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,1) A nurse manager is participating in the healthcare organization's strategic planning
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committee. Which factor is the primary driving force and controlling factor in new initiatives
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this committee might recommend?
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1. Cost of care ff ff
2. Access to care ff ff
3. Availability of care ff ff
4. Qualityof care f f
Answer: 1
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Explanation: 1. While all of the options given are driving forces in today's healthcare
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environment, the cost of providing care is still the primary issue. Cost of care controls access,
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availability, and quality.
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2. Access to care is controlled by the ability to pay.
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3. Care will not be available if it cannot be funded.
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4. Healthcare providers do not like to correlate quality with cost, but the economic reality is
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that quality care must also be funded care.
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Cognitive Level: Applying ff f f
Client Need: Safe Effective Care Environment
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Client Need Sub: Management of Care
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Nursing/Int Conc: Nursing Process: Evaluation/Leadership
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Learning Outcome: 1-1: Explain changes to healthcare over the past decade, including those
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resulting from implementation of the Affordable Care Act; demands to reduce errors and
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improve patient safety; and evolving medical and communication technology.
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, 2) A nurse has been invited to discuss healthcare costs at a senior citizens' club. What
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information should the nurse plan to include in this discussion?
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1. While healthcare costs continue to rise, the percentage of the United States (U.S.) economy
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spent on healthcare has slowly declined to less than 12%.
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2. Regulations brought about by the Patient Protection and Affordable Care Act (PPACA) f ff ff ff ff ff ff f ff f ff
should bring financial relief to healthcare consumers.
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3. The United States spends more money on healthcare than any other country.
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4. Healthcare spending in the United States is slowly declining due to passage of bills such as ff ff ff ff ff ff ff ff ff ff ff ff ff ff ff
the Patient Protection and Affordable Care Act (PPACA).
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Answer: 2 f f
Explanation: 1. In 2009, healthcare costs consumed more than 17% of the country's gross ff ff ff ff ff ff ff ff ff ff ff ff ff
domestic product.
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2. Implementation of PPACA and its regulations have not been formulated. ff ff f ff ff ff ff ff ff
3. The United States spends more than $2.5 trillion on healthcare annually, more than any
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other country.
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4. While this act has been passed, it is not operationalized. Healthcare spending continues to
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rise.
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Cognitive Level: Analyzing ff f f
Client Need: Safe Effective Care Environment
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Client Need Sub: Management of Care
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Nursing/Int Conc: Nursing Process: Planning/Education ff f f ff ff
Learning Outcome: 1-1: Explain changes to healthcare over the past decade, including those
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resulting from implementation of the Affordable Care Act; demands to reduce errors and
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improve patient safety; and evolving medical and communication technology.
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3) A 70-year-old client develops a catheter-induced urinary tract infection. Which statement
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by the nurse would indicate to the nurse manager a need for additional understanding of this
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situation?
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1. "I wonder if there was a break of sterility when this catheter was inserted."
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2. "Thankfully we can treat this with an antibiotic." ff ff ff ff ff ff ff
3. "This could potentially cost the hospital a lot of money."
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4. "I will talk to my unlicensed assistants about proper urinary catheter care."
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Answer: 2
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Explanation: 1. Wondering about a break in sterility indicates that the nurse is concerned f f ff ff ff ff ff ff ff ff ff ff ff ff
about the process that might have contributed to this infection.
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2. The nurse who focuses on taking care of the results of a potential medical mistake is not
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accepting the seriousness of the situation.
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3. The Centers for Medicare and Medicaid Services no longer cover the costs incurred by
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medical mistakes. This urinary tract infection could cost the hospital the cost of treatment,
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including increased length of stay.
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4. The nurse has identified that improper care may result in poor outcomes for the client.
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Cognitive Level: Applying
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Client Need: Safe Effective Care Environment
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Client Need Sub: Management of Care
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Nursing/Int Conc: Nursing Process: Evaluation/Education ff f f ff ff
Learning Outcome: 1-1: Explain changes to healthcare over the past decade, including those
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resulting from implementation of the Affordable Care Act; demands to reduce errors and
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improve patient safety; and evolving medical and communication technology.
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4) Which healthcare situations reflect the philosophy of quality management as designed by
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Deming?
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Note: Credit will be given only if all correct choices and no incorrect choices are selected.
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