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Potter CH 2

QuestionAnswer
Professional Standards Review Organization PSROs review the quality, quantity and cost of hospital care provided through Medicare
Utilization Review UR - committees that review admissions, diagnostic testing and treatments provided by MD to clients
Prospective Payment System PPS eliminated cost based reimbursement. Hospitals are no longer paid for all treatments, but services are bundles into groups. Each group has a fixed reimbursement no matter how long the stay
Diagnosis Related Groups DRG - groups created by PPS. Each group has a fixed reimbursement amount
Resource Utilization Group RUGs are used in long term care in place of DRGs
Levels of Health care There are six: preventative, primary, secondary, tertiary, restorative, continuing care
Secondary and Tertiary Care Acute care, ER, ICU
Restorative Care Rehab or home health
Continuing Care Hospice, Chronic long term care
Respite Care Short term relief or time off for persons providing home care
Skilled NSG SNF Skilled care from licensed personnel can include IV care, vent management, wound care, and rehab
"Knowing Clients" Measure of nurses experience and maturity. The nurse gets a grasp of the client, understands the situation in context of the illness and allows her to anticipate the clients needs.
Levels of Prevention Focus on health activities. Primary: Health promotion and disease prevention. Secondary: Curing disease Tertiary: Diminishing complications.
Created by: nurse2be
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