Discharge planning, case management roles, and interdisciplinary care coordination concepts tested on NCLEX-RN.
29 cards · basic cards · AI-written, checked twice. Edit anything.
- When should discharge planning ideally begin during a hospital stay?
- At the time of admission
- What is the primary goal of nursing case management?
- To coordinate care and resources so the patient achieves optimal, cost-effective outcomes
- Who typically coordinates the interdisciplinary team and resources across a patient's care continuum?
- The case manager
- In discharge planning, what does the social worker primarily address?
- Psychosocial needs, financial resources, and placement options
- What does utilization review evaluate?
- The necessity and appropriateness of admission, treatment, and length of stay
- What federal requirement obligates hospitals to have a discharge planning process?
- Medicare Conditions of Participation
- What is the teach-back method?
- Having the patient repeat instructions in their own words to confirm understanding
- What is health literacy?
- A patient's ability to understand and use health information to make decisions
- Under traditional Medicare rules, what inpatient hospital stay is required to qualify for skilled nursing facility coverage?
- A 3-day qualifying inpatient stay
- What two criteria must be met for a patient to qualify for home health services?
- The patient must be homebound and require skilled care
- What is durable medical equipment (DME)?
- Reusable medical equipment ordered for home use, such as a wheelchair or walker
- What must a patient be informed of before leaving against medical advice (AMA)?
- The risks of leaving before treatment is complete
- Name three common risk factors for hospital readmission.
- Multiple comorbidities, poor health literacy, and lack of social support
- What is continuity of care?
- A seamless transition of patient care across settings and providers
- What is the first step of the case management process?
- Assessment of patient needs