ambulatory,acute,chronic care
TRANSCRIPT
-
7/31/2019 Ambulatory,Acute,Chronic Care
1/41
GUJARAT INSTITUTE OFNURSING EDUCATION AND RESEARCH
SUBJECT :- Medical Surgical Nursing
TOPIC :- Presentation On Ambulatory Care, Acute and
Chronic Care
SUBMITTED TO, SUBMITTED BY,
Mrs. Minaxi D Patel, Oza Ankita B,
Lecturer, sr.scale,cl-1, F.Y.Msc Nsg Student,
H.O.D.Of F.Y.MSc Nursing, Roll No-
GINERA
-
7/31/2019 Ambulatory,Acute,Chronic Care
2/41
Ambulatory Care
Whats it all about?
-
7/31/2019 Ambulatory,Acute,Chronic Care
3/41
Objectives
Describe ambulatory care
Identify major impacts on ambulatory care
practice
Identify and describe current ambulatorypractice settings
Compare practice in ambulatory andinpatient settings
-
7/31/2019 Ambulatory,Acute,Chronic Care
4/41
Definition
Ambulatory care is a personal health
care consultation, treatment or interventionusing advanced medical technology orprocedures delivered on an outpatient
basis .
http://en.wikipedia.org/wiki/Health_carehttp://en.wikipedia.org/wiki/Health_carehttp://en.wikipedia.org/wiki/Medical_technologyhttp://en.wikipedia.org/wiki/Medical_procedurehttp://en.wikipedia.org/wiki/Outpatienthttp://en.wikipedia.org/wiki/Outpatienthttp://en.wikipedia.org/wiki/Medical_procedurehttp://en.wikipedia.org/wiki/Medical_technologyhttp://en.wikipedia.org/wiki/Health_carehttp://en.wikipedia.org/wiki/Health_care -
7/31/2019 Ambulatory,Acute,Chronic Care
5/41
Ambulatory Care
A specialty practice area which is communitybased
May take place in different sites hospitals,schools, workplaces or homes
Encounter may be face-to-face orby phone
Requires rapid response to high
volumes of patients in a short spanof time while dealing with issues thatare not always predictable
-
7/31/2019 Ambulatory,Acute,Chronic Care
6/41
Ambulatory care nursing is a unique specialtywithin the profession of nursing. It involves
promoting health and prevention of disease,illness, and disability in the individual by rapid,focused assessments.
The emphasis of ambulatory care nursing is onaiding both the patient and family in maximizingwellness and minimizing the symptoms of thecondition, chronic or acute, in a cost-effective
way. Practice standards are provided by theAmerican Academy of Ambulatory Care Nursingas well as the American Nurses Association.
http://www.aaacn.org/http://www.nursingworld.org/http://www.nursingworld.org/http://www.nursingworld.org/http://www.nursingworld.org/http://www.nursingworld.org/http://www.nursingworld.org/http://www.aaacn.org/http://www.aaacn.org/http://www.aaacn.org/http://www.aaacn.org/http://www.aaacn.org/http://www.aaacn.org/http://www.aaacn.org/http://www.aaacn.org/http://www.aaacn.org/http://www.aaacn.org/http://www.aaacn.org/ -
7/31/2019 Ambulatory,Acute,Chronic Care
7/41
Ambulatory care nurses work in outpatientsettings, responding to high volumes of patients
in short term spans while dealing with issuesthat are not always predictable. The specialtyspans all populations of patients, and careranges from wellness/prevention to illness and
support of the dying. The American Academy of Ambulatory Care
Nursing (AAACN) is the specialty nursingassociation of professional nurses who identify
ambulatory care practice as an essential to thecontinuum of high-quality, cost-effective healthcare.
http://en.wikipedia.org/wiki/Outpatienthttp://en.wikipedia.org/w/index.php?title=American_Academy_of_Ambulatory_Care_Nursing&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=American_Academy_of_Ambulatory_Care_Nursing&action=edit&redlink=1http://en.wikipedia.org/wiki/Nursehttp://en.wikipedia.org/wiki/Nursehttp://en.wikipedia.org/w/index.php?title=American_Academy_of_Ambulatory_Care_Nursing&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=American_Academy_of_Ambulatory_Care_Nursing&action=edit&redlink=1http://en.wikipedia.org/wiki/Outpatient -
7/31/2019 Ambulatory,Acute,Chronic Care
8/41
Its mission is to advance the art and science of
ambulatory care nursing.
