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Bedside Case Management | |||||||
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To assess the effectiveness of the course material, we ask that you evaluate your achievement of each learning objective on a scale of A to D (A=excellent, B=good, C=fair, D=unsatisfactory). Please indicate your responses next to each learning objective and submit it as part of the course assignment.
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10. Explain what form of nursing case management emerged in the mid 1980s to deal with restraints imposed by DRGs and third party payer resource conservation requirements. |
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11. Discern whether managed care is a new concept. |
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12. Discuss what DRGs were designed to do. |
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Explain what the initial focus of the insurance industry was in the mid 1980s. |
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14. Define capitation. |
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15. Identify what the focus of health care is now. |
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16. Discuss how health care institutions survive. |
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17. Relate how the cost for technology is paid for. |
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18. Compare lengths of stay with patient acuities. |
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19. Determine how duplication and fragmentation of health care services are influenced by the changing health care delivery system of the 1990s. |
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20. Recognize what the viability of health care institutions relies on. |
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21. Report what health care administrators have to do with finite resources in a limited reimbursement climate. |
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22. Define the goal of third party payer managed care. |
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23. Discuss what a primary care physician in a Health Maintenance Organization (HMO) is frequently charged with. |
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24. List the five HMO models. |
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25. Summarize the Individual Practice Associations' (IPAs) policy on reimbursement for health care services performed by non-member providers. |
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26. Report why physicians and health care facilitators enter Preferred Provider Organization (PPO) health care contracts. |
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27. Validate why Point of Service (POS) plans use financial incentives. |
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28. Discuss one of the premises of unit based managed care. |
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29. Recognize what critical pathways are used for in unit based managed care. |
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30. Discuss utilization management with regard to to the quality of delivered health care services. |
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31. Recall why utilization management concepts were introduced. |
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32. Define severity of illness (SI). |
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33. List the tree components to the utilization review process. |
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34. Identify a good question to ask when doing a concurrent or continued stay review. |
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35. Relate how many health care disciplines incorporate some form of case management. |
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36. Recognize other terms for case management. |
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37. Identify how case management organizes patients. |
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38. Recall what advanced skills patient case managers possess. |
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39. Tell how many fundamental steps there are to the process of planning and establishing health care goals. |
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40. Discuss how patient involvement in care relates to the success of case management. |
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41. Differentiate between case management and bedside case management. |
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42. Indicate what the nursing process has fostered in the nurse and how this relates to the transition into case management. |
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43. Relate what the nurse case manager is held accountable for in bedside case management. |
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44. Describe the form of group practice that exists within bedside case management. |
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45. Discuss what the case management plan is used for in bedside case management. |
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46. Explain the importance of communication in the successful delivery of quality patient care. |
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47. Recognize the roles of the nurse case manager in a bedside case management approach to patient care. |
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48. Identify what approach is used to accomplish cost effective, outcome oni ented, quality patient care within the shared group practice framework of bedside case management. |
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49. Determine what the nurse case manager supervising a team must be aware of in order to Judiciously delegate patient care tasks. |
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50. Summarize points to cover in the change of shift report. |
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51. Discuss what happens during intra shift report. |
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52. Discuss the use of patient care protocols. |
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53. Relate how bedside case management affects cooperation between the hospitalbased patient care disciplines and the community health care agencies. |
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54. Describe the contents of the case management plan. |
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55. Summarize the affect of bedside case management on treatment, fragmentation of health care services, and health care service delays. |
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56. Report what the influence of bedside case management is on patient education. |
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57. Discuss what encouraging the patient's participation in care activities does for the patient. |
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58. Recognize what bedside case management does for the nurse case manager. |
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59. Indicate what bedside case management does for the skill level of the patient care team members. |
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60. Discuss how bedside case management elicits physician satisfaction. |
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61. Select the focus of practice for the bedside case manager. |
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62. Summarize the qualifications the bedside case manager must inherently possess in order to orchestrate quality patient care that meets managed care dictates and requirements. |
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63. Identify clinical responsibilities of the bedside case manager. |
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64. Determine reasons the bedside case manager acts as a patient advocate. |
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65. Discuss the financial responsibilities of the bedside case manager. |
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66. Specify the learning needs of the new bedside case manager. |
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67. Identify when the use of critical pathways was developed originally. |
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68. Recognize the overall goals of a critical pathway. |
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69. Report the categories for which the clinical pictures of patients for whom critical pathways are developed fall into. |
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70. Identify variables that must be considered when developing a critical pathway. |
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71. Choose the categories that the processes and interventions of a critical pathway can be grouped under. |
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72. Relate how critical pathways affect patient care practices. |
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73. Identify how soon after admission the critical pathway chosen for the patient has to be addressed with the patient's physician(s). |
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74. Indicate what type of data critical pathways allow for the use of when determining goal evaluation. |
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75. List the components that protocols contain. |
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76. Recall the events that variances show can influence patient outcomes. |
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77. Describe what bedside case management does to the focus of quality improvement. |
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78. Discuss ways bedside case management improves the quality of patient care and the delivery of health care services. |
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79. Recall the types of patient care systems bedside case management provides for. |
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80. Indicate how bedside case management is similar to continuous quality improvement (CQI). |
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81. Define patient care standard outcome indicators. |
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82. Report at least four reasons bedside case management is instituted in acute care facilities. |
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83. Recognize the first step in the planning process before bedside case management can actually be instituted. |
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84. Deternine the overall goal of the bedside case management institution task force. |
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85. Summarize ways to encourage physician participation in the institution of a bedside case management model of patient care delivery. |
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86. Recall responsibilities that the bedside case manager will be held accountable for. |
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87. Relate what must be assessed before instituting a bedside case management patient care delivery model. |
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88. Indicate what the nurses who take on the bedside case manager role will need to know how to do. |
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89. Identify during which phase the process for evaluating bedside case management must be developed. |
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90. Discuss what connection nursing case management will have the ability to promote. |
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91. Relate what case management practice will be molded by in the twenty first century. |
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92. Recognize what it will be necessary for case management programs to do as the population of the United States grows older. |
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93. Identify two relatively new case management programs that nurses will probably become even more involved with. |
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