Ambulatory,Acute,Chronic Care

7/31/2019 Ambulatory,Acute,Chronic Care

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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


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Ambulatory Care

Whats it all about?


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Objectives

Describe ambulatory care

Identify major impacts on ambulatory care

practice

Identify and describe current ambulatorypractice settings

Compare practice in ambulatory andinpatient settings


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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


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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


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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/


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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


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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


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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.


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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.


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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.


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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.


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Current Trends Impacting

Ambulatory Care Increasing life expectancy

Environmental threats

Increased legislation & regulation

Technological Advances (clinical & non-clinical)

Consumer awareness


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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


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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


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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.


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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


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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.


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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.


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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


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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


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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,


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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


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Extraordinary Nursing Care.

Every Patient. Every Time.


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Acute & Chronic Care

Whats it all about?


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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.


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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


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Types of Hospital Which Provide

Acute Care

Govt. Sponsored Hospital

Voluntary Health Agency

For Profit Hospital

Magnet Hospital


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Role of Nurses in Acute Care

Provide of direct care

Educator Researcher

Manager


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Delivering Acute Nursing Care

Total care nursing

Functional nursing Team nursing

Primary nursing

Case management


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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


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Definition:-

Providing or concerned with long-term

medical care lasting usually more than 90days especially for individuals with chronicphysical or mental impairment.


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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.


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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?

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We have models to improve care;The Chronic Care Model

Medical Care Home The Chronic Care Model (CCM)

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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

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Is chronic care improvement possibleacross the entire population?

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FOR THE IMPROVEMENT OF THECHRONIC CARE NEED TO DO:-

Training and education

Employment areas Subspecialities

References

External links


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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


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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


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Documents

Ambulatory,Acute,Chronic Care