Allied Health Final

During World War II in the 1940s employers began to offer their employees heal benefits. Which is a reason for doing so?

It was a way to recruit potential employees and retain those already employed

The National Health Expenditure (NHE) percentage of the United States Gross Domestic Product (GDP) has decreased since 1960

False

Medicare became law in 1965. What was the purpose for enacting and passing this legislation?

It provided health care for retirees no longer covered by their employer

This group, also known as the insurer, negotiates and administers insurance

Plans

This is the largest health care insurer in the United States

Medicare

This is a system used to classify hospital cases into one of 467 groups, intended to identify "products" that a hospital provides

Diagnosis Related Group (DRG)

Administered by Medicare, this is a 29 question survey designed to measure a patients satisfaction of their hospital stay(s)/experience(s)

Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS)

This is a medical code set that is used by health care profession to report medical, surgical, and diagnostic procedures that they performed

Common Procedural Terminology (CPT)

This is an approach where clinicians and patients make decisions together using the best available evidence

Shared decision making

Which of the following is NOT part of Medicares model for reimbursing health care facilities for their services?

The quantity of the services provided

In what decade did insurance companies (ie Blue Cross) begin to start?

1920s

Treating patients as individuals considering their lifestyle and beliefs is an example of

Compassion

Examples of this professional trait include honesty, admitting to errors and being confidential

Integrity

Which of the following professional traits can be termed as commitment to advocate for the interests of others over ones own self interests?

Altruism

When assessing a patient which of the following questioning strategies is the most effective?

Open ended questions

In the APIE model which of the 4 major components of the patient education process is most likely to be overlooked?

Assessment

Give one example of a patients education program that was used in the presentation

Smoking cessation

Which of the following learning dimensions includes all intellectual behaviors and requires thinking?

Cognitive

Which of the following are included in the process of communication?

Sender, Message, and Receiver

In the APIE model which of the following involves the actual process of teaching?

Implementation

Which of the following are factors that affect communication?

Literacy Level

Language Barriers

Lack of readiness for change

Interruptions

Cultural and Spiritual Beliefs

HIPAA provides a framework for the establishment of nationwide protection for all of the following except...

Personal finance records

A covered entity is

Any healthcare professional who has direct patient relationships and anyone who is required by law to follow HIPAA rules

A patients medical record may be legally accessed by anyone in the healthcare facility

False

While health care providers must follow HIPAA rules, health insurance companies are NOT responsible for protecting patient information

False

If any direct or indirect patient identifiers are present the information is PHI and subject to HIPPA protection

True

This is a set of moral principles or standards that guide conduct by which human actions may be judged

Ethics

Which of the following is not a barrier to being ethical?

Ease of doing the right thing

This principle of medical ethics refers to the patients independence or liberty

Autonomy

This principle of medical ethics refers to helath care workers acting in the best interests of their parents

Beneficence

This principle of medical ethics refers to fairness with respect to the distribution of medical resources

Justice

The idea of "Do No Harm" can be attributed to whom?

Hypocrites

Which section of the patient chart would contain the patients information pertaining to their smoking history, alcohol use, and exercise regimen?

Social History

Which section of the patient chart would contain information pertaining to the patients parents, siblings, and children?

Family History

Which section of the patients chart would contain information pertaining to the patients subjective feelings concerning their present illness?

Review of Symptoms

Which of the following is responsible for assigning tasks, issuing orders and directing the resuscitative effort during a code?

Code Team Leader

Heart disease, Cancer, COPD, and Alzheimers disease are all examples of

Terminal Disease

An ongoing discussion between the physician, the patient, and the proxy decision maker to plan for future medical care in the event a patient becomes unable to make his or her own decisions about health care is the definition of

Advanced care planning

Patients receiving palliative care are NOT allowed to receive curative and/or therapeutic treatments

False

This type of care is reserved for those patients whose prognosis is less than six months and focuses on alleviating pain

Hospice Care

The United States spends more than any other country in the world on healthcare per capita which has lead to an increase in longevity.

False

In the study dealing with respiratory therapists and end of life discussions presented in the Advanced Care presentation, which of the following statements are true?

-A vast majority of RTs are involved in terminal extubations

-Less than 1/3 of RTs felt they were adequately educated in terminal illness

-Less than 10% of RTs are involved in end of life discussions with patients and their families

-Over half of the RTs surveyed wanted more formal education around terminal patient care.

the assumption that all blood and body fluid is infectious

Standard precautions

the pathogen is spread by direct or indirect exposure

contact precautions

the pathogen can travel only short distances (<8ft)

droplet precautions

pathogen is able to travel long distances via droplet nuclei and dust

airborne precautions

MRSE, VRE, and C. Difficile are all examples of which of the following?

bacteria

which of the following characteristics influence how susceptible a person is to a pathogen?

decreased immunity, reduced resistance, age, and heredity

which of the following is the most effective way of preventing nosocomial infections?

hand washing/hygiene upon entering and leaving a patients room

which of the following is #1 cause of non-fatal injuries for hospital workers?

sprains and strains

the number of days away from work that are caused by workplace injury, decrease as hospital workers grow older

false

according to the US Dept. of Labor, which of the following can be defined as an injury or disorder of the muscles, nerves, tendons, joints, cartilage, or spinal discs?

