A licensed practical/vocational nurse is preparing for an annual employee evaluation. Which example supports the hospital's pay for performance initiatives?

Question

A) The nurse makes a thorough assessment of the client's wounds before gathering supplies and the nurse makes sure that all supplies are properly charged to the client's account.
B) The nurse participates in her care team consisting of the registered nurse and nursing assistant and completes the care maps for her clients following hospital standards of care.
C) The nurse asked the client if he smokes and he sated he smoked 2 packs per day for 30 years but has decided to quit so the nurse charted the client is a nonsmoker.
D) The nurse provided care she was taught in nursing school 2 years ago, which does not always go along with the critical pathway.

Answer 1

Ans: B
Feedback:
Pay for performance involves reimbursement by Medicare and insurance for health care provided. A flat rate is provided for various diagnostic-related procedures and services, and if the health care facility can deliver the care for less than the provided fee, then the facility gains additional profit. The nurse during the performance review provides an example of being fiscally responsible for the pay for performance reimbursement by following the facility's standards of care and completing critical pathways and care maps to help manage client's care by providing quality, cost-effective evidence-based care that a critical pathway or care map outlines. Involving the entire team in the process is wise to ensure that the best care is provided and duplicate services that can be costly are not provided. Example A is conservation of materials and making sure that the client is properly billed, but it does not guarantee the best care was provided. Example C is incorrect because part of pay for performance is following standards set by accreditation and regulatory bodies, such as the Joint Commission, so the nurse is expected to chart for each client upon admission if he/she smokes, and if a smoker plans to quit, and if the client received educational materials about smoking cessation. In this case, the nurse did not accurately chart, which goes against the expectations for a nurse. Example D is incorrect because the nurse needs to follow the hospital's policies, procedures, and standards of care, which should be current and evidence based. The nurse needs to recognize that information learned in nursing school may become outdated, so it is important to stay up to date with practice.