Podcast
Questions and Answers
What was the goal of the Affordable Care Act regarding healthcare?
What was the goal of the Affordable Care Act regarding healthcare?
Which of the following represents a strategy to reduce overused health interventions?
Which of the following represents a strategy to reduce overused health interventions?
Which of the following is a common cause of overuse in healthcare?
Which of the following is a common cause of overuse in healthcare?
What term describes the belief that more treatment is inherently better, leading to healthcare overuse?
What term describes the belief that more treatment is inherently better, leading to healthcare overuse?
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In what year did the National Priorities Partnership identify five overused health interventions?
In what year did the National Priorities Partnership identify five overused health interventions?
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Which state is NOT mentioned as requiring nursing quality indicator reporting?
Which state is NOT mentioned as requiring nursing quality indicator reporting?
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What is a characteristic of the Evidence-based policy approach?
What is a characteristic of the Evidence-based policy approach?
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What is a potential consequence of healthcare overuse?
What is a potential consequence of healthcare overuse?
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What does value-driven health care primarily aim to achieve?
What does value-driven health care primarily aim to achieve?
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Which of the following examples reflects a common overused intervention?
Which of the following examples reflects a common overused intervention?
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What is a crucial consideration when using research to influence health policy?
What is a crucial consideration when using research to influence health policy?
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Which type of literature review is characterized by the summarization of relevant literature without in-depth analysis?
Which type of literature review is characterized by the summarization of relevant literature without in-depth analysis?
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What was a significant outcome of the 1999 nurse staffing legislation in California?
What was a significant outcome of the 1999 nurse staffing legislation in California?
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According to the frameworks for change, what is the first step in managing complex systems?
According to the frameworks for change, what is the first step in managing complex systems?
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Which regulatory code mandates hospitals participating in Medicare to maintain adequate numbers of registered nurses?
Which regulatory code mandates hospitals participating in Medicare to maintain adequate numbers of registered nurses?
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In the context of workplace cultures, what characterizes Magnet hospitals?
In the context of workplace cultures, what characterizes Magnet hospitals?
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Which important aspect of patient-centered care focuses on addressing patient fears and anxiety?
Which important aspect of patient-centered care focuses on addressing patient fears and anxiety?
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What is one common belief about unions in the workplace highlighted in the content?
What is one common belief about unions in the workplace highlighted in the content?
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Which of the following factors significantly influences reproductive health in the US?
Which of the following factors significantly influences reproductive health in the US?
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How many nurse-managed health clinics are currently present in the US?
How many nurse-managed health clinics are currently present in the US?
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What is one of the significant policy issues faced by the Veterans Health Administration?
What is one of the significant policy issues faced by the Veterans Health Administration?
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Which of the following best describes the International Council of Nurses?
Which of the following best describes the International Council of Nurses?
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What aspect of care does the Veterans Health Administration particularly need to address to reduce veteran suicide rates?
What aspect of care does the Veterans Health Administration particularly need to address to reduce veteran suicide rates?
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What is one issue related to the environment that was inadequately addressed, according to the information provided?
What is one issue related to the environment that was inadequately addressed, according to the information provided?
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Which statement regarding the scope of the Veterans Health Administration is correct?
Which statement regarding the scope of the Veterans Health Administration is correct?
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What organization works to ensure high quality nursing care worldwide?
What organization works to ensure high quality nursing care worldwide?
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Which of the following health concerns is specifically highlighted for the Veterans Health Administration?
Which of the following health concerns is specifically highlighted for the Veterans Health Administration?
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What common organizational issue is mentioned as affecting infection control?
What common organizational issue is mentioned as affecting infection control?
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Which entity is part of the Federation of National Nurses' Associations?
Which entity is part of the Federation of National Nurses' Associations?
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What was one of the founding goals of the International Council of Nurses?
What was one of the founding goals of the International Council of Nurses?
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Study Notes
Overused Healthcare Interventions
- Common overused interventions include prescription drugs, antibiotics, lab tests, imaging, and procedures like back surgery and prostatectomy, as well as end-of-life treatments.
- Identified as overused in 2008 by the National Priorities Partnership.
- Examples include antibiotic treatment for colds, spinal fusion, and pacemakers.
- Causes of overuse include fee-for-service payment, diagnostic fear, provider beliefs and expectations, patient expectations, clinical competence and skills.