Musculoskeletal Disorder (MSD)

an injury related to medical management in contrast to complications of disease

adverse event

an event or situation that could have resulted in an accident, injury or illness but did not either by chance or through timely intervention

near miss

an adverse event or near miss that is preventable with the current state of med. knowledge

medical error

term used by the Joint Commission, defined as an unexpected occurrence involving death or serious physical or psychological injury or the risk there of

Sentinel event

should you report an event no matter how big or small?

YES

exhaustion, depersonalization, and reduced personal accomplishment

three classic symptoms of burnout

what type of management do RT's prefer?

delegative and consultative managerial decision making.

-RT's want to be involved

reduced quality of care, increased # of medical errors, higher rates of hospital acquired infections, higher 30 day mortality rate, and lower patient satisfaction scores

consequences of burnout for the patient

These two sets of goals work together toward the ultimate goal

of the patient education process

That is, equipping the patient and caregiver with the knowledge, skills, and attitudes to better understand the patient's condition and to more

fully participate in health care.

Communication that deals with expression of feelings and acceptance of attitudes opinions or values

Affective

Communication that deals with acquiring skills that require integration of mental and muscular activity

Psychomotor

Communication is a complex and dynamic process

True

Multidimensional Communication

Message with two components

Studies indicate patients find communication with providers:

Difficult

Does not provide enough information

Ambiguous

Do not provide practical regimens

Verbal Expressions

Involves language, jargon, choice of words or questions, voice tone and quality, and feedback

Nonverbal Cues

Kinsics: body motion

Proxemics: the use and interpretation of space Paralinguistics: the use of sounds

Intrapersonal Factors

Previous experiences

Attitudes, values, and convictions

Cultural heritage & religious beliefs

Feelings

The acronym SENDER can help recall the six measures to enhance communication:

Set the stage

Enunciate clearly

Notify the receiver of the importance

Demand feedback

Eliminate the unnecessary

Receiver-orient the message

The five skills of active listening

Listen to the content

Listen to the intent

Assess the sender’s nonverbal communication Monitor nonverbal communication and emotional filters

Listen without judgment and with empathy

Requires both hearing and listening

Questioning techniques are

a powerful way to obtain information, clarify uncertainties, facilitate learning, and resolve conflicts

Assessment involves

determination of the patient's learning needs and readiness to learn

Planning involves

development of goals, well-written objectives, and addressing the three learning domains

Implementation involves

actual teaching, which requires a variety of strategies and techniques

Evaluation should be

a continual process encompassing evaluation of the entire teaching process and of the effectiveness of the patient's learning

Effective communication is

both multidimensional and transactional, meaning there is both content and emotion expressed in communication

Early stage

pain may disappear after a rest away from work

Intermediate Stage

body part aches and feels weak soon after starting work and lasts until well after finishing work

Advanced Stage

body part aches and feels weak even at rest, sleep may be affected, light tasks are difficult on days off

Hospitals are hazardous workplaces

True

Challenges healthcare workers face

Lifting, repositioning, and transferring

Potentially contagious patients

Physical and mental disabilites

Healthcare culture

Patient is always first, do not harm, patient safety above yours

Most injuries and illnesses result from well known sources

Injury 93%

Illness 7%

More than half the days away from work injuries are

Sprains and Strains. Over 50% are related to overexertion from lifting, bending, and reaching

Injuries are important to the employee because of

lost wages

medical costs

quality of life

Injuries are important to the employer because of

temp staffing

overtime

decrease productivity

loss of experience

patient safety and satisfaction

Staff in great physical condition are less likely to be injured

These staff are exposed to risk at a greater level; co- workers are more likely to ask them for help.

If you buy it, the staff will use it

Staff do not use equipment for several reasons including lack of training or administrative support.

Use of mechanical lifts eliminates all the risk of manual lifting

With any transfer, human effort is required and there is always a possibility of injury. However, lifts do eliminate extreme stress on the care giver.

1970

CDC releases "Isolation Techniques for Use in Hospitals, 1st ed."

1983

CDC Guideline for Isolation Precautions in Hospitals

1985

Universal Precautions

1987

Body Substance Isolation

1996

Guideline for Isolation Precautions in Hospitals

Infection Prevention

Hand hygiene/hand washing, cleaning/disinfection/sterilization, vaccination, surveillance

Infection Control

Addresses factors related to the spread of infections within the health-care setting

Incidence of Hospital Acquired Infections (HAI) (aka nosocomial infections)

1.7 million HAI each year in U.S. healthcare system

MRSA, VRE, C.diff, Salmonella Group A, Streptococcus

Bacteria

Flu, Hep B, HIV

Viruses