NURS 104 Final Exam with Complete Solution

NURS 104 Final Exam with Complete Solution Healthy People 2020 - used as a tool by the federal govt, state govts., communities, and other public and private sector partners to improve the nation's health. It is a set of goals and objectives with 10-year targets designed to guide national health. (Healthy People 2010, Healthy People 2030). It also monitors progress to determine if the set goals and objectives are being met. At the end of the 10-year period, outcomes are evaluated to plan for the next 10 years. This is an example of outcome evaluation. Every industry has a vision, mission, goals, and outcome evaluation. vision (healthy people 2020) - a society in which all people live long, healthy lives mission (healthy people 2020) - •Identify nationwide health improvement priorities •Increase public awareness and understanding of the determinants of health, disease, and disability, and the opportunities for progress •Provide measurable objectives and goals that are applicable at the national, state, and local levels •Engage multiple sectors to take actions to strengthen policies and improve practices that are driven by the best available evidence and knowledge •Identify critical research, evaluation, and data collection needs overarching goals (healthy people 2020) - •Attain high quality, longer lives free of preventable disease, disability, injury, and premature death. (Measures: life expectancy, limitation of activity, chronic disease prevalence) •Achieve health equity, eliminate disparities, & improve the health of all groups (Measures: race/ethnicity, gender, socioeconomic status, LGBT status) •Create social and physical environments that promote good health for all (Measures: social and economic factors, policies and programs) •Promote quality of life, healthy development, and healthy behaviors across all life stages (Measures: well-being/satisfaction, physical, mental, & social health-related quality of life) primary intervention - maintain health before illness occurs Ex: teaching about healthy diets & adequate exercise before obesity occurs secondary intervention - preventing complications after disease onset Ex: breast cancer & blood pressure screening tertiary intervention - maintain or improve function due to disease damage Ex: teaching a person with diabetes how to administer insulin and manage the disease Ex: referring a stroke patient for rehabilitation or providing long term care health disparity - refer to differences in access to or availability of facilities and services; refer to the variation in rates of disease occurrence and disabilities between socioeconomic and/or geographically defined population groups community - people and the relationships that emerge among them as they develop and use in common some agencies and institutions and share a physical environment population - all the inhabitants of a particular town, area, or country chaos theory - •Attempts to account for the complexity and randomness in organizations •Suggests a degree of order can be attained by viewing complicated behaviors and situations as predictable •Variation is a normal part of managing health care systems •Nurses need to expect constant change, be flexible, and embrace rather than resist change. •Nurse managers realize that they will be faced with multiple dilemmas throughout the day •They thrive best if they "think on your feet" and can gracefully put out fires all day. systems theory - views the organization as a set of interdependent parts that together form a whole; provided nurses with a framework to view nursing services as a subsystem of the larger organization and to realize the interrelatedness and interdependence of all the parts of the organization organizational theory - evolved to provide a framework for understanding complex organizations medicare modernization act - (medicare part D) added a prescription drug benefit for medicare enrollees; provides needed access to medications for Medicare enrollees, and calls attention to cost-and-effectiveness outcome from policymakers, requiring nurses to stay alert to proposed legislation and to advocate for appropriate benefits for the nation's older adults medicare part A - hospital medicare part B - requires payment of a premium and covers physician's services medicare part C - allows private health insurance companies to provide Medicare benefits medicare part D - medicare modernization act; prescription executive - •Recommends legislation and promotes major policy initiatives •Implements laws and manages programs after they have been passed by Congress through regulation, oversight, and presidential funding priorities •Writes regulations that interpret statues (laws) •Has the power to veto legislation passed by Congress Office of the President and 15 executive departments (State, Treasury, Defense, Agriculture, Energy, Housing and Urban Development, Justice, Commerce, Education, Health, and Human Services, Interior, Labor, Transportation, Veterans Affairs, and Department of Homeland Security) legislative - •Possesses the sole federal power to enact legislation and to tax citizens and allocate federal spending •Able to originate and promote major policy initiatives •Power to override a presidential veto Senate and House of Representatives, known collectively as Congress, with 535 elected members judicial - •Judicial interpretations of the Constitution or various laws may have a policy effect •Resolves questions regarding agency regulations that may affect policy U.S. Supreme Court, federal district courts, and U.S. circuit courts of appeals nurse practice acts and registration of nurses - established scope of practice and minimal educational requirements for nurses; implemented by most states sheppard-towner act - funded prenatal and child health centers staffed by public health nurses, first federal policy to provide funding for nursing services hill burton act - aka the hospital survey and construction act because it provided federal funding for hospital construction, caused a boom in hospital construction shifting nurses primary employment setting from public health to hospitals nurse training act - provided enhanced funding for collegiate nursing programs: expanded university education for nurses and laid the groundwork for the development of APRNs medicare program - provided funding for health care services for older adults and the disabled: led to an increased number of hospitalized older adults and an increased need for nurses in acute care settings renal disease program - provided funding for dialysis treatments and renal transplants for patients with kidney failure: