introductory medical-surgical nursing
DESCRIPTION
Introductory Medical-Surgical Nursing. Concepts and Trends in Healthcare. Roles of Nurses in the Healthcare Delivery System. Collect data; plan, provide, and evaluate outcomes of care Work in various settings; adhere to facility policies and state nurse practice acts - PowerPoint PPT PresentationTRANSCRIPT
![Page 1: Introductory Medical-Surgical Nursing](https://reader030.vdocument.in/reader030/viewer/2022012822/56814bfc550346895db8f6f5/html5/thumbnails/1.jpg)
Introductory Medical-Surgical Nursing
Introductory Medical-Surgical Nursing
Concepts and Trends in Healthcare
![Page 2: Introductory Medical-Surgical Nursing](https://reader030.vdocument.in/reader030/viewer/2022012822/56814bfc550346895db8f6f5/html5/thumbnails/2.jpg)
Roles of Nurses in the Healthcare Delivery SystemRoles of Nurses in the Healthcare Delivery System
• Collect data; plan, provide, and evaluate outcomes of care
• Work in various settings; adhere to facility policies and state nurse practice acts
• Educate clients, families, and staff
• Manage resources
• Participate in disease prevention and health promotion
• Practice from the perspective of holism
![Page 3: Introductory Medical-Surgical Nursing](https://reader030.vdocument.in/reader030/viewer/2022012822/56814bfc550346895db8f6f5/html5/thumbnails/3.jpg)
Health and Wellness Health and Wellness • Introduction
– WHO definition of health
• State of physical, mental, social well-being; holistic definition of health
• Wellness: A state of being; individual; components of wellness
• Illness and Disease
– Illness: State of being sick
– Disease: Pathologic condition of the body
– Difference between illness and disease
![Page 4: Introductory Medical-Surgical Nursing](https://reader030.vdocument.in/reader030/viewer/2022012822/56814bfc550346895db8f6f5/html5/thumbnails/4.jpg)
QuestionQuestion
Is the following statement true or false?
Health is a constant and intentional effort to stay healthy and achieve the highest potential for total well-being.
![Page 5: Introductory Medical-Surgical Nursing](https://reader030.vdocument.in/reader030/viewer/2022012822/56814bfc550346895db8f6f5/html5/thumbnails/5.jpg)
AnswerAnswer
False.
Health is a state of complete physical, mental, and social well-being and not merely the absence of disease and infirmity.
Wellness is a constant and intentional effort to stay healthy and achieve the highest potential for total well-being.
![Page 6: Introductory Medical-Surgical Nursing](https://reader030.vdocument.in/reader030/viewer/2022012822/56814bfc550346895db8f6f5/html5/thumbnails/6.jpg)
Health and Wellness Health and Wellness • The Health–Illness Continuum
Figure 1-1The health–illness continuum
![Page 7: Introductory Medical-Surgical Nursing](https://reader030.vdocument.in/reader030/viewer/2022012822/56814bfc550346895db8f6f5/html5/thumbnails/7.jpg)
Health and Wellness Health and Wellness
• The Health–Illness Continuum
– Considers levels of health
– Varies from person to person
– Determines a client’s health status
– Client with chronic illness can achieve a high level of wellness
![Page 8: Introductory Medical-Surgical Nursing](https://reader030.vdocument.in/reader030/viewer/2022012822/56814bfc550346895db8f6f5/html5/thumbnails/8.jpg)
QuestionQuestion
Is the following statement true or false?
Clients with chronic illness can be considered healthy.
![Page 9: Introductory Medical-Surgical Nursing](https://reader030.vdocument.in/reader030/viewer/2022012822/56814bfc550346895db8f6f5/html5/thumbnails/9.jpg)
AnswerAnswer
True.
Clients with chronic illness can be considered healthy if they are physiologically stable and engaged in personal and social activities they find meaningful.
