NURS 502 Review

NURS 502 Review .11 Elements of SPs - ANSWER-1. Be in writing, dated & signed by the org health care system personnel authorized to approve 2. Specify which SP functions RNs may perform under what circumstances 3. State specific requirements which are to be followed by RNs in performing particular SP functions 4. Specify experience, training, &/or education requirements for performance of SP functions 5. Establish a method for initial & continuing evaluation of the competence of those RNs authorized to perform SP functions 6. Maintain a written record of those persons authorized to perform SP functions 7. Specify scope of supervision required for performance of SP functions, ie. Collaboration/ supervision by MD 8. Identify any specialized circumstances under which RN is to immediately communicate with a patient's MD concerning pt condition 9. State the limitations on settings, if any, in which SP functions may be performed 10. Specify patient record keeping requirements 11. Provide for a method of periodic review of SPs .6 Quality Aims for US Health Care - ANSWER-1. Safe 2. Effective 3. Patient centered 4. Timely 5. Efficient 6. Equitable .9 NP Core Competencies - ANSWER-1. Scientific Foundation 2. Leadership 3. Quality 4. Practice Inquiry 5. Technology & Information Literacy 6. Policy 7. Health Delivery System 8. Ethics 9. Independent Practice .Acceptable Codes - ANSWER-2 sets of codes acceptable + DSM codes 1. ICD-9-CM 2. CPT DSM Codes- Psych Current procedural terminology codes (CPT) Used to bill for outpatient services NOT inpatient services = outpatient claims forms International Classification of Diseases Diagnosis & Procedural Codes (ICD-9-CM) CM = clinical modification = inpatient E/M services = inpatient claims forms .APN Leadership Role - ANSWER--Active role in political aspects of healthcare issues -Understand & become involved in policy formation -Knowledge of policy, organization, & finance in health care .APN Quality Leadership Principles: Customer Focused - ANSWER-center of quality efforts = meet or exceed customer goals, provide value Conflict w payers & customers = who is the ultimate customer? .APN Quality Leadership Principles: Freedom Through Control - ANSWER-quality control & reduction in variation = regular desired results -Standardized processes -Work processes = more efficient & effective .APN Quality Leadership Principles: Looking for Faults in the System - ANSWER-QI philosophy & culture = continuous improvements of all work systems Establish priorities for change .APN Quality Leadership Principles: Quality Obsession - ANSWER-must have a culture of quality = norm is to continuously pursue improved quality that is efficient & effective -Education of all -Communication = clear, concise which includes goals, expectations, necessary resources -Alignment of performance & rewards systems .APN Quality Leadership Principles: Recognize the Structure - ANSWER-what is the structure & process Staff working together w management = transformational leadership .APN Quality Leadership Principles: Teamwork - ANSWER-members committed to working together toward common vision Continued education & training .APN Quality Leadership Principles: Unity of Purpose - ANSWER-clear & widely understood vision in the organization that unites/aligns all who work there .APN Risk Management - ANSWER-Clinical errors: to err is human -Malpractice: -Is there a client/professional relationship? -Is the professional's behavior below the appropriate standard of care (dealing in like circumstances)? -Is there a causal link between the practitioner's failure to conform to treatment standards & harm to the patient? -Actual injury to the patient? -Existence of a professional relationship -Providing care includes BUT limiting pt relationships to a normal, safe evaluation process will manage risk : Clinic, hospital, outpatient, SNF, HH, ED Over the telephone At a social gathering -By supervising another's treatment -By providing sample medication -By giving advice or opinions to family, friends, etc -When is a person a patient? -Managing Risk by limiting patient relationships: -Refuse to give advice outside of clinical arena, scope of practice, legal standards -Require all advice be provided after patient exam in the office -Say NO anytime the request for advise or care skirts the normal, safe evaluation process -Standard of Care for APNs -What is reasonable, ordinary care, skill, & diligence that would be provided by practitioners in good standing, in the same geographic area, in the same general type of practice in similar cases (standard may be same as applied to MDs or only to APNs) -Maintain knowledge & practice within standards of care Defuse potential lawsuits when there is that opportunity -Reputation based on: -Attention to details, patients, staff -Timeliness -Appearing as a professional -Professional demeanor -Reliability -Ability to make decisions -Intelligence -Breaching Patient Confidentiality -Talking in the wrong place -Releasing medical information w/o patient, parent, guardian written permission -Leaving telephone messages on answering machines -Discussing patient condition with anyone the patient has NOT a