Audrey's Test Flashcards
Terms
undefined, object
copy deck
- When was the first PA Class? And where?
- Started 1965 graduated in 1967 from Duke University.
- Why did the PA concept emerge?
-
* Strategy to cope with a shortage of physicians.
* Increased demand for health care services.
* Mal-distribution of providers - Who was included in the first PA class?
- 3 Navy Corpsmen
- What changes in the healthcare delivery added to success of the PA concept?
- Scientific breakthroughs, new medical specialities and subspecialities, overgrowth of hospitals and hospital services.
- What did President Johnson contribute?
- "Great Society Program" was the beginning of the "war on poverty" an attempt by the federal government to reach out to the underserved.
- What is the Health Manpower Act?
- Developed and funded new programs
- What was the original concept?
-
* Brief duration of generalist training
*Physician supervised
* Medical Model (basic sciences courses followed by clinical skill development) - What is AAPA?
- American Academy of Physician Assistants
- What is KAPA?
- Kansas Academy of Physicians Assistants
- What is the PA scope of practice?
- The physician delegates to the PA, only those acts which the physician believes can be competently performed by the PA based on the PA's background, education, skill, and experience.
- What is the PA credentialing process?
-
* Attend and graduate from an accredited PA program.
* Pass the NCCPA exam
* State Registration and Licensure
* 100 CME hours every 2 years, 50 from Cateogory 1 and 2
* Recertification exam every 6 years. - Define culture.
- The integrated pattern of human behavior that includes thoughts, communications, actions, customs, beliefs, values, and institutions of a racial, ethnic, religious, or social group.
- What is cultural competency?
- A set of academic and personal skills that allows us to increase our understanding and appreciation of cultural differences between groups
- What are some "other" healing beliefs held by cultures.
-
* "Hot/cold" beliefs - not related to temperature.
* Dermabrasive procedures: coining or spooning
* "Cupping" - forming ecchymosis - What are some western medical influences that other cultures may not accept?
-
* Venicpuncture
* Surgery
* Injections
* Western medicine - may be too potent and pt's may reduce amount - What are some different cultures? Subcultures?
-
* Hispanic, Asian, Middle Eastern, Native American, etc.
* Women, homo's, Teens, Gangs, Rural, Inner city, etc. - What are some global health care issues?
-
* HIV and AIDS
* TB
* SARS
* Biological terrorism
* Avian flu - What is COGME?
- Council on Graduate Medical Education
- What is HIPAA?
- Health Insurance Portability and Accountability Act of 1996
- What are the 3 areas of primary care?
-
* Family Medicine
* Pediatrics
* General Internal Medicine - What are 3 issues confronting the PA Profession?
-
* Medical Information - widely available on the internet. Which is accurate?
* Profit - Stockholders, companies, and highly paid practitioners are all stake holders. The patient's welfare comes first.
* Loss of Autonomy - managed care, malpractice suits...? - What is NCCPA?
- National Commission on Certification of Physician Assistants
- What is ARC-PA?
- Accreditation Review Commission on Education for the Physician Assistant - Accrediting body for PA Programs
- What is SAAPA?
- Student Academy of American Academy of Physician Assistant
- How much does medicare pay?
- Services provided by the PA's in all practice settings at the rate of 85% of the physician fee schedule.
- How much does medicaid pay?
- State determined. In Kansas 75% of the physician fee.
- What is "Incident To"?
- Reimbursement of 100% by medicare if: 1) seen in office, 2) physician sees patient on initial visit and establishes diagnosis.
- What is the surgery fee paid by medicaid?
- 85% of the first-assistant fee (.85 x 16 = 13.6%)
- What are the roles of PA's in primary care?
-
* Pt makes appointment with PA
* PA makes decisions for care
* PA develops ongoing relationships
* May care for entire family
* Earned income easily identified
* Broad knowledge - know a little about a lot - What are the roles of PA's in specialty practices?
-
* PA is more of an extension of the physician
* Usually do not have own patients
* Provide peripheral care or support services
* Harder to identify income to practice
* Can be challenging to develop ongoing relationships
* Focused knowledge - know a lot about a little - What are the 4 main bioethical principles?
-
* Autonomy
* Beneficence
* Nonmaleficence
* Justice - What kinds of PA degrees can you get?
-
* Master's
* Bachelor's
* Associates
* Cartificates
* Programs range from 12-57 months - What are the PA Education Models?
-
* Hospital based - all clinical training
* Full time, part time options
* Combined military programs
* Four year curriculum
* Medex model - 18 months community based
* ND - 12 months,one physician, only RN's admitted - Who funds PA institutions?
-
* State funded
* Private institutions
* Federal Training Grants
* Other - private foundations, industry - Describe PA faculty?
-
60% are PA's
40% are non-PA's - How many CME hours are required for PA's?
