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  • 1. ARENAS OF CARE UNIT 2 THE HEALTH CARE ENVIRONMENT CHAPTER 6
  • 2. ARENAS OF CARE
    • Acute care hospital
    • Long-term care facilities
    • Home health care agencies
    • Hospice
    • Outpatient settings
    • Schools
  • 3. LICENSURE, CERTIFICATION, AND ACCREDITATION
    • Several methods have been designed to ensure that an agency, facility, or service meets minimal standards of care.
  • 4. LICENSURE
    • A state-regulated, mandatory system of granting licenses according to specified standards.
    • Designated agencies visit each facility annually.
    • If deficiencies are not corrected, the facility may lose its license to operate.
  • 5. CERTIFICATION
    • A voluntary process that establishes and evaluates compliance with rules and regulations.
    • Required for any provider who seeks reimbursement from government funds.
  • 6. ACCREDITATION
    • An additional, voluntary confirmation of quality.
    • Generally indicates that the delivery of care and service is above minimum standards.
  • 7. ACCREDITATION (continued)
    • Agencies include:
    • Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
    • The Commission on Accreditation of Rehabilitation Facilities (CARF)
  • 8. ACUTE CARE HOSPITAL
    • Provides the greatest number of services, including:
      • Nursing units
      • Specialized client care units
      • Diagnostic departments
      • Therapy departments
      • Support services
  • 9. NURSING UNITS
    • Most nursing care is provided in client rooms.
    • Often serve a particular type of client.
    • Unit coordinator, nurse manager, or head nurse is in charge of the unit.
    • RNs, LP/VNs, and nursing assistants provide the nursing care.
  • 10. SPECIALIZED CLIENT CARE UNITS
    • Provide nursing care for specific needs.
    • May employ LP/VNs.
    • Examples include emergency departments, intensive care units, psychiatric units, rehabilitation units, dialysis units, hospice units, outpatient units, home care and education units.
  • 11. DIAGNOSTIC DEPARTMENTS
    • Provide specialized tests that assist the physician in making a diagnosis:
    • Clinical laboratory
    • Radiology and nuclear medicine
    • Other diagnostic services such as sleep centers, EKGs, and EEGs
  • 12. THERAPY DEPARTMENTS
    • Provide specialized treatments and/or rehabilitation services to improve functional level in specific area:
    • Physical therapy
    • Respiratory therapy
    • Occupational therapy
    • Speech therapy
  • 13. SUPPORT SERVICES
    • Pharmacists
    • Dietitians
    • Social workers
    • Chaplains
    • Admission department
    • Medical records
    • Housekeeping and maintenance
  • 14. ROLE OF THE LP/VN IN ACUTE CARE
    • Provides direct care.
    • Performs client assessments.
    • Works with the RN to formulate nursing diagnoses and write the plan of care.
    • May work in specialized units after some years of experience, additional education.
  • 15. LONG-TERM CARE
    • Various services provided to individuals having an ongoing need for health care.
    • Provides services to those who are not acutely ill, but who cannot function independently at home.
    • May be licensed for either intermediate care or skilled nursing care.
  • 16. SUBACUTE CARE
    • Provides services for clients who are out of the acute stage of their illness but still requiring skilled nursing, monitoring, and ongoing treatments.
    • Intended to fill the gap between the acute care hospital and the traditional long-term care facility.
  • 17. CONTINUING CARE RETIREMENT COMMUNITIES
    • Designed to provide continuous care as the individual’s health care needs change.
    • May include:
      • Independent
      • Assisted living
      • Short-term or permanent health care
  • 18. ASSISTED LIVING
    • A combination of housing and services for people who need help with the activities of daily living.
    • Nursing care is not provided.
  • 19. ADULT DAY CARE
    • This is a protective setting for adults unable to stay home alone but who don’t need 24-hour care.
    • Services may include socialization, some rehabilitation, and nursing care.
  • 20. RESPITE CARE
    • May be offered by long-term facilities, adult day care centers, or private homes.
    • Provides break to caregivers for few hours a week, occasional weekend, or longer.
    • Supervision, meals, planned activities.
  • 21. FOSTER CARE
    • For individuals unable to live independently yet do not require care in a health care facility
    • Similar to the foster home concept for children
  • 22. ROLE OF THE LP/VN
    • Long-term facilities offer many career opportunities.
    • May supervise the evening or night shifts.
    • Needs good assessment skills, nursing judgment based on assessment findings.
    • Coordinates, supervises nursing assistants.
  • 23. OUTPATIENT CARE
    • Includes services provided without the client actually being admitted to health care facility.
    • Same-day surgery may be in acute care hospital or free-standing facility.
    • Clinics, treatment centers offer testing, chemotherapy, physical therapy, etc.
  • 24. ROLE OF THE LP/VN
    • Preparing the client for the treatment or procedure
    • Checking vital signs
    • Answering questions
    • Discharge teaching
    • Assisting with tests or procedures
  • 25. HOME HEALTH CARE
    • The fastest-growing segment of health care.
    • Encompasses many services delivered to persons in their homes.
  • 26. ROLE OF THE LP/VN
    • Must have excellent assessment skills.
    • Teaching is a major responsibility.
    • Clients, caregivers must be taught:
      • The disease process
      • Medications
      • Special skills
      • Documentation and communication
  • 27. HOSPICE
    • Humane, compassionate care for clients who can no longer benefit from curative treatment and have 6 months or less to live.
  • 28. HOSPICE (continued)
    • Provides sensitive support allowing clients to be alert, pain-free and have other symptoms managed so the last days are spent with dignity and quality of life at home or in a home-like setting.
  • 29. REHABILITATION
    • The process of helping individuals reach their optimal level of physical, mental, and psychosocial functioning.
  • 30. THE INTERDISCIPLINARY HEALTH CARE TEAM
    • An essential component of the rehabilitation process.
    • Professionals are selected based on client need.
    • A holistic approach is used to identify client’s physical, mental, and psychosocial needs.
  • 31. FUNCTIONAL ASSESSMENT AND EVALUATION
    • Criteria for admission to a program requires the client to be:
      • Medically stable
      • Able to learn
      • Able to sit supported for at least 1 hour a day and actively participate in the program
  • 32. ROLE OF THE LP/VN
    • Requires:
      • Specialized knowledge, skills, attitudes.
      • Sound knowledge of anatomy and physiology of the neurological, musculoskeletal, gastrointestinal, urological systems.
      • Excellent skills in ROM, ADLs, positioning, transfers, and ambulation.
  • 33. REHABILITATION SETTINGS
    • Hospital inpatient programs
    • Skilled nursing facilities
    • Outpatient rehabilitation
    • Home rehabilitation