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A comprehensive set of study questions and verified answers for the cchp exam, covering essential topics in correctional health care. It delves into various aspects of patient care, including access to care, chronic disease management, emergency response, and ethical considerations. Designed to help individuals preparing for the cchp exam by providing a structured framework for understanding key concepts and principles.
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Access to Care - ANS In a timely manner, a patient can be seen by a clinician, be given a professional clinical judgment,and receive care that is ordered Acutely suicidal inmates - ANS Constant observation Administrative Meetings - ANS Quarterly, facilitate health care delivery through joint monitoring, planning, and problem resolution by health and correctional administrators Administrative review (death procedure) - ANSAssessment of correctional and emergency response actions surrounding a death Advance Directives - ANSWritten protocols that specify end of life decisions Adverse Clinical Event - ANSInjury or death caused by medical management rather than by the patient's disease or condition; Example is giving the wrong medication to a patient during med pass Aids to impairment, such as prostheses and hearing aids for elderly inmates - ANSNot a requirement, but must be supplied when health would be adversely affected
Amount of required continuing education for NCCHC re-certification for an indvidual - ANS18 hours per year, 6 related to correctional health care Basic orientation on first day of on-site service - ANSAddresses relevant security and health services policies and procedures, response to facility emergency situations, functional position description, and inmate-staff relationships Changes to individual health service policies--documentation needs - ANSDated and signed individually by the RHA and responsible physician Chronic disease - ANSAn illness or condition that affects an individual's wellbeing for an extended interval, usually at least 6 months Chronic disease program - ANSIncorporates a treatment plan and regular clinic visits. Progress monitored by clinician, includes patient education Chronic Disease Program - ANSTreatment plan, regular clinic visits, patient education Chronic diseases - ANSAsthma, diabetes, high blood cholesterol, HIV, HTN, Seizure disorder, TB, Sickle cell, major mental illness Clinical encounters - ANSInteractions between patients and health care professionals that involve a treatment and/or exchange of confidential information
Comprehensive health summaries - ANSDocuments containing relevant health information, regarding medical, dental, MH diagnosis, medications, significant chronic conditions, and pending health referrals CQI committee meets how often to review the effectiveness of the CQI program? - ANSAnnually CQI Program - ANSIdentifies health care aspects to be monitored, implemented, monitor corrective action, and studies effectiveness of CAP CQI Thresholds - ANSExpected level of performance stabled by the quality improvement committee Deadline for an initial mental health screening for a new admission? - ANS14 days Deadline for oral screening by the dentist or quality health care professionals trained by the dentist? - ANSWithin 7 days of admission Death procedures - ANSAll deaths are reviewed within 30 days, consists of administrative review, clinical mortality review, and psychological autopsy if suicide, treating staff are informed of review and findings, all aspects of the standard are addressed by written policy and defined procedures Decision to stop medical diets - ANSCounseled, not disciplined. Decision is therapeutic.
Discharge planning - ANSLinkages between facility and community based organizations, discussions with the inmate regarding the importance of aftercare, appointments and discharge medications, timely exchange of information and medication Dispensing - ANSPlacing of one or more doses of a prescribed medication into containers that are correctly labeled to indicate the name of the patient, the contents, and all other vital information Documentation of segregation rounds - ANSIndividual logs, cell cards, or in an inmate's health record; Date/time, signature/initials of staff member Documentation of special needs patients - ANSDocumented on problem list Facility maintains a list of these patients Early release - ANSRelease before the end of his or her sentence because of the inmate's terminal condition Ectoparasite control - ANSProcedures to treat infected inmates and to disinfect bedding and clothing; Screening generally occurs at admission Emergency contraception - ANSWill be made available, as well as continued contraception Emergency Response Plan - ANSIncludes responsibilities of health staff, procedures for triage, predetermination of site for care, phone numbers and procedures for calling staff and community responders, procedures for
Exposure Control Plan - ANSApproved by responsible physician, reviewed and updated annually. Medical equipment is decontaminated, sharps and biohazard waste is disposed of property, surveillance to detect serious infection and communicable disease, immunizations, affected patients receive indicated care, medical isolation if necessary Factors for the amount and type of qualified health care professionals in a facility - ANSSize of facility, types and scope of health services delivered, needs of the inmate population, organizational structure Female admissions reporting opiate use - ANSImmediately offered a pregnancy test to avoid opiate withdrawal risks to the fetus Final clinical judgment - ANSSingle, designated licensed responsible physician Frequency of pharmacy inspections - ANSAt least quarterly if there is no onsite staff pharmacist Frequency of pick up for oral or written requests for health care? - ANSDaily by qualified health care professionals and triaged within 24 hours Frequency of supervising nurse onsite for infirmary - ANSOnce every 24 hours Full population assessment - ANSAssessment on 100% of population
