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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 containment. New policies and regulations. Competency of Health Care Providers. Promoting a continuum of care. Increase scientific advances and technology.
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