ADVANCED EXAM FOR AMBULATORY CARE TEST 1

ADVANCED EXAM FOR AMBULATORY CARE TEST 1 Key Roles/Responsibilities is Ambulatory Care RN (4) - CORRECT ANSWER-1) enhance pt safety and quality/effectiveness of care delivery (irreplaceable) 2) responsible for design/administration/eval of professional nursing services within organization in accordance with nurse practice acts/scope of practice/org standards 3) provide leadership necessary for collab/coordination of services; includes defining appropriate skills mix + delegation of tasks to licensed and unlicensed workers 4) RN fully accountable in amb care for all nursing services and associated pt outcomes provided under their direction Role of RNs in Ambulatory Care (7) - CORRECT ANSWER-1) TELEHEALTH NURSE - uses nursing process/tech to care for remote pts. 2) NURSE NAVIGATOR - helps nagivate health system 3) NURSE EDUCATOR - educate pts and educate other nurses 4) NURSE-RUN CLINICS - APRN clinics 5) RESEARCH NURSE - for enrolling pts in trials and providing care during trial 6) CARE COORDINATOR - similar to nurse navigator 7) PROCEDURAL - infusion center, cath lab, amb surgery Categories of Challenges to RNs in Ambulatory Setting (6) - CORRECT ANSWER-1) Societal Changes 2) Healthcare environment 3) Integration of Health Records 4) Changing Reimbursement Models 5) Ambulatory Care Nursing Workforce 6) Nursing Education Amb RN Challenges: Societal Changes - CORRECT ANSWER-- pop w/ more old people and more diverse w/ complex behavioral needs - high quality/individalization w/ care tech (mobile devices/social media - societal violence: challenges of settings lacking infrastructure + resources of larger facility Amb RN Challenges: Healthcare Environment - CORRECT ANSWER--fragmented care delivery; struggle to coordinate across specialties - amb care increasing regulatory control -- demand for high quality/safety --> impacts reimbursement/ability to compete for contracts - increase demand for care; shortage of primary care providers Amb RN Challenges: Integration of Health Records - CORRECT ANSWER--lack of record integration -- system fragmentation - longitudinal health records not accessible across settings/providers/services - EHRs not patient-centered; not good for care coordination Amb RN Challenges: Changing Reimbursement Models - CORRECT ANSWER-nursing filed struggles w/ bill recognition from third-party payers Amb RN Challenges: Ambulatory Care Nursing Workforce - CORRECT ANSWER-- RNs need skill development/situational translation of knowledge to amb environment - more interdisciplinary team members working in amb environment Amb RN Challenges: Nursing Education - CORRECT ANSWER-- nursing ed still mostly on acute care -idea that nurses need to work inpatient before doing amb; reality is that hospital skills are not needed in amb care - amb care needs to integrate new grads early' starts with having nurse educators integrate amb clinical experience in with nursing curriculum Goal of Affordable Care Act - CORRECT ANSWER-LESS HOSPITALIZATIONS AND MORE FOCUS ON PREVENTION Changes from ACA in Slides (5) - CORRECT ANSWER-1) gives free preventive care for seniors 2) Community Care Transitions Program for at risk seniors to prevents ED visits and hospital readmissions 3) Increase primary care reimbursement 4) State-sanctioned patient-centered medical homes 5) physician reimbursement changed to value based care models How are nurses meeting ACA goal of quality affordable health care for all Americans? - CORRECT ANSWER-increasing use of APRNs and RNs in primary care nurses practicing to the fullest extent How are nurses meeting ACA goal of improving the quality and efficiency of health care? - CORRECT ANSWER-improved patient care through nursing education expanded opportunities for nurses to lead/diffuse collaborative improvement efforts achieving high value w/ innovative models How are nurses meeting the ACA goal of preventing of chronic disease and improving public health? - CORRECT ANSWER-Achieving high value w/ innovative models expanding opportunities for nurses to lead/diffuse collaborative improvement efforts How are nurses meeting ACA goal of increasing the healthcare workforce/quality of workers? - CORRECT ANSWER-increase in proportion of nurses w/ BSNs ensure nurses engage in lifelong learning How are nurses meeting the ACA goal of strengthening quality, affordable health care for all Americans? - CORRECT ANSWER-prepare and enable nurses to lead change to advanced health support students to be change agents Core of what the ACA means for nurses - CORRECT ANSWER-nursing in prime time!! - huge emphasis on APRNs - RN role in amb care now see as crucial to care coordination - APRN and RN-led clinics important to increases assess to care and for chronic disease mangement -RNs as clinical leaders