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

2. 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

3. 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

4. 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

5. 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

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

7. 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

8. 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

9. 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)

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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.

16. 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?