Podcast
Questions and Answers
How does managed care affect the economics of health care delivery?
How does managed care affect the economics of health care delivery?
- Provides incentives for smaller private or individual hospitals
- Uses corporate economics to achieve a profit
- Care is paid for at a prearranged rate (correct)
- Increases the tax base for the community
Which statement regarding characteristics of clinical pathways shows the nurse's lack of understanding?
Which statement regarding characteristics of clinical pathways shows the nurse's lack of understanding?
- "Clinical pathways use a timeline with sequenced interventions."
- "Clinical pathways focus on patient outcomes."
- "Clinical pathways collaborate efforts by health care professionals."
- "Clinical pathways involve nurse-centered orientation." (correct)
Which statement shows the nurse's understanding of patient-focused care?
Which statement shows the nurse's understanding of patient-focused care?
- "Patient-focused care is a clinical pathway within an institution."
- "Patient-focused care is a nursing care delivery system." (correct)
- "Patient-focused care is an institutional value and philosophy."
- "Patient-focused care is a model for a health care organization."
Which statement by the nurse manager is inaccurate regarding the forces of magnetism? "Forces of magnetism include
Which statement by the nurse manager is inaccurate regarding the forces of magnetism? "Forces of magnetism include
A nurse manager is training a new hire. Which statement shows an understanding of functional nursing?
A nurse manager is training a new hire. Which statement shows an understanding of functional nursing?
Which of the following statements shows the nurse's understanding of primary nursing?
Which of the following statements shows the nurse's understanding of primary nursing?
Which statement is true about case management?
Which statement is true about case management?
A nurse is interested in case management. Which statement indicates an understanding of the primary work environment of case managers?
A nurse is interested in case management. Which statement indicates an understanding of the primary work environment of case managers?
Which statement is true about patient classification systems?
Which statement is true about patient classification systems?
Which of the following best describes the concept of evidence-based practice?
Which of the following best describes the concept of evidence-based practice?
A female patient is admitted to the labor and delivery unit, where she is assigned to a registered nurse who will manage her care for the duration of her hospitalization. What type of nursing care delivery model is represented in this nursing unit?
A female patient is admitted to the labor and delivery unit, where she is assigned to a registered nurse who will manage her care for the duration of her hospitalization. What type of nursing care delivery model is represented in this nursing unit?
The nurse is reviewing the upcoming discharges. Which patient would a case manager be assigned to?
The nurse is reviewing the upcoming discharges. Which patient would a case manager be assigned to?
Which of the following statements about evidence-based practice shows that the nurse has an adequate understanding?
Which of the following statements about evidence-based practice shows that the nurse has an adequate understanding?
A new nurse is determining which hospital to apply for. The nurse has heard a lot about magnet hospitals from friends, who are nurses, and knows that working for a magnet hospital would mean that
A new nurse is determining which hospital to apply for. The nurse has heard a lot about magnet hospitals from friends, who are nurses, and knows that working for a magnet hospital would mean that
The nurse assesses the quality of patient care to be higher in the Total Patient Care model because
The nurse assesses the quality of patient care to be higher in the Total Patient Care model because
A nurse has been assigned as team leader for the day and is working with two LPNs and two unlicensed personnel. What should the nurse do to ensure success in caring for patients?
A nurse has been assigned as team leader for the day and is working with two LPNs and two unlicensed personnel. What should the nurse do to ensure success in caring for patients?
The nurse has an adequate understanding of patient-focused care when stating which of the following?
The nurse has an adequate understanding of patient-focused care when stating which of the following?
Which type of nursing delivery models would be appropriate in a rural area that would require fewer numbers of registered nurses? (Select all that apply.)
Which type of nursing delivery models would be appropriate in a rural area that would require fewer numbers of registered nurses? (Select all that apply.)
The nurse understands cost containment when stating which of the following? Major elements of the law that support cost containment include (Select all that apply.)
The nurse understands cost containment when stating which of the following? Major elements of the law that support cost containment include (Select all that apply.)
Which actions can the hospital administrator take to reduce health care costs? (Select all that apply.)
Which actions can the hospital administrator take to reduce health care costs? (Select all that apply.)
Which statements by the nurse indicate the understanding of the case manager's role? The case manager (Select all that apply.)
Which statements by the nurse indicate the understanding of the case manager's role? The case manager (Select all that apply.)
The nurse judges that the disease management program has been successful when the patient (Select all that apply.)
The nurse judges that the disease management program has been successful when the patient (Select all that apply.)
Which actions can hospitals take to retain nurses in light of the current and projected nursing shortage? (Select all that apply.)
Which actions can hospitals take to retain nurses in light of the current and projected nursing shortage? (Select all that apply.)
What actions can the hospital Chief Nursing Officer take to decrease staff nurse turnover? (Select all that apply.)
What actions can the hospital Chief Nursing Officer take to decrease staff nurse turnover? (Select all that apply.)
The nursing manager explains value-based care with which statements? (Select all that apply.)
The nursing manager explains value-based care with which statements? (Select all that apply.)
Flashcards
Managed Care
Managed Care
Care paid at a prearranged rate, reducing healthcare costs by avoiding billed rates.
