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67 Cards in this Set

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  • Back
Beneficence
duty to help others

Do good; at least do no harm
Nonmaleficence
avoidance of harmful behavior
duty
the clinician has the duty to exercise reasonable care when undertaking and providing treatment to the patient when a pt -clinician relationship exists.
Breach of duty
the clinician violates the applicable standard of care in treating the patient 's condition.
Proximate cause
there is a causal relationship between the breach in the standard of care and the patient's injuries.
Damages
There are permanent and substantial damages to the patient as a result of malpractice
Act that established a databank to scrutinize the members of the healthcare profession and list those practitioners who have had a malpractice claim asserted against them?
Health Care Quality Improvement Act of 1986
The term managed care or managed health care is used to?
The term managed care or managed health care is used in the United States to describe a variety of techniques intended to reduce the cost of providing health benefits and improve the quality of care ("managed care techniques") for organizations that use those techniques or provide them as services to other organizations
How have MCO's treated NP's
frequently excluded NPs from being designated as PCPs so the only option is for NP to work as a salaried employee. Job security risk- ghost provider status
Purpose of the (NPDB) National Practitioner Data Bank (HIPDB) Helath Intregrity and Protection Data Bank?
developed as flagging system
keeps info on NP, malpractice suits against them
PPO?
Preferred provider organization/ Participating provider organization/ Preferred provider option) is a managed care organization of medical doctors, hospitals, and other health care providers who have covenanted with an insurer or a third-party administrator to provide health care at reduced rates to the insurer's or administrator's clients.
PPO vs HMO?
PPOs have gained popularity in the past decade because, although they tend to have slightly higher premiums than HMOs and other more restrictive plans, they offer patients more flexibility overall.
What do PPOs do?
Preferred provider organizations themselves earn money by charging an access fee to the insurance company for the use of their network (unlike the usual insurance with premiums and corresponding payments paid either in full or partially by the insurance provider to the medical doctor). They negotiate with providers to set fee schedules, and handle disputes between insurers and providers.
Types of reimbursement?
Medicare and medicaid
Federal and State Benefit Plans (FEBP)
TRICARE
Out of pocket payment
Direct reimburesement to the NP is?
85% of the scheduled amount paid to the MD
Who makes the rules for Medicaid?
individual states
General systems theory?
Family unified whole, dynamic, parts interact and dependent on each other, must change with time to cope/ adapt and maintain homeostasis
Structural Functional theory?
Social system that form interdependent, independent, relationships within and outside the family.
Subsystems (parent-child etc.)
Suprasystem-outside family
Ecomap; dx/illness can create dysfunction, poor coping
Developmental theory?
Erickson, Piaget, Duval
Communication theory?
interaction, verbal and nonverbal communication
Crisis theory
Crisis is normal and growth producing, everyone experiences it. Stress is a major factor.
Type I Error
We REJECT the null hypothesis when in reality it is TRUE.
Type II Error
We ACCEPT the null hypothesis when in reality it is FALSE.
Sensitivity
POSITIVE

Probability that a test will be positive when dx is present.
Specificity
NEGATIVE

