Professional Organizations and Health Care Politics Flashcards Preview

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Flashcards in Professional Organizations and Health Care Politics Deck (24)
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Health care domain

-those interrrelated and dynamic systems that influence quality of life and health related services


Health care Delivery

providing collaborative nursing care using multiple resources from inter-related and dynamic systems that influence quality of life and health


Health care policy

-set course of action taken by governments or health care organizations to obtain desired health outcome

-private health policy is made by health care organizations such as hospitals and managed care organizations

-public health policy refers to local, state and federal legislation; regulation and court rulings that govern the behavior of individuals and organizations in the provision of health care services


Health policy

enactment of legislation taken for heath outcome for the public's interest



written set of rules issued by the government agency that has responsibility for administering the new law


local health policy

-cities or counties offer a variety of health care services to meet the needs of their residents

-local laws, public health department

-examples include free or reduced-rate immunizations tobacco free public buildings, safe drinking water, enforcemnt of seat belt and child restraint laws and provision of an emergency medical system


state health policy

-ACHA, State Medicaid regulations, FBON

-governs nursing through NPA

-provides "invisible services" through regulatory activities

-pays for health care services through various programs

-medicaid and state children's health insurance program which are partly funded by federal funds


federal health policy

-CMS, Patient Bill of Rights, HIPPA, ACA, DHHS, and the CDC

-funds health related research

-funds education for health professionals, including nurses and physicians

-pays for health care through medicare, medicaid, SCHIP, and the VA heath care system

-plays a monumental role in shaping nursing practice


Health care influences

-florida agency for health care admin (AHCA, FL)

-primarily responsible for the state's medicaid program

-licensure of the states 45k health care facilities and the sharing of health care data through the Florida Center for Health Information and Policy ANalysis


National regulatory bodies

-Nursing education accreditation bodies: ACEN and CNE
-Magnet recognition and others



-formerly JCAHO
-US-based organization that accredits more than 20k health care org

-focuses on patient safety and quality of care

-surveys typically follow triennial cycle

-developed the national patient safety goals

-results available to public in an accreditation quality report on the Quality Check Website



-Crossing the Quality Chasm: A new health system for the 21st century

-To Err is human: building a safer health system

-Future of Nursing: Leading the change, advancing health


Be Knowledgeable and Involved

--registering to vote and voting in all elections

-joining a professional nursing organization

-attending a "meet the candidates" town hall meeting

-visiting with policymakers or their staff

-communicating with policymakers by email, fax, and phone



-major national nursing organization concerned with broad scope of practice issues, standards of practice, scope of practice ethics, legal, employment, a federation of state nurses associations

-currently focusing on such issues

-keeping abreast of issues related to healthcare access

-addressing nursing shortage and issues such as mandatory overtime, control over work environment

-nursing shortage



-voice for change

-over a century of history representing nurses regardless of specialty or area of practice

-believe in working together to create one strong voice for the protection of nurses and the communities we serve

-serve and support all RNs through professional development, advocacy and the promotion of excellence at every level of professional nursing practice


Workforce Issues

-nursing shortage
-faculty shortage
-aging workforce
-safe work environment
-mandatory overtime
-safe staffing


Florida: Regulated OT rules/regulated nurse-patient ratios??



Whistle Blowing

-prohibits employers from taking retaliatory action against an employee because the employee has disclosed or threatened to disclose to a government agency an activity or practice of the employer that is in violation of a law, rule, or regulation

-employer must first have brought the unlawful practice or activity to the attention of a supervisor and give the employer a reasonable opportunity to correct the practice

-florida workers are also covered by OSHA, the federal law that prohibits retaliation against employees for reporting workplace health and safety concerns


Collective Bargaining

-usually only occurs when nurses feels they need to organize and take action

-do not need to have an union present already

-state nurse's associations usually have a bargaining division that can assist any group of nurses in need

-problems with wages, working conditions, benefits, work place taffeta, and quality of care all issues that can benefit from collective bargaining


What type of method is collective bargaining?

-equalizing power between the employer and employee

-involves power sharing and negotiation

-certain rules and negotiation must be followed

-can be ineffective if there is low membership

-have many different forms of negotiation


Process/Phases of CB

1. prep phase
2. discussion phase
3. proposal phase
4. bargaining phase
5. settlement phase
6. formalization phase
7. enforcement phase


Social and economic issues that impact environment of care

-cost of healthcare (ACA)
-funding of medicaid, medicare
-limits to reimbursement from insurance companies
-DRGs and HMOs
-Consumer action groups
-magnet recognition program


Health care reform

-general term used to refer to policy initiates to effect significant changes in how health care is delivered and paid for

-historic health care reform legislation has become a reality with passage of The Health Care and Education Affordability Reconcilation Act of 2010


Most significant problem to address through health care reform

access to care

-lack of insurance, greatest barrier to access to health care

-50 percent of the uninsured have no regular source of health care

-uninsured more likely to delay or ignore needed tx

-uninsured more likely to be hospitalized for avoidable conditions