BSNC 3020 Exam Notes PDF

bsnc 3020 exam notes Breakdown: Section 1: 50% —> 13 questions Section 2: 17% —> 4/5 questions Section 3: 33% —> 8/9 questions  ——— Section 1: Canada's Healthcare System: History, Legislation, and Organizational Structures ——— Learning Outcome #1: Define social safety net and provid...

bsnc 3020 exam notes Breakdown: Section 1: 50% —> 13 questions Section 2: 17% —> 4/5 questions Section 3: 33% —> 8/9 questions  ——— Section 1: Canada's Healthcare System: History, Legislation, and Organizational Structures ——— Learning Outcome #1: Define social safety net and provide other examples within Canadian Society. Social Safety Net: a network of national, provincial and territorial social programs and policies implemented by the government to provide financial support and assistance to those in need (ex: elderly, disabled and low-income individuals) Examples: EI, OAS, CPP, and GIS Medicare: a key component of Canada’s social safety net and provision of hospital and medical insurance that is funded by general taxation. It is also referred to as a “national” program. Medicare is an interlocking set of 10 provincial and 3 territorial insurances schemes that provide reasonable “prepaid access to medically necessary hospital and physician services for all citizen and permanent residents. Medicare is also a source of national pride and solidarity as a commitment to the well-being of Canada’s citizens. It is also a source of national debate regarding costs, effectiveness, and sustainability. Sustainability requires long-term maintenance and invokes creation of “standards of health human resources, infrastructure, clinical outcomes and fiscal capacity” for the health system. As urbanization continued, rural communities experienced difficulty attracting and paying physicians The federal Municipality act of 1916 gave communities the power to levy taxes to pay for physicians. With increasing needs, it became apparent that many provinces did not have the tax base to fund and ensure parallel services across the country. Medical care act of 1966 allowed all federal, provincial and territorial governments to agree to share health care expenses equally. By 1972, all provincial and territorial insurance plans extended coverage to include medical services to outside hospitals. Forming the modern Medicare with all Canadians enjoying free access to hospital and medical care, regardless of ability to pay. The Truth and Reconciliation Act understood the impact of residential schools and established cultural competency for Indigenous professionals in health care. Learning Outcome #2: Briefly explain the role of the Canada Health Act (1984) in the development of Medicare. The Canada Health Act articulates the requirements for selected publicly financed health services. Federal legislation that establishes the criteria and conditions that must be met by provincial and territorial health insurance plans in order to recieve funding from the federal government This prohibits user fees or copayments from insured individuals for covered services. Some groups are instead paid/provided for by the federal government including the RCMP, Armed forces, members of parliament, eligible Indigenous groups and federal inmates. Under the act the deferral government is obligated to “protect, promote and restore the physical and mental well-being of residents of Canadians to facilitate reasonable access to health services without financial or other barriers.” (Health Canada, 2011). Learning Outcome #3: List and describe the five principles enshrined in the Canada Health Act. Universality: all eligible residents of Canada must have access to medically necessary hospital and physician services on a prepaid basis Accessibility: all eligible residents must have reasonable access to medically necessary services, without financial or other barriers Portability: resident must maintain coverage when moving between provinces/territories Comprehensivness: the healthcare system must cover all medically necessary services provided by hospitals, physicians and other health professionals Public Administration: healthcare services must be publicly administered by a non-profit entity Learning Outcome #4: Explain the role and influence of the Canada Health Act in establishing health care as a right for all Canadians. This legislation ensures that health care services are publicly funded, accessible to all residents, and delivered without user fees or extra billing. Learning Outcome #5: What are some of the barriers and challenges to implementing Medicare in Canada Funding challenges (accessibility and increased costs), Interprovincial variations, Human resources (recruiting and retaining healthcare workers in rural areas), aging population (managing chronic disease), Wait times, pharmaceutical costs (access to necessary medication), coordination, demographics, technological advancements, geographical barriers and systemic challenges Learning Outcome #6: Who is responsible for the delivery of healthcare in Canada? How are the levels of government responsible for the delivery of health care in Canada? Federal: sets national standards and providing funding to provinces and territories through the Canada Health Transfer. National standards through the Canada Health Act and is responsible for healthcare services for Indigenous