AAACN (formerly the American Academy of
Ambulatory Nursing Administration) wasfounded in 1978 as a non-profit education forum.In 1993, the organization's name was changedto the American Academy of Ambulatory Care
Nursing.
http://en.wikipedia.org/wiki/1978http://en.wikipedia.org/wiki/1993http://en.wikipedia.org/wiki/1993http://en.wikipedia.org/wiki/1978 -
7/31/2019 Ambulatory,Acute,Chronic Care
9/41
Background:-
Ambulatory care nursing, previously
defined by the setting and the length of thehealthcare encounter, has evolved into aspecialty whose practice settingemphasizes health promotion and disease
prevention and nursing care with extensivepatient and family involvement.
-
7/31/2019 Ambulatory,Acute,Chronic Care
10/41
Ambulatory care nurses are facing issuessuch as the use of the increasingly desirableand less invasive technologies; an agingpopulation; the need for education, clinicalexpertise and competence in disaster
preparedness; and such workplace issues asthe nursing shortage and the necessity ofadapting to doing more with fewer resources.
The healthcare delivery system will continueto change, and nurses will be challenged toprovide alternative care delivery methodssuch as telehealth and on-line clinics.
-
7/31/2019 Ambulatory,Acute,Chronic Care
11/41
The American Academy of AmbulatoryCare Nursing and the American NursesAssociation have defined professionalambulatory care nursing as those clinical,
management, educational, and researchactivities provided by registered nurses forand with individuals who seek care forhealth-related problems or concerns or
seek assistance with health maintenanceand/or health promotion.
-
7/31/2019 Ambulatory,Acute,Chronic Care
12/41
Ambulatory Care is Changing
As the costs of acute care services increase,as new technologies are adopted & as
reimbursement shrinks, patient care isbeing shifted to the outpatientsetting resulting in increased
patient volume and sickerpatients.
-
7/31/2019 Ambulatory,Acute,Chronic Care
13/41
Current Trends Impacting
Ambulatory Care Increasing life expectancy
Environmental threats
Increased legislation & regulation
Technological Advances (clinical & non-clinical)
Consumer awareness
-
7/31/2019 Ambulatory,Acute,Chronic Care
14/41
Conceptual Models That Influence
Ambulatory Care Nursing Practice:- The Clinical Model
Level of Prevention Model
1) Primary Prevention
2) Secondary Prevention
3) Tertiary Prevention Primary Health Care, Primary Care, and
Managed Care Models
-
7/31/2019 Ambulatory,Acute,Chronic Care
15/41
Conceptual framework ofAmbulatory Care Nursing
Conceptual framework shown three rolefor ambulatory care nurses:-
1) The Clinical Nursing Role
2) The Organizational/ Systems Role
3) The professional Role
-
7/31/2019 Ambulatory,Acute,Chronic Care
16/41
Characteristics Of Ambulatory
Care Visit Encounters are short.
Control of care and treatment modalitiesare in the hands of the client and his family.
Many members of health care worktogether.
Contact through communication Devices.
Constant Pressure to increase efficiency
and effectiveness of care.
-
7/31/2019 Ambulatory,Acute,Chronic Care
17/41
Ambulatory Patient Characteristics
Acutely ill requiring triage & possible emergency care Acutely ill requiring support, diagnosis & treatment Chronically ill requiring ongoing monitoring & assistance
with education/self-management Chronically ill with acute exacerbation In need of a defined treatment & procedure In need of education, reassurance & support In need of preventive services May not walk in &/or may not walk
out
-
7/31/2019 Ambulatory,Acute,Chronic Care
18/41
Continue
Ambulatory nursing care requires criticalreasoning and astute clinical judgment.
