What is the Free Enterprise System?

In the US, it is a health service that is delivered in an open market, with little government intervention or control over supply, demand, or cost for services.

What is the Welfare System and what contries use this system?

(England, Canada, Sweden)

Emphasizes equal services for all members of population with considerable government involvment in the delivery of health care

What countries use the Transitional System and how does it run?

(Mexico, India)

Modest government run structure for providing basic health services with a growing private fee-for-services for the affluent. Most of the population is poor.

Underdeveloped Systems are from what country and runs how?

(Africa)

Poorly organized systems of health care delivery, paarticularly in rural areas.

What countries run the Socialist system and how is it ran?

(Cuba, Poland, China)

Almost complete government control of health care delivery.

What is pluralism?

No single agency is totally responsible for health of nation.

What is the term for many independent systems public and private-competing services

Muticentricity

What is the term for fragmentation-too many services and gaps?

Duplication

What country has inequalities of health care access/delivery to the population as a whole?

United States

What is the term for the paradigm-

"rescuing people from the river"

(Microspopic)

Short term episodic, individually based intervention

What paradigm-Assesses the cause of the precursors to illness

Community is the client

"greatest good for the greatest number"

(Macroscpoic)

"Looking upstream to see why people are drowning"

What prevention prevents problems before they occur-actions taken prior to the occurrence of health problems?

Primary Prevention

(Public Health Realm)

What is Secondary Prevention?

(Pubic Health/Private Realm)

 Early detection, early intervention including health screenings-occurs after health problems exist but early enought to prevent serious consequences.

(higher control/higher cure rates)

What is correction/prevention of deteriorization or disability of disease state?

(not prescribed for health people)

Tertiary Prevention

(Private Health Realm)

Population

What is a Community?

-refers to a collection of people who interact with one antoher and whose common interest or characteristics form the basis for a sense of unity or belonging.

What is a subpopulation group within the community with some common characteristics often related to high risk for specific health issues or disease.

Aggregate

What is the term when the nurse encourages client to take an active role in health care by supporting the client's self determination.

Autonomy

What is the term

Continuity mean for Atributes of a Community Health Nurse

evaluates long/short term goals on a continuing and comprehensive basis that so that care flows uninterrupted.

Explain the Unfreezing process for change-change by design?

Dissatisfaction with status quo

creating an awareness and need for change

Dealing with resistance through explaining, teaching, and discussing the benefits of the change.

What part of the 3 change-change design is-

accepting and trying new methods or ideas

modeling new behaviors, skill

practicing sessions, supportive climate, and energizer feedback?

Moving

What is Refreezing in the change-change design?

change is establish and stabilized, internalize the change, part of routing, continue to direct new behaviors.

What are the 3 R's the educator uses?

Review, Repitition, Reinforcement

What level or kind of audience should recieve a Lecture?

lower level cognitive learners and in large groups

What does Role playing provide to the group?

Disadvantages?

Problem solving skills and insight into attitudes.

Disadvantage:  Time comsuming: focus may get off track

Belief that everyone should conform to the dominant culture

Cultural Imposition

Ridicule of cultural beliefs and practies of others because of percieved threats to one's beliefs

Cultural Conflict

What are Health problems/challenges with

African Americans?

lactose intolerance, cardiovascular diseas, DM, AIDs, high infant mortality rate, stroke, homicide, malnutrition

What are Health Problems/challenges that face

Native Americans?

DM, TB, Obesity, alcoholism, epidemic levels, maternal infant mortality, teen suicide

This group faces these Health Problems/challenges:

TB, mental illness, CA, respiratory infections, arthritis, suicide, malnutrition

Asian Americans/Pacific Islanders

Life expectancy 49 years old

Infant Mortality Rate 25 times higher

Malnutrition higher than any subpopulation

Parasitic infection 11 to 59 times higher

Migrant Laborer

What population has Health problems and challenges with:

TB, HBP, DM, violence, alcohol/drug abuse infectious diseases, AIDs, parasitic infections

Spanish/Hispanic

What is unexpressed and unconscious behaviors?

(ex: Space diameters, breast-feeding in public)

Tacit

The educator uses 3 things to teach?

3 R's

Review, repetition, reinforcement

Cognitive-Intellectual

What is learning with the heart, focuses on attitudes/acceptance (new ideas)?

Affective-Emotion

What is learning with the hands,neuromuscular cooridination, practice?

Psychomotor/Physical Manipulation

Formative evaluation?

To evaluate teaching effectiveness

Communication and interest of audience is maintained

(happens during actual teaching time for refining or improving programs-assessing degrees of confusion, lack of understanding)

Summation evaluation?

What is the outcom impact on the target audience?

(were objectives met?

examples are exams, quizzes, clinicals)

Process evaluation?

Evaluating teaching strategies, materials and content and make modification as appropriate.

The major segment of population that has no access to quality health care?

Aggregates

Should a nurse politically be able and willing to negotiate with conflicting views?

Yes or No

Yes

without compromising goals of the nursing profession

What is an alliance of special interest groups working together to influence outcomes of health policies?

Coalition

-attempting to elicit a specific action to a specifice policy

-attending hearings and giving public testimony?

What's the definition?

Lobbying

What is the ability to view beliefs and behaviors in the context of the culture in which they originated?

Cultural Relativism

What is modification of health care delivery in light of cultural factors?

Cultural Accommodation

Cultural Brokering?

Mediation between individuals or groups from different cultures

Who acts as the "gatekeeper" for health care for an individual client by crossing all setting in which pat receives care?

Case Manager

Can a case manager help with low cost in a time efficent manner?

Yes

What are the 6 Rights a case manager must perform

for his/her patient?

Right task

Right circumstance

Right person

Right communication

Right Supervision

Right quality of the Service

What are some Indicators that a Case Manager should step in for a client?

(There are 5, list one)

Functional Deficits-mental illness, strokes

Educational Deficits-developmental delays

Extensive Needs-Alzheimers, burns, head injuries

Chronic Disease Management-AIDs

Social Indicators-lack of support systems

3rd Party Remibursment

(Health Care Service)

cost of services are paid for by some one other than the individual receiving health care such as private insurance, employee based group plans

(includes premiums, co-payments and deductibles)

What is- payment by insurance companies that is paid after the client receives those services.

(disadvantage of providing services that may not be necessary and cause high rise health care costs)

Retrospective Reimbursement

Prospective Reimbursement

Payment is Predetermined and a fixed rate for a set of health care services that eliminates the incentive to over treat the client.

(instituted by Medicare)

PCP gatekeeper, prepayment basis is a fixed amount regardless of volume or expense of services?

HMO's

(Health Manintenance Organization)

 discounts given to groups insured as negotiated by employment groups.  Providers are monitored for quality and cost containment.

PPO's

Preferred Provider Organization

Costs of health care borne by the US Government or Taxpayers?

Public Funded Insurance

(Medicare, Medicaid, SCHIP)