Exam 3: Healthcare Fraud, Cultural Competence, Nutrition

Culture

learned and shared beliefs, values, norms, and traditions of a particular group, which guide our thinking, decisions, and actions. How we relate to one another. Learned behavior that is constantly changing.

unconscious bias

occurs and we are not always aware of it. We make quick judgements

Implicit Bias

we are aware of the bias

competence

professional health care must be culturally sensitive, culturally appropriate, and culturally competent to meet the multifaceted health care needs of each person, family, and community

5 categories of social determinants

economic stability, education access and quality, health care access and quality, neighborhood and built environment, social and community context

cultural awareness

Processing of conducting a self-examination of one's own biases towards other cultures.

Cultural Knowledge

the process in which a health care professional seeks and obtains a sound educational base about culturally diverse groups. Includes integration of health-related beliefs, care practices, and disease incidence

cultural skill

is the ability to conduct a cultural assessment of a patient to collect relevant cultural data.

cultural encounter

the process that encourages health care professionals to directly engage in face-to-face cultural interactions with other cultures.

healthcare waste

Medical items like needles and expired medicines.

healthcare fraud

an intentional deception or misrepresentation made by a person with the knowledge that the deception could result in some unauthorized benefit to himself or some other person. It includes any act that constitutes fraud under applicable Federal or State law.

healthcare abuse

Any practice that creates unnecessary cost to federal healthcare programs

types of healthcare waste

supplies, equipment, medications

Nutrition

the process of providing or obtaining the food necessary for health and growth.

carbohydrates

the starches and sugars present in foods, quick energy

Proteins

Nutrients the body uses to build and maintain its cells and tissues, vital for skin breakdown

fats

calorie dense foods, saturated and unsaturated, long term energy

water

vital for hydration and cell function

vitamins

organic substances present in small amounts in food. They are catalyst for biochemical reactions. Can be fat-soluble or water-soluble

fat soluble vitamins

A, D, E, K

water soluble vitamins

B and C

vitamins absorbed via diet

A,B,C,D,E,K

ALL BUT D

True or False, Water soluble vitamins are stored in the body

False, B and C are not stored

Dietary Reference Intakes (DRIs)

set of recommended intakes for each nutrient published by the Institute of Medicine

factors influencing nutrition

Environmental, developmental needs, illness, age, adverse effects, cognitive impairment.

best way to get information about diet preferences and culture

ASK YOUR PATIENT

dietary screening tools

24 hour recall and food diary

Anthropometry

measures the size and make up of the body. This includes height and weight upon admission and at routine intervals. Weigh the patient at the same time each day, on the same scale, wearing the same type of clothing. An ideal body weight (IBW) is an estimate of what a patient should weigh

rapid weight gain may indicate

fluid retention

rapid weight loss may indicate

fluid loss

labs measuring nutritional status

albumin, prealbumin, transferrin, and hemoglobin

Normal BMI

18.5-25

Obesity BMI

30 or greater

Underweight BMI

less than 18.5

Dysphagia

difficulty swallowing

dysphagia interventions

positioning, thickened liquids, feeding tubes, speech therapy

best way to weigh a patient

standing, dry weight, hoyer lift, same clothing, compare to admission weight

False Claims act

An act that allows employees to sue employers on behalf of the federal government for fraud against the government. The employee retains a share of the recovery as a reward for his or her efforts.

Antikickback Law

Prohibits payment in money or services to a physician in order to solicit business from that physician

Stark Law

Prohibits physicians or their family members who own health care facilities from referring patients to those entities if the federal government, under Medicare or Medicaid, will pay for treatment.

Whistleblower Protection Act

Prohibits reprisal against employees who reveal information on white collar crime

HIPPAA

The privacy element, patient confidentiality

1 cup = ___ oz

8 oz

3 tsp = ? Tbsp

1 tbsp

15 mL = ___ tbsp

15 mL = 1 tbsp

5 social determinants of health

economic stability, education, social and community context, health and health care, neighborhood and built environment