Work Environment

For the NA

HEALTHCARE IS OFFERED IN A VARIETY OF SETTINGS. WHAT ARE SOME SETTINGS?

Activity

• Divide into 4 groups:– Discuss and describe what the purpose of your

assigned topic:• Health promotion• Disease prevention• Detection and treatment of disease• Rehabilitation and restorative care

• Report to class in 5 minutes

Agency Purposes

• Health Promotion: healthy living • Disease Prevention: prevent disease • Detection and treatment: treat illnesses • Rehab and restoration: get back to normal

activity

• Discuss any personal experience with healthcare agencies– Positive and negative experiences– What services were required and which health

team members provided services?– How were services paid for?

• What is:– Acute illness

– Chronic illness

– Terminal illness

Types of Illnesses

• Acute• Chronic• Terminal

Activity: what is the purpose and services provided by the following?

– Hospitals– Rehabilitation & sub acute care agencies– Long-term care centers (nursing homes, nursing

facilities, nursing centers)• Skilled nursing facilities (SNFs)

– Assisted living residences– Mental health centers– Home care agencies– Hospices– Health care systems

Assignment

Divide your paper into 8 sections

Draw a picture to represent each of the types of agencies

Hospital

Rehabilitation

• Cardiac • Brain Injury • Spinal Cord • Stroke • Respiratory • Musculoskeletal • Complex medical and surgical conditions

Long term care facility (LTCF)

Skilled Nursing Facility (SNF)

Assisted Living

Mental Health Center

Home Health Agencies

Hospice

Health Care System

Nursing Team

• RN– Nurse practitioner

• LPN • PCT-patient care technician • NA-nurse aid

The Nursing Team Activity

• Describe the role and responsibilities of these members: RN, Nurse Practitioners, LPN / LVN, NA– What is the difference in education?– What are the licensure requirements?– Who can they delegate to?

Nursing care patterns

• Functional Nsg.- jobs by task- pass meds • Team Nsg.- RN oversees LPN, nurse aids • Primary Nsg- RN does all care for pt. • Case management: RN manages care from

admit-discharge • Pt focused care: services are done at bedside.

Ex: draw blood, do EKG

Draw pictures to represent the nsg. care patterns

Paying for health care

• Private insurance:– individual pays for

• Group Insurance: – paid for by employers

• Medicare– federal health insurance for elderly – Part A- pays hospital – Part B- dr. offices, meds- person pays for or is

retirement benefit

Medicare

• Insurance for those over 65 years old• Pay into throughout life• Part A• Part B

Medicaid

• Federal insurance program • For disabled • For low income

Prospective Payment Systems

• Limit amount paid for by insurance– DRG's- diagnostic related groups– RUG's- nursing homes– CMG's- rehabilitation centers– HHRG's- home health care

Managed care

• Have contract with dr. and facilities • May need pre approval • HMO- Health Maintenance Organization– Pay a prepaid fee for services (copay)

• PPO- Preferred provider Organization – Contract with group of dr./facilities to provide

care. – Reduced rate for going to them

Assignment

• Complete chart indicating each type of insurance

Standards set by government/accrediting agencies

• Must meet for:– Licensure-to provide care– Certification-to get paid by Medicare/Medicaid– Accreditation- voluntary "excellence"

• Survey process• Deficiency

Assignment

• Using the organizational chart, decide who you would report problems to

Case Study

Mr. Jansen a 70 yr. old had surgery to repair a fractured hip. His wife died 2 years ago & his son lives in the same town. The son is married & has a 16 year old daughter. The son & daughter-in-law both work full time. Mr. Jansen lives alone & works part time as a janitor. Today is his 3rd day in the hospital & his 2nd day after surgery. He has Medicare part A & B. The hospital discharge planner told him he is ready to be discharged from the hospital.

Questions?

1. Is Mr. Jansen condition- acute, chronic or terminal?2. Can Mr. Jansen go directly home from hospital?

Explain3. What care & services does he need?4. Where can he receive the care & services he needs?5. What healthcare providers will be involved in his care?6. What healthcare agencies will be involved in his care?7. How will he pay for his care?