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73 Cards in this Set
- Front
- Back
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Advanced Directive |
patient's intent regarding medical treatment |
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Healthcare directive |
advanced directive that may or may not include a living will and/or specifications regarding durable power of attorney in one or two separate documents |
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Living Will |
specifies which life-prolonging measures one does and does not want to be taken if he/she becomes incapacited |
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HIPPA |
NPI numbers
health plans most health care providers health care clearinghouse
generally anyone who accepts health insurance |
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Those note required to follow HIPPA |
life insurance employers work comp carriers schools and school districts state agencies like CPS law enforcement agencies municipal offices |
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Patient Safety and Quality Improvement Act (PSQIA) |
voluntary reporting system to enhance data available to assess and resolve patient safety and health care quality issues |
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Confidentiality vs. "duty to warn" |
duty to warn supersedes the right to confidentiality if patient's condition may harm others
duty to protect a patient from harming him/herself supersedes right to confidentiality |
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Goals of Healthy People 2020 |
increase the quality and years of healthy life
eliminate health disparities among Americans |
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NP Must notify DHS of which diagnosis |
gonorrhea chlamydia syphilis HIV TB |
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Animal bites are reported to who? |
animal control |
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Suspected child or elderly abuse |
Required to report via social services |
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domestic violence |
not legally required to report in most states |
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E&M codes |
identify the level of care provided
codes match level of service provided to the complexity of the presenting patient problem |
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Categories of Third-Party Payers |
Medicare Medicaid Commercial Indemnity Insurers HMOs Businesses or schools eating health services for their employees or students |
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Medicare A |
covers inpatient/hosptialization skilled nursing facility home health hospice associated with inpatient event most qualify to receive at 65 |
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Medicare B |
physician services outpatient hospital stays lab/diagnostics medical equipment home health |
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Medicare C |
A+B=C |
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NPs are reimbursed what? |
85% of physician reimbursement for services provided in collaboration with physician |
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Medicare D |
limited prescription coverage |
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Medicare Payments |
80% and patient pays 20%
Reimbursement 85% of physician
Procedures: 80% of 80% of physician fee schedule rate |
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Incident-To-Billing |
billed under physician's provider number to get the full physician fee (100%) given the following rule:
physician must perform initial service and subsequent services of a frequency which reflect his/her active participation
physician must be in office while service is provided
NOT allowed in hospital setting |
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Medicaid |
low income families
vary from state to state
payments made after 3rd party payments have been made |
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Case Manaement |
mobilize, monitor, control resources that a patient uses during a course of an illness while balancing quality and cost |
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QI/QA |
process for evaluating the care of patients using established standards of care to ensure quality
management process of monitoring, evaluating, continuous review, and improving the quality in providing health care |
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Nurse practice acts through who? |
state |
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Standards of Practice |
delineated by ANA |
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State Practice Acts |
authorize boards of nursing to establish statutory authority for licensure of RNs
Includes: use of title, authorization for scope of practice including prescriptive authority and disciplinary ground |
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Prescriptive Authority |
dependent on state nurse practice acts
while DEA has ruled that nurses in advanced practice may obtain registration numbers, state practice acts dictate the level of prescriptive authority |
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Credentials |
education licensure certification
ensured safe health care is provided comply with federal and state laws |
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Licensure |
granted by governmental regulatory board like state board of nursing |
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certification |
mastery |
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Priviledges |
process by which NP granted permission to practice in inpatient setting
Hospital committee for hospital priviledges
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Informed Consent |
patient has received adequate instruction or information regarding aspects of care to make a prudent, personal choice regarding treatment |
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Competence Decisional capability |
patient is able to make personal decisions about his/her care
implies the ability to understand, reason, differentiate good and bad, and communicate |
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Right to refuse care |
as long as patient is competent |
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nonmaleficence |
duty to do no harm |
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utilitarianism |
produces greatest good for the greatest number |
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beneficence |
prevent harm and promote good |
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justice |
duty to be fair |
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fidelity |
duty to be faithful |
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veracity |
duty to be truthful |
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autonomy |
respect an individual's thoughts and actions |
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Role of NP started where? |
pediatrics |
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Four distinct roles of an NP |
clinician consultant/collaborator educator researcher |
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Major steps in research process |
formulating the research problem reviewing related literature formulating hypotheses selecting the research design identify population to be studied specify methods of data collection design the study conduct the study analyze data interpret results communicate findings |
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non-experimental research |
no experiment descriptive and ex post facto/correlational
ex post facto: examines relationships among variables |
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cross sectional research |
examines a population with a very similar attribute but differs in one specific variable (age) to find relationships between variables
surveys |
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cohort research |
compares a particular outcome (lung cancer) in individuals who are alike in many ways but differ by a certain characteristics |
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longitudinal research |
taking multiple measures of groups/population over an extended period of time to find relationships between variables |
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experiemental |
experimental manipulation utilizing randomization and a control group to test the effects of an intervention or experiement |
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Quasi-experiemental |
manipulation of variables but lacks a comparison group or randomization |
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qualitative research |
case studies open-ended questions field studies participant observation
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confidence interval |
an interval with limits at either end specific probability of including the parameter being estimated
Example: confidence interval =2.8-3.2 terminally ill bone cancer patients in the final stages of illness have between 2.8 and 3.2 episodes of nausea every 24 hours |
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standard deviation |
average amount of deviation of values from the mean |
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level of significance |
probability level of which the results of statistical analyses are judged to indicate a statistically significant differences between groups |
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perfect correlation |
measure of the interdependence of two random variables that range from -1 to +1 |
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t-test |
statistical test to evaluate the differences in means between two groups |
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reliability |
consistency of a measurement or the degree to which an instrument measures the same way over time with the same objects |
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validity |
degree to which a variable measures what is intended to measure |
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liability |
legal responsibility that a NP has for actions that fail to meet the standard of care
resulting in actual or potential harm to patient |
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negligence |
failure to do what a reasonable person would do
resulting in injury to the patient |
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malpractice |
failure to render services with the degree of care, diligence, and precaution that another member of the same profession under similar circumstances would render to prevent injury to someone else |
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malpractice insurance |
does not cover an APN from charges of practicing medicine without a license of the APN is practicing outside the legal scope of practice for that state |
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Assault |
intentional act by one person that creates an apprehension in another of an imminent harmful or offensive contact
assault is carried out by a threat of bodily harm coupled with apparent present ability to cause the harm
ex: shaking fist at someone |
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battery |
illegal, willful, angry, violent, or negligent striking of a person, his clothes, or anything with which he is in contact
can commit battery on unconscious person but not assault |
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defamation |
communication that causes someone to suffer damaged reputation |
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libel |
written material |
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slander |
spoken material |
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Involuntary commitment |
duty to commit someone who is in danger of hurting themselves or others as a result of mental illness |
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Good samaritan statutes |
protect health care providers from law suits when they aid at the scene of an accident |
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Cultural competence Standard 4 |
organization must provide language assistance services including bilingual staff and intepreter services with no cost to patient |
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Cultural competence Standard 5 |
organization must provide must provide in their preferred language verbal offers, written notices |
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Cultural competence Standard 6 |
organization mus assure the competence of language assistance provided |
