Management of Care Study Guide Quiz 1

Chapter 5 Regulatory Agencies:     Are charged by federal and state governments to set standards for the operation of health care organizations ensure compliance with federal and state regulations developed by government administrative agencies investigate and make judgments regarding complaints brought by consumers of the service and the public health care organizations work with myriad accrediting and regulatory agencies so that optimum standards of care and delivery of care can be met. Role of Nurse in hospital surveys     Daily adherence requires nurses to be aware of accreditation standards, best practice, and current evidence and to deliver nursing care that meets and exceeds standards During site visit, nurses will participate in interviews or team meetings with representatives from the accrediting agency Surveyors will also interview patients, families, and clinical staf Surveyors will review policies, procedures, protocols, and practices Accreditation – definition   is the voluntary process but federal reimbursement of health care is dependent on it founded to set a minimum of standard of care Accreditations- benefits    leads to improved patient care, demonstrates the organizations commitment to safety and quality, ofers an educational on-site survey experience, and supports and enhances safety and quality improvement eforts. Strengthens and supports recruitment and retention eforts, may substitute for federal certification surveys for Medicare and Medicaid, and helps secure managed care contracts Facilitates the organization’s business strategies, provides a competitive advantage, enhances the organization’s image to the public, purchasers, and payers, fulfills licensure requirements in many states, recognized by insurers and other third parties, and strengthens community confidence The Joint Commission   The accreditation organization that strives to continuously improve the safety and quality of care provided to the public through the provision of health care accreditation and related services that support performance improvement in health care organizations. The Joint Commission—It is the predominant standards-setting and accrediting body in health care in the United States.   Independent not-for-profit organization The Joint Commission (TJC) standards address an organization’s level of performance in key functional areas, such as patient rights, patient treatment, and infection control. Det Norske Veritas     DNV approach to accreditation focuses on quality, innovation, and continual improvement. Requires an annual survey and the organization’s continual compliance with the DNV accreditation process. Provides disease-specific certifications such as primary stroke center 364 health care institutions that partake in DNV The American Osteopathic Association     AOA is recognized as an alternative accreditation agency Primarily deals with osteopathic hospitals and institutions Certifies institutions as “stroke ready” and as primary stroke centers and comprehensive stroke centers 174 AOA accredited institutions Education Accreditation – ACEN and CCNE    Hospitals who participate in the education of health care personnel, nurses, and physicians are subject to visits by the accrediting agencies used by the schools working with ACEN and CCNE The schools are usually responsible for the compliance with standards The nurse’s role is to respond to the role of the students in the provision of care on the unit Regulatory Agencies      These regulatory and advisory agencies have an impact on the standards of health care OSHA regulates workplace safety and standards CDC has created multiple infection control standards FDA regulates drugs, medical devices, and radiation-emitting products, which form the basis of the medication management standards of accreditations Such agencies regulate the way a hospital implements workplace standards Licensing Bodies      Licensed to perform services by the state department of health State department of health: regulate a variety of health care setting for quality of care State department of health: investigate complaints received from patients, other consumers, and other state and federal agencies State department of health: provide consumer information in the form of report cares and other performance information Nurses are often called to assists hospital administrators regarding complaints lodged with the state department of health Government Agencies – OSHA, USDHHS, NIOSH, FDA, State Health Dept.   OSHA: U.S. Department of Labor agency that ensures the safety and health of America’s workers; They set and enforce standards; provide training, outreach, and education; establish partnerships; and encourage continual improvement in workplace safety and health o An example of an OSHA guideline of importance to nursing was the September 12, 2005, guideline for the recommendation to minimize patient lifting to prevent health care musculoskeletal injuries. The result is that there has been a decline in nursing back injuries. USDHHS: 115 programs included not limited to health and social science research Other groups – ANCC  ANCC: magnet award o Magnet award  highest level of recognition that the ANCC can award to organized nursing services. o ANCC recognizes nursing sensitive outcomes as a predictor of quality of patient care o ANCC values the retention of highly competent nurses Chapter 1 Leadership vs. Management Theories of Leadership (Trait, Behavioral, Contingency) Leader vs. Manager characteristics Comparing Nursing Process with management process Levels of management and their responsibilities Competencies of Patient Care Managers Chapter 2 Leadership structures in Healthcare (Organizational, Functional, Product Line, Matrix and Integrated) Pros and cons and RN’s role in each type of care delivery system Total Care Functional Nursing Team Nursing Primary Nursing Case Management Chapter 13 Accountability and RN’s role in delegation Roles of other patient care team members, i.e. LPNs and UAP 5 Rights of Delegation ANA & NCSBN policies on delegation Acceptance of delegated assignments Delegation factors Direct patient care activities Indirect patient care activities Activities that cannot be delegated Levels of clinical experience (Unit-based scenarios, pairing, partnering)