CNA chapter 1.txt
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Chain of command
The order of authority within a facility
The knowledge and skill required to perform tasks correctly
An approach to health care education that involves training a staff member to perform basic skills that have traditionally been considered the responsibility of another member of the health care team
holistic health care
An approach to health care in which the whole person is treated, both physically and emotionally. It involves treatment of both of the physical illness and the person's emotional response to the illness.
health care team
The group of people who provide care and services for the patient.
A type of health care agency that treats patients who are terminally ill and offers support services to their families.
humanistic health care
An approach to health care in which each person is treated as an individual. A person's culture and beliefs are considered as well as their illness and disease
licensed practical nurse (LPN)
Health care team member who is educated and licensed to assist the registered nurse in planning and providing nursing care
State-funded program designed to help meet the medical needs of low- income families
Federal program that helps provide medical and hospital care to persons who are 65 years or older or a permematehy disabled
nursing assistant (NA)
Health care team member who provides care for the patients under the supervision of a nurse
Omnibus Budget Reconciliation Act (OBRA )
Federal act whose purpose is to improve the quality of health care. This act addressed the safty, happiness, and well-being of patients
registered nurse (RN)
Health care team member who is educated and licenced to assess, plan, provide, coordinate, and evaluate nursing care
The process of restoring the patient To as nearly normal function as possible
A type of nursing care that assists patients in meeting their needs as independently as possible
The history of health care
- 1. Health care began many centuries ago in the home.
- 2. The hospitals were located in monasteries And other church buildings where members of religious groups provides care for the sick
Holistic and Humanistic Health Care
- 1. Holistic health care means treating the whole person, both physically and emotionally. It involves not only treating the patient's illness, but also exploring how he or she thinks and feels about the illness.
- 2. Holistic care focuses on the psychological and social aspects of the patient's recovery as well as on the medical progress
- 3. humanistic health care means treating each person as an individual. It emphasizes respecting all cultures and beliefs and acknowledges that people cannot classified by groups of disease. The humanistic heath approach adds an important component to holistic health care.
Changes and Trends in the Heath Care System
- 1. DRGs(diagnostic related groups)
- Under the DRGs system, an average cost and length of stay was established for each disease having a related diagnosis. Reimbursement退款to health care facilities was based on" average stays" A facility is not provide additional payment for patients who remain beyond the established time, patients go home "quicker and sicker"
- 2. HMOs(Health Maintenance Organization)
- HMOs were developed by insurance companies and groups to offer Complete health care coverage through their own providers. In an HMO, a group of heath care professionals, called a network. The price of services is reduced as long as patients stay within the network. Limits the patient's choice of providers.
- 3. Managed Case
- Managed case or case management involves the coordinate of health care services to meet an individual patient's needs in a cost-effective manner.A case manager assesses the patient, plans and coordinates services, and evaluates the results. The goal is to reduce costs and improve the quality of care. Limits de patient's right to make decisions.
Cross-training involves training a stuff member to perform a basic skill that has traditionally been considered the responsibility of another member of heath care team.
phlebotomy: draw blood
The expansion of home health care and outpatient门诊病人 units
- 1. Subacute Care Units
- The subacute care unit was designed to care for groups of patients who share specific needs
- 2. Rehabilitation and Restorative Care
- Rehabilitation is the process of restoring the patient to as nearly normal function as possible. Restorative care is the nursing care that assists patients in meeting Their needs as independently as possible. The approach is holistic, caring, and positive.
- 3. One of the options currently available is an ALF (assisted living facility) that provides help with activities such as bathing, dressing, and toileting.
Government Regulations and Programs
1. Health care facilities are regulated by the federal, state, and local governments. The purpose of these regulations is to protect patients and promote quality patient care In all heath care settings.
- 2. OBRA(Omnibus Budget Reconciliation Act)公共综合预算法案
- OBRA a federal act passed in 1987 whose purpose is to improve the quality of health care
- OBRA requires that nursing assistants complete a state -approved training program and demonstrate competency. Each state must meet federal regulation but may also have additional requirement
- OBRA requires facilities to provide inservice eduction for nursing assistant and other employees.
- OBRA also requires that each state establish and maintain a nursing assistant registry.
- If you stop working as a paid nursing assistant for 24 consecutive months, your certificate will no longer be valid.
- 3.OSHA (Occupational Safty and Health Administration)
- OSHA is a government agency that is concerned with the sa.fty and health of workers in industry
- 4.Medicare and Medicaid
- Medicare is federal program that helps provide medical and hospital care to persons who are 65 years or older or are permanently disabled.
- Medicaid is a program, funded by each state, that is designed to help meet the medical needs of low-income families.
- The primary difference between the two programs is that Medicare is based on age, while Medicaid is based on income.
Health Care Facilities
- 1. General Hospitals
- Provide treatment for variety of problems.
- 2. Specialty Hospital
- Treat patients of a certain age group or those who have a specific health problem.
- 3. Long-term Care Facilities(nursing home, extended care facilities...)
- Treat patients who are unable to care for themselves at homes, but who do not need to be in a hospital.
- 4. Home Health Agencies
- Provide health care to patients with varying diseases and of all ageso in their own homes.
- 5. Hospice
- Treat patients who are terminally ill and offers support services to their families.
Health Care Facility Organization
- 1. An administrator was responsible for the entire facility.
- 2. Health care facility may be divided into three major departments, such as administration, patient services, and support services.
- 3. Each department has an individual in charge who may be called a department head, vice president, or director.
- 4. chart on Page8
The Chain Command
- 1.The chain of command is the order of authority within a facility.
- 2.Employees should take problems, questions,and reports to the person directly above them in the chain.
The Health Care Team/The Nursing Team
- l. The health care team includes all of the people who provide care and services for the patient, at the center of the team is the patient and the patient's family.
- 2. The largest department in the most health care facilities is the nursing department. The person responsible for the entire nursing department is a registered nurse who may be called a director of Nurse(D.O.N). Assistant director of nurses(A.D.O.N)
- 3. The nursing staff is composed of registered nurses (RN), Iincenced practical Nurses (LPN), and nursing assistant(NA).
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