Transition To The Registered Professional Nurse Role-Healthcare Deliver Systems & Community Based Practice

Front 1

Single-parent families

Back 1

-need for support services such as daycare
-approximately 50% of children live in single family homes
-increased overload and fatigue in managing daily tasks
-increased financial concerns
-social isolation

Front 2

Working Parents

Back 2

-increased since the 1960s due to increased careeer opportunities for women
-good quality affordable child care is a major stressor

Front 3

Adolescent Parents

Back 3

-parents often developmentally, physically, emotionally and financially ill prepared to take on the role of care-provider
-children of adolescent parents at greater risk for health and social problems
-at greater risk for abuse and neglect
-fewer role models to assist in breaking out of the cycle of poverty
-because they often live in poverty children may not receive immunizations or routine medical care
-increased risk for malnutrition in children
-poor access to prenatal care during pregnancy

Front 4

Aging population

Back 4

-increased life span
-greater occurance of long-term or chronic illnesses
-increased need for nursing services specializing in gerontology and age related illnesses
-increased need for SNF and long-term care facillities
-feelings of lack of purpose and decreased self-esteem lead to decreased participation of health promoting activities (ie exercise or community or family involvement)

Front 5

Shift from Rural to Urban

Back 5

-increased need for nursing related to problems caused by pollution and by the effects on the environment on concentrations of people

Front 6

Immigration

Back 6

-emphasis on care that is culturally sensitive, cultural approriate and culturally competant
-increased need for nurses that speak multiple languages
-culture may include herbal remedies and folk medicine that may impact prescription medications

Front 7

Poverty

Back 7

-delayed access to health care until illness reches a level where longer and more complex treatments may be necessary
-lack of access to routine health screenings and preventative care
-non-compliance with medicine regimens due to financial reasons

Front 8

Substance Abuse

Back 8

-increased cases of violence, injury and blood born disease from needle sharing (ie HIV )
-increased morbitity and mortality
-deterioration of social structure puts addicts at risk for homelessness, poverty and malnutrition

Front 9

Child/Elder abuse

Back 9

-factors associated with abuse include stress, poverty, social isolation, psycopathology, and learned family behavior
-substance abuse, pregnancy, sexual orientation and mental illness may increase the incidence of abuse
-may have long-term physical and emotional consequences even after being removed from the enviroment.
-continued cycles of abuse
-can include physical, mental, neglect

Front 10

Violence

Back 10

-predisposing factors include poverty, family breakdown, child abuse and neglect, repeated exposure to violence, readily accessible weapons, environment

Front 11

Aquired Immunodeficiency Syndrome (AIDS)

Back 11

-medical advances have decreased the incidence of AIDS and slowed progression from HIV to AIDS
-increased life expectency compared to before mid-90s
-high risk behaviors such as substance abuse, unprotected sex increase likelyhood of contraction
-higher incidence in minorities and women
-emotionally and financially devestating

Front 12

Uninsured Patients

Back 12

-delay access to healthcare until illnesses have progressed often requiring longer and more complicated treatment
-lack of preventative care
-unmanaged chronic conditions due to costs of treatment

Front 13

Homelessness

Back 13

-children often in fair or poor health with higher rates of asthma, ear infections, stomach problems and mental illness
-poor nutrition
-exposure

Front 14

Chronic Illness

Back 14

-high health costs for medication and treatment
-social and economic strain on the family unit may predispose chronicly ill individuals to abuse/neglect
-may require long-term care in a SNF

Front 15

preventative services

Back 15

-lower overall cost by reducing incidence of illness by controlling risk factors through activities such as immunizations and occupational health programs

Front 16

Health Maitenance Organization (HMO)

Back 16

-group healthcare agency that provides basic and supplemental health maitenance and treatment services to voluntary enrollees
-a fee is set without regard to amount or kind of service provided
-must aquire a refferal from PMD to see a specialist

Front 17

Managed Care Organizations (MCO)

Back 17

-administrative control over primary care for a defined client population
-referral to specialists must be approved by the MCO
-to control costs focus shifts from care for the individual illness to concern for the health of the covered population

Front 18

Capitation

Back 18

-a method of paying health care service providers a set amount for each enrolled person assigned to that physician or group of physicians, whether or not that person seeks care, per period of time.