- Strategies to reduce overuse include the Choosing Wisely Campaign and encouraging conversations between providers and patients. Public reporting of hospital-specific information (LeapFrog) is also used.
- "Marinated Mind" describes the idea that more treatment is better, leading to a rushed workflow.
Affordable Care Act (ACA)
- Goal is to increase access to healthcare by expanding coverage, incentivizing quality and efficiency, and providing the best care at the right price.
- Three main goals are cost, quality, and access, achieved through accountability, transparency, performance measurement, public reporting, and value-based purchasing.
Value-Driven Healthcare
- Improves care quality while lowering costs.
- Links affordable care with quality.
- Examples include performance measurement (e.g., Nursing Quality Indicators) and public reporting, which empowers consumers and incentivizes quality care. Maine and Colorado require nurse reporting.
Using Research to Influence Policy
- Research uptake into policies is often slow (can take up to 20 years).
- Difficulties include financial consequences for industries related to healthcare research, potential controversy in data collection, and research being influenced by sponsors.
- Positives include the ability to understand policies and potential opponents, consider study limitations, and refer to related research.
- Negatives include assuming policymakers are interested in research methods, biased writing, exaggerating effects, citing unreliable research, and failing to see research as one aspect of policy.
Types of Literature Reviews
- Systematic Reviews: Focus on experimental studies, precise searches, and duplicates, aiming to reach conclusions on a topic.
- Literature Reviews: Summarize relevant literature, descriptive without analysis, ideal for background knowledge, starting reading lists and searches.
- Integrative Reviews: Often include non-experimental studies (case studies, observational), precise criteria for selection, analyzing instead of summarizing literature.
Nurse-Patient Ratios and State Policy
- First US legislation was in 1999 in California.
- Most states have guidelines for nurse staffing plans, public disclosure of staffing levels, and minimum staffing ratios. California is the only state with minimum ratios. New York mandates reporting.
- The only federal regulation directly referencing nurse staffing is 42 CFR 482.23(b), requiring Medicare-participating hospitals to have adequate RNs.
Workplace Cultures
- Complex systems can be managed through a framework for change.
- Three types of workplace cultures: Union/collective bargaining, Magnet, and nondesignated.
- Union culture is declining, with success relying on distrust in management. Management must work with union leaders.
- Magnet culture (397 hospitals) has decentralized decision-making, transformational leadership, new knowledge and innovation.
- Nondesignated culture (5723 hospitals) is guided by CEO management philosophy, relying on a high level of trust.
John Kotter's 8 Stages of Change
- Establish urgency; create a guiding coalition; develop strategy/vision; communicate vision; empower action; generate short-term wins; consolidate gains; anchor new approaches in culture. Framework for change.
Reproductive Health Policy
- Issues surrounding control over a pregnant woman's body, sexual health, and religious beliefs.
- The ACA mandates women's preventative care, including contraception without copays.
Patient-Centered Care
- Eight dimensions include respecting values, information/education, access to care, emotional support, family involvement, continuity/transitions, physical comfort, and care coordination. Patient-centered care is comprehensive care (whole person - mind, body, soul).
Nurse-Managed Health Clinics
- Run by advanced practice nurses (APRNs), these clinics provide primary care to underserved populations.
- About 250 in the US, primarily serving low-income, uninsured patients.
- Focuses on chronic disease management through patient education, lifestyle changes, and counseling.
Nursing Homes and Quality of Care
- Nursing homes often have poor quality of care.
- State surveys and certifications address compliance, but enforcement is weak, staffing is inadequate, and corporate ownership is a factor.
Veterans Health Administration (VHA) Policy
- Serves 8.3 million service members, retirees, and families.
- Large integrated system (152 medical centers, 1400+ outpatient clinics).
- Policy issues include PTSD assessment/treatment, sexual assault investigation, suicide prevention, access to care.
International Council of Nurses (ICN)
- Policy on ethical nurse recruitment and retention.
- International organization for health professionals, representing over 130 countries. Founded in 1899. Works to ensure high quality care, sound policies, advanced nursing knowledge, and a satisfied nursing workforce. Partners with WHO, UNAIDS, UNICEF.
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Description
This quiz explores the common overused healthcare interventions identified by the National Priorities Partnership in 2008, including unnecessary prescription drugs and procedures. It also discusses the Affordable Care Act's goal to improve healthcare access and quality. Test your knowledge on these important healthcare topics!
