chapter 6.ppt
TRANSCRIPT
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ARENAS OF CARE
UNIT 2 THE HEALTH CARE ENVIRONMENT
CHAPTER 6
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ARENAS OF CARE
Acute care hospital Long-term care facilities Home health care agencies Hospice Outpatient settings Schools
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LICENSURE, CERTIFICATION, AND ACCREDITATION
Several methods have been designed to ensure that an agency, facility, or service meets minimal standards of care.
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LICENSURE
A state-regulated, mandatory system of granting licenses according to specified standards.
Designated agencies visit each facility annually.
If deficiencies are not corrected, the facility may lose its license to operate.
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CERTIFICATION
A voluntary process that establishes and evaluates compliance with rules and regulations.
Required for any provider who seeks reimbursement from government funds.
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ACCREDITATION
An additional, voluntary confirmation of quality.
Generally indicates that the delivery of care and service is above minimum standards.
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ACCREDITATION (continued)
Agencies include: Joint Commission on Accreditation of
Healthcare Organizations (JCAHO) The Commission on Accreditation of
Rehabilitation Facilities (CARF)
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ACUTE CARE HOSPITAL
Provides the greatest number of services, including:
Nursing units Specialized client care units Diagnostic departments Therapy departments Support services
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NURSING UNITS
Most nursing care is provided in client rooms.
Often serve a particular type of client. Unit coordinator, nurse manager, or head
nurse is in charge of the unit. RNs, LP/VNs, and nursing assistants
provide the nursing care.
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SPECIALIZED CLIENT CARE UNITS
Provide nursing care for specific needs. May employ LP/VNs. Examples include emergency
departments, intensive care units, psychiatric units, rehabilitation units, dialysis units, hospice units, outpatient units, home care and education units.
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DIAGNOSTIC DEPARTMENTS
Provide specialized tests that assist the physician in making a diagnosis:
Clinical laboratory Radiology and nuclear medicine Other diagnostic services such as sleep
centers, EKGs, and EEGs
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THERAPY DEPARTMENTS
Provide specialized treatments and/or rehabilitation services to improve functional level in specific area:
Physical therapy Respiratory therapy Occupational therapy Speech therapy
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SUPPORT SERVICES
Pharmacists Dietitians Social workers Chaplains Admission department Medical records Housekeeping and maintenance
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ROLE OF THE LP/VN IN ACUTE CARE
Provides direct care. Performs client assessments. Works with the RN to formulate nursing
diagnoses and write the plan of care. May work in specialized units after some
years of experience, additional education.
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LONG-TERM CARE
Various services provided to individuals having an ongoing need for health care.
Provides services to those who are not acutely ill, but who cannot function independently at home.
May be licensed for either intermediate care or skilled nursing care.
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SUBACUTE CARE
Provides services for clients who are out of the acute stage of their illness but still requiring skilled nursing, monitoring, and ongoing treatments.
Intended to fill the gap between the acute care hospital and the traditional long-term care facility.
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CONTINUING CARE RETIREMENT COMMUNITIES
Designed to provide continuous care as the individual’s health care needs change.
May include: Independent Assisted living Short-term or permanent health care
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ASSISTED LIVING
A combination of housing and services for people who need help with the activities of daily living.
Nursing care is not provided.
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ADULT DAY CARE
This is a protective setting for adults unable to stay home alone but who don’t need 24-hour care.
Services may include socialization, some rehabilitation, and nursing care.
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RESPITE CARE
May be offered by long-term facilities, adult day care centers, or private homes.
Provides break to caregivers for few hours a week, occasional weekend, or longer.
Supervision, meals, planned activities.
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FOSTER CARE
For individuals unable to live independently yet do not require care in a health care facility
Similar to the foster home concept for children
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ROLE OF THE LP/VN
Long-term facilities offer many career opportunities.
May supervise the evening or night shifts. Needs good assessment skills, nursing
judgment based on assessment findings. Coordinates, supervises nursing
assistants.
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OUTPATIENT CARE
Includes services provided without the client actually being admitted to health care facility.
Same-day surgery may be in acute care hospital or free-standing facility.
Clinics, treatment centers offer testing, chemotherapy, physical therapy, etc.
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ROLE OF THE LP/VN
Preparing the client for the treatment or procedure
Checking vital signs Answering questions Discharge teaching Assisting with tests or procedures
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HOME HEALTH CARE
The fastest-growing segment of health care.
Encompasses many services delivered to persons in their homes.
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ROLE OF THE LP/VN
Must have excellent assessment skills. Teaching is a major responsibility. Clients, caregivers must be taught:
The disease process Medications Special skills Documentation and communication
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HOSPICE
Humane, compassionate care for clients who can no longer benefit from curative treatment and have 6 months or less to live.
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HOSPICE (continued)
Provides sensitive support allowing clients to be alert, pain-free and have other symptoms managed so the last days are spent with dignity and quality of life at home or in a home-like setting.
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REHABILITATION
The process of helping individuals reach their optimal level of physical, mental, and psychosocial functioning.
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THE INTERDISCIPLINARY HEALTH CARE TEAM
An essential component of the rehabilitation process.
Professionals are selected based on client need.
A holistic approach is used to identify client’s physical, mental, and psychosocial needs.
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FUNCTIONAL ASSESSMENT AND EVALUATION
Criteria for admission to a program requires the client to be:
Medically stable Able to learn Able to sit supported for at least 1 hour a
day and actively participate in the program
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ROLE OF THE LP/VN
Requires: Specialized knowledge, skills, attitudes. Sound knowledge of anatomy and physiology
of the neurological, musculoskeletal, gastrointestinal, urological systems.
Excellent skills in ROM, ADLs, positioning, transfers, and ambulation.
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REHABILITATION SETTINGS
Hospital inpatient programs Skilled nursing facilities Outpatient rehabilitation Home rehabilitation