The Health Care Delivery System
The health care delivery system definition and basic components
The health care delivery system consists of a network of
... [Show More] agencies, facilities, and health care providers
involved in the health promotion, prevention, care, and maintenance of the population served.
the health care delivery system environment includes
1. The patient
2. The patient's family
3. The community in which the system operates
4. Technology
5. Governmental and regulatory agencies
6. The medical care professionals
7. Third - party agencies (e.g., insurance companies)
LPN and his/her role in the health care team
1. Practices under the supervision of the RN, the physician, osteopathic physician or dentist.
2. Working together (team), they are the direct patient caregivers in most institutions
3. The activity of the LPN/LVN is based on the scope of practice outline in a given state's Nurse Practice
Act.
4. Nursing recognizes the benefit of having this bedside caregiver on the Health Care Team.
Wellness-Illness Continuum
Is the range of a person's total health. One's position on the continuum is ever changing and is influenced
by the individual's physical condition, mental condition, and social well-being. wellness the highest level
of optimal health and illness the lowest level.
Wellness Definition
a dynamic state of health in which an individual progresses toward a higher level of functioning,
achieving an optimal balance between internal and external environment. factors that impact the level of
wellness include age, gender, family relationships, emotional stressors, ethnic and cultural influences, and
economic status.
illness definition
represent a diminished or impaired state of health
holistic health care
a system of comprehensive or total patient care that considers the physical, emotional, social, economic,
and spiritual needs of a person.environmental factors affecting health and illness.
1. social factors: financial hardships, lifestyle, social pressures, societal issues such as AIDS, abortion, or
drug abuse.
2. physical factors: stress, conflict, smoking, obesity, alcoholism or drug abuse.
environmental factors that can affect health and illness
1. Factors that affect and individuals mental state: fear of illness and dehumanizations, loss of identity,
and loss of control can affect ones mental state
2. factors that affect an individual physical condition: imbalance in body function can affect a person's
physical condition(illness, AIDS, cancer)
Maslow's hierarchy of needs and its relationship to health and illness
five levels of essential human needs. A person has to meet needs at the base of the pyramid before
advancing to the needs higher on the pyramid.
1. physiologic
2. safety and security
3. love and belonging
4. esteem
5. self-actualization
1. physiologic
nutrition, elimination, oxygenation, sexuality
2. safety and security
stability, protection, security, freedom from fear and anxiety
3. love and belonging
affection, acceptance, by peers and community
4. esteem
self-respect, self-confidence, feeling of self-worth
5. self-actualization
full use of individual talents
health promotion
1. the general consensus in the U.S is that everyone has a right to healthcare regardless of economic
status.
2. prevention and education have become important as the population ages.
3. the acute awareness of preventive medicine has resulted in today's emphasis on education about issuessuch as smoking, heart disease, drug and alcohol abuse, weight control, and mental health and wellness
promotion activities.
prevention levels (health promotion)
1. Primary Prevention
2. Secondary prevention
3. Tertiary prevention
Primary Prevention
seek to avoid disease states through wellness activities and preemptive screening programs such as
mammograms, colonoscopies, and glucose screening.
Secondary prevention
recognizes the presence of disease but seeks to reduce the impact of the condition by encouraging
behaviors to promote health
Tertiary prevention
the management of care activities for those with serious health problems who seek to improve the quality
of life and reduce further loss of function.
Participants in the health care system ( the health care team)
1. physicians, dentists, osteopathic physicians, surgeons, psychiatrists.
2. nurses(RN, LPN/LVN)
3. additional caregivers: social worker, physical therapist, dietitians, respiratory therapist.
4. technologists, medical technicians: laboratory, radiology and other diagnostic personal
nurses(RN, LPN/LVN)
direct patient caregivers. their duties and tasks vary according to educational background and the state's
nurse practice act.
social worker
trained to counsel patients who have social, emotional, or environmental problems.
physical therapists
use precise methods of massage, exercise, and hydrotherapy, to help restore physical function of the body.
dietitians
trained to determined the foods that meet the nutritional requirements of the patient.
respiratory therapistassist the patient by administering oxygen, monitoring and maintaining ventilators, drawing blood for
blood gas analysis, performing pulmonary function test.
unlicensed assistive personnel (UAP)
educated in basic nursing techniques and performs under the supervision of the RN
rights of health care providers
health care workers expect that patients will actively participate in their care as much as possible, by
taking an active role in the planning process, by having an understanding of the care and the treatment
given, by asking questions, by following the treatment plan prescribed, by acting responsibly with respect
to their own conditions, and by giving health care workers the same respect to which patients are entitled.
patient's bill of rights
1. established by the American hospital association (AHA)replaced in 2003 when the AHA adopted the
patient care patient care partnership.
under the terms of this document, patients are assure:
-high quality hospital care
-a clean and safe environment
-involvement in their care and the decision making process
-protection of privacy
-help when leaving the hospitals and with billing concerns
Economic factors affecting health and illness
1. Rising health care costs
2. Aging population
3. Advances in technology
4. Health care insurance
5 Malpractice insurance
Rising health care costs
health care cost have reached a critical height. several factors playing a role in the increase in cost
includes
- aging population,
- increased use of advance technologies
- rising cost of private health care insurance
- rising cost of medical malpractice insurance
-struggling economy
aging population
as the baby boom generation nears the age of retirement, their health problems increase, this onset of
chronic diseases in a large segment of the population strains the health care system. As the US population
ages an increasing number of older adults needs nursing home care which is costly.advances in technology
research and the development of technology cost millions of dollars a price that is passed on to the patient
in the cost of the individual, tests or treatment.
health care insurance
it made health care more affordable but it also raised the demand for it. as more individuals sought care
the price of health care services and insurance costs spiraled.
malpractice insurance
as malpractice claims have increased in frequency and amount, the premiums for this insurance have also
risen.
Changes in the health care delivery system
-case management
-cross training
-Health maintenance organizations (HMO's)
-diagnostic related groups (DRG's)
health maintenance organizations (HMO)
health maintenance organizations or group health care practices provide health care to members for a
fixed prepaid rate. the service includes medical care, nursing care, diagnostic test, hospitalization, and
various inpatient and outpatient services . has provided low cost health care. emphasis on prevention.
diagnostic related groups
this is a system that classifies patients by age, diagnosis, and surgical procedure, producing 300 different
categories used in predicting the use of hospital resources, including length of stay. many private
insurance companies now use similar illness categories when setting hospital payment rates. (used
initially by medicare and medicaid)
case management
involves care of groups of patients by a case manager. the case manager is an RN who coordinates and
plans the care of the caseload. AN LPN works works with the RN to meet the needs of the patients in the
caseload. case management nursing maps out expectations of the hospitalized patient to reach desired
outcomes of care.
cross training
allows employers to maximize the staff that are available. employees are trained to perform that cross
traditional role and responsibilities.
Describe the interdisciplinary approach to heath carethe primary goal of the health care team is the optimal physical, mental, and social well-being of the
patient (holistic care). this goal is achieved by promoting and restoring health within the wellness/illness
continuum, and preventing the fragmentation of patient care.
-includes developing a comprehensive care plan, effectively communicating and keeping accurate
records.
nursing care plan
a nursing care plan is a document that outlines the individual needs of the patient and the approach of the
health care team in meeting those needs. the document guides and direct the activities surrounding the
patients care, and ensures that continuity of care will be provided hopefully eliminating duplication of
services. [Show Less]