Probability that a test will be negative when a dx is not present.
False negative rate
probability that a test will be negative when a dx is present
Positive predictive value
probability that a dx is present when test is positive
Primary prevention
directed at preventing dx from occurring
Secondary prevention
Interventions at the subclinical stage, directed at early detection of the illness or problem to reduce the severity of the dx
Examples of secondary prevention?
Genetic testing in newborns
lead screening
vision and hearing screening
smoking cessation programs
cholesterol screening
mammography
testicular self examination
Tertiary prevention
treatment and rehab of illness to prevent or minimize progression or it's sequelae
Examples of primary prevention?
Education
Exercise
Nutrition
Water Fluoridation
Immunizations
Food handling Regulations
Pollution Control p 29
Examples of tertiary prevention?
Use of inhaled steroids for asthma
use of PCN Prophylaxis in pt's with SS dx
Vitamin therapy in pregnancy
Infection
colonization and multiplication of an organism in the host, typically producing an IMMUNUNE RESPONSE but NO SIGNS OR SYMPTOMS. p 29
Disease
Stage when an infection PRODUCES SIGNS OR SYMPTOMS (including pathologic changes). Some organisms are capable of infection w/ or w/o dx, other organisms always produce dx, but severity may vary.
Colonization
organism invades the host at a particular site, multiplies and acts as a parasite, but DOESN'T PRODUCE INFECTION, IMMUNE RESPONSE OR DX.
Carrier state
Persistence of an organism in a host; this stage may follow infection, dx, or colonization and may be infective to others.
Infectitvity
ability of an organism to invade and multiply in a susceptible host. (varicella is highly infective, TB has low infectivity.
Pathogenicity
ability of an organism to produce dx (TB has low pathogenicity, rabies and rhinovirus is high) p 29
Virulence
severity of dx that an organism can produce.
fatality rate, seriousness of sequelae, # of hospital days p 30
Immunogenicity
ability to produce a lasting and effective immunity
Latent infection
Organism is not shedding or obtainable. (likely hidden in the host cells)
Patent infection
organism is shedding/ obtainable from such areas as feces, urine, blood, reps tract. Can be permanently patent (some hep B), or intermittent (herpes) or can be latent and then reactivate to produce dx (TB, Herpes zoster)
Period of communicability
time when sufficient # of organisms are shed to cause transmission; usually concurrent with dx
Incubation period
time from exposure to onset of dx
Generation time
interval b/t receipt of infection and the maximal communicability of host
Human Development theory
Erickson
Piaget
Bowen
Sadavoy
Bowen
explains family situations in term of past relationships and family histories
Sadavoy
Geriatric age related stresses
2 periods of rapid growth are?
infancy and adolescence
Denver Developmental II tests what ages?
test development from birth to 6 yrs
Health Belief Model p 42
Model to explain why healthy people do/ don't take advantage of screening programs
Perceptions of susceptibility
Seriousness of a dx
Benefits of tx
Barriers to change
Expectations of efficacy
optimal interventions consider all of these factors
Basic belief of Maslow's Hierarchy of Needs p 42
Some needs are more important the others and must be met before other needs can be considered
Trans-theoretical Model of Change p 42
6 Predictable Stages of Change

1 Pre contemplation
2 Contemplation
3 Preparation
4 Action
5 Maintenance
6 Termination
Self Efficacy or Social Theory Model (Bandura) p 42
self-efficacy is the perception of 1's ability to perform a certain task at a certain level of accomplishment
Behavior change and maintenance are a function of outcome expectations and efficacy expectations
Name Maslow'sHierarchy of Needs p 42
1 Survival needs: Water, food, sleep
2 Safety and security: Protection from hazards
3 Love and belonging: Affection, intimacy, companionship
4 Self esteem: Sense of worth
5 Self actualization: Achieving potential
Deontology
"Following the rule"
Utilitarianism
Doing the Greatest Good for the Greatest Number of people
Social or Cultural Relativism
Beliefs of a Particular Society, Culture, or Religion are Paramount
Deficiency: Only Consequences to the Group Matter
Emotivisim
If I Believe it is Right, It is Right


The Individual Determines Consequences for self; Consequences to Others are Irrelevant
Ethics
Ethics is concerned with the “good of the individual.”
Husteds’ Symphonological Bioethical Decision Making

Symphonology = ?
Agreement
Autonomy?
Autonomy- Individual and Uniqueness of Each Patient
Freedom?
a person's capacity to take INDEPENDENT ACTION based on his evaluation of his situation
Objectivity?
Ability to deal with the reality of one's situation
Self-assertion?
Right to control of one’s time and effort
Fidelity?
Faithfulness to the terms of an agreement