TERMINOLOGY AND LANGUAGE
IN INFORMATICS.
This week's graded discussion topic relates to the following Course Outcomes (COs).
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• CO3 Define standardized terminology that reflects nursing's unique contribution to patient outc o
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mes. (PO 3)
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• CO8 Discuss the value of best evidence as a driving force to institute change in delivery of nur sing
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care. (PO 8)
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1. What is the impact of Centers for Medicare and Medicaid Services (CMS) payment deni al o
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n the healthcare system?
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2. What are the implications for our nursing practice related to use of standardized terminol og
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y for documentation?
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3. How do evidence- xz xz
based practice guidelines impact patient outcomes and necessitate improved practice car e?
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, ANSWER
Hello Instructor and Class,
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Centers for Medicare and Medicaid Services (CMS) impact and reflect our Healthcare syste
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m every day. Payments from Medicaid to hospitals and other providers play an important r ole in hos
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pitals’ financial condition and effect patient care as well. Denials of payment by Medi care usually o
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ccur because of hospital errors, such as hospital-accrued infections or patient re-
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admission to the hospital because of mistakes made. Previously, hospitals where reimbursed for hos
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pital-accrued infection or patient readmission due to hospital’s fault.
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Medicare reimbursements for hospitals have changed in 2012. Medicare started to pay n ot
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only for services hospitals provide, but they require for those services to be high quality. CM S creat
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ed several programs to improve quality of care. First, Hospital Re-
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admission Reduction Program was designed to reduce hospital re-
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admissions. Secondly, Hospital Value- xz xz xz
Based Purchasing (VBP) program was created to expect better clinical results for hospitalized p atie
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nts and improve their experience of care while they are in the hospital. Hospital quality of ca re effect
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s the payment it gets from Medicare. A third program Hospital-
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Acquired condition (HAS) reduction program was created to encourage the health care provider s t
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o improve patients’ safety and reduce hospital-
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acquired conditions. These denials have a negative effect on the Hospital because they then hav e le
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ss money for the necessary resources.
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