led to the development of a new area of nursing practice that is now a recognized specialty—nephrology nursing diagnosis related groups (DRGs) - changed Medicare reimbursement to hospitals from a fee-for-service method to a fixed-fee method: forced hospitals to reduce patients lengths of stay, cut costs, and initially reduce staff, including nurses; led to the development of new nursing roles—nursing case management and utilization review grassroots political strategies - •Registering to vote and voting in all elections •Joining professional nursing organizations with policy, advocacy agendas] •Working in political candidates campaigns •Meeting with policymakers or their staff members •Attending "meet the candidates" town hall meetings •Communicating with policymakers by e-mail, fax, and telephone health policy - A set course of action undertaken by governments or health care organizations in order to achieve a particular health outcome. Private health policy is made by health care organizations, such as hospitals, whereas public health policy refers to local, state, and federal legislation, regulation, and court rulings that govern health care within a certain area. regulation - written set of rules issued by the executive branch agency that has responsibility for administering a law constituent - a citizen who has the opportunity to vote for candidates in elections for representation at the local, state, and federal level constituent/state nurses association (C/SNA) - the professional organizational unit member of the ANA that represents all professional nurses within a state or territory or other defined organizational entity or boundary lobbying - acting to persuade, educate, and or convince policymakers to respond positively to a particular position on an issue or to follow a particular course of legislative, regulatory, or funding activity platform - the statement of principles and policies of a political party, candidate, or elected official policymaker - a local, state, or federally elected or appointed official who can propose and directly affect legislation, regulations, or programs that can become actualized stakeholders - individuals, groups, or organizations who have a vested interest in and may be affected by policy decisions and actions being taken, and thus may attempt to influence those decisions and actions local health policy - many cities or countries offer a variety of health care services to meet the needs of their residents •Immunizations at the public health unit •Allocating funds to employ RNs in the school setting •Tobacco-free public areas •Safe drinking water •Seat belt laws •Emergency medical systems state health policy - has a powerful influence on the health and safety of each state's residents •Safe meat supply •Restaurant inspections •Nursing licensure •Medicaid •Children's Health Insurance Program •Public mental health •Substance abuse services •Long-term care services for the elderly, disabled, or prisoners federal health policy - plays a vitally important leadership role in the health of Americans •PPACA •Funding for health and research •Funding for the education of health care professionals •Medicare, Medicaid, CHIP, VA, Indian Health Services medicare - what is the largest payer of hospital charges? medicaid - a jointly sponsored state and federal program that pays for medical services for persons who are elderly, poor, blind, or disabled and for certain families with dependent children who meet specified income guidelines medicare - a federally funded health insurance program for the disabled, persons with end-stage renal disease and persons 65 years of age and older who qualify for Social Security benefits PPACA/Obamacare - a federal statute enacted in 2010 that requires U.S. citizens and legal residents to have health insurance through comprehensive health care reform; expands health care coverage access to millions of people who were previously uninsured capitation - a method reimbursing providers (usually primary care providers, such as physicians or nurse practitioners) in which the insurance company pays the provider a set payment each month to provide a defined set of health care services for the patient enrolled in the insurance company's health plan. The payment is typically expressed as a per-member-per-month payment. The defined health care services generally include preventative, diagnostic, and treatment services. centers for medicare & medicaid services (CMS) - the federal government agency that administers Medicare & Medicaid private health insurance - a method for individuals to maintain insurance coverage for health care costs through a contract with a health insurance company that agrees to pay all or a portion of the cost of a set of defined health care services such as routine, preventative, and emergency health care; hospitalizations; medical procedures; and/or prescription drugs. Typically, the private insurance is provided through an individual's employer with a portion of the cost paid by the employer and a portion paid by the employee. Private insurance policies can also be purchased by individuals but are generally much more expensive than when provided through an employer's group plan. retrospective payment system - a method of reimbursing health care providers (e.g., physicians, hospitals) in which professional services are rendered and charges are billed based on each individual service provided; also known as the "fee-for-service" payment system. This system may encourage overuse of health care services because the more services rendered or procedures performed, the more revenue received by providers. prospective payment system - a method of reimbursing health care providers (e.g., physicians, hospitals) in which the total amount of payment for care is predetermined based on the patient's diagnosis; provides for a "set price per diagnosis" payment system; encourages increased efficiency in the use of health care services because providers are reimbursed at a predetermined level regardless of how many services are rendered or procedures performed to treat a particular diagnostic category; the most common method of payment in today's health care system. single payer system - a method of reimbursement in which one payer, usually the government, pays all health care expenses for citizens, funded by taxes; decisions about covered treatments, drugs, and services are made by the government. Though the terms universal health care and single payer system are sometimes used interchangeably, universal health care could be administered by many different payer groups; both offer all citizens health insurance coverage.