Nur 102 Ch 2 healthcare delivery 2005 by osJ0v81


									                   NUR 102 FUNDAMENTALS
                         OF NURSING
                        The Health Care Delivery System
                            Learning Objectives
 Define Key Terms.
 Describe the effects of managed health care within the health care system.
 Identify the six levels of health care.
 Describe the role of the nurses in different health care settings.
 Identify the various methods of financing health care.
 Discuss the implications that changes health care system on nursing.
 Describe the elements of the future of health care.

Health Care Regulation and Competition
 Professional standards review organizations (PRSO)
 Utilization Reviews (UR)
 Prospective payment systems
 Diagnosis-related group (DRG’s)
 Capitation
 Resource Utilization Group (RUG)
 Managed Care
   – Medicare
   – Medicaid
   – Private insurance
   – Long-term care insurance

                              Six Levels of Care
 Preventive Care
   – Education and Prevention
   – Community health nursing
 Primary Care
   – Physicians Offices, Nursing Centers, Primary Health Care Centers
   – Early detection and treatment
 Secondary Care(acute, intensive)
   – Urban and rural Hospitals,
    – Emergency Care
 Tertiary Care
   – Special care – psychiatric care
 Restorative Care
   – Home Health Care, Rehabilitation, Extended Care Facilities(long term care)
 Continuing Care
   – Group home, retirement, adult day care, Hospice, respite, Meals on Wheels

                               1# Critical Thinking Ex.
 Part of your education includes education in different types of health
   care settings. How would your role in the primary care settings be
   different from your role in the acute care settings?
                               2# Critical Thinking Ex.
 1.    Recently, a person who has had a stroke, is now stable, but needs to reach optimum level of function.

 2. A patient with many years onset of multiple sclerosis and requires assistance.

 3. A terminally ill patient requiring assistance at home.

 4. A patient who was in a motor vehicle accidents with multiple injuries.

 5. A person who attends aerobic classes two times a week.

                        Issues in Health Care Delivery
 Competency of Health Care Providers
   – Pew Health Professions Commission (1989 & 2005)
 Patient- Centered Care(Discharge Planning)
 Quality Health Care
   – Different indicators
   – Define quality care is different for clients than for health care professionals
   – Client satisfaction
                                  Client Satisfaction
 Respectful

 Coordinating and Integrating Care

 Inform client, communicate and teach

 Promote comfort
 Provide emotional support

 Patient as part of the Family Unit
 Comprehensive continuity in care
                             “Knowing the Client”
                              Competency in Care
 Review medical chart prior to interacting with client

 Interact with client using open ended questions

 Be observant and thoughtful
   – Facial expression
   – Posture
   – Body movement
 Ongoing assessments

 Family as a resource-patient and family as one

 Make rounds frequently

 Talk with other health care professionals

                                   Client’s Rights
 Everyone has the right to Health Care.

 Everyone has the right to be fully informed, to privacy, easy access to health care and the
  right to participate or to refuse care.

   American Nurse Association               (2004)
                                    Technology in
                                     Health Care
 Computerized equipment and devices
 Electronic documentation
  – Pop up screens
  – Computerized nursing care plans
  – Quick charting
  – Important, updated data
 Confidentiality
  – Password protected
  – Limited Printing
Future Health Care
 Exploring health care in the US
   – Complex with some deficiencies
   – Fragmented
   – Lack comprehension, follow-up
   – Expensive
   – Citizens lack health care coverage
   – Lack accessibility
   – Lack equality
 Nurses are instrumental in promoting quality in delivering health care at
  affordable rates (ANA).

Summary – Health Care Delivery System
 Presently under going change with main focus on quality care and cost

 New policies and regulations.

 Competency of Health Care Providers.

 Promoting a continuum of care.

 Increase scientific advances and technology.

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