ACNP Boards > Soft Topics > Flashcards

Soft Topics Flashcards

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1
Q

What is the single best predictor of someone’s health?

A

Health literacy

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2
Q

Who lays out accreditation guidelines?

A

Joint commission

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3
Q

Who lays out the national safety goals?

A

Joint commission

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4
Q

What are the goals of joint commission for acute care? (6)

A

Proper ID, communication, safe med use, effective alarms, infection prevention, and preventing mistakes

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5
Q

CAGE-AID Assessment Tool for Alcoholics

A
  1. Have you thought about CUTTING down
  2. Have anyone around you ANNOYED you by asking you to?
  3. Have you felt GUILT?
  4. Have you had drinks of drugs first thing in the morning to cure hangover (EYE-OPENER)
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6
Q

Crit care pain observation tool (CPOT)

A
  1. Facial expression (relaxed, tense, grimacing)
  2. Body movements (relaxed, protective, restless)
  3. Muscle Tension (relaxed, tense, rigid)
  4. Compliance with ventilator or vocalization (relaxed, coughing/moaning, crying/fighting vent)
    Each scored 0, 1, or 2 for total of up to 8.
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7
Q

Confusion assessment method (CAM-ICU)

A
  1. acute onset AMS or fluctuating course
  2. Inattention
  3. Disorganized thinking
  4. Altered LOC
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8
Q

Mini mental state exam components

A

O - Orientation (place/time)
R - Recognition (Name 3 objects to remember for recall portion)
A - Attention (Count backwards from 100 by 7s)
R - Recall (Recall objects 5 mins later)
L, 2 - 3 - Language (Identify names of 2 objects / Follow 3 step command)
RWD- Reading/Writing/Drawing (Copy design)

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9
Q

Mini mental state exam point system

A

> 24 = no impairment
18-24 = mild
0-17 = severe impairment

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10
Q

Clock drawing test

A

Used to assess cognitive dysfunction. Patient draws face of clock to read 10 after 11. Scored 1-6.

A score of 3+ equals cognitive deficit

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11
Q

Index of independence and ADLs/Cats index (6 items)

A

Includes bathing, dressing, toileting, transferring, continence, and feeding

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12
Q

Gait and immobility / fall risk test; Get up and go test

A

Pt asked to stand up, stand still, walk short distance, turn around, walk back to chair, turn around, and sit in chair. Performance rated 1-5. >3 indicates fall risk

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13
Q

Pain assessment for advanced dementia

A

Breathing, negative vocalization, facial expression, body language, and consolability. Each scored 0-2. Lower score = less pain

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14
Q

What durable medical equipment items does medicare cover?

A

Beds, wheelchairs, walkers, O2, canes/crutches, CPAP, lifts, commodes, BG monitors, pump

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15
Q

What item does medicare not cover?

A

Hearing aids

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16
Q

Benchmarking

A

comparison of healthcare org services against other healthcare organizations to allow sharing of best practices and evidence-based research outcomes

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17
Q

Four core principles of benchmarking?

A

Maintaining quality, inc. customer satisfaction, patient safety, and continuous improvement

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18
Q

What is a good example of benchmarking

A

All patients having med recs completed upon admission and hospital readmission rates

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19
Q

Meeting benchmarks requires:

A
  1. management must support goal,
  2. compliance measured,
  3. time allocated
  4. resources for implementation
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20
Q

What is required for magnet recognition?

A

A formalized systematic peer review

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21
Q

Principles of a peer review that must be met:

A

Someone of the same rank, practice focused, timely feedback, continuous learning culture of pt. safety and best practices, not anonymous, and incorporates the nurses developmental stage

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22
Q

FIFE model

A

Feelings, Ideas (pts understanding of condition), Functioning (how the condition will affect everyday life), and Expectation (what the pt thinks/hopes might happen with course)

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23
Q

Establishing Rapport (5 items)

A
  1. Non-judgemental
  2. Mutual trust
  3. Professional boundaries
  4. Confidentiality
  5. Cultural competency (with respect and spiritual needs)
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24
Q

ayurvedic medicine

A

Holistic Indian system of health focused on balancing mind/body/spirit through diet, herbal remedies, yoga, meditation

