UConn Nursing 1130 Exam One – Flashcards
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Florence Nightingale
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Defined nursing education curriculum by setting up first nursing school in London (1860)
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Yale University
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First US school that had a nursing program for education and NOT need
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Lillian Wald
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Founded many programs: Henry Street Settlement, visiting nurses, Department of Special Needs, Children's Bureau, etc.
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Mary Breckinridge
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Introduced midwives and spread healthcare to rural areas
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John Snow
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Found contaminated water caused cholera
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Clara Barton
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Founder of the American Red Cross (1881) and aided soldiers in civil war
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Loretta Ford
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Co-founder of the nation's first nurse practitioner program and was Dean of Nursing at Rochester University
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Federal Nursing Training Act of 1964
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Gave funding to collegiate nursing programs
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NINR (National Institute of Nursing Research)
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Opened in 1983 to help nurses study at the graduate level
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The Future of Nursing report
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Report in 2010 that used data to support nursing and their higher education
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What was public health like in the 1700s?
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Unsanitary conditions that caused massive outbreaks
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Endemic
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A disease regularly found among people in a certain area
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Pandemic
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An epidemic of infectious disease across a large region, like continents
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Polio Vaccine
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Polio's largest breakout was 1952, and the vaccine was created for it in 1955 (oral version made in 1960)
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Hospitals in 1820s
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"Poorhouses" made to medically serve poor people
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Pesthouse
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Place for people with contagious diseases to stay (quarantine)
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Where were the first hospitals located?
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NYC, Boston, Philadelphia
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Who owned the first hospitals?
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Primarily physicians, and the conditions were terrible
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Narcotic Control Act of 1929
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Hospitals were made for drug addicted patients
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Change in ER protocols in 1980-90s
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ERs now have to screen/stabilize patients regardless of their ability to pay
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Joint Commission
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Issued standards to increase consumer awareness
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When was the blueprint for insurance established?
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1929, laid foundation for BC/BS
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Who opposed the National Insurance Plan in the 30s?
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The AMA
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When (decade) was the Patient Bill of Rights created?
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1970s-80s
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What happens when Medicare patients return within 30 days of their hospital visit with the same ailment?
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Hospital loses reimbursement from the Medicare payments
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How much of the payment did the first insurance plans cover?
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Only the hospital fees to not take money from private physicians
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What is the DRG?
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Developed diagnostic system to control costs for Medicare reimbursement
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How does the DRG work?
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It breaks ailments from 20 major body systems into 500 different groups for reimbursement
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Who does the SSA insurance cover?
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People in older age
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What does COBRA do?
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Requires employers to provide some coverage to terminated employees
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What does FMLA do?
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Allows employees up to 12 weeks unpaid leave due to family illnesses
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What does HIPAA do?
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Makes it easier to carry insurance while switching jobs and increases patient confidentiality
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What is CHIP?
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Children's Health Insurance Program
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Who was the first state to mandate that all its citizens carry insurance?
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Massachusetts
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What does the ACA do?
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Made it illegal for insurance companies to rescind insurance on sick individuals; can't impose limits on essential benefits
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What are the three levels of "government" healthcare?
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Federal, state, local
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What are some examples of health agencies?
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CDC, CMS, FDA, CMHS, AHRQ
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What does the iron triangle consist of?
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Quality, access, and cost
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What is the OECD?
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Organization for Economic Co-operation and Development; stimulates economic progress and world trade in 34 countries
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Around how many uninsured Americans are there?
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41,000,000
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Which groups are more likely to be uninsured?
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Colored people and adults
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What is Title One about?
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Affordability and Accessibility to Healthcare
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What is Title Two about?
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The Role of Public Programs: Medicare, Medicaid, CHIP
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What is Title Three about?
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Improving Quality and Efficiency of Care
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What is Title Four about?
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Prevention of Chronic Disease and Improving Public Health
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What is Title Five about?
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Healthcare Workforce
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What is Title Six about?
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Transparency and Program Integrity
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What is Title Seven about?
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Improving Access to Innovative Therapies
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What is Title Eight about?
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Community Living Assistance Services and Supports (CLASS)
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What is Title Nine about?
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Revenue Provisions
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What is Title Ten about?
