AG-ACNP - Issues, Trends, and Health Policy
Crisis/Acute Grief Communication Answer- Acknowledge feelings
Offer self
Crisis Intervention Answer-
... [Show More] Boundaries
Security if necessary, NOT police
Establish trust/rapport
Advance Directive Answer- Written statement of patient's intent regarding medical treatment
The Patient Self-Determination Act of 1990 Answer- All patients in a hospital setting are required to be advised of their right to execute an advance directive
Living Will Answer- Compilation of statements that specify which life-prolonging measures one does and does not want if they become incapacitated
Durable Power of Attourney Answer- Individual designated in the living will that is authorized to make medical decisions in the event patient is incapacitated
Title I of HIPPA Answer- Protects health insurance coverage for workers and their families in the event they change or lose their jobs
COBRA
COBRA Answer- protects health insurance coverage for workers and their families in the event worker loses or changes jobs
Who enforces HIPPA Answer- Office for Civil Rights
Patient Safety Rule Answer- Protects patient information to analyze patient safety events and improve
True or False: A patient has the right to see their medical record Answer- True
The Privacy Rule: Patient's Rights Answer- See/have their medical record
Corrections added to medical record
Patient Safety and Quality Improvement Act (PSQIA) Answer- Voluntary reporting system
improve patient safety outcomes through anonymous reporting by providers of patient safety outcomes and events
Duty to Warn Answer- Patient's condition may endanger others overrides confidentiality
Patient is diagnosed with HIV. Duty to Warn applies how? Answer- Can notify providers not family
Invasion of Privacy Answer- Damaging one's reputation as a result of sharing patient information without their permission
When can invasion of privacy charge not be made Answer- in good faith
accurate information
receiver has valid reason to obtain information
Initiating any change in heathcare Answer- Begin at most local level and expand outward
What comes first when treating a patient with a medical and psychosocial condition Answer- Medical condition
strongest method to evaluate teaching Answer- returned demonstration
when to transfer to teritary care facility Answer- seriously ill or injured patients that cannot be cared for at your institution
stabilize and ship
Patient reluctant to undergo procedure. you should? Answer- Fully educate patient and tell them why
Primary care screening exams that are not emergent Answer- do not delay hospital discharge refer to PCP
most powerful data collected from patient Answer- subjective or data you observed as the np
RN calls you as the night shift NP and states patient is decompensating. You would? Answer- Call primary MD when patient status changes
Code goes bad and all involved are talking badly about it on the unit. You should? Answer- Hold a one time debriefing with everyone invovled
What is a response that would suggest admitting a patient to a SNF would be the best action? Answer- Needing assistance with ADLs
Goals of Healthy People 2020 Answer- increase the quality and years of healthy life
eliminate health disparities among americans
Healthy People 2020 purpose Answer- used to understand health status of the nation and plan prevention programs
NP must notify department of health with what dx Answer- Gonorrhea
Chlamydia
Syphillis
HIV
TB
NPs must report to state Answer- Criminal acts and injury from dangerous weapon (GSW)
Gonorrhea
Chlamydia
Syphillis
HIV
TB
Animal bites
Suspected/actual child abuse
Domestic violence
Physical Therapy Answer- Strength training
coordination
Occupational Therapy Answer- ADLs
Medicare Answer- Third party payers
sets the standard for reimbursement and cutting costs
>65 yo.
Disabled
Medicaid Answer- Third party payers
Poverty
Medicare A Answer- Covers inpatient hospitalizations
SNF
home health
hospice
>65 yo.
Medicare B Answer- Covers physician services
outpatient hospital services
labs/diagnostic procedures
medical equipment
Pay premium
NPs 85% physician scheduled fee
Medicare B pays how much of bill Answer- Medicare pays 80% and patient pays 20%
Medicare D Answer- Limited prescription drug coverage
Monthly premium required
Co-pay on each prescription required
Incident-to-Billing Answer- Services billed under MD provider number to get the full physician fee
Under MD direct supervision
Does direct supervision require MD to be physically in the room with NP to be eligible for incident-to-billing Answer- no same office suite and easily accesible
does incident-to-billing apply to the inpatient hospital setting Answer- No. NP must bill under their NPI in the hospital setting
Root Cause Analysis Answer- Tool for identifying prevention strategies to ensure safety
Culture of safety and not culture of blame
Root Cause Analysis involves Answer- Interdisciplinary experts
those who are most familiar with the situation
continually asking why at each level of cause and effect
Identifying changes
Impartial process
Debriefing after an event is an example of Answer- root cause analysis
Sentinel Events Answer- Unexpected occurrences involving death or serious physical injury or psychological injury or risk thereof
immediate investigation and response
Sentinel Event and medical error Answer- not synonymous
not all sentinel events occur because of an error
not all medical errors result in a sentinel event
Response to Sentinel Event Answer- Root Cause Analysis
Scope of Practice Answer- Based on legal allowances in each STATE
Provides guidelines for nursing practice
How can the ACNP demonstrate and advocate for full scope of practice? Answer- ACNP bills independently
State Practice Acts Answer- STATE Board of Nursing grants authority includes title, authorization of scope including prescriptive authority, disciplinary grounds
What dictates the nurse practitioners prescriptive authority Answer- State Nurse Practice Acts
State Board of Nursing
Credentials Answer- Encompass required education, licensure and certification to practice as an NP
Establish MINIMAL levels of acceptable performance
Licensure Answer- GOVERNMENT STATE BOARD OF NURSING
Establishes a person is qualified to perform
Certification Answer- NONGOVERNMENTAL AGENCIES ANCC
Establishes a person has met certain standards which signify mastery of specialized knowledge and skills
Licensure vs. Certification Answer- Government state board of nursing vs. nongovernmental agencies ancc
Credentialing and Privileging Answer- Process by which a nurse practitioner is granted permission to practice in an inpatient setting
Hospital Credentialing Committee Answer- Comprised of physcians
Credentialing with hospital privileges grant
Most common method of documentation in Risk Management Answer- Incident Reports
Medical Futility Answer- Interventions that are unlikely to produce any significant benefit for the patient
Quantitative Futility Answer- Where the likelihood that an intervention will benefit the patient is extremely poor
Qualitative Futility Answer- Where the quality of the benefit an intervention will produce is extremely poor
Competence Answer- Decisional capability
State in which patient can make personal decisions about their care
Informed Consent Answer- Patient has received adequate instruction or information regarding aspects of care to make a personal choice
Informed Consent includes Answer- discussing all risks and benefits
Ethics Answer- The study of moral conduct and behavior
Nonmaleficence Answer- Duty to do no harm [Show Less]