Health care delivery and the roles of the nurse delune ladner chapter 4 roy 429 39
This presentation is the property of its rightful owner.
Sponsored Links
1 / 43

Health Care Delivery and the Roles of the Nurse Delune & Ladner Chapter 4, Roy 429-39 PowerPoint PPT Presentation


  • 112 Views
  • Uploaded on
  • Presentation posted in: General

Health Care Delivery and the Roles of the Nurse Delune & Ladner Chapter 4, Roy 429-39. Factors Influencing Healthcare. Longevity US population 90% of healthcare $ in last 6 months of life Increasing age of baby boomers Technological advances Educated consumers

Download Presentation

Health Care Delivery and the Roles of the Nurse Delune & Ladner Chapter 4, Roy 429-39

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


Health care delivery and the roles of the nurse delune ladner chapter 4 roy 429 39

Health Care Deliveryand the Roles of the NurseDelune & Ladner Chapter 4, Roy 429-39


Factors influencing healthcare

Factors Influencing Healthcare

  • Longevity US population

    • 90% of healthcare $ in last 6 months of life

  • Increasing age of baby boomers

  • Technological advances

  • Educated consumers

  • Politics of Health care industry


Focus of care

Focus of Care

  • Type of service – philosophy (fig 4-1 pg. 58)

    • Promotion - prevention

      • Education, counseling

    • Nurture and support

      • Hospice, homecare

    • Diagnosis and treat

      • Hospital, clinic

    • Rehabilitation

      • Nursing homes, Senior centers


Health care settings table 4 3 pg 61

Health Care Settings Table 4-3, pg 61

  • Private – investor owned

  • Public - Government

  • Hospitals

  • Clinics - ambulatory centers

    • Schools, health departments, private offices, churches,

  • Extended care facilities


Health care delivery and the roles of the nurse delune ladner chapter 4 roy 429 39

  • Day care

    • Child, homeless, elderly

  • Home care Agencies

  • Hospice centers

  • Retirement communities


Roles of the nurse pg 63

Roles of the Nurse – pg. 63

  • Caregiver, teacher, advocate, manager, team member

  • Related to settings of practice

  • Defined by

    • Level of education

    • Standards of care - practice

    • Oklahoma nurse practice act


Healthcare issues 2010

Healthcare Issues 2010

  • Rising cost

  • Access - financial, geographic

  • Fragmentation of service

  • Quality/quantity of care

    • Shortage of personnel

  • Alternative therapies

  • Ethical considerations


Healthcare cure care vs commodity

Healthcare Cure/care vs. Commodity

Product

Producers

Consumers

Quality / Quantity

Availability

Regulation


Access political

Access - Political

  • Geographical - proximity

  • Financial - ability to pay

  • Cultural - language, treatment alternatives

  • Educational - awareness


Economics of healthcare

Economics of Healthcare

  • Right Vs privilege

  • Technology

  • Demographics

    • Age, lifestyle, environment.

      • Acute Vs chronic

      • Urban Vs rural


Healthcare economics

Healthcare Economics

  • One of the largest industries in the US.

    • 13.7% of GDP.

    • More Than any other industrialized nation.

    • Cost shifting.

      • Public Policy – Taxes.

      • With in a business - $8.00 aspirin.


Philosophy of financing and utilization

Philosophy of Financing and Utilization

  • Pay for service - product

  • Fee for service

  • Prospective payment

  • DRG’s - Diagnostic related groups

    • definitions of service/reimbursement


Funding

Funding

  • Financial Flow – Fig. 3-4 pg. 109

  • Sources

  • Insurance

    • business

    • government

  • Self pay

  • Charity


Types of finance

Types of Finance

  • Private - self, insurance

  • Government

    • Medicare - federal

    • Medicaid - state

  • Managed care group

    • PPO, HMO,

    • Charity


Healthcare issues 20101

Healthcare Issues 2010

  • Rising cost

  • Access - financial, geographic

  • Fragmentation of service

  • Quality/quantity of care

    • Shortage of personnel

  • Alternative therapies

  • Ethical considerations


Oklahoma nurse practice act

Oklahoma Nurse Practice Act

  • State law that defines the practice of nursing with in that states boundaries

  • Legal document

  • www.ncsbn.org


Definition of nursing

Definition of Nursing

  • Legal

  • RIGHTS/RESPONSIBILITIES

  • Standards of performance

    • Operational definition


Oklahoma nurse practice act1

Oklahoma Nurse Practice Act

  • “The practice of Nursing means the performance of services provided for purposes of nursing diagnosis and treatment of human responses to actual or potential health problems consistent with educational preparation”

Pg..... 1, 1994


What are some practice issues

What are Some Practice Issues?