![Page 10: Introductory Medical-Surgical Nursing](https://reader030.vdocument.in/reader030/viewer/2022012822/56814bfc550346895db8f6f5/html5/thumbnails/10.jpg)
Health and Wellness Health and Wellness • Health Maintenance and Promotion
– Health maintenance
• Preventing illness or deterioration
• Being screened for diseases or practicing safe sex
– Health promotion
• Engaging in strategies to enhance health
• Eating a diet high in fiber and complex carbohydrates and exercising regularly
• Balancing work with leisure activities
![Page 11: Introductory Medical-Surgical Nursing](https://reader030.vdocument.in/reader030/viewer/2022012822/56814bfc550346895db8f6f5/html5/thumbnails/11.jpg)
Health and Wellness Health and Wellness
• Health Maintenance and Promotion
– Health promotion (cont’d)
• Practicing stress reduction techniques
– Client
• Active partner in nursing care
• Takes great responsibility for meeting health maintenance and promotion needs
• Actively participates in treatment decisions regarding health restoration
![Page 12: Introductory Medical-Surgical Nursing](https://reader030.vdocument.in/reader030/viewer/2022012822/56814bfc550346895db8f6f5/html5/thumbnails/12.jpg)
HealthcareHealthcare• Introduction
– Development of highly sophisticated methods for diagnosing and treating disease
– Increasing costs; advances in science and technology
– Healthcare system: Multiple outpatient, short-term, and long-term care facilities with care given by various providers
![Page 13: Introductory Medical-Surgical Nursing](https://reader030.vdocument.in/reader030/viewer/2022012822/56814bfc550346895db8f6f5/html5/thumbnails/13.jpg)
QuestionQuestion
Is the following statement true or false?
Rapid advances in science and technology have increased disparity in access to healthcare.
![Page 14: Introductory Medical-Surgical Nursing](https://reader030.vdocument.in/reader030/viewer/2022012822/56814bfc550346895db8f6f5/html5/thumbnails/14.jpg)
AnswerAnswer
False.
Escalating healthcare costs have created difficult economic conditions, disparity in access to healthcare, and shorter stays in hospitals.
![Page 15: Introductory Medical-Surgical Nursing](https://reader030.vdocument.in/reader030/viewer/2022012822/56814bfc550346895db8f6f5/html5/thumbnails/15.jpg)
Figure 1-2 Members of the healthcare team
HealthcareHealthcare
![Page 16: Introductory Medical-Surgical Nursing](https://reader030.vdocument.in/reader030/viewer/2022012822/56814bfc550346895db8f6f5/html5/thumbnails/16.jpg)
Individual student activityIndividual student activity
• List and identify the function of all the various members of the healthcare team.
• Allow 5 minutes. Submit to instructor.
![Page 17: Introductory Medical-Surgical Nursing](https://reader030.vdocument.in/reader030/viewer/2022012822/56814bfc550346895db8f6f5/html5/thumbnails/17.jpg)
HealthcareHealthcare
• Healthcare Providers
– Specially trained personnel work together to help clients meet their healthcare needs
– Team: Physicians, nurses, psychologists, pharmacists, dietitians, social workers, respiratory and physical therapists, occupational therapists, nursing assistants, technicians, and insurance company staff
![Page 18: Introductory Medical-Surgical Nursing](https://reader030.vdocument.in/reader030/viewer/2022012822/56814bfc550346895db8f6f5/html5/thumbnails/18.jpg)
HealthcareHealthcare• The Healthcare Delivery System
– Full range of services: Prevention, identification, treatment, or rehabilitation of health problems
– Primary care: First resource; family practitioner, internist, or nurse practitioner
– Secondary care: Referrals to facilities for additional testing
– Tertiary care: Provided in hospitals; skilled nursing care; rehabilitative services; home care; hospices and home hospice
![Page 19: Introductory Medical-Surgical Nursing](https://reader030.vdocument.in/reader030/viewer/2022012822/56814bfc550346895db8f6f5/html5/thumbnails/19.jpg)
QuestionQuestion
Is the following statement true or false?
Groups most likely to be underserved by healthcare include children, older adults, ethnic minorities, and the poor.
![Page 20: Introductory Medical-Surgical Nursing](https://reader030.vdocument.in/reader030/viewer/2022012822/56814bfc550346895db8f6f5/html5/thumbnails/20.jpg)
AnswerAnswer
True.
Groups most likely to be underserved by healthcare include children, older adults, ethnic minorities, and the poor.