Ambulatory care registered nurses providecare across the life span to individuals,families, caregivers, groups, populations,and communities.
Ambulatory care nursing occurs across thecontinuum of care in a variety of settings.
-
7/31/2019 Ambulatory,Acute,Chronic Care
19/41
Continue
Ambulatory care registered nurses interactwith patients during face to faceencounters or through a variety of
telecommunication strategies. Nurse patient encounters can occur once
or as a series of occurrences.
Ambulatory care registered nurses, actingas partners and advisors, assist andsupport patients and families to optimallymanage their health care.
-
7/31/2019 Ambulatory,Acute,Chronic Care
20/41
Continue
Ambulatory care registered nursesfacilitate continuity of care using the
nursing process, multidisciplinarycollaboration
Ambulatory care registered nurses areknowledgeable about and provideleadership in the clinical and managerialoperations
-
7/31/2019 Ambulatory,Acute,Chronic Care
21/41
Where Ambulatory Care is
Practiced/Provide University hospital
outpatient
Community hospitaloutpatient
Solo & group medicalpractices
HMO Government health
systems
Occupational healthcenters
School health clinics Shelters for the
homeless
Community clinics
Surgical procedurecenters
Urgent care centers
-
7/31/2019 Ambulatory,Acute,Chronic Care
22/41
Inpatient Practice vs. Ambulatory Practice
Aspect of Role Inpatient Ambulatory
Treatment episode Inpatient Visit/phone/email
Observation mode Direct & continuous Episodic
Management of
treatment plan
Nurse - Input from
patient &/or family
Patient &/or family-
Input from nurse
PrimaryIntervention Mode
Direct Consultative
Organizationalpresence of nursing
Nurse managed dept. May or may not be
formal nursing
structure
Workloadvariability/intensity
Bed capacity, staffing
ratios
Scheduling system,
-
7/31/2019 Ambulatory,Acute,Chronic Care
23/41
Nursing Responsibilities:-
Provide Direct Patient Care
Conducting Patient intake Screening
Treating Patient With all conditions Refering Patient to other agencies for
additional services
Teaching patient self care activities Offering health education
-
7/31/2019 Ambulatory,Acute,Chronic Care
24/41
Extraordinary Nursing Care.
Every Patient. Every Time.
-
7/31/2019 Ambulatory,Acute,Chronic Care
25/41
Acute & Chronic Care
Whats it all about?
-
7/31/2019 Ambulatory,Acute,Chronic Care
26/41
Acute Care:-
Introduction:-
Pattern of health care in which a patient istreated for a brief but severe episode of illness,
for the sequelae of an accident or other trauma,or during recovery from surgery.
Acute care is usually given in a hospital byspecialized personnel using complex andsophisticated technical equipment and materials,and it may involve intensive or emergency care.This pattern of care is often necessary for only a
short time, unlike chronic care.
-
7/31/2019 Ambulatory,Acute,Chronic Care
27/41
Definition of Acute care
Acute care is a branch of secondary
health care where a patient receives activebut short-term treatment for a severe injury
or episode of illness, an urgent medical
condition, or during recovery from surgery.
http://en.wikipedia.org/wiki/Health_carehttp://en.wikipedia.org/wiki/Health_carehttp://en.wikipedia.org/wiki/Patienthttp://en.wikipedia.org/wiki/Patienthttp://en.wikipedia.org/wiki/Health_carehttp://en.wikipedia.org/wiki/Health_care -
7/31/2019 Ambulatory,Acute,Chronic Care
28/41
Types of Hospital Which Provide
Acute Care
Govt. Sponsored Hospital
Voluntary Health Agency
For Profit Hospital
Magnet Hospital
-
7/31/2019 Ambulatory,Acute,Chronic Care
29/41
Role of Nurses in Acute Care
Provide of direct care
Educator Researcher
Manager
-
7/31/2019 Ambulatory,Acute,Chronic Care
30/41
Delivering Acute Nursing Care
Total care nursing
Functional nursing Team nursing
Primary nursing
Case management
-
7/31/2019 Ambulatory,Acute,Chronic Care
31/41
Chronic Care
Introduction:- Chronic care encompasses the
oversights activities conducted by health
care professionals to help patients withchronic diseases and health conditionssuch as diabetes, high blood pressure,lupus, multiple sclerosis and sleep apnea
learn to understand their condition and livesuccessfully with it. This term isequivalent to disease management(health) for chronic conditions.