-
100 hours every 2 years
* 50 are cateogory 1 - preapproved
* 50 are cateogory 2 - self learning; on your honor - What are malpractice issues PA's get involved with?
-
* Lack of adequate supervision - documentation
* Untimely referral
* Not following protocol
Failure to diagnose
* Inadequate examination
* Parental Consent when treating minors
* Restraints and seclusion
* Negligence/abandonment - What is PHI?
- Protected Health Information
- What are patient rights regarding PHI?
-
Patient may have/request:
* Restrictions on use of PHI
* Alternative forms of communication
* Access to their own PHI
* Access to disclosure of PHI
* Amendments to their PHI - What are the fundamental principles of medical professionalism?
-
* Primacy of patient welfare
* Patient autonomy
* Social justice - Define professionalism.
- Conduct, aims, or qualities that characterize or mark a profession or a professional person.
- What is the ultimate goal of professionalism?
-
* Honor patients
* Earn their trust
* Provide the best and most appropriate care possible
* Understand and recognize that your personal values and beliefs can impact the care you provide. - What is altruism?
- patient interest comes first
- What is OSCE?
- Objective Structured Clinical Exam
- Physician assistants hold in their responsibility...
- the health, safety, welfare, and dignity of all human beings.
- Physician assistants uphold the tenets of ...
- patient autonomy, beneficence, nonmaleficience, and justice
- Physician assistants recognize and promote...
- the value of diversity.
- Physician assistants treat equally...
- all persons who seek their care.
- Physician assistants hold in confidence...
- the information shared in the course of practicing medicine.
- Physician assistants assess their personal capabilities and...
- limitations, striving always to improve their medical practice.
- Physician assistants actively seek to expand...
- their knowledge and skills, keeping abreast of advances in medicine.
- Physician assistants work with...to provide...
-
other members of the healthcare team
compassionate and effective care of patients - Physician assistants respect...
- their professional relationship with physicians.
- Physician assistants share and...
- expand knowledge within the profession.
- What are the differences between the living will and a durable power of attorney?
-
* The living will is a statement of personal values, and only applies when a person has been diagnosed as "terminal" by 2 physicians.
The durable power of attorney is useful in cases when one may not be terminal, but will never recover enough to live a life meaningful to them.
Neither takes effect until the person can no longer make, or communicate, decisions for themselves. - What are the 3 advance directives?
-
* Living will
* Durable power of attorney
* DNR - What is a DNR order, what is included?
-
* Limits emergency care
* No CPR
* Does NOT limit other medical care, such as antibiotics, pain medications, or comfort carfe
* Can be revoked at any time
* Must be assigned by the attending physician (the pt's PCP) - What is the Patient Determination Act of 1990?
- Requires the hospital to provide written information to adult patients re: rights to make decisions regarding their own healthcare
- When is a living will effective?
-
* 2 physicians must examine the patient and determine that the patient has a terminal illness
* They must agree that death will occur whether or not the medical intervention is done.
* The form is not effective if the pt is pregnant - Where should you put copies of the advance directives?
- Several places: family physician, hospital, attorney, and family members.
- What are patients rights concerning advance directives?
-
* Information about their medical condition, diagnosis, prognosis, and possible treatments.
* Refuse any treatment
* NOT make advance directives, it's their choice. - When can one change their mind about an advance directive?
- Any time
- What are rules for licensure in KS?
-
* Pass NCCPA
* Maintain CME's
* Renew license annually
* Have a supervising physician and a back-up
* Have protocol on record at KSBHA - What must you do concerning hospital credentials?
- - Apply to hospital credentials committee for staff priveleges
- What are PA's liberties/allwances in the state of KS?
-
* Two PA's per physician
* Short protocol
* Prescriptive privelege (may require a DEA #)
* Supervised (at least 30 min by phone)
* Physician actively practices medicine within state.
*DR annually reviews drug protocol
* Reports any disciplinary actions
* Signs all pt encounters (at least every 14 days)
* Reviews pt charts within 48 hours of emergent care by PA - What is APAP?
- Association of Physician Assistant Programs.
- What is the purpose of HIPAA?
-
* To allow people to keep their insurance when they change jobs
* Prevent health care fraud and abuse
* To promote electronic healthcare transactions and streamline claims processing
* PRIVACY - protect patient information - What did COGME commission?
- AGPAW - Advisory Group on Physician Assistants and the Workforce
- What are AGPAW's recommendations?
-
* Increase federal support for PA programs
* Funding should give priority to PA programs that succeed in placing PA's in primary care settings
* Policy initiatives should include removing legislative obstacles to PA clinical practice on federal and state levels - Who said, "Education is what survives when what has learned has been forgotten" ?
- BF Skinner
- When was the national certification exam first given?
- 1973
- Who is eligible to take the certification exam
- All graduates of an accredited PA program (This was placed into effect in 1986)
- When did the ARC-PA begin?
- 1971