Dimensions Of Nursing Practice Exam #1 – Flashcards

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Evidence-based practice
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The practice of nursing in which interventions are based on data from research that demonstrates that they are appropriate and successful
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Position
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A group of tasks assigned to one individual
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Job
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A group of positions similar in nature and level of skills that can be carried out by one or more individuals
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Occupation
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A group of jobs similar in type of work that are usually found throughout industry or work environment
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Profession
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A type of occupation that requires prolonged preparation and formal qualifications and meets certain higher level criteria that raise it to a level above that of an occupation
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Professional
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A person who belongs to and practices a profession
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Professionalism
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The demonstration of high-level personal, ethical, and skill characteristics of a member of a profession
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Traits that define a profession
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-High intellectual level -High level of individual responsibility and accountability -Specialized body of knowledge -Knowledge that can be learned in institutions of higher education -Public service and altruistic activities -Public service valued over financial gain -Relatively high degree of autonomy and independence of practice -Need for a well-organized and strong organization representing the members of the profession and controlling the quality of practice -A code of ethics that guides the members of the profession in their practice -Strong professional identity and commitment to the development of the profession -Demonstration of professional competency and possession of a legally recognized license
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High Intellectual Level
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On a daily basis, nurses use assessment skills and knowledge, use the ability to reason, and make routine judgments based on clients' conditions
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High Level of Individual Responsibility and Accountability
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Nurses are often the primary, and frequently the only defendants named when errors are made that result in injury to the client. The concept of accountability has legal, ethical, and professional implications that include accepting responsibility for actions taken to provide client care and for the consequences of actions that are not performed
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Specialized Body of Knowledge
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As more nurses obtain advanced degrees, conduct research, and develop philosophies and theories about nursing, the body of knowledge increases in the scope and quality
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Public Service and Altruistic Activities
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Nursing has been viewed universally as an altruistic profession composed of selfless individuals who place their lives and well-being of their clients above their personal safety. Today, nurses are found in remote and often hostile areas, providing care for the sick and dying, working 12 hour shifts, being on call, and working rotating shifts.
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Peer Review
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a process that requires any manuscripts submitted to be reviewed by two or three professional who are considered experts, or at least knowledgeable, in the subject matter
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Author Credentials
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name of the author and his or her titles and credentials should be listed. Be cautious if no author or publisher is listed
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Prejudice and Bias
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the is most always a small degree of prejudice and bias in all written material, BUT most legitimate authors strive to be as objective as possible
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Timeliness
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determine when the site was last updated and how extensively the information was revised
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Presentation
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you often tell a lot about a website by its presentation, if the graphics seem to be just decorative, it should raise a red flag about the content of the site, and if you do not have access to the program or article, move on to the next site
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Nurses' Code of Ethics
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general statements and thus do not give specific answers to every possible ethical dilemma that might arise, offer guidance; written by Florence Nightingale
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Meta-Ethics
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The abstract, overarching philosophical way of understanding ethics; "how we know what we know"; refined to how do we know what is right and wrong
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Normative Ethics
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the use of the concepts and principles discovered by meta-ethics to guide decision-making about specific actions in determining what is right or wrong when interacting with other people; tends to be more prescriptive than meta-ethics and forms the basis for theories and system of ethics
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Applied Ethics
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The application of the theories and systems of ethics developed by normative ethics to real-world situations; is broken down into specialized fields such as health-care ethics, legal ethics, bioethics, or business ethics and is mostly used by nurses and other health-care providers
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Descriptive Ethics
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A bottom-up approach to ethics that starts with what society is already doing ethically and developing ethical principles based on the observed actions of people rather than starting with ethical principles and applying them to society such as normative ethics does.
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Nurses having autonomy and independence of practice
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No, despite efforts to expand nursing practice into more independent areas through updated nurse practice legislation, nursing retains much of its subservient image. Nurses in all health-care settings must work closely with physicians, hospital administrators, pharmacists, and other groups in the provision of care
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Professional Unity
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There are approximately 2.7 million nurses in the United States. It is not difficult to imagine the power that the ANA could have to influence legislators and legislation if all of those nurses were members of the organization rather than the 250,000 who actually do belong, nurses need to belong to their national nursing organization.
