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36 Cards in this Set

  • Front
  • Back
Define Primary Care
“Primary care is the provision of integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community.”
“a collective or network of professionals that jointly designs, delivers, and evaluates outcomes of care"
Health maintainence
A "health maintenance evaluation" includes identifying risk factors in one's personal and family health history, performing a focused exam, as appropriate, obtaining needed screening tests at the right intervals, and encouraging people to choose healthy lifestyles to maximize their health. This "checkup" can occur during an office visit devoted to health maintenance or may be covered during an office visit for other concerns.
a means of accomplishing early detection of disease in asymptomatic people”
What is the purpose of primary health care?
“to encourage wellness, prevent illness, treat chronic disease, and provide palliative care”
What does your textbook mean by “…health care is not a commodity – it is a relationship between the patient and the provider?”
the patient-provider relationship is essential to therapeutic care – this partnership requires trust, respect, caring & can be threatened by the demands of the health care environment
What are the elements of collaborative practice?
Focus on the needs of the pt, trust, recognition of each discipline’s contribution/expertise, time for care planning
What are practice guidelines?
References for patient care that identify suggested treatment options & are designed by a network of health care providers
Level 1 research question
“What is ?”
Level 1 research purpose
Describe pertinent characteristics of a phenomenon of interest
Level 1 research method
Survey data,
Qualitative methods
Structured interviews
Level 1 research analysis
Nonparametric statistics, measures of central tendency, ethnography, content analysis
Level 1 research application
Guides assessment parameters, does not guide selection of intervention or treatment
Level 2 research question
“What is happening here?”
Level 2 research purpose
Establish relationships (associations or differences) between variables
Level 2 reseach method
Epidemiologic study w large data set
Compare 2 groups
Level 2 reseach analysis
Measures of association (correlation coefficients) or differences (t-tests, ANOVA)
Level 2 research application
May suggest change in behaviors, but doesn’t guide how to change beh or explain how the behavioral change will be effective
Level 3 reseach method
Experimental design
Level 4 reseach method
Randomized clinical trials (RCT)
Level 3 reseach analysis
Test hypothesized relationship between independent & dependent variables (ANOVA, regression analysis
Level 4 reseach analysis
Intent to treat analysis, ANOVA, regression analysis
Level 3 research application
Predict outcomes, suggest underlying pathologic conditions that may be treated
Level 4 research application
Demonstrate usefulness of a particular treatment for a pt population. With sufficient replication, clinician may be reasonably sure the tx will be effective
Level 3 Research question
“What is the nature of the relationship among variables?”
Level 4 research question
“What is the effect of an intervention?
What is the proper dose of tx to achieve predictable outcome?”
Level 3 research purpose
Identify the mechanistic relationship among characteristic variables associated with the phenomenon of interest; determine cause & effect
Level 4 research purpose
Demonstrate effectiveness of an intervention or treatment
What are four questions that can be used to guide analysis of ethical dilemmas?
1)Distinguish moral from nonmoral evaluations and who ought to determine the outcome of a clinical situation
2)What acts are right? What are the principles involved and how are the principles of the parties involved balanced?
3)How do the principles (or rules) apply to this specific situation?
4)What should be done in this particular situation?
Define informed consent
pt has the right to relevant, current, understandable info regarding diagnosis, tx, prognosis & is entitled to request info regarding procedures/tx and their risks, benefits, alternatives. Pt must be able to give consent & consent must be voluntary
What are two basic tenets in the Patient’s Bill of Rights?
1)respect for the role of the patient in decision making regarding treatment choices and all aspects of care
2)sensitivity to racial, cultural, linguistic, religious, and gender differences, as well as to the needs of pts with disabilities
Why are privacy and confidentiality essential ethical standards in the practice of primary health care?
Essential to the establishment of trust
What is malpractice?
“Deviation from the standard of care compared to what another prudent provider with the same education and skills would do under the same circumstances”. Pt must show evidence of: duty, breach of duty, proximate cause, damages. Typically results from poor communication and little/no follow-up.
How can you, a health care provider, reduce your risk of malpractice? (List of 8 steps)
1) Quote pt directly. Have pt sign if they refuse test/tx or sign that side effects of tx were reviewed
2) Have MA or nurse accompany you for sensitive exams and document this
3) Write exact thoughts when documenting differentials, don’t limit to one diff
4) Document discussion of risks/benefits of tx or tx refusal & document pt’s understanding of what will happen if tx refused. May require multiple visits
5) Dictate in front of the pt & ask them “is that correct?” at the end
6) Document that you protected people who aren’t your pts (ie that you advised partner notification for STIs)
7) Document goals of care and the pt understands them
8) When prescribing meds, document that you gave exact instructions re taking meds and have reviewed common side effects.
Review the components of lifestyle assessment.
Occupation, diet, exercise, stress, social support, smoking, substance use, contraception, domestic violence, home safety, other safety measures (fire extinguisher, seat belts, sunscreen, bike helmets, etc) health screenings – dentist, eyes, etc
Review the vaccine-preventable infectious diseases prevalent among adults in the United States.
Td: booster q10 yrs
MMR: 1 dose MMR unless contraindicated if not immunized as a child
Hepatitis B: 7yrs-adult series of 3 doses
Influenza: annually in the fall
Pneumococcal: adults >65 1 dose revaccination recommended only for those at highest risk> 6yrs after 1st dose
Varicella: 1dose then repeat