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Routine admissions are
those that are scheduled in advance.
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Emergency admission is
one for which there was no prior planning.
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These occur when
sudden illness, injury, or abrupt worsening of an existing condition requires emmediate admission for treatment.
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Routine admissions normally take place
the day of the scheduled procedure. Come in a day or two before admin to complete administrative paperwork and have any labs or studies completed.
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Mangaged care plans are
health care plans in which all medical care except emergency care is managed and must be preauthorized by the insuring group
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Health Maintenance Organizations HMO's
organizations that provide most outpatient care at organization clinics, may provide inpatient care at organization hospitals and must authorize usage of outside services.
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Medicaid is
state medical care coverage for low-income individuals and families
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Medicare is
medical care coverage provided through social security administration primarily for people age 65 and over.
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Tricare previously called CHAMPUS
coverage in civilian facilities for military staff, family, and retirees.
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Deductibles and copays are
the amounts the insurance carrier may require the patient to pay for care.
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Lab work and examinations are
done before routine admissions.
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Never assume that
a patient wishes to be called by his or her first name. They are entitled to addressed in the manner that is most comfortable for them.
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THe patient must also be
given ample opportunity to have questions answered and procedures explained.
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It is important to
notify the physician of any medications the patient has been taking at home that are not included in the present orders.
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The nursing assessment in an acute care facility is
written by the RN, but the LPN,LVN can greatly assist in this process by data gathering during the initial contact.
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LPN/LVN are
frequently charge nurses in skilled facilities and are responsible for completing the written assessment and care plan.
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The nurse who reviews the orders must
verify that each order has been processed and that the transcription is accurate.
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This means the nurse
must read every lab slip, procedure request, and consent form, correcting as necessary.
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When the patient is to be transferred,
the patient's physician must be notified and approve the transfer.
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it is also important that
the family or signifcant other be notified, preferable prior to the actual transfer. In emergency situations, notification should be made ASAP.
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All equipment brought to the hospital by the patient,
should be clearly labeled, usually with a wide piece of tape on which the patients name is written in large letters.
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Discharge planning begins at admission
particularly when the diagnosis indicates the patient will need rehab or long term assitance.
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Discharge planner is
an RN who implements and organizes the plan for patient discharge.
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Actual discharge orders are
written by the physician.
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The discharge planner will use this information,
as well as information gathered from the patient, the family, and the physician, to make appropriate discharge arrangements for the patient.
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Written discharge instructions are
prepared by the RN and reviewed with the patient and often with family members as well.
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The discharge form lists
medications, activity restrictions, special diet instructions, and ordered follow-up appointments.
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Home health services include
skilled nursing, such as wound care, diabetic care and teaching, and intravenous medication administration.
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Medical Social Worker (MSW) helps with
counseling and information regarding long-term planning, financial assistance, or community services available.
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Medicare, Medicaid, and some insurance and managed care plans
provide for payment of portions or all of these services when ordered by a physician.
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Against Medical Advice
the patient has the right to leave and must sign a form.
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If patient refuses to sign,
document, date and sign that patient refused and patient's stated reasons for leaving are written in the nursing notes.
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Important gift we can give the bereaved is
just being there, simply sit and listen while they talk of their loss and the fears about the changes it will bring.
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Physician
is required to pronounce death in most states.
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Nursing notes must have
the time life signs ceased, the time death was pronounced, and the name of the person making the official pronouncement.
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Autopsy is
an examination of the remains by a pathologist to determine cause of death.
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Usually performed when a patient has died of
unknown causes, has died at the hands of another, or has not been seen within a specific period of time by a physician.
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Coroner
city/county medical officer responsible for investigating unexplained death.
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Autopsy on performed
for specific reasons and must be ordered by the coroner or authorized by next of kin.
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