Fundamentals: Ensuring continuity of care

components of effective discharge planning

accurate measurement of patient's health literacy level, ongoing comprehensive assessment of personal and health data, appropriate care plans developed, appropriate patient education, inter-professional team meetings

hospitals

average LOS 4.8 days, classification is public or private, size and services, services delivered depend on size, inpatient or outpatient is short stay

specialized care

daycare centers, schools, rural healthcare centers, industry/occupational health, parish nursing, urgent care centers, home healthcare

payment sources of healthcare

federal insurance programs: medicare, prospective payment program, medicaid, SSI, CHIP; private insurance, group plans, HMO, PPO, PPA, IPA, PHO, long term care insurance

secondary prevention

focuses on resources on diagnosis and treatment of disease, care delivered mainly in the hospital, free standing outpatient agencies, MD offices, etc. hospitals focus significant resources on emergency care, intensive care and acute around the clock care, also includes screening or early detection of the disease **screening is always secondary prevention level

primary prevention

health promotion/disease prevention, addresses adequate proper nutrition, weight control, exercise, and stress reduction, directed toward individual patients or communities, emphasize personal responsibility for maintaining health, involves activities like teaching, immunizations, identifying risk factors, etc.

cost/quality trade off

healthcare is different than other consumer products, patient willing to pay for higher quality of care as long as the benefit out weighs the cost

factors affecting healthcare delivery

increasing consumer awareness, desire for more information and inclusion in healthcare, increasing number born early and living longer, increasing cultural diversity, advances in technology, uneven distribution of services, the homelss and the poor, access to health insurance, healthcare reform

accomplishing continuity of care

initiate discharge planning when patient is admitted, involve the client and family/significant others in the planning process, collaborate with the interdisciplinary healthcare team, ensure biophysical, cultural, and spiritual needs are addressed

appropriate patient education

medication, dietary, and activity restrictions, follow-up appointments, ability to safely perform any necessary skills/treatments

healthcare reform

patient protection and affordable care act decreases number of people uninsured by making available access to affordable insurance, 30 million will gain access, individual mandate, 2014 each non-elderly individual must be insured major issue is balance between comprehensive and affordable

comprehensive assessment

physical, cognitive and functional abilities, caregiver responses/abilities, available financial resources, available community supports, resources, hazards or barriers in the home environment

primary care centers

physician offices and clinics, ambulatory care centers and clinics, deliver medical care on an outpatient basis, outpatient surgery/same day surgery is located in convient spots, improve access for un or under insured patients

continuity of care

process y which healthcare providers give appropriate, uninterrupted care and facilitate the patient's transition between different settings and levels of care

long term care

provides medical or nonmedical care to people with chronic illness

ten titles of ACA

quality, affordable health care for all amercians, role of public programs, improving quailty and efficiency of healthcare, preventing chronic disease and improving health, the jobs bill/healthcare workforce, transparency and program integrity, improving access to innovative therapy, community living assistance service and support, revenue provision, strengthening ACA

tertiary prevention

rehabilitation, health restoration, and palliative care, the goal is to attain and maintain their highest level of functioning, palliative care is a growing field, appropriate if patient can't return to previous state of health, pain and symptom management

healthcare report cards

summary of information on the MDs and hospitals, ANA looking for ways to measure nursing's contribution measuring outcomes: HAI rates, med errors, pressure ulcers, falls, patient/family complaints, mortailty rates

discharge planning

the process of preparing a client to leave one level of care for another within or outside the current health care agency