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N138 Final N138 Samuel Merritt University Questions With Complete Solutions
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N138 Final N138 Samuel Merritt University Questions With Complete Solutions
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N138 Final N138 Samuel Merritt University Questions WithComplete Solutions
How does the principle of a free market economy relate to
healthcare?
In a pure free market, the use of the healthcare system is
determined by the person's ability to pay. This makes healthcare
a privilege, not a right.
When health care is a right, it has to be accessible to all.
(Medicare/Medicaid try to make this a reality in the US)
Distinguish among the four main nursing care delivery methods
1) Team nursing: RN is leader of a team, where the least skilled
members take the least complex patients and the most skilled
members take the most complex patients
2) Primary nursing: A single RN has 24-hour accountability for
a patient, with assistants (e.g. NICUs, bone marrow transplant
units).
3) Case management nursing: following critical paths (care
maps), with a focus on helping patients get or stay out of the
hospital
4) Patient-centered care: Uses teamwork, communication,
traditional, and nontraditional methods to put patient needs
above those of the institution.
Distinguish between closed shop and open shop workplaces.
,Closed shop—the management is required to bargain with the
union and union membership is required as a condition of
employment.
Open shop—employees are not required to join but in which an
individual's contract will be dependent on what the union and
management have negotiated.
Describe the change in the economics of nursing.
Nursing services were first seen as a "room rate" (a line item on
the invoice for charges for a hospital room).
Later, hospitals came up with a Patient Classification System
(quantitative identification of the patient needs) to help
determine the need for nurses. For example, a charge nurse in a
hospital might assess the acuity of each patient to determine how
many nurses are needed for the oncoming shift.
Describe the major change in the overall history of healthcare
finance.
90% of patients used to pay out-of-pocket or rely on charity for
healthcare. After WWII, most industrialized nations began a
publicly financed health care system (though the US continued a
private system).
This improved health coverage, access and quality, but also
created unforeseen loopholes.
Describe the five methods of payment for healthcare
,1) Private insurance: insurance premiums paid between
individual and employer
2) Medicare/Title VIII of Social Security Act: available to all
65+, with kidney failure, and with disabilities. Includes
premiums.
3) Medicaid/Title XIX of Social Security Act: available to low
income elderly, blind, or disabled people. No regular fees.
4) Personal (out-of-pocket) payment: not a reality for most
people
5) Worker's compensation: covers treatment for injuries
sustained at work, and weekly payment for missed wages
Distinguish between the internal focus and the external focus of
case management nursing
Internal focus: Case manager works at a specific treatment
facility
External focus: Case manager oversees patients and the delivery
of services across the continuum of care (home or inpatient), get
to partner with families and patient, with a main goal to make
the need for hospitalization less likely
Describe principalism. What are its limitations?
Uses key ethical principles of beneficence, nonmalfeicence,
autonomy, and justice in resolution of ethical conflicts or
dilemmas
Limitation: no guidance on which principle is more important
than any other
, Distinguish between fidelity and veracity
Fidelity: faithfulness, or honoring one's commitments or
promises
- e.g. Fidelity to patients: practicing within scope of practice,
keeping our skills current, following employer's policy, etc.
Veracity: telling the truth, not lying
- e.g. what to tell a patient who is asking if results are back, and
they are, but you can't share them with them.
What is General Systems Theory?
A common framework for studying several similar disciplines,
allows scientists and scholars to organize and communicate
findings, making it easier to build on the work of others
VON BERTALANFFY
What are the components of General Systems Theory?
The suprasystem and subsystems under it.
Each system has 5 parts:
1) Input: any material that enters a system
2) Throughput: processing a system & converting material
3) Output: the end result or product
4) Evaluation: measures the success/failure of the output
(effectiveness of the system)
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