NU-126 Test 2 Guide With
Complete Solution
Nursing plays an important role in - ANSWER Care quality and safety as well
as cost contaimenent, care coordination, and service delivery
National Quality Forum - ANSWER (2010) identified 34 health care practices,
organized in seven functional areas that improve patient safety by decreasing
the occurrence of adverse events (reimbursement $$$$)
National quality form (NQF) - ANSWER Not for profit organization= not for
profit organization= focus on safety; better patient outcomes
Financing Health Care- - ANSWER Had gone from retrospective,
few-for-service payment system to prospective payment systems.
Cost reduction and managed care - ANSWER Continues to evolve to new
models, such as pay-for-performance and never events.
Cherry and Jacob p110
Pay for performance - ANSWER Provide financial and non-financial incentives
to promote high-quality care; hospitals and other providers are rewarded for
meeting standards of care for certain conditions such as diabetes,
pneumonia, MI, and HF
Never events (serious reportable events in some states) - ANSWER Medicare
adopted a policy in 2008 that it will no longer pay hospitals for the extra
costs of treating preventable errors, commonly referred to as never events
,National Quality Forum (NQF) - ANSWER Created a list of never events that
are "devastating and preventable."
P&P- 390
Examples of never events - ANSWER - pressure ulcers stage 3&4
- falls and trauma
- surgical site infection after bariatric surgery for obesity, certain orthopedic
procedures, and bypass surgery.
- vascular- catheter associated infection
- catheter associated UTI
- administration of incompatible blood
- air embolism
- foreign object retained after surgery
Patient satisfaction - ANSWER - every major health care organization
measures aspects of patient satisfaction
- emphasis on patient-centered care
- HCAHPA- patient's satisfaction questionnaires.
C&J 7.1
P&P ph. 24
&
, Box 2-4
Managed care organizations - ANSWER -health maintenance organizations
- preferred provider organizations
- point of service plans
- use some form of review for medical necessity of the services under
consideration
Table 7.2 c&j
Managed care plans - ANSWER Plans that restrict your choices usually cost
less. If you want a flexible plan, it will probably cost more. There are three
types of managed care plans:
- Health maintenance organizations
- preferred provider organizations
- point of service
Health maintenance organizations - ANSWER Usually only pay for care within
the network. You choose a primary care doctor who coordinates most of your
care
Complete Solution
Nursing plays an important role in - ANSWER Care quality and safety as well
as cost contaimenent, care coordination, and service delivery
National Quality Forum - ANSWER (2010) identified 34 health care practices,
organized in seven functional areas that improve patient safety by decreasing
the occurrence of adverse events (reimbursement $$$$)
National quality form (NQF) - ANSWER Not for profit organization= not for
profit organization= focus on safety; better patient outcomes
Financing Health Care- - ANSWER Had gone from retrospective,
few-for-service payment system to prospective payment systems.
Cost reduction and managed care - ANSWER Continues to evolve to new
models, such as pay-for-performance and never events.
Cherry and Jacob p110
Pay for performance - ANSWER Provide financial and non-financial incentives
to promote high-quality care; hospitals and other providers are rewarded for
meeting standards of care for certain conditions such as diabetes,
pneumonia, MI, and HF
Never events (serious reportable events in some states) - ANSWER Medicare
adopted a policy in 2008 that it will no longer pay hospitals for the extra
costs of treating preventable errors, commonly referred to as never events
,National Quality Forum (NQF) - ANSWER Created a list of never events that
are "devastating and preventable."
P&P- 390
Examples of never events - ANSWER - pressure ulcers stage 3&4
- falls and trauma
- surgical site infection after bariatric surgery for obesity, certain orthopedic
procedures, and bypass surgery.
- vascular- catheter associated infection
- catheter associated UTI
- administration of incompatible blood
- air embolism
- foreign object retained after surgery
Patient satisfaction - ANSWER - every major health care organization
measures aspects of patient satisfaction
- emphasis on patient-centered care
- HCAHPA- patient's satisfaction questionnaires.
C&J 7.1
P&P ph. 24
&
, Box 2-4
Managed care organizations - ANSWER -health maintenance organizations
- preferred provider organizations
- point of service plans
- use some form of review for medical necessity of the services under
consideration
Table 7.2 c&j
Managed care plans - ANSWER Plans that restrict your choices usually cost
less. If you want a flexible plan, it will probably cost more. There are three
types of managed care plans:
- Health maintenance organizations
- preferred provider organizations
- point of service
Health maintenance organizations - ANSWER Usually only pay for care within
the network. You choose a primary care doctor who coordinates most of your
care
