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71 Cards in this Set

  • Front
  • Back
Economics based on 3 principles
scarcity, choice, and preference
altruism
unselfish concern for the welfare of others
ethics
general welfare of society being the goal of an individual
Health Savings Account by Medicare
insurance that offer a choice of tax-advantaged low premiums in xchange for higher deductibles and copays
Patient Classification System (PCS)
tool to identify nursing cost and predict staffing
3 principles/ framework of Organization of HltCare by Donabedian
structure, process, and outcome
3 goals of WHO
best possible hlt status across lifespan
pt focused
financial protection for everyone
primary care
provide accessible hltcare services who provide a majority of personal hltcare needs, develop a partnership with pts, and practice w/in context of family and community.
7 features of primary care
CCCFCB
continuous, comprehensive, coordinated, community oriented, family centered, culturally competent, and begin at first contact with pt
main cause of hltcare disparity
SES
largest governmental program of hltcare in America
Medicaid
XVIII Medicare
insurance for 65 or above
XIX Medicaid
insurance for low income or disability
Cost shifting
providers raise prices for the privately insured to offset the lower hltcare payments from Medicare and Medicaid
capitation
payment of fixed dollar amount, per person, for the provision of hlt services to a pt population for a specified period of time

hltcare organizations able to keep people well from using their financial resources
Prospective Payment System (PPS)
Method of reimbursement in which Medicare payment is made based on predetermined, fixed amount for reimbursement to acute inpatient hospitals and other organizations
federal government
major driver of hltcare organization and delivery
Factors contributing to Risking Costs in Hltcare
aging population, pharmaceuticals, technology, rising hospital costs, physican bx, cost shifting, administrative costs
Most important reason for managing health care as a business
Must have profit for the system to continue
2 types of civil law
contract and tort
2 types of tort laws
intentional (assault and battery)
unintentional (malpractice or neglect)
omission
nothing was done when something should have been done
commission
something that was done when it should not have been done
3 types of false imprisonment
misinterpretation of rights granted by power of attorney
person incorrectly led to believe they can not leave a place
improper use of physical or chemical restraints
Referent power
power based on the trust and respect that ppl feel for their association
Ex: gaining power by affiliating with nurses who have power in the organization
Ex: oprah winfrey
connection power
power that comes fr personal and professional relationships that enhance one's resources and the capacity for learning and info sharing; connected with others
Ex: bill gates; developed good working relationships and mentoring with your boss
legitimate power
power derived from an academic degree; from a position a nurse holds in a group
Ex: license, wearing professional symbols
Hawthorne effect
how being observed or studied results in a change of bx
3 fundamentals of effective leaders
guiding vision, passion, integrity
informal leader
demonstrate leadership outside of the scope of a member of a group; when she is accepted by others and perceived to have influence
formal leader
person w/authority that's assigned a role within an organization that connotes influence like clinical nurse specialist
federal policies
policies that include rules and regulations governing Medicaid and Medicare funding
Fastest growing consumer group
elderly
mission statement
formal expression of the purpose or reason for existence of the organization. The driving force of its vision
philosophy
typically in the mission statement; a value statement of the principles and beliefs that direct the organization's bx.
SWOT analysis
-tool used to conduct environmental assessments
-strenght, weaknesses, opportunities, and threats
focus groups
small groups of individuals selected because of a common characteristic
Types of Battery
-touching a person w/o their consent
-failing to honor an AD
-living will, medical power of attorney, durable power of attorney
Types of false imprisonment
-misinterpretation of rights granted by power of attorney
-person led to believe they cant leave a place
-improper use of chemical/phys restraints
invasion of privacy
revealing pt info (HIPAA)
Tort law
private or civil wron/injury including bad faith or breach of contract neeeding a remedy for damages incurred
Total Pt Care
nurse responsible for total care of assigned pts for shift; one-on-one care where pts family needs are unstable, need frequent assessment
Ex: hospice, ICU
funcional nursing
divides nursing work into fcnal roles that are assigned to one of the team members; each provider has specific tasks
Ex: 1 charge nurse, 1 medication
nurse, 1 bath tech, 1 VS tech, etc.
team nursing
care provided to group of pts by team of personnel; team leader responsible for coordination; must have good delegation skills
primary nursing
1 RN functions autonomously as the pt's primary provider thru the hospital stay
Primary nurse assumes 24hr responsibility
advantages and disadv of primary nursing
adv: clearly defined accountability and responsibility; holistic approach
disadv: RN will be constantly called, heavy responsbility
adv and disadv for functional nursing
adv: efficient care
disadv: disorganized, more focus on task than nursing care; *communication big problem
adv and disadv for team nursing
adv: team participation
disadv: too much responsibility on 1 person, not everyone will be happy
case management
strategy to improve pt care and reduce hosp cost thru COORDINATION of care

establish goals fr admission to discharge
NHPPD
standard measure that quantifies the nursing time available to ea pt by available nursing staff
how do u calculate NHPPD
divide total nursing care hrs by total census (# of pts on the unit)
pt acuity
measure of nursing workload that's generated for each pt; the sicker the higher the acuity
benchmarking
tool used to compare producitivity across facilities to establish performance goals
staffing plan
articulates how many and what kind of staff ar needed by shift and day to staff a department
average daily census
calculated by taking total numbers of pts at a census time over a period of time and dividing by number of days in the time period
episodic care unit
episodes of care like dialysis
IOM 6 quality Aims for improvement
STEEEP
safe, timely, effective, efficient, equitable, pt centered
safe harbor act
RN believes the requested conduct violates his/her duty to the pt
adv and disadv of factor system
adv: data readily available
disadv: ongoing workload
Factor system
nursing tasks are assigned time or are weighted to reflect amount of time needed to perform the task
prototype system
allocates nursing time to large pt groups based on an avg of simlar pts
adv and disadv for prototype system
adv: reduction of work for nurse, don't need to classify
disadv: not adjusted for variances in pt's self-care and severity of illness
threat to touch another w/o person's permission
assault
order to which tells the staff to perform or not perform CPR if pt codes
DNR, do not need living will to do this
Definition for battery and what's included?
TOUCHING another person w/o their consent

Failing to honer AD, medical power of attorney, durable power of attorney, living will
intentional verbal or written rumors about pt
defamation
revealing confidential pt info
pt led to believe they can't leave the place
false imprisonment
person or group with vested interest in a program/project
stakeholder
a group who reviews plan and makes recommendations; id concerns and provide guidance
advisory board
power that is from the ability to reward or punish others
reward/coercive power
power from the ability to influence others with the info they have; may not be an expert but have info.
information power

ex: pt's fall; student