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Healthcare of Ancient civilizations
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Major concern was survival of the group since illness and injury threatened this survival; practices grew from processes of trial and error. Women tended to care for the ill and injured. Evil spirits thought to be the cause. Medicine men and women who practice witchcraft were considered religious figures.
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Hippocrates
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the father of medicine; beliefs focus on harmony with the natural law instead of on appeasing the gods. emphasized treating the whole client- mind, body, spirit, and environment- and making diagnoses on the basis of symptoms rather than on an isolated idea of a disease. also concerned with ethical standards for physicians, expressed in the now-famous Hippocratic Oath.
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Influences of Religion
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the rise of Christianity, starting from AD 30, brought with it a strong belief in the sanctity of all human life. Christians considered practices such as human sacrifice, infanticide, and abortion, which had been common in roman society to be murder. Following the teachings of Jesus meant that caring for the sick, poor, and disadvantaged was of primary importance, and groups of believers soon organized to offer care for those in need
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Influences of Science
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Technological developments in the 19th century included medications such as morphine, and codeine for pain and quinine to treat malaria
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Influences of War
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Nurses' roles rapidly expanded and began to be recognized for their skills in providing care and saving lives
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Lamp
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the significance of light; had been used by human beings for thousands of years to push back the darkness of night. It dispelled fear and allowed people to pursue learning long after the sun went down. was used as a religious symbol; schools and universities adopted the lamp as a symbol of learning. Burning of the lamp meant continual seeking of knowledge. Also symbolizes the enlightenment that accompanies knowledge
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Pin
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traces its origins to the heavy protective war shields as far back as the Greek and Roman Empires; attributed to Florence Nightingale. Awarded as a badge of excellence
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Cap
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signified "service to others." Kept nurses long hair from becoming soiled. During nursing school, it showed a sign of rank and status. First year- plain white, Second-year- vertical black band added to the edge, third-year- two vertical black bands. When student graduates, a black band was placed across the front. Continued to service as a reminder of the unchanging values of wisdom, faith, honesty, trust, and dedication.
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Florence Nightingale
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founder of modern nursing; dedicated her long life to improving health care nursing standards. reformed nursing education, and health care; advocated health maintenance and that nursing was an art and a science
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Isabel Adams Hampton Robb
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dedicated her life to raising nursing standards of nursing education in the US, unique ideas included developing and implementing a grading policy for nursing students that required nurses to prove their abilities in order to be award a diploma, developed the American Journal of Nursing, the first professional journal dedicated to the improvement of nursing. She headed the new John Hopkins Training school for Nurses and formed the American Society of Superintendents of Training Schools for Nurses and served as chairman.
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Lillian Wald
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dedicated social reformer, efficient fundraiser and eloquent speaker. advocated wellness education; was the first to place nurses in public schools; Opened a storefront health clinic called the Henry Street Settlement in NY; became the first president of the National Organization for Public Health Nursing
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Loretta Ford
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founded nurse practitioner practice; served as director at the Boulder County Health Department from 1956-1958, and was appointed assistant professor at the University of Colorado College of Nursing in Denver.
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2 years
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Length of time for obtaining an associate's degree as a registered nurse
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4 years
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Length of time for obtaining a bachelor's degree in nursing
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5 to 7 years
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Length of time for obtaining a master's degree in nursing
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Bachelor's degree in Nursing
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Complete 120 to 124 hours of college-level courses
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Master's degree in Nursing
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Specialist's degree; concentrate in one particular area and become an expert in that area; attend classes on a part-time basis while they work and may take up to 5 years to complete.
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Doctorate's degree in Nursing
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Generalist's degree- prepare the individual to conduct advanced conduct much of the research used in evidence-based practice
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Case Manager
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Overseeing the clients' care while they are in the hospital and following clients through their rehabilitation at home, long-term follow-up, healthcare practices, and developmental stages.