![Page 21: Introductory Medical-Surgical Nursing](https://reader030.vdocument.in/reader030/viewer/2022012822/56814bfc550346895db8f6f5/html5/thumbnails/21.jpg)
HealthcareHealthcare
• The Healthcare Delivery System
– Access to care
• Clients who do not have access to healthcare or inadequate healthcare
• Unaffordable luxuries
• Underserved: Children, older adults, ethnic minorities, and the poor
• Local hospital emergency department: Long waits and no follow-up care
![Page 22: Introductory Medical-Surgical Nursing](https://reader030.vdocument.in/reader030/viewer/2022012822/56814bfc550346895db8f6f5/html5/thumbnails/22.jpg)
HealthcareHealthcare• The Healthcare Delivery System
– Financing the costs of healthcare
• Payment for healthcare: Private insurance, self-insurance, and Medicare
• Higher charges: More revenues for healthcare facilities; no incentives to control costs; escalated charges, abuse, and fraudulent billing
• 1990s: Streamlined government payment systems and innovative approaches from private insurers
![Page 23: Introductory Medical-Surgical Nursing](https://reader030.vdocument.in/reader030/viewer/2022012822/56814bfc550346895db8f6f5/html5/thumbnails/23.jpg)
HealthcareHealthcare
• The Healthcare Delivery System
– Financing the costs of healthcare
• Government-funded healthcare: Medicare
• Federally run program financed primarily through employee payroll taxes
• Covers: People 65 years of age or older, permanently disabled workers of any age with specific disabilities and their dependents, and people with end-stage renal disease
![Page 24: Introductory Medical-Surgical Nursing](https://reader030.vdocument.in/reader030/viewer/2022012822/56814bfc550346895db8f6f5/html5/thumbnails/24.jpg)
HealthcareHealthcare• The Healthcare Delivery System
– Financing the costs of healthcare
• Government-funded healthcare: Medicare (cont’d)
• Several parts: A, B, C, D
• Part A: Hospital, skilled care; hospice; home health services
• Part B: Physician services; outpatient care; other selected services
• Part C: Combines Parts A, B, and sometimes D
![Page 25: Introductory Medical-Surgical Nursing](https://reader030.vdocument.in/reader030/viewer/2022012822/56814bfc550346895db8f6f5/html5/thumbnails/25.jpg)
HealthcareHealthcare• The Healthcare Delivery System
– Financing the costs of healthcare
• Government-funded healthcare: Medicare (cont’d)
• Part D: Prescription drug coverage
• Government-funded healthcare: Medicaid
• State-administered entitlement program; funded from federal, state, and local sources
• Covers: Hospitalization, diagnostic tests, physician visits, rehabilitation, outpatient care, and long-term care
![Page 26: Introductory Medical-Surgical Nursing](https://reader030.vdocument.in/reader030/viewer/2022012822/56814bfc550346895db8f6f5/html5/thumbnails/26.jpg)
HealthcareHealthcare• The Healthcare Delivery System
– Financing the costs of healthcare
• Prospective payment system (PPS)
• Financial incentives: Decrease total charges by reimbursement
• Diagnosis-related group (DRG): Method of grouping clients with similar diagnoses
• Reimburses predetermined amounts to hospitals; premature discharge
• Private insurance companies; Medicare revenue
![Page 27: Introductory Medical-Surgical Nursing](https://reader030.vdocument.in/reader030/viewer/2022012822/56814bfc550346895db8f6f5/html5/thumbnails/27.jpg)
HealthcareHealthcare
• The Healthcare Delivery System
– Financing the costs of healthcare
• Managed care organizations (MCOs)
• Insurers carefully plan and closely supervise the distribution of healthcare services; focus on prevention to manage healthcare costs
![Page 28: Introductory Medical-Surgical Nursing](https://reader030.vdocument.in/reader030/viewer/2022012822/56814bfc550346895db8f6f5/html5/thumbnails/28.jpg)
HealthcareHealthcare• The Healthcare Delivery System
– Financing the costs of healthcare
• Managed care organizations (MCOs)
• Capitation: Preset fee paid per month to healthcare provider
• Covers: All medical costs incurred
• Use of high-cost resources by client
• Provides strongest incentives: Limiting use of expensive services
![Page 29: Introductory Medical-Surgical Nursing](https://reader030.vdocument.in/reader030/viewer/2022012822/56814bfc550346895db8f6f5/html5/thumbnails/29.jpg)
HealthcareHealthcare• The Healthcare Delivery System
– Financing the costs of healthcare
• Managed care organizations (MCOs):
1. Health maintenance organizations
• Group insurance plans; fixed fee
• Financial stability; provide ambulatory, hospitalization, and home care; own facilities and community agencies; authorized and unauthorized secondary care; gatekeepers for healthcare services
![Page 30: Introductory Medical-Surgical Nursing](https://reader030.vdocument.in/reader030/viewer/2022012822/56814bfc550346895db8f6f5/html5/thumbnails/30.jpg)
HealthcareHealthcare• The Healthcare Delivery System
– Financing the costs of healthcare
• Managed care organizations (MCOs):
2. Preferred provider organizations
• Operate on the principle that competition can control costs
• Agents for health insurance companies: Create a community network of providers willing to discount their fees
![Page 31: Introductory Medical-Surgical Nursing](https://reader030.vdocument.in/reader030/viewer/2022012822/56814bfc550346895db8f6f5/html5/thumbnails/31.jpg)
HealthcareHealthcare• The Healthcare Delivery System
– Financing the costs of healthcare
• Managed care organizations (MCOs):
3. Point-of-service plans
• Involve network of providers
• Clients select primary care provider (PCP) to act as gatekeeper for services
• Using providers outside group may increase deductible or copayment unless PCP approves
![Page 32: Introductory Medical-Surgical Nursing](https://reader030.vdocument.in/reader030/viewer/2022012822/56814bfc550346895db8f6f5/html5/thumbnails/32.jpg)
HealthcareHealthcare• The Healthcare Delivery System
– Financing the costs of healthcare
• Managed care organizations (MCOs):
4. Physician hospital organizations
• Corporate structure created between physician groups and hospitals
• Contract with MCO to negotiate fees for self-insured employees
• Goals: Maintain high service quality; contain costs; foster group contracts, collaboration, and capitation
![Page 33: Introductory Medical-Surgical Nursing](https://reader030.vdocument.in/reader030/viewer/2022012822/56814bfc550346895db8f6f5/html5/thumbnails/33.jpg)
Groups of 4-5 students activityGroups of 4-5 students activity
• Describe and explain the purpose of HMOs; describe the positive and negative effects of DRGs
• Allow 10 minutes. Present result of discussion in class.
