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| Lillian Wald established Henry Street Settlement House in NYC. Also persuaded the Metropolitan Life Insurance Company. |
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| Congress Passed the Health Insurance Portability and Accountability Act (HIPAA). |
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| This legislation protects the client's private information through the electronic transfer of health records, allows individuals full access to their personal medical records, provides clear information,records to allow the client to have control over that information and ensures legal protection. |
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| Lady Benevolence Society Found in Charleston. |
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| Ladies' charitable organizations provided care to the sick in their own homes by hiring nurses. |
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| Home care as a benefit for Medicare enrollees. |
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Term
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| The only ANA-recognized terminology developed inductively (initially)by and for practicing nurses in the community. |
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| To develop a structured and comprehensive system that could be both understood and used by the members of various disciplines. Also, to foster collaborative practice. |
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| to guide practice decisions, sort and document pertinent data uniformly, and provide a framework for an agency-wide, multidisplinary clinical information management system capable of meeting the needs of practitioners, managers, and adminstrators. |
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| sharing health information between the client and clinicians using either synchronous or asynchronous electronic communications via telephone, videophone, or a biometric monitoring unit...Examples are WebTV and ViaTV. |
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| All healthcare organizations were required to meet HIPAA federal privacy standards. |
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| Practice, Documentation, and Information management. |
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| A federal insurance program administered by the Social Security Administration. |
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| Age 65 years and over or disabled. |
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Term
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| Restorative program, skilled service, pays for rental and purchase, reimbursement by prospective payment and based on national rates. |
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Definition
| A federal AND state assistance program administered by the state and is income-based eligibility. |
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Term
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| not necessarily homebound, custodial and maintenance program, state option to use therapist, medical or social service. |
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Term
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| Pays for purchase of equipment, reimbursement-maximum allowed at the state level and is based on a negotiated rate between the federal government and state. |
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Term
| The Reimbursement System Scenario |
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Definition
| If a clent has both Medicare and Medicaid or a private insurance plan, Medicare is used as the primary payment source. After Medicare pays, then private insurance is used. When the client is no longer eligible for home care under Medicare, the Medicaid benefits can be used. |
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Term
| Quality Improvement activities that the nurse can do is: |
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Definition
| monitor care,seeing and analyzing opportunities for improving care, developing guidelines to improve care, collecting data, making recommendations and implenting activities to enhance quality of care. |
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Term
| OASIS (OUTCOME AND ASSESSMENT INFORMATION SET) |
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| Measures outcomes for quality improvement and lient satisfaction with care. Funded by the Centers for Medicare and Medicaid services and the Robert Wood Johnson Foundation. |
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| OASIS was revised and renamed, now called OASIS-BI |
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Term
| OBQI (OUTCOME BASED QUALITY IMPROVEMENT) |
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| Is a two staged framework that includes "outcome analysis" and "outcome enhancement" |
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Term
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Definition
| comparing yourself with national standards and guidelines and with other agencies. Clinical guidelines, pathways and clinical maps are examples. |
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Term
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| The responsibilities and functions of other health professions in home care are dictated by Medicare regulations, professional organizations, and state licensing boards. |
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Term
| Interprofessional Team consists of: |
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Definition
Physician, physcial therapist, occupational therapist, social worker, homemaker, home healthaide and speech pathologist.
Example: nurses must reinforce the teaching by the physical therapist of exercise regimen and gait training. |
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Term
| Educational Requirement for Home care |
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Definition
A baccalaureate degree in nursing should be the minimum requirement for the entry into professional practice in any community health setting.
A nurse with a master's degree is prepared for the advance practice role as clinical specialist, nurse practitioner, researcher, administrator, or educator. |
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Definition
| teach clients an families the "how to" and "why" of self care. |
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Term
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Definition
| coordinating care with and for clients over time and across settings. They function according to client needs,either providing the care to meet those needs or making referrals an coordinating care. |
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Term
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| participating in the ongoing education of their colleagues, both formally, providing inservice education, and informally as team members.. Additionally they teach classes to community groups regarding health education topics. |
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Term
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| in home care it is increasingly important, as the efficacy, or quality, and cost effectiveness of care become mandated by Medicare and other payers. All nurses should use current research to improve practice, must be a priority in the future. |
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Definition
| a nurse who is advanced with public health experience; requirements are stipulated by both fed and state. |
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Term
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Definition
| maintaining client confidentiality, promoting informed consent, and making and following up on contacts to see that the community resources are available. |
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Definition
| may provide advice and counsel to staff and clients. |
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Term
| Official or Public Agencies include: |
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Definition
| those agencies operated by the state, county, city, and or other local government units, such as health departments. Nurses may provide well-child clinics, immunizations, health education programs and home visits |
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Term
| Voluntary and private agencies include: |
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Definition
| agencies are grouped together as nonprofit home health agencies. Volunteer agencies are supported by charities such as United Way, Medicare, Medicaid and other third party payers. Traditionally, visiting nurse associations were the principal type of voluntary hoome health agency. |
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| Combination agencies include: |
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Definition
| provides home health care and decrease cost and prenvent duplication of services. |
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Term
| Hospital Based Agencies include: |
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Definition
| In 1970s, emerged in response to the recognized need for continuity of care from the acute care setting and also because of the high cost of institutionalization. |
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Term
| Proprietary (Profit Making) Agencies include: |
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Definition
| not eligible for income tax exemption. Can be licensed and certified for Medicare by the state licensing agency. |
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Term
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Definition
| The Hospice movement in the United States gained momentum in response to awakened public interest generated by Dr. Elisabeth Kubler-Ross's work on death and dying. |
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| Medicare reimbursement for hospice services became available. |
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Term
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Definition
| To help maintain the client's dignity and comfort. |
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