Study Guide for Fundamentals of Nursing The Art and Science of Nursing Care

CHAPTER 8 HEALTHCARE DELIVERY SYSTEMS 43

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins. Study Guide for Fundamentals of Nursing:

c.

d.

e.

f.

5.Explain the term DRGand how it is

implemented in hospitals:

6.Define the term fragmentation of careand its

effect on the healthcare system:

APPLYING YOUR KNOWLEDGE

CRITICAL THINKING QUESTIONS

1.Think about a group of individuals in your

community that is underserved and lacks

access to nursing resources. How might the

needs of this group be addressed?

2.Visit a healthcare clinic in your community.

Find out what types of services are performed

and the backgrounds of the patients seeking

these services. Research how the clinic is

funded and how the staff is reimbursed for its

services. Would you feel comfortable being

cared for in this clinic? Explain why or why

not.

3.Look at the promotional materials for a local

healthcare plan and interview people on the

plan. Which features of the plan are most

important for the insured? What does the

plan lack? Is the insured party free to choose

his/her own doctors or treatment plans?

4.Compare the roles and responsibilities of a

physical therapist versus an occupational ther-

apist, a physician versus a physician assistant,

and a social worker versus a chaplain. Write

down the responsibilities of each professional,

where they overlap to provide continuity of

care for the patient, and where they diverge to

meet the specific needs of each patient. How

will this information help you as a nurse to

coordinate the efforts of the interdisciplinary

team?

REFLECTIVE PRACTICE USING CRITICAL

THINKING SKILLS

Use the following expanded scenario from

Chapter 8 in your textbook to answer the

questions below.

Scenario:Margaret Ritchie, age 63, is caring

at home for her 67-year-old husband, who is

diagnosed with amyotrophic lateral sclerosis

(ALS, or Lou Gehrig’s disease). She says, “All

the help from the home care agency has been

a blessing, but I need more help and some

other equipment now, and our insurance com-

pany doesn’t cover these things. Plus, now the

doctor says that his condition has really wors-

ened and he probably has 6 months or less to

live.” On further assessment, the nurse notes

that Mrs. Ritchie appears overwhelmed with

her home situation and may be suffering from

“caregiver burnout.”

1.What nursing interventions might the nurse

employ to assist Mrs. Ritchie with her caregiver

duties?

2.What would be a successful outcome for this

patient?

3.What intellectual, technical, interpersonal,

and/or ethical/legal competencies are most

likely to bring about the desired outcome?

4.What resources might be helpful for

Mrs. Ritchie?

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