peoples, veterans and the military. Provincial/Territorial: responsible for the delivery and administration of healthcare services within their jurisdictions. Manage and fund hospitals, healthcare providers and other healthcare facilities. They also determine scope and nature of healthcare services provided. Learning Outcome #7: Explain the role of each of the following institutions in delivering health care: Hospitals: most specializing in acute care services (short term) Long-term care facilities: provide accommodations for 24-hour intermediate and custodial care for residents of any age with chronic or debilitating illnesses or disabilities Psychiatric facilities: institutions in hospitals/mental clinics/ that offer inpatient and outpatient services to patients. Nurses collaborate with other HCW to make a plan that enables the patient to return to the community. Rehabilitation centre’s: residential institutions that provide therapy and restorative training to decrease patients dependence on care. Substance rehabilitation center help patients withdraw from alcohol and drug dependence and return to the community Learning Outcome #8: Explain the role of each of the following in delivering health care in the community: Public health: focuses on entire populations or subsets of populations rather than on individual patients Primary care: first contact a patient has with the health care system Community health centers and clinics: services that are directed at primary and secondary care Assisted living: community-based residential facilities where adults live and receive a range of support services Home care: provision of health care services and equipment to patients and families in their homes, residential setting, hospitals and ambulatory clinics Adult day support programs: alternative to hospitalization that may be associated with a hospital or LTC facility or exist independently and provide continuous health care services for specific patients (ex: dementia, counselling) Community and voluntary agencies: Heart and Stroke Foundation, Canadian diabetes association Occupational health: focuses on promoting and maintaining the health and safety of workers in their workplaces, including injury prevention, health assessments and wellness programs Hospice and palliative care: family centred care system that enables a person to live in comfort and dignity while living with a life ending illness Learning Outcome #9: List and briefly describe the 5 levels of health care Health Promotion: services and activities that are designed to maintain and improve health status. Enables people to increase control over, and to improve their health Disease and Injury Preventive: services that are for illness prevention and to help reduce the risk of disease and injury Diagnosis and Treatment: recognizing and treating the clients existing health problems Rehabilitative Care: restoration of a person to the fullest physical, mental, social and vocational functioning from a physical or mental illness, injury or chemical addiction Supportive Care: address chronic health needs to patients at any age Learning Outcome #10: Explain primary care, secondary care and tertiary care Primary Care: 1st point of contact for patients seeking healthcare, usually provided by family physicians or nurse practitioners in community settings Secondary Care: involves specialized medical services provided by specialists and hospital-based care Tertiary Care: provides highly specialized medical care such as organ transplants and neurosurgery  ——————————— Section 2: Funding of the Canadian Healthcare System ———————————— Learning Outcomes #1: Briefly explain the 4 areas of federal jurisdiction for healthcare in Canada (1) Set and Administer Canada Health Act principles for the health care system (2) Assist in financing provincial and territorial health care services through transfer payments (ex: transferring money to share cost) in alignment with Canada Act Principles (3) Deliver or co-deliver health services for targeted groups, as described previously (4) provide national policy and programming to promote health and prevent disease, such as health environment, consumer safety and public health programs Learning Outcomes #2: Briefly explain the role of the provincial and territorial governments in the organization and delivery of health care in Canada Each provincial and Territorial government is charged to do the following: - develop and administer its own health care insurance plan - manage, finance, and plan incurable health care services and delivery, complying with Canada Health Act principles - determine organization and location of health care facilities, mix of health care providers employed in these facilities, and money allocations for health care services - reimburse physicians and hospital expenses; provide some rehabilitation and long-term care services, usually on the basis off co-payments with individual users Learning Outcomes #3: Who funds Canada’s health care system? Health care in Canada is funded at both the provincial and federal levels. The financing of healthcare is provided via taxation both from personal and corporate income taxes. At a federal level, funds are allocated to provinces and territories via the Canadian Health and Social Transfer (CHST) Learning Outcomes #5: Recognizing that the out-of-pocket cost