ATI Fundamentals for
Nursing ATI
Medicare - for clients over age 65 and/or with permanent disabilities. premiums applied as
insurance program reimburses providers based on DRGs. Premiums applied as Managed Care
Organizations (MCOs) provide enrolled clients with comprehensive care overseen by a primary
care provider. Is federally funded.
Medicaid - for clients with low income. is federally funded and individual states determine
eligibility requirements.
Traditional Insurance - reimburses for services on fee-for-service basis.
Managed vCare vOrganizations v(MCOs) v- vcomprehensive vcare vis voverseen vby va vprimary
vcare vprovider v& vfocuses von vprevention vand vhealth vpromotion
Preferred vProvider vOrganizations v(PPOs) v- vclient vchooses vfrom va vlist vof vcontracted
vproviders. vusing vnon-contracted vproviders vincreases vthe vclient's vout vof vpocket vcosts
Exclusive vProvider vOrganizations v(EPOs) v- vthe vclient vchooses vfrom va vlist vof vproviders
vwithin va vcontracted vorganization
Long-Term vCare vInsurance v- vprovides vfor vlong-term vcare vexpenses vnot vcovered vby vMedicare
Preventive vhealth vcare v- vfocuses von veducating vand vequipping vclients vto vreduce vand
vcontrol vrisk vfactors vof vdisease. vExamples vinclude vimmunizations, vstress vmanagement
vprograms, vand vseat vbelt vuse
,Primary vhealth vcare v- vemphasizes vhealth vpromotion, vand vincludes vprenatal vand vwell-baby
vcare, vnutrition vcounseling, vand vdisease vcontrol. vis vbased von va vsustained vpartnership
vbetween vclient vand vprovider. vexamples vinclude voffice vor vclinic vvisits vand vscheduled
vschool/work vcentered vscreenings v(vision, vhearing, vobesity)
Secondary vhealth vcare v- vincludes vthe vdiagnosis vand vtreatment vof vemergency, vacute
villness, vor vinjury. vexamples vinclude vcare vgiven vin vhospital vsettings v(inpatient vand vEDs),
vdiagnostic vcenters, vor vemergent vcare vcenters
Tertiary vhealth vcare v- vinvolves vthe vprovision vof vspecialized vhighly vtechnical vcare.
vexamples vinclude voncology vcenters vand vburn vcenters
Restorative vhealth vcare v- vinvolves vintermediate vfollow-up vcare vfor vrestoring vhealth.
vexamples vinclude vhome vhealth vcare, vrehab vcenters, vand vskilled vnursing vfacilities
Continuing vhealth vcare v- vdesigned vto vaddress vlong-term vor vchronic vhealth vcare vneeds.
vexamples vinclude vhospice, vadult vday vcare, vand vin-home vrespite vcare
Health vcare vregulatory vagencies vinclude: v- v-US vDept vof vHealth vand vHuman vSrvcs
-US vFDA
-State vand vlocal vpublic vhealth vagencies
-State vlicensing vboards v(to vensure vproviders v& vagencies vcomply vwith vstate vregulations)
-the vJoint vCommission/JCAHO v(set vquality vstandards vfor vaccreditation vof vhealth vcare vfacilities)
-Professional vStandards vReview vOrganizations v(PSROs)
-Utilization vreview vcommittees v(monitor vfor vappropriate vdiagnosis vand vtreatment vof
vhospitalized vclients)
Clergy v- vJob: vprovide vspiritual vcare vto vclient v(pastors, vrabbis, vpriests)
,Refer vto vwhen: vthe vclient vrequests vcommunication vor vthe vfamily vasks vfor vprayer vprior vto
vclient vundergoing va vprocedure
Registered vdietitian v- vJob: vassess, vplan vfor, vand veducate vthe vclient vreg. vnutritional
vneeds; vdirect vcare vof vnutritional vaids
Refer vto vwhen: vex- vthe vclient vhas vlow vnutrient vlevels vand/or vexperienced va vrecent
vunexplained vweight vloss
Lab vtech v- vJob: vobtain vspecimens vof vthe vclient's vbody vfluids vand vperform vthe vnecessary
vdiagnostic vtests
Refer vto vwhen: vex- vthe vprovider vorders va vCBC vto vbe vperformed vimmediately
Occupational vtherapist v- vJob: vassess vand vplan vfor vthe vclient vto vregain vADLs, vesp vmotor
vskills vof vthe vupper vextremities; vdirect vcare vof voccupational vtherapy vassistants
Refer vto vwhen: vex- vclient vhas vdifficulties vusing van veating vutensil vwith vdominate vhand
vfollowing va vstroke
Pharmacist v- vJob: vprovide v& vmonitor vmeds vfor vthe vclient vas vprescribed vby vthe vprovider;
vsupervises vpharm vtechs vin vstates vin vwhich vthe vpractice vis vallowed