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Strengthening Quality Affordable Care
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To achieve the three aims of the NQS, what are the six priorities?
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Reducing harm in delivery of care Each person is engaged in their care Promoting communication Promoting most effective prevention and treatment Work with communities Make care more affordable
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What are the three main aims of the National Quality Strategy?
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Better care, healthy people and communities, and affordable care
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What are the five largest areas of health care costs?
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Hospital care, physician/clinician services, prescription drugs, nursing expenditures, and home health care expenditures
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How does legislation target the five areas of high healthcare costs?
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Increasing quality assurance and providing reimbursement, providing accessibility regarding quality of their health, and increasing access
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What are some consequences of being under/uninsured?
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Worse access to care, less likely to receive preventative care, more likely to be hospitalized and charged more
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What are some examples of essential health benefits insurance companies must offer?
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EMS, ambulatory, hospitalization (surg.), maternity/newborn, mental health, prescription drugs, labs, rehab, peds, chronic disease management
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What is the consequence of not having insurance under the ACA?
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Billed fees per year, increasing in cost with each year
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Who does the ACA uninsured fee not affect?
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The insured, very low income, certain religious sects, and federally recognized Indian tribes
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What are Cadillac taxes?
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Taxes on generous insurance plans in an effort to get more money to employees; would generate 91 billion in 10 years
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How far (%) does Medicaid cover beneath the FPL (Federal Poverty Line)?
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133%
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What does PCORI (Patient-Centered Outcomes Research Institute) do?
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Compares outcomes of disease treatment to aid doctors, patients, and policymakers in improving healthcare outcomes
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Why was the National Prevention Council established?
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To develop a national health prevention strategy
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What are the strategic directions of the National Prevention Strategy?
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Healthy and safe communities, clinical and community preventive services, empowered people, and elimination of health disparities
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Why was the National Health Care Workforce Commission established?
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To review healthcare workforce and projected needs
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What is the Elder Justice Act?
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An act to prevent and eliminate elder patient abuse which targets abuse, neglect, and exploitation of the elderly
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What is "greying of population"?
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The population gets progressively older, therefore there will be more disease and difficulty
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What percent of older Americans experience elder abuse?
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At least 10%
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Where are victims of elder abuse more likely to end up?
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Three times more likely to wind up in a hospital and four times more likely to end up in a nursing home
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What happened to the CLASS insurance program?
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Found not to be a viable service and was repealed
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According to Title Nine, how do employees know the value of their insurance program?
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Employers report the value of their health insurance benefit coverage on their W-2 form
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What is the ACA "cafeteria plan" system?
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Allows employees to choose different benefits based on their lifestyle; more cost effective
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To strengthen quality affordable care, what websites were developed?
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Physician Compare, Nursing Home Compare, and The Cures Acceleration Network
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What is some of the information the Physician Compare website provides?
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Contact info, education, languages spoken, gender, specialty, Medicare acceptance, and sponsor hospital
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What is some of the information the Nursing Home Compare website provides?
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Quality measures (# residents with bed sores, incontinence), quality of care and staffing information, and the facilities' inspection records from the past three years
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What does the Cures Acceleration Network do?
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Works to reduce time to move new drugs and therapies to market, advances development of high-need cures, funds/addresses scientific and technical changes
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What does the future of the ACA look like?
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Trump's vision of "insurance for all"
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What are the ANA's three main principles for health system transformation?
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Ensure universal access to a standard package of essential healthcare services to all, optimize privacy while supporting cost-effectiveness, encourage mechanisms to stimulate economical use of health care services for all, and ensure a sufficient workforce
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What does the ANA's principle for the health system include?
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An essential benefits package, prohibition of coverage denial due to pre-existing conditions, inclusion of kids on parents' insurance until 26, and expansion of Medicaid
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What would change for Indian tribes if the ACA was repealed?
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A portion of the law might be cut that provides federal funding for tribal health care around the country
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What does the ACA require for expectant/new mothers?
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Workplaces must have a dedicated lactation room that isn't the bathroom and provide breastfeeding equipment with no co-pay
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What changed about habilitative care when the ACA was put in place?