Front 19

healthcare rationing

Back 19

-access to insurance limited by ability to pay
-rejection or increased premiums based on preexisting conditions (will be eliminated as of 2014)

Front 20

Independant Practice Associations (IPA)

Back 20

-clients pay a fixed perspective payment to the IPA and the IPA pays the providers
-at the end of the year any surplus is divided among the providers and any loss is assumed by the IPA

Front 21

Preffered Provider Organization (PPO)

Back 21

-a group of providers that offer an insurance company or employer services at a discounted rate
-offers the client more choice in providers that a HMO but is usually more expensive

Front 22

Medicare

Back 22

-established in 1965, the medicare ammendment to the social security act provided national and state insurance to adults over 65 or workers with permantent disability and their dependants
-all memebers pay deductibles and coinsurance

Front 23

Medicare

Back 23

-established in 1965, the medicare ammendment to the social security act provided national and state insurance to adults over 65 or workers with permantent disability and their dependants
-all memebers pay deductibles and coinsurance

Front 24

Medicaid

Back 24

-federal puplic assistance program paid for out of general taxes

Front 25

Supplemental Security Income (SSI)

Back 25

-payments made to those who are blind or disabled that are not restricted to health care cost
-a person may be eligible even if the are not eligible for social security

Front 26

diagnosis-related groups (DRGs)

Back 26

-establish pretreatment billing catagories
-payment is a predetermined amount based off the diagnosis regardless of the care provided

Front 27

resource utilization groups (RUGs)

Back 27

-used by long-term care facillities to control costs

Front 28

Internet sites

Back 28

-allows the consumer to access healthcare information once only available through your provider
-not all sources are reliable or acurate

Front 29

Self-care

Back 29

-higher focus on quality of life
-active participation in healthcare decisions
-lifestyles focused on energy, vitality and a feeling of wellness through exercise, diet and preventative care

Front 30

Acountability

Back 30

-expectation the providers are giving the best and most appropriate care posible
-expectation of full disclosure and participation in health care decisions

Front 31

Biomedical Technology

Back 31

-nurses may have to be specialized to operated sophisticated monitoring and diagnostic equipment
-expanded capabilities and improved treatments i.e. DNA based vaccines replacing conventional ones

Front 32

Infomation Technology

Back 32

-telehealth is the use of technology to share information and specialties regaurdless of location
+raises questions of licensure
+improves access to specialists in isolated areas
-electronic medical records allow quick and easy access to records allowing an improved continum of care and improved record keeping
+raises issues of security and privacy

Front 33

community based care

Back 33

-a primary health care system that provides health related services within the context of people's daily lives
-care is specific to a group within a geographical area
-holistic, designed to promote health and prevent illness and protect the public

Front 34

Acute Care

Back 34

-urgent care provided for serious illness or injury often by a hospital or urgent care provider
-episodic care provided at secondary care settings

Front 35

long-term care

Back 35

care provided to meet the needs of client that due to a chronic or dibilitating illness are unable to provide some or all daily needs on their own
-provides intermidiate medical, nursing and custodial care
-assistence in ADLs

Front 36

rehabilitation care

Back 36

-provide care with the goal of restoring an person to the fullest physical, mental, social, vocational and economic usefulness possible
-include physical, occupational, speech therapy and social services such as addiction counseling

Front 37

specialty care

Back 37

-highly technical services provided for pt in a large geographical area (i.e. burn center, trauma center, pediatric center ect.)
-often provide acute and on-going care

Front 38

The Joint Commision (formerly JAHCO)

Back 38

-a non-for-profit based organization that accredits health care facilities on the basis of safe and effective care
-in some places a codition for licensure or medicaid reimbursement

Front 39

National Committeefor Quality Assurance (NCQA)

Back 39

-established by the Robert Wood Johnson Foundation to provide management of voluntary accredidation programs

Front 40

Home Health Organizations

Back 40

-provide education to clients and families and provide comprehensive care to the acute, chronic and terminally ill within the setting of their home

Front 41

Hospice

Back 41

-interdisciplinary health care services provided for the dying in the home or in another health care setting.
-focused on improving quality of life leading up until death

Front 42

Occupational Safety and Health Administration

Back 42

An agency of the Department of Labor that publishes and enforces regulations to protect healt h care workers from occupational injuries including exposures in the workplace

Front 43

Centers for Medicare and Medicaid Servies

Back 43

previously known as the Health Care Financing Administration (HCFA)
-federal agency within the United States Department of Health and Human Services (DHHS)
-administers the Medicare program and works in partnership with state governments to administer Medicaid, the State Children's Health Insurance Program (SCHIP), and health insurance portability standards

Front 44

Equal Employment Opportunity Commision

Back 44

a federal law enforcement agency that enforces laws against workplace discrimination

Front 45

legislative process

Back 45

issues are presented to legislators that the create bills that are presented to lawmakers if voted into law it is the responsiblity of administrative agencies to create policies and regulations to enforce the satute. Federal law supercedes State law which supercedes local law

Front 46

American Nurses Association-Political Action Committee (ANA-PAC)

Back 46

established to promote the improvement of the healthcare system in the United States by raising funds and contributing to worthy candidates for federal office who have demonstrated their belief in the legislative and regulatory agenda of the American Nurses Association

Front 47

National League for Nursing (NLN)

Back 47

-aim to shape legislature and policies that affect nursing

Front 48

Special Interest Groups

Back 48

attempt to influence legislature through financial and consituent support to develop policies and laws that benifit the groups they represent (ie AARP supporting medicare laws)