  • Knowledge - education

  • Skills - training, practice

  • Abilities - environment, tools


Nursing standard of practice care pg 71

Nursing Standard of Practice – Care pg. 71

  • Guidelines to describe minimum nursing practice

  • General guidelines ANA

  • Specialty guidelines are developed by the specialty groups

  • Legal documents – Agency for Health Care Quality and Research (AHCPR)


Examples of standards

Examples of Standards

http://nursingworld.org/anp/pdescr.cfm?CNum=15.


Responsibilities

Responsibilities

  • Provider of care (Role)

    • Manager

    • Communicator

    • Decision maker

    • Coordinator

    • Educator

    • Client advocate


Nursing leaders

Nursing Leaders

  • Develop the ability to influence people

  • Develop a style or combination of styles that best suits the situation

Page 64

Figure 4 - 1


Example nursing leader

Example Nursing Leader

  • Florence Nightingale

  • Sister Calista Roy

  • Donna Wong

  • Susan Gaston


Nursing managers

Nursing Managers

  • Use developed skill to accomplish the work of managing

    • Planning

    • Organizing

    • Directing

    • Controlling

  • All nurses are managers of patient care


Example nursing manager

Example Nursing Manager

  • Head Nurse

  • Director ANA

  • Case Manager


Professional nurses are expected to an be both leaders and managers

Professional Nurses are expected to an be both Leaders and Managers


Not all managers are leaders and not all leaders have management skill

Not all managers are leadersand not all leaders have management skill


Level and type of education

Level and Type of Education

  • RN - basic license, 2 years

  • BSN - baccalaureate, 4 years

  • MS, MSN - Masters, 2 years

  • pH.D..... - Doctorate, 2 - 3 years


Advanced practice

Advanced Practice

  • NP - Nurse practitioner, 1 - 2 years

  • CNM - Citified Nurse Midwife

  • CRNA - Citified Nurse Anesthetist

  • CNS - Clinical nurse specialist


Certification

Certification

  • Post license education and evaluation that results in a certificate stating you have participate and met minimum criteria.

  • May have renewal clause


Certification1

Certification

  • Certificate in specialty

    • Pediatrics

    • Psychiatric Nursing

    • Home health

    • Perinatal

    • Womans’ health

    • Geriatrics

    • School nurse


Nursing delivery systems

Nursing Delivery Systems

  • Primary - 24 hour accountability, shared responsibility

  • Team - shared, accountability and responsibility

    • Organized around geographical arraignments, care functions, or job skills


Members of the healthcare team

Members of the Healthcare Team

  • Nurses - RN, LPN, UAP’s

  • Physicians - MD., DO., PA

  • Dentist

  • Opthamalogist

  • Pharmacists

  • Chiropractor


Health care delivery and the roles of the nurse delune ladner chapter 4 roy 429 39

  • Therapists - BS., MS., pH.D.

    • Social worker, psychologists, nutritionists, respiratory, physical, recreational, rehabilitation, vocational, speech.

  • Technologists

    • radiology, laboratory, dietary, medical records.


Healthcare teams

Healthcare Teams

  • Two or more people working collaboratively on an issue

  • Teams are necessary because

    • Increased complexity of care

    • Increased technology

    • Increased specialization of team members


Teams

Teams

  • Interdependent group of people

  • Effectiveness/success requires

    • Respect

    • Commitment

    • Communication


Work teams in healthcare

Work Teams in Healthcare

  • Group of Differently Skilled Professionals

  • Share a body of knowledge/client

  • Utilize different approaches/ view point to same situation


Professional teams

Professional Teams

  • Every member is required to

    • Plan

    • Perform their share

    • Participate in problem solving

    • Attend meetings

    • Provide constructive feedback


Examples of healthcare team

Examples of Healthcare Team

  • Operating room - members

    • Patient, Physician, Anesthesiologists Circulating nurse, Scrub tech, Surgical assistant.

  • Psychiatric Team - members

    • Psychiatrist, Social Worker, Nurse, Nutritionist, Recreational therapist.


Group process

Group Process

  • Forming - in or out

  • Storming - battle for power

  • Norming - rules of membership

  • Performing - work gets done

  • Adjourning - summarize and feedback


Most frequent reasons for team failure

Most Frequent reasons for Team Failure

  • The team had allowed some other issue to replace the work focus of the group.

    • Control - who’s in charge

    • Socialization

    • Personal success

    • Incompetent team members - technical skill and membership ability.


Methods to increase team effectiveness

Methods to increase Team Effectiveness

  • Clear definition of roles and goals

  • Access to each other - Location, time

  • Limit number of members

    • 5 - 7 most efficient

  • Rotate team manager

  • Keep social function of team to a minimum


  • Login