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Skills that weren't originally there can be treated now, ex. speech therapy for a child who never learned to speak
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Around what percent of the GDP does healthcare expenditures comprise?
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Around 17.5%, the highest of the world
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Who are some of the major stakeholders in the healthcare industry?
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Consumers, employers, hospitals, nursing and residential care facilities, nurses and other healthcare professionals, home healthcare services,outpatient care centers, labs, government, insurance companies, educational and training organizations, research organizations, professional associations, and pharmaceutical companies
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What is the principle of duty to treat?
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Any person deserves basic care
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What is charitable care?
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Provider does not expect payment after the person's inability to pay has been determined
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What is bad debt?
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Efforts to secure payment have failed
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Where does the healthcare industry rank on how many people it employs?
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It's the largest U.S. employer
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Are hospitals more inpatient or outpatient care based?
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Inpatient
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What are two of the three nursing/residential care facilities?
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Elderly in assisted living, children in group homes, and drug rehabilitation centres
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Who provides the majority of care in nursing facilities/homes?
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Nursing aides
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What are some CAM (complementary and alternative medicine) practitioners?
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Yoga, chiropractor, and acupuncturists
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What is the purpose of NCCAM (National Center for Complementary and Alternative Medicine)?
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To explore CAM practices, train CAM researchers, and disseminate information
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What is home telehealthcare?
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Healthcare delivered to patients in their homes in part by telecommunication devices like a phone and a telecommunication-ready monitor, like a bp cuff
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What is mHealth?
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The use of computers and phones for health services and information
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Which federal department is in charge of approving drugs for human use?
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The FDA
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What are some examples of outpatient care centres?
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Kidney dialysis centres, mental health and substance abuse clinics, and surgical/emergency centres
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What are some examples of ambulatory health services?
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Transport services, blood and organ banks, and smoking cessation programs
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What is Tricare?
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Gives care to members of the military and their dependents
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What is the name of the major professional nursing association?
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ANA (American Nursing Association)
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What does the ANA do?
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Advance the nursing profession for all
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What are some examples of working environments?
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Hospitals, outpatient centres, schools, churches, labs, prisons, and physician offices
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Where do healthcare providers rank in the injury/illness scale?
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One of the highest, with nurses and nursing assistants at the highest injury rate of all occupations
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Around what percent of ER patients were admitted in 2015?
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Around 9.3%
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What are the life expectancy trends for the US?
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The life expectancy rates are increasing/living longer
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Why is life expectancy trending the way it is?
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Improving health care, lifestyle changes, and increased public health education
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How do we compare regarding life expectancy to other countries?
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Lower than Spain and Switzerland, but higher than Mexico
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How does education affect life expectancy?
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Higher education increases life expectancy by around 6 years
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What is the US' infant mortality rate?
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It's around 5/1000, which is higher than Iceland etc. but lower than India
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Roughly how many people die per year due to tobacco use?
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6,000,000, 10% of those deaths are from second hand smoke
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What has caused a decline in tobacco use?
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Public health campaigns, smoke-free-environment policies, and increased price of tobacco products
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Roughly how many deaths does alcohol cause worldwide per year?
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Around 3,300,000
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What is alcohol use associated with?
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Cirrhosis of the liver, strokes, MVAs, violence, suicide, and reduced work productivity
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Roughly what percent of adults in the US are overweight or obese?
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Roughly 53.8% for the US (Japan's the lowest at 3.7%)
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How many children are overweight in the US?
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Around 1 in 3
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How did Michelle Obama intend to fight back against childhood obesity?
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Empowering parents, serving to healthier school lunches, access to healthier food options, and increasing physical activity
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What's the most common type of brain disorder that diminishes cognitive function?
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Alzheimer's
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Only three nations in the OECD do NOT have Universal healthcare. Which are they?
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Greece, Poland, and the United States
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What is the US satisfaction rate with healthcare?
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80.9%, lower than the OECD average of 85%
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What are some of the factors in the patient satisfaction rate with United States healthcare?
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Communication with providers, time spent, clarity of explanations, and opportunities to ask questions about care
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What does the QSEN (Quality and Safety Education for Nurses) do?
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Addresses the challenge of preparing future nurses to improve the quality and safety of their healthcare systems