N108: Transition to the Registered Professional Nurse

N108: Transition to the Registered Professional Nurse Role Study Guide • Ambulatory care: This is care for the person who can come to the healthcare agency, receive needed healthcare, and then be discharged to home. It may be a clinic or office. It may also be in hospital departments that provide skilled care for 24 hours or less. Goals are focused on treating a health problem and returning the person to an independent living situation. • Home care: Care providers visit the home to provide some types of care, teach the patient and family how to manage care in the home, and evaluate response to treatment. The goal is effective patient and family self-care. Hospitals Classified by Mix of Services The two terms used frequently to describe today’s modern hospital services are inpatient care and outpatient care. Individuals are termed inpatients when they have been admitted for the purpose of staying 24 hours or longer. The outpatient comes to the hospital for services but is expected to stay less than 24 hours. Inpatient units comprise what most people think of when they use the designation “acute care hospital.” Nurses work in all of these service departments and coordinate the nursing care for individual clients, manage the care environment, delegate and supervise the care provided by others, and provide direct skilled care. In addition to these usual acute care units, hospitals have developed transitional care and rehabilitation units that provide long-term care services. A transitional care or rehabilitation unit allows a hospital to discharge an individual from acute, inpatient care in a timely fashion because the next level is guaranteed to be available. Reimbursement for the transitional or rehabilitation care is based on long-term care guidelines, and the care must meet long-term care standards for skilled nursing care. Outpatient care , also termed “ambulatory care,” is care that is provided for a period of time expected to be less than 24 hours. The outpatient goes through the admission process, has a procedure performed or care is delivered, is determined to be ready for home care, and is discharged. Many diagnostic and treatment procedures, surgeries, and emergency health needs are treated as outpatient care. Sometimes patients remain longer than 24 hours for observation and management; their status may remain as outpatient, and not be converted to inpatient, unless a continued stay is expected. Types of hospitals: • General or community hospital: Medical, surgical, emergency, and diagnostic, plus laboratory services • Tertiary care hospital: Referral centers for clients with complex or unusual health problems such as level 1 trauma, major burns, bone marrow transplant, and research based oncology, in addition to standard care; part of a large medical center associated with a university and serves a wide geographic area • Specialty hospital: Offers only a particular type of care (i.e. psychiatric, pediatric)

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