Transcript Chp. 1 PPT
https://www.youtube.com/watch?v=cDDWvj_q-o8
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WELCOME TO MEDICAL PROFESSIONS I
MRS. NGUYEN MSN, RN CEN F-303
Cleveland Clinic
YouTube
• Empathy: The
Human
Connection to
Patient Care
CHAPTER 1
Introduction to Health Care
Agencies
HEALTH CARE AGENCIES
The person is always the focus of care.
Staff members have special talents, knowledge, and skills.
All work to meet the person’s needs.
AGENCY PURPOSES
The purposes of health care include:
Health promotion
The goal is to reduce the risk of illnesses.
Disease prevention
Detection and treatment of disease
Rehabilitation and restorative care
Many agencies are learning sites for students.
The students assist in the purposes of health care.
TYPES OF AGENCIES
Hospitals
Rehabilitation and subacute care agencies
Long-term care centers (nursing homes, nursing facilities, nursing centers)
Skilled nursing facilities (SNFs)
Assisted living residences
Mental health centers
Home care agencies
Hospices
Health care systems
ORGANIZATION
An agency has a governing body called the board of trustees or board of
directors.
The board makes policies.
An administrator manages the agency.
Directors or department heads manage certain areas.
The health team (interdisciplinary health care team) involves the many health
care workers whose skills and knowledge focus on the person’s total care.
The goal is to provide quality care.
The person is the focus of care.
ORGANIZATION (CONT’D)
Nursing services
The director of nursing (DON) is an RN.
The DON is responsible for the entire nursing staff.
Nurse managers assist the DON.
Nursing areas usually have charge nurses for each shift.
Staff RNs report to the charge nurse.
LPNs/LVNs report to staff RNs or to the charge nurse.
You report to the nurse supervising your work.
Nursing education (staff development) is part of nursing services.
THE NURSING TEAM
The nursing team involves those who provide nursing care.
Registered nurses
Licensed practical nurses and licensed vocational nurses
Nursing assistants
NURSING CARE PATTERNS
The pattern used depends on how many persons need care, the staff,
and the cost.
Functional nursing focuses on tasks and jobs.
Team nursing involves a team of nursing staff led by an RN.
Primary nursing involves total care.
Case management is like primary nursing.
A case manager (an RN) coordinates a person’s care.
Patient-focused care is when services are moved from departments to the bedside.
PAYING FOR HEALTH CARE
Private insurance is bought by individuals and families.
Group insurance is bought by groups or organizations for individuals.
PAYING FOR HEALTH CARE (CONT’D)
Medicare is a federal health insurance program for persons 65 years of
age or older.
Some younger people with certain disabilities are covered.
Part A
Part B
Medicaid is a health care payment program sponsored by the federal
government and operated by the states.
PAYING FOR HEALTH CARE (CONT’D)
Prospective payment systems limit the amount paid by insurers, Medicare,
and Medicaid.
Diagnosis-Related Groups (DRGs) are for hospital costs.
Resource Utilization Groups (RUGs) are for SNF payments.
Case Mix Groups (CMGs) are used for rehabilitation centers.
Home Health Resource Groups (HHRGs) are used for home health care.
PAYING FOR HEALTH CARE (CONT’D)
Managed care
Managed care deals with health care delivery and payment.
Managed care limits:
The choice of where to go for health care
The care that doctors provide
Managed care as pre-approval for services.
Many insurers must approve the need for health care services.
If the need is approved, the insurer pays for the services.
If the need is not approved, the person pays the costs.
MEETING STANDARDS
Standards are set by:
The federal and state governments
Accrediting agencies
An agency must meet standards for:
Licensure
Certification
Accreditation
AZ SBON / AZ MB
AZ SBON LNA
CREDENTIALING (ENDORSEMENT PROCESS) PROCESS 2016
https://www.azbn.gov/licensure-certification/licensed-nursing-assistant/
AZ SBON LNA EXAM PROCESS 2016
AZ SBON LNA RENEWAL PROCESS 2016
SCOPE OF PRACTICE (STANDARDS OF CONDUCT)
RN – R4-19-402
LVN/LPN – R4-19-401
LNA- R4-19-814
https://www.azbn.gov/media/1426/rules.pdf
OMNIBUS BUDGET RECONCILIATION ACT
(OBRA)
Omnibus Budget Reconciliation Act of 1987
On December 22, 1987, President Ronald Reagan signed the Omnibus Budget
Reconciliation Act of 1987 (OBRA-87) also known as the Federal Nursing Home Reform Act.
While not all components have to do with drugs and pharmacology, there are a few points
you should be aware of. OBRA-87 was enacted to protect the rights of patients in longterm care facilities such as nursing homes, skilled nursing facilities, and assisted living homes.
It sets forth regulations for Medicare and Medicaid Conditions of Participation in long-term
care facilities. It states that residents should not be given unnecessary medications, and that
antipsychotic drugs can only be given to patients who have a condition that necessitates
them. These patients must have documentation stating that they have a condition requiring
antipsychotic drugs. For those who do receive it, doses must be gradually tapered off, and
behavior modification and “drug holidays” (a drug-free period) can be used to see if the
medication can be stopped completely.
In addition, long-term care residents should not have any significant medication errors, and
all necessary drugs, both routine and emergency, must be given as required. The facility
itself is required to have a consultant pharmacist, and medications must be labeled and
stored according to federal and state laws.
http://www.careerstep.com/blog/pharmacy-technician-news/omnibus-budget-reconciliation-act-of-1987
INFORMED CONSENT & ADVANCED DIRECTIVE
Informed Consent
Advance Directives
http://medical-dictionary.thefreedictionary.com/informed+consent
http://www.azsos.gov/services/advance-directives
Do Not Resuscitate (DNR)
Living Will
Medical Power of Attorney (MPOA)
MEETING STANDARDS (CONT’D)
Surveys are done to see if the agency meets set standards.
If standards are met, the agency receives a license, certification, or accreditation.
When problems (deficiencies) are found, the agency:
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Is given time to correct them
Can be fined for uncorrected or serious deficiencies
Can lose its license, certification, or accreditation
MEETING STANDARDS (CONT’D)
You have an important role in meeting standards and in the survey process.