Author Question: The nurse has taken a position in the utilization review (UR) department of a hospital. This nurse ... (Read 91 times)

bobypop

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The nurse has taken a position in the utilization review (UR) department of a hospital. This nurse can expect to be involved in evaluating which care components? Select all that apply.
 
  1. Was the care provided necessary?
  2. How much medication did the patient receive?
  3. How appropriate was the care provided?
  4. How much did each procedure cost to provide?
  5. How efficiently was care provided?

Question 2

What has not been considered a common reason for lack of preventive services?
 
  1. Presence of a fragmented healthcare system
  2. Lack of provider time with patients to explain preventive interventions
  3. Limited types of preventive interventions
  4. Lack of reimbursement for preventive services



joshbk44

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Answer to Question 1

1, 3, 5
Explanation: 1. Utilization review and management is the process that evaluates the necessity of the healthcare services provided for specific patients or patient populations.
2. Medication reconciliation is done jointly by nursing and the pharmacy and is not a UR focus.
3. UR evaluates the appropriateness of care provided.
4. Cost should be a secondary factor in UR. The focus is quality of care.
5. Efficiency of provision of care is evaluated by UR.

Answer to Question 2

3
Explanation: 1. The fragmented system lacks coordination.
2. Providers do not have enough time with patients.
3. This is not a common reason. We have many prevention interventions.
4. Reimbursement for these interventions has been a problemthough ACA is offering more reimbursement for the interventions, and this is still new.



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