©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
NU-126 Test 2 Study Guide with
Complete Solutions
Nursing plays an important role in - Ans:✔✔-Care quality and safety as well as cost contaimenent, care
coordination, and service delivery
National Quality Forum - Ans:✔✔-(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) - Ans:✔✔-Not for profit organization= not for profit organization= focus on
safety; better patient outcomes
Financing Health Care- - Ans:✔✔-Had gone from retrospective, few-for-service payment system to
prospective payment systems.
Cost reduction and managed care - Ans:✔✔-Continues to evolve to new models, such as pay-for-
performance and never events.
Cherry and Jacob p110
Page 1/33
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
Pay for performance - Ans:✔✔-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) - Ans:✔✔-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) - Ans:✔✔-Created a list of never events that are "devastating and
preventable."
P&P- 390
Examples of never events - Ans:✔✔-- 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
Page 2/33
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
- administration of incompatible blood
- air embolism
- foreign object retained after surgery
Patient satisfaction - Ans:✔✔-- 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 - Ans:✔✔--health maintenance organizations
- preferred provider organizations
- point of service plans
Page 3/33
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
- use some form of review for medical necessity of the services under consideration
Table 7.2 c&j
Managed care plans - Ans:✔✔-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 - Ans:✔✔-Usually only pay for care within the network. You choose a
primary care doctor who coordinates most of your care
Preferred provider organizations - Ans:✔✔-Usually pay less if you get care within the network (list of
providers and hospitals). They still pay part of the cost if you go outside the network. May or may not
pay for preventative care.
Point of service - Ans:✔✔-Plans that let you choose between an HMO or a PPO each time you need care.
How health care is paid - Ans:✔✔--Private insurance- blue cross blue shield
Page 4/33
FIRST PUBLISH OCTOBER 2024
NU-126 Test 2 Study Guide with
Complete Solutions
Nursing plays an important role in - Ans:✔✔-Care quality and safety as well as cost contaimenent, care
coordination, and service delivery
National Quality Forum - Ans:✔✔-(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) - Ans:✔✔-Not for profit organization= not for profit organization= focus on
safety; better patient outcomes
Financing Health Care- - Ans:✔✔-Had gone from retrospective, few-for-service payment system to
prospective payment systems.
Cost reduction and managed care - Ans:✔✔-Continues to evolve to new models, such as pay-for-
performance and never events.
Cherry and Jacob p110
Page 1/33
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
Pay for performance - Ans:✔✔-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) - Ans:✔✔-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) - Ans:✔✔-Created a list of never events that are "devastating and
preventable."
P&P- 390
Examples of never events - Ans:✔✔-- 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
Page 2/33
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
- administration of incompatible blood
- air embolism
- foreign object retained after surgery
Patient satisfaction - Ans:✔✔-- 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 - Ans:✔✔--health maintenance organizations
- preferred provider organizations
- point of service plans
Page 3/33
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
- use some form of review for medical necessity of the services under consideration
Table 7.2 c&j
Managed care plans - Ans:✔✔-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 - Ans:✔✔-Usually only pay for care within the network. You choose a
primary care doctor who coordinates most of your care
Preferred provider organizations - Ans:✔✔-Usually pay less if you get care within the network (list of
providers and hospitals). They still pay part of the cost if you go outside the network. May or may not
pay for preventative care.
Point of service - Ans:✔✔-Plans that let you choose between an HMO or a PPO each time you need care.
How health care is paid - Ans:✔✔--Private insurance- blue cross blue shield
Page 4/33