http://en.wikipedia.org/wiki/Health_care_providerhttp://en.wikipedia.org/wiki/Health_care_providerhttp://en.wikipedia.org/wiki/Chronic_diseaseshttp://en.wikipedia.org/wiki/Diabeteshttp://en.wikipedia.org/wiki/High_blood_pressurehttp://en.wikipedia.org/wiki/Lupus_erythematosushttp://en.wikipedia.org/wiki/Multiple_sclerosishttp://en.wikipedia.org/wiki/Sleep_apneahttp://en.wikipedia.org/wiki/Disease_management_(health)http://en.wikipedia.org/wiki/Disease_management_(health)http://en.wikipedia.org/wiki/Disease_management_(health)http://en.wikipedia.org/wiki/Disease_management_(health)http://en.wikipedia.org/wiki/Sleep_apneahttp://en.wikipedia.org/wiki/Multiple_sclerosishttp://en.wikipedia.org/wiki/Lupus_erythematosushttp://en.wikipedia.org/wiki/High_blood_pressurehttp://en.wikipedia.org/wiki/Diabeteshttp://en.wikipedia.org/wiki/Chronic_diseaseshttp://en.wikipedia.org/wiki/Health_care_providerhttp://en.wikipedia.org/wiki/Health_care_provider -
7/31/2019 Ambulatory,Acute,Chronic Care
32/41
Definition:-
Providing or concerned with long-term
medical care lasting usually more than 90days especially for individuals with chronicphysical or mental impairment.
-
7/31/2019 Ambulatory,Acute,Chronic Care
33/41
Important of chronic care
Chronic care needed for better lifeexpectancy.
They need to be motivated to complybecause treatment usually produces animproved state, rather than the results thatmost patients desirea cure.
Chronic care management helps patients
systematically monitor their progress andcoordinate with experts to identify andsolve any problems they encounter in theirtreatment.
-
7/31/2019 Ambulatory,Acute,Chronic Care
34/41
Practice systemsoriented to acutedisease that arent
working for patients orprofessionals
Inadequate use ofinformation technology
Poorly aligned paymentstructure
Whats responsible for the quality chasm
for the chronically ill?
34
-
7/31/2019 Ambulatory,Acute,Chronic Care
35/41
We have models to improve care;The Chronic Care Model
Medical Care Home The Chronic Care Model (CCM)
35
-
7/31/2019 Ambulatory,Acute,Chronic Care
36/41
Medical Home and Chronic Care Model
are complementary
Both emphasize and support patient role
in decision-making
MH redefines primary care
responsibility
CCM redesigns care delivery
for planned care
Elements of both are
integrated into the
Patient-Centered Medical
Home
36
-
7/31/2019 Ambulatory,Acute,Chronic Care
37/41
Is chronic care improvement possibleacross the entire population?
37
-
7/31/2019 Ambulatory,Acute,Chronic Care
38/41
FOR THE IMPROVEMENT OF THECHRONIC CARE NEED TO DO:-
Training and education
Employment areas Subspecialities
References
External links
-
7/31/2019 Ambulatory,Acute,Chronic Care
39/41
Differences Between Acute and
Chronic ConditionsACUTE CHRONIC
Beginning Rapid Gradual
Cause Usually one ManyDuration Short Indefinite
Diagnosis Commonly
accurate
Often uncertain
Diagnostictests
Often decisive Often limitedvalue
Treatment Cure common Cure rare
-
7/31/2019 Ambulatory,Acute,Chronic Care
40/41
Differences Between Acute and
Chronic CareACUTE CHRONIC
Role of
Professional
Select and
conduct therapy
Teacher/coach
and partner
Role of Patient
Lorig 2000
Follow orders Partner/ Dailymanager
-
7/31/2019 Ambulatory,Acute,Chronic Care
41/41