Nursing Assistant Program Bradwell Institute Community Health Care Nursing Assistant Program Bradwell Institute

Health Care Facility Functions Provide services for the ill and injured Prevent disease Promote individual and community health Educate health care workers Promote research in medicine and nursing

Health Care Today Patient Focused Care Each patient is an individual and has different needs Must give attention to the physical, mental and emotional aspects of each person’s life Preserving quality of life is viewed as more important than living longer

Health Care Today Many changes are occurring. Why? People are living longer Many ethical questions are coming up that must be answered by health care workers and consumers Cost of health care is increasing Demand for services and advanced technology More lives are saved by advanced technology They will need continuing health care

Health Care Today What are we doing to help reduce cost? Discharging patients earlier Using skilled care facilities and home health care Using outpatient facilities Using managed care Approving certain procedures and test Negotiating for a lower cost Using DRG’s Having procedures done as an outpatient

Community Needs Preventative care Emergency care Surgery Prenatal, well-baby checkups, routine physicals Emergency care Surgery Rehabilitation Long-term care Hospice

Who Do We Take Care Of? Resident Client Patient People in long-term care facilities Client Persons receiving care in their own homes Patient Persons in an acute care facility

Health Care Facilities Short-Term Care Care for acute illness Hospitals Urgent care facilities Surgicenters Outpatient clinics Psychiatric hospitals Doctor’s offices Long-Term Care Care for chronic illness Skilled care facilities Adult day care Assisted living Rehabilitation centers Psychiatric hospitals Respite care Home care

Hospitals Care for persons of all ages and problems May care for certain age groups only Pediatric (birth to 18 yrs) Psychiatric (mental illness) Rehabilitation (restorative services to return patients to their highest level of functioning)

Hospital Organization Volunteers Dietary Services Pharmacy Services Social Services Environmental Services Rehabilitation Physical, occupational, speech, respiratory Pastoral Care Diagnostic Services Pathology, Radiology, Lab Medical Departments Pediatric Department Emergency Department Critical Care Specialized Areas Obstetric Department Postpartum Surgical Departments PACU Business Services Medical Records

How Do We Pay Insurance Out-of-pocket payments DRG’s HMO (preventative care) or PPO Out-of-pocket payments DRG’s Uses average length of stay and will only pay for that period of time or that particular fixed set amount* Medicare (federal) Persons over 65 yrs and who are permanently disabled (getting social security for 2 yrs) Medicaid (state and federal) Covers persons with low incomes, physically disabled and blind

How Are Facilities Regulated? Joint Commission for Accreditation of Healthcare Organizations (JCAHO) Accredits most health care agencies Facilities are not eligible for Medicare payments if they are not accredited Sets high standards Patient needs and care giver qualifications must be looked at when making assignments Reviews caregiver qualifications (age-related care) Evaluate staff competence and Offer educational programs for staff Reviews policies and procedures (best practice) Makes sure employees know and follow these procedures

How Are Facilities Regulated? Occupational Safety and Health Administration (OSHA) Interviews employees and tours the facility Protects the health and safety of employees Reviews infection control practices, isolation practices Requires PPD testing Requires MSDS sheets Asks about health and safety practices Makes recommendations for corrections Issues citations (written notice) or fines or both

Quality Assurance (QA or CQI) Conducts internal reviews to identify problems and find solutions Meet periodically to evaluate care provided and practices in the facility Will conduct audits May find areas needing improvement internally before an OSHA or JCAHO inspection Restraint use, infection rate, pressure ulcer rate, fall rate, infection control practices, blood administration practices

Nursing Assistant Challenge Mrs. Hernandez is pregnant with her first child. She wants to do everything she can to make sure that she has a safe and uncomplicated pregnancy, labor and delivery, and that her baby is healthy. Consider how Mrs. Hernandez will move through the health care system to achieve this goal.

Nursing Assistant Challenge What is the first type of care that Mrs. Hernandez needs to help her meet her goal of an uncomplicated pregnancy? In your community, where is this type of care provided? From which hospital departments do you think Mrs. Hernandez will receive services when delivers her baby? After the baby is born, what health care will the baby need?