| Accreditation | A process whereby a professional association or nongovernmental agency grants recognition to a school or institution for demonstrated ability in a special area of practice or training |
| Certification | A process in which the government evaluates and recognizes an individual institution or educational program as meeting certain predetermined standards |
| Diagnosis-related groups (DRGs) | Pays a set rate according to diagnosis for the hospitalized patient's care rather than the "cost" |
| Telehealth services | Allows for patient and care provider interaction and monitoring through the use of telephones, computers, televisions, and two-way monitors |
| Home health care | Services enable individuals of all ages to remain in the comfort and security of their home while receiving health care |
| Medicaid | Program pays for home care services to indigent and low-income people of all ages |
| Medicare | A federal program that requires agencies to be certified as meeting the federal conditions of participation which set forth specific requirements for organization, staffing, training, types of services covered, and agency evaluation |
| 4 different perspectives of home health care | Official
Patient
Family
Provider |
| Official | A component of comprehensive health care in which individuals and their families receive services in their place of residence for the purpose of promoting, maintaining, or restoring health, or of minimizing the effects of illness and disability |
| Patient | Skilled and compassionate care provided on a one to one basis in the comforting and familiar surroundings of the home |
| Family | A means to keep the family together as a functioning, integrated unit |
| Provider | Challenges all disciplines involved to provide excellent care in often less-than-excellent conditions and surroundings |
| How did Medicare revolutionize home care? | Changing it to a medical rather than nursing model of practice
Defining and limiting the services it reimbursed
Changing the payment source and even changing the reason for providing homecare |
| What does licensure by the state allow? | Gives LEGAL permission to operate within that state only |
| Explain "Certificate of Need" | According to rules and formulas devised by state regulators, "Certificate of Need" is granted |
| "Deemed status" allows what? | Allows for their accreditation also to serve as the required certification |
| What are agencies classified according to? | tax status, for profit or non-profit
location, freestanding or institution-based
governance, public or private |
| Social workers provide what? | Assistance with a patient's emotional, financial, and household problems, thus allowing the nurse more time to perform nursing interventions |
| Primary services include? | Skilled nursing
Physical therapy
Speech-language therapy
Occupational therapy
Medical social services
Homemaker-home health aide |
| A plan of treatment signed by the physician that outlines all disciplines, treatment, frequency, and duration is required by what? | Medicare |
| The 4 major goals of skilled nursing services | Restorative
Improvement
Maintenance
Promotion |
| Restorative/Restorative goals | Returning to previous level of functioning as appropriate and realistic
-Restorative goals: patient able to feed self without signs of choking |
| Improvement | Achieving better health and higher level of functioning that admission
-Improvement goals: patient verbalizes understanding of signs of impending heart attack or brain attack and when to call emergency |
| Maintenance | Preserving functional capacities and independence by maintaining current level of health
-Maintenance goals: patient demonstrates compliance with daily exercise routine to maintain strength and prevent further decline |
| Promotion | Teaching healthy lifestyles that keep the effect of illness or disability to a minimum and prevent reoccurrence of illness
-Promotion goals: patient demonstrates compliance in low-fat, low-cholesterol, low-sodium diet |
| Name the types of nurses who practice in the home setting | Caregivers, teachers, counselors, case managers, and advocates |
| Physical therapy treatments range from-? | Muscle strengthening, transcutaneous nerve stimulation, and ultrasound treatments
These may aide in pain management |
| Speech-language therapy goals include-? | Reducing to a minimum communication disorders and their physical, emotional, and social impact |
| Speech-language therapy ranges from-? | Language relearning to working with eating or swallowing disorders or teaching lipreading to those with hearing disorders |
| Occupational therapy services include-? | Techniques to increase independence
Analysis of activities as they relate to patients' skin, environment, families, and routines
Expanding the disease management approach into lifestyle management approach
Design, fabrication, and fitting of orthotic or self-help devices
Assessment for vocational nursing |
| Occupational therapists assist with what? | They assist patients to improve in their performance of activities of daily living and their sensory-motor, cognitive, and neuromuscular functioning |
| What do medical social services focus on? | Their focus is on the emotional and social aspects of illness |
| Home health aide falls into what 3 categories? | Personal care
Physical assistance
Household chores |
| Personal care | Bathing, oral hygiene, eating, dressing, and toileting |
| Physical assistance | Transfers, medications, and ambulation |
| Household chores | Cooking, light housekeeping, shopping, and laundry |
| What do both Medicare and Medicaid require? | On-site supervision of the aide every 2 weeks, principally by the RN |
| Evaluation and admission generally include what? | Complete patient evaluation
Environmental assessment RELATING SPECIFICALLY TO SAFETY AND ABILITY to provide services effectively in the home
Identification of primary functional impairments
Identification of the impact of the disease or disability on the patient and family
Assessment of the support system of the family/significant other
Determination of knowledge and adherence to treatments and medications
Determination of desire for care/services
Involvement of the patient and the family in the development of the plan of care and goals
Notification of the patient of rights as a patient along with information on costs, payment resources, and billing practices
Explanation of patient's right to self-determination
Provision of initial nursing interventions |
| What does the treatment plan describe? | Describes current physical status of patient, medications, treatments, the disciplines needed to provide care, the frequency and the duration of services, the goals and outcomes, and the time frame for implementation |
| Explain what documentation provides | Extended periods of health information
Accessible medical docs by health care team
Monitor patient compliance and care needs
Promote quality of care |
| When does discharge planning begin? | During admission |
| 3 major elements of quality assurance, assessment, and improvement | 1. Structural criteria
2. Process criteria
3. Outcome criteria |
| Structural criteria | Organization, philosophy, policies, procedures, bylaws, personnel practices, supervision, orientation, contracts, and physical facilities |
| Process criteria | Evaluation of care delivery |
| Outcome criteria | Measurement of change in patient behavior, results of patient care in terms of changes, health indicators, and satisfaction |
| Major principals of quality assurance, assessment, and improvement | Quality of patient care
Processes are carried out
Coordination and integration of processes
Employees are motivated and competent to carry out processes |
| Beneficiaries of services are REQUIRED to be 65 years or older or disabled or have end-stage renal disease. In addition, they have to be under the care of a licensed physician in order to be eligible for what? | Medicare |
| What is the standard of care for many illnesses? | Medical management and control rather than cure |
| Explain what home health care allows for | Allows individuals to maintain personal control and participate in the direction of their own care |
| What do health care workers provide? | Care, supervision, assistance, and support in attaining the care plan goals |
| What has changed the way home health care is provided? | Legislative, regulatory, and current health care trends have changed the way it is provided |
| Home care services is based on what? | A coordinated plan of care approved by a physician |
| What are home health agencies? | Organized groups that employ or contract with professionals/paraprofessionals to provide services |
| What type of nursing is the most frequently provided service? | Skilled nursing care |
| Who reimburses home health services? | Federal, state, local, group, and private services |
| Home health care nurses pay particular attention to what? | Interaction and cooperation among family members, the patient, and other members of the health care team |