Refer vto vwhen: vclient vconcerns vover vmeds; vdosage vconcerns; vetc
Physical vTherapist v- vJob: vassess vand vplan vfor vclient vto vincrease vmusculoskeletal
vfunctions, vesp vof vlower vextremities, vto vmaintain vmobility; vdirect vcare vof vphysical vtherapy
vassistants
Refer vto vwhen: vex- vfollowing va vhip vreplacement, va vclient vrequires vassistance vlearning vto
vambulate vand vregain vstrength
, Provider v- vJob: vassess, vdiagnose, vand vtreat vcllient vfor vdisease vand/or vinjury; vincludes vMDs,
vDOs, vAPNs, vand vPAs
Refer vto vwhen: vex- vclient vexperiences vchange vin vvital vsigns
Rad vTech v- vJob: vposition vclient vand vperform vx-rays vand vother vimaging vprocedures vfor
vproviders vto vreview vfor vdiagnosis vof vdisorders vof vvarious vbody vparts
Refer vto vwhen: vex- vprovider vorders vx-ray vof vclient's vhip vafter va vfall
Respiratory vtherapist v- vJob: vevaluate vresp vstatus vand vprovide vprescribed vresp vtreatments
vincluding vO2 vtherapy, vchest vphysiotherapy, vinhalation vtherapy, vand vartificial vmechanical
vventilation
Refer vto vwhen: vex- vclient vwith vresp vdisease vexperiences vSOB vand vrequests vnebulizer
vtreatment vthat vis vordered vPRN
Social vWorker v- vJob: vwork vwith vclient vand vclient's vfamily vby vcoordinating vinpatient vand
vcommunity vresources vto vmeet vpsychosocial vand venvironmental vneeds vthat vare
vnecessary vfor vrecovery vand/or vdischarge
Refer vto vwhen: vex- vclient vdying vof vcancer vwishes vto vgo vhome vbut vis vunable vto vperform
vADLs; vthe vspouse vneeds vmed vequipment vin vthe vhome vto vcare vfor vclient
Speech vtherapist v- vJob: vevaluate vand vmake vrecommendations vregarding vthe vfunctions vof
vspeech, vlanguage, vand vswallowing vimpacted vby vvarious vclient vdisorders vor vinjuries; vteach
vclient vtechniques vand vexercises vto vimprove vfunction vwhen vpossible
Refer vto vwhen: vex- va vclient vis vhaving vdifficulty vswallowing va vregular vdiet vafter vtrauma vto
vthe vhead vand vneck
Nursing ATI
Medicare - for clients over age 65 and/or with permanent disabilities. premiums applied as
insurance program reimburses providers based on DRGs. Premiums applied as Managed Care
Organizations (MCOs) provide enrolled clients with comprehensive care overseen by a primary
care provider. Is federally funded.
Medicaid - for clients with low income. is federally funded and individual states determine
eligibility requirements.
Traditional Insurance - reimburses for services on fee-for-service basis.
Managed vCare vOrganizations v(MCOs) v- vcomprehensive vcare vis voverseen vby va vprimary
vcare vprovider v& vfocuses von vprevention vand vhealth vpromotion
Preferred vProvider vOrganizations v(PPOs) v- vclient vchooses vfrom va vlist vof vcontracted
vproviders. vusing vnon-contracted vproviders vincreases vthe vclient's vout vof vpocket vcosts
Exclusive vProvider vOrganizations v(EPOs) v- vthe vclient vchooses vfrom va vlist vof vproviders
vwithin va vcontracted vorganization
Long-Term vCare vInsurance v- vprovides vfor vlong-term vcare vexpenses vnot vcovered vby vMedicare
Preventive vhealth vcare v- vfocuses von veducating vand vequipping vclients vto vreduce vand
vcontrol vrisk vfactors vof vdisease. vExamples vinclude vimmunizations, vstress vmanagement
vprograms, vand vseat vbelt vuse
,Primary vhealth vcare v- vemphasizes vhealth vpromotion, vand vincludes vprenatal vand vwell-baby
vcare, vnutrition vcounseling, vand vdisease vcontrol. vis vbased von va vsustained vpartnership
vbetween vclient vand vprovider. vexamples vinclude voffice vor vclinic vvisits vand vscheduled
vschool/work vcentered vscreenings v(vision, vhearing, vobesity)
Secondary vhealth vcare v- vincludes vthe vdiagnosis vand vtreatment vof vemergency, vacute
villness, vor vinjury. vexamples vinclude vcare vgiven vin vhospital vsettings v(inpatient vand vEDs),
vdiagnostic vcenters, vor vemergent vcare vcenters
Tertiary vhealth vcare v- vinvolves vthe vprovision vof vspecialized vhighly vtechnical vcare.
vexamples vinclude voncology vcenters vand vburn vcenters
Restorative vhealth vcare v- vinvolves vintermediate vfollow-up vcare vfor vrestoring vhealth.