of healthcare for average Canadians is increasing, what might be a nurse's role in the delivery and sustainability of healthcare in Canada? plays a role in promoting preventative care measures, advocating for changes to healthcare policies and funding models, and educating patients on ways to access and afford necessary healthcare services  ————————————— Section 3 Primary Health Care——————————————— Learning Outcomes #1: Explain the differences between primary care and PHC. Primary Care: doctor’s office, emerge ® personal health services on an individual level. Primary Health Care: [encourages health promotion] broader, it extends beyond the individual, more towards the area of healthcare, immunizations, maternal child health, nutrition, provides an entry point to the health care system. Focuses on how services are delivered from birth to death across the continuum of care. An issue is a rise in costs of acute, episodic and hospital-based care. Policies and funding decisions have overemphasized illness care at the expense of promoting health, that is why transforming the healthcare system through strengthened PHC is vital. More effective and efficient than those centred on speciality and tertiary care. Goal is to address non-medical determinants of health to improve health by connecting health status and social determinants of health A key point to understand at this stage: By the 1970s, 1980s, and onward, health care professionals, government officials, and world leaders in health care all started to emphasize the importance of health promotion and disease prevention, rather than just treating existing illnesses. In other words, our healthcare system began to respond more comprehensively to health and illness through key reforms in primary health care (Government of Canada, 2019). Learning Outcomes #2: What are the barriers to PHC? Lack of information about technology support Disincentives created by compensation systems Lack if physician leadership and participation on the PHC teams Learning Outcomes #3: What are the 4 pillars of PHC in the Canadian Fundamentals text? Describe each pillar. Teams: PHC functions with team-based care, which improves access and coordination, reduces waiting times and enhances comprehensiveness of care Access: PHC strives to ensure better access to appropriate services when and where they are needed by expediting entry into the health care system, maximizing scopes for practice of health professionals, and reducing demands for care by keeping clients healthier Information: using technology to improve efficient and quality. Tools (electronic health record) skills (tele-health) facilitate quality access and coordination of information. Healthy Living: PHC embraces strategies of prevention, chronic illness management and self-care while recognizing that factors outside of health care systems (social, economic, environmental) influence individual and community health Learning Outcomes #4: What does the CNA position statement on PHC state are the 5 essential principles of PHC? Acccessibilty Active public participation Health promotion and chronic disease prevention and management The use of appropriate technology and innovation Intersectoral cooperation and collaboration Learning Outcomes #5: What does the CNA PHC position statement say about interprofessional collaborative teams? PHC approach calls for a broader collaborative engagement strategy that safeguards the principles of social justice and health equity. PRACTICE QUESTIONS: Queston 1: In Canada’s health care system, physicians act as independent contractors. This is an example of: (A) Decentralization (B) Privatization (C) Universality (D) Accessibility Question 2: An Indigenous child is transferred from Alberta to BC for specialized care that is available at BC Children’s Hospital. Which statement best describes how the child’s health care is funded? (A) The province of Alberta is responsible for the funding (B) The BC Government is responsible for the funding (C) The federal government is responsible for the funding (D) The Indigenous community is responsible to assist with funding Question 3: Which of the following is NOT included as a responsibility of the Federal Government? (A) Set and administer the principles of the health act (B) Deliver or co-deliver health services for targeted groups (C) Develop and administer health care insurance plans (D) Provide national policy and programming to promote health and prevent disease Question 4: An example of Primary Health Care at the macro level would be: (A) Individual immunizations (B) Local water quality (C) Canada’s life expectancy rate (D) Bike accidents in the local school zone Question 5: Which of the following statements best describes Medicare? (A) Funded by provincial and municipal taxes (B) Consistently cost effective and sustainable (C) Required to cover dental and eye care (D) A commitment to the well-being of Canadians Textbook Key Concepts: Medicare is a key component of Canada's social safety net. All levels of government play a major role in co- funding national health insurance and setting health care policy in accordance with the Canada Health Act. The Canada Health Act forbids extra billing and user fees, while articulating the five principles of public administration, comprehensiveness, universality, portability, and accessibility. Health