Clinical Pathways
Clinical Pathways
Interdisciplinary plans outlining optimal intervention sequencing and timing for specific conditions or procedures.
Patient-Focused Care
Patient-Focused Care
Delivery system focused on centralizing functions and cross-training staff to increase productivity and reduce patient contact.
Forces of Magnetism
Forces of Magnetism
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Functional Nursing
Functional Nursing
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Primary Nursing
Primary Nursing
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Case Management
Case Management
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Patient Classification Systems
Patient Classification Systems
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Evidence-Based Practice
Evidence-Based Practice
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Primary Care Nursing
Primary Care Nursing
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Case Manager Role
Case Manager Role
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Disease Management Program Success
Disease Management Program Success
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Retaining Nurses
Retaining Nurses
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Value-Based Care
Value-Based Care
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Study Notes
Managed Care Economics
- Managed care pays for care at a prearranged rate, aiming to lower healthcare costs
- It doesn't raise the community tax base since patients and insurers cover costs
- Managed care favors larger hospitals/corporations and reduces service duplication
Clinical Pathways
- Clinical pathways are interdisciplinary care plans with optimal intervention sequencing and timing for specific diagnoses, procedures, or symptoms
- Clinical pathways are not nurse-centered
Patient-Focused Care
- Patient-focused care centralizes functions like phlebotomy and respiratory therapy on the unit under a nurse's direction
- It involves cross-training ancillary workers and reduces the number of people a patient interacts with
Forces of Magnetism
- Forces of magnetism encompass professional care models, consultation, resources, and nurses as educators
- They do not include cost reduction and sound budgets
Functional Nursing
- Functional nursing divides care into tasks performed by different personnel, resulting in fragmented care
- Aides, vocational nurses, and LPNs can perform specific functions
Primary Nursing
- Primary nursing assigns one nurse to plan care for a patient over a 24-hour period
- It eliminates fragmentation between shifts and nurses
Case Management
- Case management reduces costs and ensures care coordination
- Its goal is to assist clients in achieving goals and it also involves cost control, but may not always provide direct patient care
- Multiple health team members are often involved
Work Environment of Case Managers
- Case managers work in various healthcare settings, including acute care, rehab, and outpatient facilities
- They may work for insurance companies or in health-related areas of large businesses
- Registered nurses, social workers, and therapists can be case managers
- Essential skills include communication, critical thinking, negotiation, and collaboration skills
Patient Classification Systems
- Patient classification systems estimate the intensity of nursing care needed in acute care hospitals, based on patient needs
- These systems do not measure all patient needs, provide absolute staffing formulas, or make patient assignments
Evidence-Based Practice (EBP)
- EBP uses current best evidence to inform care and decision-making
- IOM reported that it took 17 years for research to be reflected in daily practice
- EBP is not designed for cost containment or reimbursement determination by external entities
Primary Care Nursing (Example)
- In primary care, a single nurse manages and coordinates patient care around the clock
- Patient-focused care takes an interdisciplinary approach
- Functional care involves care from nursing and ancillary staff
- Case management coordinates care, especially for patients with complicated healthcare needs, the nurse case manager coordinates and collaborates with other health services
Case Manager Assignment Criteria
- Case managers are involved when patients have complicated, expensive care or are treated by multiple providers
- They help transition care, for example moving over to a nursing home
Understanding of Evidence-Based Practice
- Evidence-based practice is using current best evidence when making decisions about patient care
Magnet Hospitals
- Magnet hospitals attract and retain nurses due to high job satisfaction rates
- These hospitals have low turnover and vacancy rates
Total Patient Care Model
- The total Patient Care model that has higher quality because nurses focus all their care on one patient
Nurse's Role as a Team Leader
- Nurses should communicate with team members continuously, updating them on patient status and plan of care
Adequate Understanding of Patient-Focused Care
- Nurses supervise the delivery of care
Rural Nursing Delivery Models
- Functional nursing, team nursing, and patient-focused care are suitable for rural areas
- Because they require fewer registered nurses.
- These models effectively utilize ancillary staff
Cost Containment Elements in Law
- Cost containment is supported by increased government regulation of insurers
- The cost containment also includes increased incentives for care coordination
Hospital Administrator Actions to Reduce Healthcare Costs
- Hiring case managers
- Ensuring appropriate staffing
- Encouraging evidence-based practice
Nurse Case Manager Role
- The case manager guides patients through the healthcare delivery process
- The case manager Coordinates care and helps patients achieve goals efficiently, also collaborating with the healthcare team
Successful Disease Management Program
- Disease management programs the patients assume health responsibility, maintain good health, manage conditions, and prevent worsening.
Hospital Actions to Retain Nurses
- Healthcare systems should support advancement, foster cohesion, allow autonomy, and offer varied specialties
Chief Nursing Officer (CNO) Actions for Decreased Staff Turnover
- Actions for decreasing staff turnover include nurse residency programs, magnet status, and scheduling flexibility
Value-Based Care
- Value-based care has reimbursement based on patient outcomes, uses evidence-based approaches, and it aims for reduced adverse events
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