry Street Settlement House was started in what year and by who? | 1893, Lillian Wald
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| Occupational Health Nursing was established... | in PA in 1888
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| Margaret Sanger spent time in jail for what? | conducting a birth control clinic in Brooklyn (1913)
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| Functions of CBN are? | Assessment, Teaching, Managing/Delagating
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| Assessment in CBN focuses on what? | Self-care.
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| Teaching in CBN consist of? | Goals are assisting client/family to achieve self-care; Assess and ID needs or problems; evaluate if teaching was understood
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| Teach is only reimbursable if.. | it is properly documented
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| Teach is NOT reimbursed if.. | not documented; not working within reasonable time. (adapt, use new methods); CNAs and LPNs CANNOT teach. OT/PT can
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| Public Health Systems are funded by? | Federal, State, or Local Tax money
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| DHHS is most involved with? | the health and welfare of US citizens
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| The mission of DHHS is: | promote the protection and advancement of the Nation's physical and mental health.
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| DHHS accomplishes it's mission though: | medical research, track/ID disease, alcohol/substance abuse programs, ID/Correct health hazards, FDA
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| Medicare is health insurance for? | people over 65, people with disabilities, end-stage renal dx patients. Federally funded
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| Medicaid is health insurance for? | low income people or fit within an eligibility
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| How is medicaid funded? | is it federally funded but ran by the state
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| Department of Social Services assists with? | public assistance, housing of delinquent children, inspection of maternity clinics, inspection/operation of jails
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| How is DSS funded? | federally funded, state mandated
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| What is the primary focus of Health Services? | Tracks infectious disease, mainly TB
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| What is Health Services | Epidemiology in the Public Health division (DHHS) that collects data and collaborates with other providers to decrease infectious diseases
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| Rural health clinics are part of? | state ran health services
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| Local health services are provided by... | the Health department
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| What services does the Health Dept provide? | disease prevention, health promotion, education.
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| Private health care systems are funded by: | private sources, donations, grants
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| There are 2 types of private health care, what are they? | profit and nonprofit
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| Non profit are tax exempt. Examples are: | United Way, Salvation Army, WISH, American Heart Association
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| Profit HCS receive payment for services. Examples are: | Home Health Agencies; Assisted Living; Urgent Care; MD offices
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| Managed care is | an organized system of health care that plans and monitors the use of HCS
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| What are the focuses of managed care? | efficiency and cost control
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| Case management is also called? | Care coordination
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| What is case management? | a process for delivering healthcare to a client or group, including: assessment, developing of a plan of care, initiation & coordination of referrals & services, & evaluation of care
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| What are the goals of case management? | improve quality of care, decrease cost (empowering clients/families), improve satisfaction by promoting multidisciplinary collaborative practice
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| Steps of Case Management: steps 1-4 | 1) involve clients/family in assessing lvl of fx 2) ID resources/services necessary for max quality of life 3)Involve client/family in ID, explore, accessing resources 4) Have client/family ID most appropriate referral for their needs.
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| Steps of Case Management: steps 5-7 | 5)Make referrals and supply services with needed info. 6) act as advocate/troubleshooter as necessary 7) Evaluate progress toward health outcomes, revise plan if needed.
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| What is delegation? | transferring to a competent individual the authority to perform a selected nursing task. RN retains accountability for delegation
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| What CANNOT be delegated? | assessment, evaluation, nursing judgment
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| NA I tasks consist of: | Personal care, body mechanics, nutrition, elimination, safety, VS, Ht/Wt, hot/cold application, skin preps/scrubs, clean dressing change, TEDs, EKG leads, postmortem care
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| NA II task consist of NA I task and.. | O2 therapy, break-up/removal fecal impaction, IV Fluid assistive, nutrition activities, suctioning, trach care, elimination procedures, urinary cath,
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| Third party reimbursement: | refers to fiscal payments by a middleman such as: insurance co., medicare/medicaid. The individual usually pays a premium for coverage and insurer pays health care bills on his behalf
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| Medicaid is: | income related started in 1965, provides coverage for eligible indigent, blind, uninsured children, disabled, pregnant.
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| Medicare is: | natl insurance started in '65 for persons over 65 yr old, disabled, or patient with end stage renal dx. Provides post hospital rehab, home health care, and hospice care
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| Medigap | private insurance to supplement original medicare plan. Fills in the gaps.
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| Managed care: | a health care delivery system developed to provide quality health care with cost control
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| HMO (Health maintenance organization) is managed care that: | contracts to provide health care for enrollees. HMO agrees to provide a set of services for a set fee (capitated fee). The provide care to clients with no or minimal deductibles and copays. Referrals are needed to see a specialist
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| PPO (Preferred Provider Organization) are: | business arrangements/contracts between a panel of health care providers and purchasers of health care services.
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| Gatekeeper is: | the primary care physician within magaged care plan. Usually family practitioner, pediatrician, gynecologist. Gatekeeper coordinates all care and determines when to refer to specialist.
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| Workman's Comp | began in early 1900s as social insurance operated by each state. Cover workers against costs of medical care and loss wages from work related injury or illness
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| Capitation is described as: | a negotiated, prepaid fixed fee for each covered individual or family in a managed care plan
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| Coinsurance is a.. | predetermined amount or percentage of the cost of covered services that a beneficiary will pay. The coinsurance may be an agreed on percentage of the total cost of care (20-30%)
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| DRG (diagnosis related group)represents | a classification system that groups patients into categories based on the coding system.
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| TANF (Temp Assistance for Needy families) is funded from: | a cash black grant from the fed govt.
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| TANF is designed to | decrease number of people dependent on fed assistance. There is a 5 yr time cap on this assistance.
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