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71 Cards in this Set
- Front
- Back
Economics based on 3 principles
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scarcity, choice, and preference
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altruism
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unselfish concern for the welfare of others
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ethics
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general welfare of society being the goal of an individual
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Health Savings Account by Medicare
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insurance that offer a choice of tax-advantaged low premiums in xchange for higher deductibles and copays
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Patient Classification System (PCS)
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tool to identify nursing cost and predict staffing
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3 principles/ framework of Organization of HltCare by Donabedian
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structure, process, and outcome
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3 goals of WHO
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best possible hlt status across lifespan
pt focused financial protection for everyone |
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primary care
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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.
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7 features of primary care
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CCCFCB
continuous, comprehensive, coordinated, community oriented, family centered, culturally competent, and begin at first contact with pt |
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main cause of hltcare disparity
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SES
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largest governmental program of hltcare in America
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Medicaid
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XVIII Medicare
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insurance for 65 or above
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XIX Medicaid
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insurance for low income or disability
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Cost shifting
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providers raise prices for the privately insured to offset the lower hltcare payments from Medicare and Medicaid
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capitation
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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 |
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Prospective Payment System (PPS)
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Method of reimbursement in which Medicare payment is made based on predetermined, fixed amount for reimbursement to acute inpatient hospitals and other organizations
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federal government
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major driver of hltcare organization and delivery
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Factors contributing to Risking Costs in Hltcare
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aging population, pharmaceuticals, technology, rising hospital costs, physican bx, cost shifting, administrative costs
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Most important reason for managing health care as a business
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Must have profit for the system to continue
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2 types of civil law
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contract and tort
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2 types of tort laws
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intentional (assault and battery)
unintentional (malpractice or neglect) |
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omission
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nothing was done when something should have been done
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commission
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something that was done when it should not have been done
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3 types of false imprisonment
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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 |
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Referent power
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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 |
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connection power
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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 |
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legitimate power
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power derived from an academic degree; from a position a nurse holds in a group
Ex: license, wearing professional symbols |
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Hawthorne effect
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how being observed or studied results in a change of bx
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3 fundamentals of effective leaders
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guiding vision, passion, integrity
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informal leader
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demonstrate leadership outside of the scope of a member of a group; when she is accepted by others and perceived to have influence
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formal leader
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person w/authority that's assigned a role within an organization that connotes influence like clinical nurse specialist
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federal policies
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policies that include rules and regulations governing Medicaid and Medicare funding
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Fastest growing consumer group
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elderly
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mission statement
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formal expression of the purpose or reason for existence of the organization. The driving force of its vision
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philosophy
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typically in the mission statement; a value statement of the principles and beliefs that direct the organization's bx.
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SWOT analysis
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-tool used to conduct environmental assessments
-strenght, weaknesses, opportunities, and threats |
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focus groups
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small groups of individuals selected because of a common characteristic
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Types of Battery
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-touching a person w/o their consent
-failing to honor an AD -living will, medical power of attorney, durable power of attorney |
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Types of false imprisonment
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-misinterpretation of rights granted by power of attorney
-person led to believe they cant leave a place -improper use of chemical/phys restraints |
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invasion of privacy
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revealing pt info (HIPAA)
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Tort law
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private or civil wron/injury including bad faith or breach of contract neeeding a remedy for damages incurred
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Total Pt Care
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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 |
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funcional nursing
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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. |
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team nursing
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care provided to group of pts by team of personnel; team leader responsible for coordination; must have good delegation skills
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primary nursing
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1 RN functions autonomously as the pt's primary provider thru the hospital stay
Primary nurse assumes 24hr responsibility |
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advantages and disadv of primary nursing
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adv: clearly defined accountability and responsibility; holistic approach
disadv: RN will be constantly called, heavy responsbility |
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adv and disadv for functional nursing
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adv: efficient care
disadv: disorganized, more focus on task than nursing care; *communication big problem |
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adv and disadv for team nursing
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adv: team participation
disadv: too much responsibility on 1 person, not everyone will be happy |
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case management
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strategy to improve pt care and reduce hosp cost thru COORDINATION of care
establish goals fr admission to discharge |
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NHPPD
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standard measure that quantifies the nursing time available to ea pt by available nursing staff
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how do u calculate NHPPD
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divide total nursing care hrs by total census (# of pts on the unit)
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pt acuity
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measure of nursing workload that's generated for each pt; the sicker the higher the acuity
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benchmarking
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tool used to compare producitivity across facilities to establish performance goals
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staffing plan
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articulates how many and what kind of staff ar needed by shift and day to staff a department
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average daily census
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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
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episodic care unit
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episodes of care like dialysis
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IOM 6 quality Aims for improvement
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STEEEP
safe, timely, effective, efficient, equitable, pt centered |
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safe harbor act
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RN believes the requested conduct violates his/her duty to the pt
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adv and disadv of factor system
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adv: data readily available
disadv: ongoing workload |
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Factor system
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nursing tasks are assigned time or are weighted to reflect amount of time needed to perform the task
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prototype system
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allocates nursing time to large pt groups based on an avg of simlar pts
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adv and disadv for prototype system
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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 |
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threat to touch another w/o person's permission
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assault
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order to which tells the staff to perform or not perform CPR if pt codes
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DNR, do not need living will to do this
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Definition for battery and what's included?
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TOUCHING another person w/o their consent
Failing to honer AD, medical power of attorney, durable power of attorney, living will |
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intentional verbal or written rumors about pt
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defamation
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revealing confidential pt info
pt led to believe they can't leave the place |
false imprisonment
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person or group with vested interest in a program/project
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stakeholder
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a group who reviews plan and makes recommendations; id concerns and provide guidance
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advisory board
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power that is from the ability to reward or punish others
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reward/coercive power
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power from the ability to influence others with the info they have; may not be an expert but have info.
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information power
ex: pt's fall; student |