Chapter One
Introduction to Health Care
Objectives
Define the key terms and key abbreviations in this chapter.
Describe the purposes and types of health care agencies.
Describe the persons cared for in nursing centers.
Describe the health team and nursing team members.
Describe 5 nursing care patterns.
Describe the programs that pay for health care.
Explain how government agencies and health care agencies ensure safe, quality care.
Explain your role in meeting standards.
Explain how to promote PRIDE in the person, the team, and yourself.
Key Terms
Acute Illness: An illness of rapid onset and short duration; the person is expected to recover
Admission: The official entry of a person into a health care setting
Assisted Living Residence (ALR): Provides housing, personal care, support services, health care, and social activities in a home-like setting to persons needing some help with daily activities
Chronic Illness: A long-term health condition that may not have a cure; it can be controlled and complications prevented with proper treatment
Discharge: The official departure of a person from a health care setting
Health Team: The many health care workers whose skills and knowledge focus on the person's total care; interdisciplinary health care team
Hospice: A health care agency or program that promotes comfort and quality of life for the dying person and the person's family
Licensed Practical Nurse (LPN): A nurse who has completed a practical nursing program and has passed a licensing test; also referred to as Licensed Vocational Nurse (LVN) in California
Nursing Assistant: A person who has passed a nursing assistant training and competency evaluation program (NATCEP); performs delegated nursing tasks under supervision of a licensed nurse
Nursing Team: Those who provide nursing care- LPNs/LVNs and nursing assistants
Registered Nurse (RN): A nurse who has completed a 2- or 4-year nursing program and has passed a licensing test
Regulations: Rules made by government agencies
Survey: The formal review of an agency through the collection of facts and observations
Surveyor: A person who collects information by observing and asking questions
Terminal Illness: An illness or injury from which a person will not likely recover
Key Abbreviations
ALR: Assisted Living Residence
APRN: Advanced Practice Registered Nurse
LPN: Licensed Practical Nurse
LVN: Licensed Vocational Nurse
DON: Director of Nursing
RN: Registered Nurse
HHS: U.S. Department of Health & Human Services
SNF: Skilled Nursing Facility
Nursing Service
Nursing service is a large department managed by the Director of Nursing (DON), who is generally a registered nurse (RN). Titles may include Chief Nurse Executive and Vice President of Nursing.
DON Responsibilities: Responsible for the entire nursing staff and nursing care provided in the facility.
Nursing Supervisors and Nurse Managers: Usually RNs who oversee nursing functions, ensuring quality nursing care on their shift.
Charge Nurses: RNs assigned to oversee nursing care during shifts.
LPNs/LVNs may serve as charge nurses in some states.
They are responsible for all nursing care and the actions of nursing staff during their shift.
Staff RNs report to the charge nurse; while LPNs/LVNs report either to staff RNs or charge nurses.
Nursing education staff are also part of nursing service, with responsibilities including:
Planning educational programs (in-service).
Providing new information regarding policies and procedures.
Educating nursing assistants and conducting orientation for new employees.
The Nursing Team
Involves those who provide nursing care: RNs, LPNs/LVNs, and nursing assistants.
Focus is on the whole person’s physical, social, emotional, and spiritual needs.
Registered Nurses (RNs)
Complete a 2-, 3-, or 4-year nursing program and pass a licensing test.
RNs work in various programs:
Community College (2 years)
Hospital-based Diploma (2 or 3 years)
College/University programs (4 years)
Functions
Assess, diagnose, plan, implement, and evaluate nursing care.
Delegate care to LPNs/LVNs and nursing assistants.
Teach patients how to improve health and introduce independence.
Implement doctor's orders but do not prescribe treatments or drugs unless they are clinical nurse specialists or nurse practitioners (limited functions defined by state law).
Licensed Practical Nurses (LPNs) and Licensed Vocational Nurses (LVNs)
Complete a practical nursing program (10, 12, or 18 months).
Must pass a licensing test and are supervised by RNs and doctors.
LPN/LVNs have fewer responsibilities than RNs but can manage simpler care tasks and assist in care for acutely ill patients.
Nursing Assistants
Complete a training program (NATCEP) and perform delegated nursing tasks under a licensed nurse's supervision.
Staffing in Nursing
Agencies must maintain adequate nursing staff to provide safe care. Staffing describes the number and type of nursing team members assigned to patients/residents.
Factors in Staffing Decisions:
Number of patients/residents needing care
Care needs or acuity levels
A policy should maintain a safe staffing ratio to ensure the comfort and quality of care provided.
The Health Team
The interdisciplinary health team focuses on the person's total care, needing coordinated and well-communicated efforts across various specialties.
Health Team Members
Activities Director/Recreational Therapist: Plans programs to maintain/improve physical, social, emotional well-being.
Audiologist: Treats hearing and balance problems.
Cleric: Assists with spiritual needs.
Clinical Nurse Specialist (CNS): Advanced practical nurse providing specialized consultation and can prescribe medications in some states.
Dietitian/Nutritionist: Plans nutritional needs and teaches about healthy eating.
Licensed Practical/Vocational Nurse (LPN/LVN): Provides nursing care under direction of RNs and doctors.
Medical or Clinical Laboratory Technician: Collects specimens and performs tests.
Medication Assistant-Certified (MA-C): Administers medications under supervision.
Nurse Practitioner (NP): An APRN who diagnoses and treats common health problems.
Occupational Therapist (OT): Helps persons with skills needed for daily living and working.
Pharmacist: Fills drug orders and consults on safe usage.
Physical Therapist (PT): Aids in rehabilitation and mobility.
Physician: Diagnoses and treats diseases.
Podiatrist: Treats lower leg and foot problems.
Radiographer/Technologist: Uses imaging equipment for diagnostics.
Registered Nurse (RN): Assesses and supervises nursing care.
Respiratory Therapist (RT): Provides therapy for lung conditions.
Social Worker: Addresses social/emotional issues affecting health care.
Speech-Language Pathologist: Focuses on communication and swallowing disorders.
Nursing Centers
Nursing Center (Nursing Facility/Nursing Home): Provides a range of services from medical care to rehabilitation. Skilled care usually requires licensed professionals.
Types of Care Provided
Skilled Care: Services such as wound care, IV therapy, and rehabilitation are typically provided by licensed nurses and therapists.
Memory Care Units: Designated for those with cognitive impairments like Alzheimer's disease. Features a secure environment to ensure safety while allowing residents to move freely.
Assisted Living Residences (ALR): Provide housing and support services to persons who need assistance with daily activities such as bathing, cooking, and safety.
Home Care Agencies: Provide nursing and support services in the person's residence.
Hospice: Supports comfort for terminally ill patients and their families, focusing on quality of life rather than curative measures.
Purposes of Health Care
Health Promotion and Disease Prevention: Educate on healthy lifestyles to reduce illness risk.
Detection and Treatment of Disease: Involves exams and tests to assess health, with possible interventions including medications and surgery.
Rehabilitation and Restorative Care: Aims to help individuals return to their highest functional ability and independence.
Types of Health Care Agencies
Acute Care Agencies: Provide urgent care and typically have a short patient stay (e.g., hospitals).
Rehabilitation/Sub-Acute Care Agencies: Offer care that is less intensive than hospital care for individuals who are transitioning.
Long-Term Care Centers: Accommodate individuals who require assistance but not hospitalization.
Outpatient Care: Medical care provided without overnight admission. Common for routine check-ups and minor treatments.
Home Care Agencies: Deliver comprehensive care directly to people in their homes. Services may range from daily assistance to end-of-life care.