care services are provided in institutional, community, and home settings; across all age groups; and for individual, family, group, and community populations. Five levels of health care are promotive, preventive, curative, rehabilitative, and supportive. Escalating costs, technological innovations, and consumer expectations challenge the health care system in efforts to deliver innovative, efficient, and quality care. Equality, equity, access, interdisciplinary approaches, communication, and continuity of care challenge the health care system. The primacy of PHC and home care align with the reforming health care environment and cost- effectiveness. Successful health promotion and disease prevention programs help patients acquire healthier lifestyles and achieve an optimal quality of life. Sufficient, diverse, and qualified human health resources are essential for a culturally competent workforce attending to a culturally safe Canadian health care system. Enhancing the health of Canada's Indigenous peoples is a significant challenge to society and to the health care system. Nurses must continually seek out information and evidence to remain responsive to providing quality, culturally competent, and safe care. Textbook Review Question #1: A nurse working in a new position in policy development has been asked to identify agencies in Canada that have undertaken an effort to reduce wait times, reduce duplication of tests, and support coordination of care. Which of the following agencies would you expect to be on the list? (Select all that apply.) 1. Canada eHealth 2. Canadian Institute for Health Information 3. Canada Health Infoway 4. Canadian Institutes for Health Research 5. Consumer Association of Canada Textbook Review Question #2: Which of the following people fall outside the Canada Health Act? (Select all that apply.) 1. Indigenous peoples 2. RCMP members 3. Recently arrived newcomers 4. Members of military services 5. Persons in transit between provinces Textbook Review Question #3: A nursing student is discussing public health with her preceptor and asks about the main focus of public health. The mentor responds that public health primarily focuses on: 1. Reporting 2. Promotion 3. Intervention 4. Institutionalization 5. Immunization Textbook Review Question #4: The Canada Health Act embraces which of the following five principles: 1. Social justice, equity, acceptability, efficiency, effectiveness 2. Accountability, equality, economy, collaboration, coordination 3. Insured health services, provider compensation, hospital services, community care, and pharmaceutica 4. Public administration, comprehensiveness, universality, portability, accessibility Textbook Review Question #5:. At the clinic, the nurse sees a middle-aged woman who is nearing exhaustion caring for her aging mother, who is experiencing dementia. As the nurse opens the dialogue on potential placements for her mother, it is obvious that there is a lack of understanding about the existence of community agencies such as _____________________, which might provide an alternative for this family. 1. Home care 2. Palliative care 3. Hospital care 4. Ambulatory care 5. Adult day support Textbook Review Question #6: A nurse practitioner is establishing an interprofessional team to work with pregnant newcomer women, focusing on nutrition. In addition to the nurse, the three most critical members of the team at this early stage will include: (Select all that apply.) 1. Obstetrics specialist 2. Dietitian 3. Pharmacist 4. Social worker 5. Translator Textbook Review Question #7: A nurse practitioner who is working in a northern remote community notes a trend toward depression and anxiety among a subset of the population in the 40–60 age group who were residential school survivors. A culturally competent strategy to work with this group might be to: 1. Provide individual counselling on a case-by-case basis to protect confidentiality. 2. Offer a weekly peer support program. 3. Work with the elder and chief of the community to determine a way forward. 4. Consult with a psychologist or psychiatrist before undertaking any programming to affirm risks and potential barriers. Textbook Review Question #8: Management has requested a brief report from the nurse manager on a Human Resources plan for the next 5 years. Which of the following statements best represents the factors that should be mentioned? 1. We should be working with our aging nurses to transition out of full- time work and let younger nurses be mentored into their vacated positions. 2. With all the workplace injuries, we should be hiring an occupational therapist or there will soon be no nurses working. 3. We will soon be able to replace nurses with robots and technology, so that is where we should be investing. 4. We are not educating enough nurses, so we may have to recruit from international pools to fill positions. 5. There are too many variables to be able to predict what will be needed in 5 years, so the best we can do is try to keep the nurses we have. Textbook Review Question #9: A nurse organizes a blood pressure screening program as a ______________ strategy. 1. Primary level 2. Secondary level 3. Tertiary level 4. Rehabilitative level Textbook Review Question #10: Primary care can only be provided by a physician or in a hospital setting. 1. True 2. False