Coordinated Care 1.What are advanced directives and what information should be provided to clients regarding advanced directives?

Advance directives are written instructions that allow a client to convey his wishes regarding medical treatment for situations when those wishes can no longer be personally communicated 2.What does it mean to be a client advocate? Provide an example of how nurses can be advocates. Advocacy is one of the most important roles of the nurse, especially when clients are unable to speak or act for themselves. Nurses must be careful to assist clients with making health care decisions and not direct or control their decisions 3.What concepts should nurses consider when prioritizing care? durable power of attorney for health care (health proxy) is anindividual designated to make health care decisions for a client who is unable based upon the clients living will. 4.What is informed consent? Provide an example of when informed consent is required. Consent is required for all treatment that is given to the client in a healthcare facility. The nurse may serve as a language interpreter for the primary care provider,who is responsible for obtaining informed consent, only if allowed by facility policy and state law 5.Provide examples of how confidentiality can be breached in health care facilities? The Privacy Rule of the Health Insurance Portability and Accountability Act(HIPAA) requires that the nurse protect all written and verbal communicationabout clients. Only health care team members directly responsible for the clients care should be allowed access to the clients records. The client has the right to review his medical record and request information as necessary for understanding. 6.How would you respond to a colleague who is yelling and complaining that you always get to take your lunch break first?

Notify the appropriate supervisor if indicated. Clarify, with appropriate personnel, current legal scope of practice and area ofcompetence. 7.Provide examples of information technology in the health care setting. Name some advantages and disadvantages of the use of information technology in this setting

8.Differentiate between responsibility, accountability, and authority. The nurse may transfer the responsibility for the performance of a taskor activity but retains accountability for its outcome. 9.How can the nurse use case management as a resource in meeting the needs of the clients? 1. Coordination of the clients care to provide continuity of care. 2. Facilitating communication between the client and the primary care provider. 3. Clarifying information given by the primary care provider to the client. 4. Confusing and complex information combined with use of medical jargon may make it hard for the client to understand proposed therapeutic interventions. 5. Assisting the client to resolve any conflicts with the primary care provider 10.What are the 5 rights of delegation? List tasks that can be delegated to unlicensed assistive personnel. Assisting a client with toileting. Assisting a client with ambulation Turning a client every 2 hr. Providing oral and bathing hygiene to an immobilized client Calculating a clients intake and output Safety and Infection Control 12.Explain the following types of isolation precautions and give an example of when each would be used: .

contact Infection transmission in healthcare settings may occur via direct or indirect contact with contaminated animate and inanimate surfaces. Staff may acquire organisms on their hands during patient contact or contact with contaminated objects in the environment, and subsequently transfer the org colonisation or infection with multi-resistant organisms (MRO) of epidemiological significance (eg MRSA, ESBL, VRE, Acinetobacter spp.) enteric diseases (eg faecally incontinent patients and children) respiratory viruses (eg RSV, influenza) chickenpox, shingles anisms to a susceptible patient or client. droplet In the case of specific infectious diseases transmitted by this route, measures to prevent droplet transmission must be observed in addition to standard precautions. Examples of conditions that require droplet precautions include (refer to complete list in Appendix D): meningitis (Neisseria meningitidis and Haemophilus influenzae type b) pertussis viral infections including rubella, mumps, influenza, adenoviruses and Hendra virus airborne precautions Diseases transmitted via the airborne route involve small (5m or smaller) airborne droplets that can remain suspended in the air for long periods. They are easily dispersed in air currents and transmitted when susceptible people inhale contaminated air. varicella (chickenpox or disseminated varicella) measles (rubeola) pulmonary tuberculosis

13.Explain the procedure that should be followed for a fire in a clients room. RACE: Rescue, Alarm, Confine, and Extinguish Remove everyone from the area. Pull the fire alarm, which will activate the EMS response. Once the room or area has been cleared, the fire doors should be kept closed in order to confine the fire. An attempt to extinguish the fire using a single fire extinguisher can be made only when practical and only when an employee has been properly trained in the safe and proper use of a fire extinguisher

14.What is an incident report? Provide specific examples of when an incident report would be required. Incident reports are records made of unexpected or unusual incidents thatoccurred when a client was in a health care facility. Incident reports include: Medication errors. Client falls. Accidental omission of a therapy. Needlestick injury. Incident reports: Are considered confidential and are not shared with the client.Include a description of the incident and actions taken to safeguard theclient and/or assessment and treatment for injuries sustained.Are not placed in the clients chart but are usually handled by a riskmanagement department or officer (varies from facility to facility).