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Therapeutic Relationship Skills
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stressed by mental health nursing faculty as a key element in the treatment of psychiatric problems. They are essential for all nurses to fulfill their roles as healthcare providers and healers
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Relationship-centered nursing
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client focused and revolves around the client's trust in, value of, and understanding of the nurse's skills and role in the healing process. Clients must be able to feel comfortable with their nurse and share his or her understanding of both illness and health.
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Registered
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Listing of a license with a state for a fee
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Certification
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Official recognition of a degree of education and skills in a profession by a national specialty organization; recognition that an institution has met standards that allow it to deliver certain services
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Licensure
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Process by which an agency or government grants an individual permission to practice; establishes a minimal level of competency for practice
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The Nurse Practice Act
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State legislation regulating the practice of nurses that protects the public, defines the scope of practice, and makes nurses accountable for their actions; also establishes state boards of nursing and define specific SBN powers regarding the practice of nursing within the state
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Establishing a professional organization
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By working together for a specific purpose, an association or organization amplifies its impact, and by developing a strategic plan, it focuses that impact to achieve certain results. Many professions have a single major professional organization to which most of its members belong and several specialized sub organizations that members may also join
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Reasons why the state board may revoke a nursing license
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-Conviction for a serious crime -Demonstration of gross negligence or unethical conduct in the practice of nursing -Failure to renew a nursing license while still continuing to practice nursing -Use of illegal drugs or alcohol during the provision of care for clients or use that carries over and affects clients' care -Willful violation of the state's nurse practice act
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Goals behind establishing the licensure of nurses
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To achieve consistency of quality across the country
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National League for Nurses
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all nurses with individual certification are required to maintain their skills and competencies through continuing education units. Recertification may be achieved by completing CEUs or retaking the certification examination
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Purpose of the Quality and Safety Education for Nurses project
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increase level of safety and high-quality nursing care at all times. five key competencies that nursing students must be able to achieve upon graduation: client-centered care, interdisciplinary teamwork, evidence-based practice, quality improvement, and informatics
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Reason behind licensure
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The achieve consistency of quality across the country, all nurses needed to pass a uniform examination. It allows individuals to practice nursing as long as they do not use the letters RN after their names. It is conducted through the state and protects the registered nurse.
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Public Health Departments
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Government agencies that are established at the local, provincial or state, and federal levels to provide health services
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Home Health Care
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Care of the ill and injured in the home; main goal is to provide health care to clients in their own home rather than use hospital, residential, or long-term care facilities
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School-based Services
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services includes screenings, health promotion and illness prevention programs, and treatment of minor health problems
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Community Health Centers
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using a team approach involving physicians, nurse practitioners, and community nurses working together to provide health services; has diagnostic and treatment facilities that provide medical, nursing, laboratory, and radiological services
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Physician Offices and General Clinics
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accesses primary health care; services range from routine health screening to illness diagnosis and treatment and even some minor surgical procedures
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Responsibilities of nurses in physicians' offices or clinics
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obtaining personal health information and histories of current illness and preparing the client for examination; also assist with procedures and obtain specimens for laboratory analysis
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Occupational health clinics
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Services range from providing exercise facilities and fitness programs to health screenings and referrals
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Hospitals
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offer a variety of services, such as medical, surgical, obstetric, pediatric, and psychiatric care
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Long-term Care Facilities
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services are provided for both elderly and younger clients who have spinal cord injuries, rehabilitation, intermediate care, or long-term care
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Retirement and Assisted Living Centers
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allows clients, or residents, to maintain the greatest amount of independence possible in a partially controlled and supervised living environment; consists of separate apartments or condominiums for the residents and provides amenities such as meal preparation and laundry services
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Rehabilitation Centers
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Provides services to complete the recovery and restore a high degree of independence
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Day-Care Centers
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provides services for elderly adults who cannot be left at home alone but do not require institutionalization
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Rural Primary Care
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have fewer family practice physicians and often no specialists at all
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Hospice
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provides a variety of services in a caring and supportive environment to terminally ill clients, their families, and other support persons; central concept is not saving a life, but improving or maintaining the quality of life until death occurs
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Telehealth
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services generally available 24 hours a day, 7 days a week; Nurses answer the phones, supply answers to health-related questions, and advise callers on how to handle non urgent health situations
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Prospective Payment Systems
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system required facilities providing services to Medicare clients to be reimbursed using a fixed-rate system and included monetary incentives to reduce the length of hospital stays. If the client is discharged sooner than anticipated, the facility keeps the difference. If the client requires a lengthier hospital stay, the hospital pays the extra cost; emphasis is on the efficient delivery of services in the most cost-effective manner.