vexamples vinclude vhome vhealth vcare, vrehab vcenters, vand vskilled vnursing vfacilities
Continuing vhealth vcare v- vdesigned vto vaddress vlong-term vor vchronic vhealth vcare vneeds.
vexamples vinclude vhospice, vadult vday vcare, vand vin-home vrespite vcare
Health vcare vregulatory vagencies vinclude: v- v-US vDept vof vHealth vand vHuman vSrvcs
-US vFDA
-State vand vlocal vpublic vhealth vagencies
-State vlicensing vboards v(to vensure vproviders v& vagencies vcomply vwith vstate vregulations)
-the vJoint vCommission/JCAHO v(set vquality vstandards vfor vaccreditation vof vhealth vcare vfacilities)
-Professional vStandards vReview vOrganizations v(PSROs)
-Utilization vreview vcommittees v(monitor vfor vappropriate vdiagnosis vand vtreatment vof
vhospitalized vclients)
Clergy v- vJob: vprovide vspiritual vcare vto vclient v(pastors, vrabbis, vpriests)
,Refer vto vwhen: vthe vclient vrequests vcommunication vor vthe vfamily vasks vfor vprayer vprior vto
vclient vundergoing va vprocedure
Registered vdietitian v- vJob: vassess, vplan vfor, vand veducate vthe vclient vreg. vnutritional
vneeds; vdirect vcare vof vnutritional vaids
Refer vto vwhen: vex- vthe vclient vhas vlow vnutrient vlevels vand/or vexperienced va vrecent
vunexplained vweight vloss
Lab vtech v- vJob: vobtain vspecimens vof vthe vclient's vbody vfluids vand vperform vthe vnecessary
vdiagnostic vtests
Refer vto vwhen: vex- vthe vprovider vorders va vCBC vto vbe vperformed vimmediately
Occupational vtherapist v- vJob: vassess vand vplan vfor vthe vclient vto vregain vADLs, vesp vmotor
vskills vof vthe vupper vextremities; vdirect vcare vof voccupational vtherapy vassistants
Refer vto vwhen: vex- vclient vhas vdifficulties vusing van veating vutensil vwith vdominate vhand
vfollowing va vstroke
Pharmacist v- vJob: vprovide v& vmonitor vmeds vfor vthe vclient vas vprescribed vby vthe vprovider;
vsupervises vpharm vtechs vin vstates vin vwhich vthe vpractice vis vallowed
Refer vto vwhen: vclient vconcerns vover vmeds; vdosage vconcerns; vetc
Physical vTherapist v- vJob: vassess vand vplan vfor vclient vto vincrease vmusculoskeletal
vfunctions, vesp vof vlower vextremities, vto vmaintain vmobility; vdirect vcare vof vphysical vtherapy
vassistants
Refer vto vwhen: vex- vfollowing va vhip vreplacement, va vclient vrequires vassistance vlearning vto
vambulate vand vregain vstrength
, Provider v- vJob: vassess, vdiagnose, vand vtreat vcllient vfor vdisease vand/or vinjury; vincludes vMDs,
vDOs, vAPNs, vand vPAs
Refer vto vwhen: vex- vclient vexperiences vchange vin vvital vsigns
Rad vTech v- vJob: vposition vclient vand vperform vx-rays vand vother vimaging vprocedures vfor
vproviders vto vreview vfor vdiagnosis vof vdisorders vof vvarious vbody vparts
Refer vto vwhen: vex- vprovider vorders vx-ray vof vclient's vhip vafter va vfall
Respiratory vtherapist v- vJob: vevaluate vresp vstatus vand vprovide vprescribed vresp vtreatments
vincluding vO2 vtherapy, vchest vphysiotherapy, vinhalation vtherapy, vand vartificial vmechanical
vventilation
Refer vto vwhen: vex- vclient vwith vresp vdisease vexperiences vSOB vand vrequests vnebulizer
vtreatment vthat vis vordered vPRN
Social vWorker v- vJob: vwork vwith vclient vand vclient's vfamily vby vcoordinating vinpatient vand
vcommunity vresources vto vmeet vpsychosocial vand venvironmental vneeds vthat vare
vnecessary vfor vrecovery vand/or vdischarge
Refer vto vwhen: vex- vclient vdying vof vcancer vwishes vto vgo vhome vbut vis vunable vto vperform
vADLs; vthe vspouse vneeds vmed vequipment vin vthe vhome vto vcare vfor vclient
Speech vtherapist v- vJob: vevaluate vand vmake vrecommendations vregarding vthe vfunctions vof
vspeech, vlanguage, vand vswallowing vimpacted vby vvarious vclient vdisorders vor vinjuries; vteach
vclient vtechniques vand vexercises vto vimprove vfunction vwhen vpossible
Refer vto vwhen: vex- va vclient vis vhaving vdifficulty vswallowing va vregular vdiet vafter vtrauma vto
vthe vhead vand vneck