![Page 34: Introductory Medical-Surgical Nursing](https://reader030.vdocument.in/reader030/viewer/2022012822/56814bfc550346895db8f6f5/html5/thumbnails/34.jpg)
HealthcareHealthcare• The Healthcare Delivery System
– Effects of cost-driven changes
• Providers and consumers unable to provide or obtain care free from the insurer’s economic pressure
• Influence of managed care on hospitals
• Downsizing, restructuring, closing
• Fewer hospitals; higher nurse/client ratios; higher client acuity levels
• Insurance company profit at the expense of quality, jobs
![Page 35: Introductory Medical-Surgical Nursing](https://reader030.vdocument.in/reader030/viewer/2022012822/56814bfc550346895db8f6f5/html5/thumbnails/35.jpg)
HealthcareHealthcare• The Healthcare Delivery System
– Effects of cost-driven changes
• Integrated delivery systems
• Networks: Hospitals and healthcare facilities
• Provide full range of healthcare services: result in highly coordinated and cost-effective care
• Shorter hospital stays
• Nurses: Take an active role in advocating for high quality
![Page 36: Introductory Medical-Surgical Nursing](https://reader030.vdocument.in/reader030/viewer/2022012822/56814bfc550346895db8f6f5/html5/thumbnails/36.jpg)
HealthcareHealthcare• The Healthcare Delivery System
– Sources of standards of care
• Nurse Practice Act, NCLEX (National Council Licensure Exam), ANA (American Nurses Association, Joint Commission, Hospitals
• Nurse Practice Act-laws established in each state
• NCLEX-nurses’ educational preparation and licensure
• ANA-an example of a professional organization with established code of ethics guiding Nursing practice
• JCAHO-Joint Commission Association of Hospital Organization
![Page 37: Introductory Medical-Surgical Nursing](https://reader030.vdocument.in/reader030/viewer/2022012822/56814bfc550346895db8f6f5/html5/thumbnails/37.jpg)
HealthcareHealthcare
• The Healthcare Delivery System
– Measures of quality of care
• Government and private sector demands of: Evidence that high-quality, cost-effective care is provided; Medicare guidelines, JCAHO surveys, surprise visits from federal and state regulators
• Performance improvement committees
• Factors assessed by such committees
• Insurers: Set up quality improvement departments
• Practitioners: Ensure total care, teaching, and preparation before discharge
![Page 38: Introductory Medical-Surgical Nursing](https://reader030.vdocument.in/reader030/viewer/2022012822/56814bfc550346895db8f6f5/html5/thumbnails/38.jpg)
HealthcareHealthcare• The Healthcare Delivery System
Figure 1-3 Emergency department critical pathway for pneumonia-an example of hospital standard of quality
![Page 39: Introductory Medical-Surgical Nursing](https://reader030.vdocument.in/reader030/viewer/2022012822/56814bfc550346895db8f6f5/html5/thumbnails/39.jpg)
HealthcareHealthcare
• The Healthcare Delivery System
– Measures of quality of care (cont’d)
• Guidelines for managing care
• Critical pathways
• Analyzing variances from the pathway
• Measures assessed when examining quality
![Page 40: Introductory Medical-Surgical Nursing](https://reader030.vdocument.in/reader030/viewer/2022012822/56814bfc550346895db8f6f5/html5/thumbnails/40.jpg)
Role of vocational nursing studentRole of vocational nursing student
• Nursing students prepare themselves to become excellent care providers to promote quality of care
• How?
• Learn and practice Time management
• Develop organizational skills
• Practice excellent study techniques
• Incorporate stress management in daily practice