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25
Qigong
ancient Chinese system combining gentle movements, deep breathing, and meditation to cultivate and balance the body's vital energy (qi) for improved health, well-being, and spiritual development
26
Advanced directive
Written statement of patients intent regarding medical treatment
27
What "Act" requires that all patients entering a hospital should be advised of their right to execute an advanced directive
The patient self-determination act
28
Healthcare directive
Type of AD that may/may not include a living will with specifications regarding POA in one or two seperate documents
29
Living Will
Written compilation of statements that specifies which life-prolonging measures one wants. Must usually be in writing before it is honored by most institutions
30
Title I of HIPPA
The right to COBRA (Consolidated Omnibus Budget Recon Act) insurance
31
Title II of HIPPA
AKA the administrative simplification provision; requires establishment of national standards for EMRs for patient privacy and security
32
Who enforces HIPPA?
The Office For Civil Rights
33
Who is a "covered entity" of HIPPA
Health insurance companies, health care providers, and healthcare clearinghouses
34
Le forts fractures of the skull
Le fort 1: floating palate Le fort 2: floating maxilla Le fort 3: Floating faces
35
Healthy people 2030
Increase the quality and years of healthy life and eliminate health disparities among americans
36
What do the objectives of healthy people 2030 include
Equal access, availability, cost, and quality of care
37
What diseases/conditions are required to be reported
1. Gun shot wounds 2. Gonorrhea, Chlamydia, HIV, Syphilis, TB, COVID-19 3. Animal bites 4. Suspected abuse child or elder
38
Collaborative practice
Exists to enhance the quality of care and improve outcomes
39
ANA 1995 Social Policy Statement
Collaboration is a true partnership in which all players have and desire power, share common goals, and recognize or accept separate areas of responsbility
40
What controls/sets the standard for healthcare reimbursement and cutting costs
Medicare
41
Medicare A
Covers inpatient/SNF/Home health
42
Medicare B
Covers outpatient/labs/diagnostic procedures/medical equipment/ and some homehealth. Requires patient payment
43
Medicare C
A + B
44
Medicare D
Drugs (limited prescription coverage). Requires patient payment (copay/monthly premium)
45
How does an NP qualify to be medicare provider?
MSN, state license, and certification by national certifying body
46
Incident to billing
Services billed under the physicians provider number for full 100% reimbursement with these rules: - Services must be part of physicians professional services, rendered without charge or included in physicians bill, common in offices/clinics, furnished under the direct supervision of the physician (same building). Physician must perform initial visit/be active in treatment plan. Never inpatient.
47
Medicaid
Federally supported but state administered program for low income. Benefits vary from state to state. Medicaid payments are made after third party payers have paid.
48
Quality Assurance
process that evaluates care of patients using established standards of care to ensure quality (Audits, inspections, and monitoring)
49
Quality improvement
Proactive approach to enhance services, aiming for the "best possible" outcome. PDSA model
50
Continuous process improvement
Commitment to constantly improve processes to eliminate waste and boost efficiency. Structures: Inputs of care like resources/equipment/# of or qualification of staff Processes: Assessments/planning/managing complications Outcomes: adverse events or results
51
Quality and Safety Education Initiative and the 6 competencies
Providing nurses with knowledge and skills to ensure cont. improvement in quality/safety. 1. patient centered care 2. quality improvement 3. teamwork 4. safety 5. evidence based practice 6. informatics
52
Steps of Continuous quality improvement/QA outlined by the joint commission (4)
Quality planning Delineate scope of care Critical path Care map (monitoring outcomes)
53
Root cause analysis
A tool for identifying prevention strategies to ensure safety
54
Scope of practice and ability to prescribe is delineated by who?
By individual state-Nurse practice acts
55
Who grants licensure?
State board of nursing
56
Who grants certification?
ANCC or AACN
57
Who credentials the NP
Hospital credentialing committee composed of physicians
58
Non-experimental research
Descriptive, ex post facto/correlational, Cross-sectional, cohort, or longitudinal
59
Cross-sectional research
observational study comparing similar pop. with one specific variable difference like age
60
Cohort
observational study comparing outcomes in groups who are alike in many ways but differ by a certain characteristics (nurses who smoke vs nurses who dont)
61
Quasi-experimental research
manipulation of variables but lacks control group/randomization
62
Problems with qualitative research
Bias and generalizability of findings
63
PICOT
Population, intervention, control, outcome, timing
64
Type I error
false positive; incorrectly rejecting the true null hypothesis. High specificity minimizes Type I errors
65
Type II error
false negative; failing to reject a null hypothesis which is false. High sensitivity minimizes Type II errors
66
Confidence intervals
range of values, calculated from sample data, that likely contains the true, unknown value (parameter) of a whole population, with a specific level of certainty; smaller the better
67
Standard deviation
the average amount of deviation of a value from the mean showing how consistent or variable a dataset is; a low SD means data clusters tightly, indicating consistency
68
T-test
Statistical test to evaluate the differences in means between two groups
69
Internal consistency
Estimates reliability with testing to determine if instrument is reliably measuring a concept; only one measurement
70
Cronbachs alpha
way of computing correlation values; the closer it is to 1 the higher reliability estimate of the instrument
71
Validity
the accuracy
72
What is used to determine whether negligence has occured?
Standards of care
73
Incidence of disease
rate at which NEW cases occur during a given time.
74
Prevalence of disease
Proportion of population with a disease at a given time
75
Specificity
The degree to which those who are negative test negative; TRUE NEGATIVE
75
Sensitivity
The degree to which those who are positive test positive; TRUE POSITIVES
76
The CURVES Mnemonic for Decision-Making Capacity
Choose and communicate: Can the patient express a clear choice? Understand: Can the patient comprehend the risks/benefits Reason: Can the patient demonstrate a logical thought process? Value: consistent with the patient’s own personal values? Emergency: Is there an emergent risk that necessitates an immediate decision? Surrogate: Is there proxy available if the patient lacks capacity?
77
If the P-value > a-coefficient
You fail to reject the null hypothesis; not statistically significant result
78
If the P-value is < a-coefficient
You reject the null hypothesis; results are statistically significant
79
Glasgow Coma Scale
Eyes 4: none, pain, to voice, spont. Verbal 5: none, incomprehensible, inappropriate words, answers but confused, oriented Motor 6: none, extension, flexion, flexion withdraw to pain, moves to local pain, follows commands
80
Test–retest reliability measures:
Consistency of scores over time
81
Internal relability
82
Why does sensitivity rule things out
Sensitivity rules things out because a highly sensitive test has a very low rate of false negatives, meaning it rarely misses a true case
83
Why does specificity rule things in
because a highly specific test rarely yields false positives, meaning a positive result is highly likely to be correct
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