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Medicare
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Federally funded national health insurance program in the US for people older than 65 years or have disabilities;
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Medicare Part A
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provides basic protection for medical, surgical, and psychiatric care costs based on diagnosis-related groups
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Medicare Part B
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voluntary medical insurance plan that covers physician and certain outpatient services
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Medicare Part D
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unfunded insurance for medications
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DRGs and Medicare relation
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both used as prospective payment methods and are both used by the US government
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Hospice Care
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alternative way of providing care to the terminally ill clients; main goals are to control pain, provision of emotional support, promotion of social interaction, and preparation of death
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Palliative Care
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Type of treatment directed toward minimizing the severity of a disease or illness rather than curing it; pain management
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Main Goal of the Affordable Care Act
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to provide affordable health care to US citizens who, before its passage, were unable to pay for or obtain health insurance
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Type 1 Health Care Systems
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private approaches to health services. individuals who can afford private health insurance, or who simply can pay for their health care, choose their care providers and receive health services. Those who cannot pay do not have a choice or benefits.
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Type 4 Health Care Systems
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focuses on keeping the general public healthy so that they can continue to contribute to society and the economy. Seen in such organizations as the military, hockey teams, and other sports teams. Health care is considered an essential service or even a right, not necessarily involving compassionate motives
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Primary Care
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Refers to health promotion and preventive care; focuses on health education and on early detection and treatment
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Secondary Care
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Focus shifts toward emergency and acute care; frequently provided in hospitals and other acute care settings, with an emphasis on diagnosis and the treatment of complex disorders
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Tertiary Care
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emphasizes rehabilitative services, long-term care, and care of the dying
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Outpatient
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clients who requires a relatively high level of skilled health care but do not need to stay in a hospital for an extended period of time
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Inpatient
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someone who enters a setting as a hospital and remains for at least 24 hours
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Public Health Departments
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Government Agencies that are established at the local, provincial or state, or federal levels to provide health services
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Civility
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often thought of as good manners; based on recognizing that all human beings are important. "treat others the way you would want to be treated."
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Incivility
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unacceptable behavior in a civilized society; any type of activity that creates an unpleasant or negative learning atmosphere
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Factors Contributing to Incivility
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Cyber-harassment, vicious anonymous e-mails, hate text messages, harmful Facebook posts, tweets, other destructive social networking, acts of rudeness & social rejection
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Minimizing incivility
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eliminate negative, uncivil thoughts and behaviors, use positive actions such as manners, complimenting someone when they do a good job, asking people if they need help, avoid escalating uncivil behavior
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Interpersonal relationships
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a fundamental part of being civil; The reason incivility is on the rise can be uncovered by a closer examination of the interpersonal relationships found in toxic work and learning environments.
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Horizontal violence
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bullying that takes place in a work setting;one of the leading causes of poor staff morale, excessive sick days, turnover of staff, nurses leaving the profession, poor quality of care, and physical symptoms such as insomnia, hypertension, depression, and gastrointestinal upset. can either be covert or overt.
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Bullying
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Any behavior that could reasonably be considered humiliating, intimidating, threatening, or demeaning to an individual or group of individuals
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Overt lateral violence
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can include name calling, threatening body language, physical hazing, bickering, fault finding, negative criticism, intimidation, gossip, shouting, blaming, put-downs, raised eyebrows, rolling of the eyes, verbally abusive sarcasm, or physical acts
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Covert lateral violence
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includes unfair assignments, marginalizing a person, refusing to help someone, ignoring someone, making faces behind someone's back, refusing to work with certain people, whining, sabotage, exclusion, and fabrication
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Process Approach
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views all occupations as points of development into a profession situated along a continuum ranging from position to profession
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Power Approach
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refers to the political power and how much money that person makes in that position
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Trait Approach
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Identified when defining a profession
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