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33 Cards in this Set
- Front
- Back
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Nursing Models of Care |
Functional Nursing
Team Nursing
Primary Nursing
Modular Nursing
Case Method
Patient-Centered/Patient-Focused Care |
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Functional Nursing |
Divides nursing work into functional roles assigned to one or more team member; Each team member is responsible for specific duties or task |
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Team Nursing |
Assigns tasks to teams, then they're responsible for a group of pt.; Grouped by acuity |
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Primary Nursing |
Delineates responsibility and accountability to the RN for their primary care |
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Modular Nursing |
Like team nursing, but assigned to a geographical area instead of group pt., not grouped by acuity |
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Case Method |
Nurse is responsible for of one case, one individual patient |
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Patient-Centered/Patient-Focused Care |
Focuses on pt. needs rather than staff needs. Staffing is based on pt. needs; The right person doing the right things. (Care teams can include respiratory, PT) |
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DRG (Diagnostic Related Groups) |
Designed to control costs & decrease LOS
Reimbursement is predetermined, fixed amt. based on diagnosis
Restored reimbursement fees that had been cut w/ Balanced Budget Act 1997 |
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PPO (Preferred Provider Organization) |
Don't have to use Gatekeeper (PCP) and no referral is required for specialty cervices
Somewhat restrictive, but less restrictive than HMO
Pay a portion if outside the network
More out-of-pocket costs than HMO
Example: Medical Mutual SuperMed Plus |
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HMO (Health Maintenance Organization) |
Pt. chooses Gatekeeper-Primary Care Provider (PCP)
Most restrictive
Can only see specialist if PCP refers them
Least choice in selecting HCP
Lowest out-of-pocket expense
Example: HealthSpan (formerly Kaiser Permanente) |
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(POS) Point of Service Plan |
Hybrid or open-ended POS Plan
Least restrictive
Can choose between HMO or PPO
Can choose own PCP
More flexibility & freedom of choice
Can use specialist in or out of network |
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Managed Care |
Health insurance plans that contract w/ healthcare providers and medical facilities. |
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Nurse Case Manager |
Responsibility for monitoring and improving care Collects aggregate data on pt.'s clinical pathways
Provide info to the staff nurse at the bedside |
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Delegation |
Accountability - Be responsible, answerable for actions of self or others
Responsibility - Reliability, dependability & obligation to accomplish accepted assignments Authority - Right to act or to command the action of others; Required for nurses
Assignment - Distribution of work that each staff member is to accomplish during a given shift or work period
Competence - Application of knowledge & interpersonal decision-making & psychomotor skills
Supervision - Provision of guidance, direction, follow up of accomplishment of nursing task |
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Principles of Delegation |
Positive attitude Effective communication
Indicate priorities
Be fair about undesirable activities
Be aware of the manner in which you delegate
Trust |
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Sources of Power |
Expert - Power derived from the knowledge and skills nurses possess
Legitimate - Power derived from the position a nurse holds in a group, and it indicates the nurses degree of authority
Referent - Power derived from how mush others respect and like any individual , group, or organization.
Reward - Ability to reward others to influence them to change their behavior
Cohesive-People who have ability to administer punishment or disciplinary action against others to influence them to change behavior
Connection- Extent to which nurses are connected with others in power |
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Whistle Blowing |
An act which an individual discloses information regarding a violation of law, rule or regulation, or a substantial danger to public health or safety
Nurse is pt advocate and has an ethical and moral duty to protect patients |
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Baby Boomers |
Workaholics, material gain, corner offices
Had dramatic impact on present and will impact future as they continue to retire |
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Generation X |
Latchkey kids
Independent
As staff they respond well to goal setting
Current w/ technology |
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Gen Y |
Grew up at end of Cold War
Called "Millenials"
Grew up w/ internet and speak your mind philosophy
Their lives have been filled with structure and activity |
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Autocratic |
Centralized decision, leader makes decisions, uses power to command/control others |
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Democratic |
Close personal relationship to others, delegates |
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Lassez-faire |
Passive, permissive, defers decision-making |
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Principles of Quality Improvement |
1) Priority to benefit pt. and all other external customers
2) Quality achieved through participation of all in the organization
3) Improvement opportunity developed by focusing on the of the work process
4) Decisions to change or improve a system is based on data
5) Improvement of the quality of service is a CONTINUOUS process |
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Benchmarking |
Measuring and comparing results of key work processes w/ the best |
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PDSA Cycle |
3 questions to increase the ability to predict the effect that one or more changes would have if implemented |
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FOCUS |
Step wise process to move through the improvement process |
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Sentinel Event
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Unexpected occurrence involving death, injury |
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EBP |
Unconscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients
Uses outcomes research and other to guide development of appropriate strategies to deliver quality cost-effective care
Nurses make clinical decisions using best available research evidence, their clinical expertise and pt. preferences in the context of available resources |
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Ethics Committee |
Comprised of an interdisciplinary group representing medicine, nursing, pastoral care, pharmacy, nutrition, social services, legal and community
Purpose is to provide a thoughtful and timely consultation when an ethical issue arises
Ethics committee consults, gives guidance, provides resources needed for ethically sound decision-making
They DO NOT make decisions |
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Change Process |
Assess, implement, evaluate, stabilization of change (similar to nursing process) |
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Priorities of Care |
1 – ABCs, abnormal vitals, evidence of low oxygenation 2 – Need immediate intervention after #1 addressed – mental status changes, acute anxiety, pain, urinary elim, medical problems needing immediate attention (ie: insulin), abnormal lab values, risk to safety/security, infection
3 – care problems not in above (lack of rest, teaching needs, family coping, activity) |
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Benner's Five Stages |
1. Novice |