Grievance - ANSAddress inmate complaints about health services Health Administrator - ANSA person by virtue of education, experience, or certification is capable of assuming responsibility for arranging all levels of health care and ensuring quality and accessible health services for inmates Health care - ANSSum of all actions, preventive and therapeutic, taken for the physical and mental wellbeing of a population. Includes dental, medical, mental health, nutrition, and other ancillary services, as well as maintaining a clean and safe environment Health care liaison - ANSCorrection officer or other person without a health care license who is trained/instructed by the responsible physician in limited aspects of health care coordination and coordinates services on days when no qualified health care professionals are available for 24 hours Health education - ANSInformation on preventing disease and maintaining a healthy lifestyle Health hazards of tobacco - ANSInformation should be available to inmates How do personnel working in radiology monitor levels of exposure? - ANSDosimeters How long should health records be retained? - ANSAccording to the legal requirement of the jurisdiction the facility is in
How often does CQI meet? - ANSQuarterly How often is RHA onsite? - ANSWeekly How often should man down drills occur? - ANSOnce a year on each shift How often should segregated inmates be monitored by medical staff? By MH staff? - ANSDaily by medical, once a week by mental health (extreme); 3 days a week (limited); Once a week (seg inmates with access to rec/other routine social contact) How to address specific problems that arise with medical autonomy? - ANSRevised policies and/or reviewed as part of the CQI program Infirmary Care - ANSPatients are always within sight or hearing of a QHCP; Illness or 0 Information about availability of and access to health care services communicated orally and in writing - ANSTo inmates on their arrival at the facility, within 24 hours regarding access of emergency and routine medical, dental, MH, fees, and grievance process Inmate workers - ANSDo not make treatment decisions or provide patient care, do not distribute or collect sick slips, schedule appointments, or handle medical records, medications, or surgical instruments and sharps.
Is Hepatitis C a special need? - ANSNo Juveniles - ANSNeed greater opportunity to work large muscles, more food, more rec Licensing requirements for staff if an institution wishes to be accredited by NCCHC - ANS12 hours per year of continuing ed, or a current license that meets basic requirements for that state Measuring appropriateness of care - ANSRecord license status, credentials, CME/CEUs, required certification Measuring continuity of care - ANSThe extent to which pre-existing conditions are identified and addressed during intake, follow up services, and timeliness of follow up Measuring effectiveness of care - ANSMonitor clinical outcomes Measuring efficiency - ANSCost efficiency Measuring quality of clinician-patient satisfaction - ANSSurveys, number/type of of grievances, questions about knowledge of their diseases for patients with chronic disease Measuring safety - ANSInspections to identify safety concerns related to sanitation, trip hazards, and other potential problems. Root Case Analysis for all deaths and adverse events.
NCCHC Performance Measures for evaluating health care programs - ANSAccessibility, Appropriateness of clinical decision making, continuity, timeliness, effectiveness (outcomes), efficiency, quality of clinician-patient satisfaction, and safety Near Miss Clinical Event - ANSError in clinical activity without a consequential adverse patient outcome; Example, a wrong drug is dispensed but not administered to a patient Nonacutely suicidal inmates - ANSUnpredictable schedule for monitoring, no more than 15 minutes between checks Nursing assessment protocols - ANSWritten instructions that specify the steps to be taken in evaluating a health status and providing intervention. Provide a sequence of steps to be taken to evaluate and stabilize the patient until a clinician is contacted and orders are received for further care Oral care - ANSInstruction on oral hygiene, examination, and treatment of dental problems, to include information on plaque control and proper brushing of teeth Oral examination - ANSTaking or reviewing oral history, extraoral head and neck examination, charting of teeth, examination of hard and soft tissue of the oral cavity with a mouth mirror, explorer, and adequate illumination Oral screening - ANSVisual observation of teeth and gums, and notation of any obvious or gross abnormalities requiring immediate referral to a dentist
Outcome CQI - ANSExamines whether expected outcomes of patient care were achieved by identifying a clinical care problem, conducting a baseline study, developing and implementing a CAP, and restudying the problem Patient Safety Systems - ANSPractice interventions designed to prevent adverse or near miss clinical events. Example: photo ID during med pass Policy - ANSOfficial position on a particular issue related to operations PREA Victim - ANSReferred to community facility for treatment, or treated in house. History taken by QHCP, examined, prophylactic treatment offered, evaluation by a QMHP, report made to correctional authorities for housing assignment considerations Preserving physical evidence (sexual abuse) - ANSEvidence is not contaminated or destroyed. Does not mean collecting or handling physical evidence. Primary method of infection control - ANSStandard precautions Procedure - ANSDescribes in detail how a policy is to be carried out Process CQI - ANSExamines the effectiveness of the health care delivery process. Baseline of facility problem, developing an implementing a CAP, then restudying the problem.
Retrospective approach to identify what happened during an adverse event
Table top exercises - ANSDiscussion about health staff's projected response to emergencies Treatment for patients with substance use problems - ANSAssessed and properly managed by a physician or other qualified health care professional Treatment Plans - ANSFrequency of follow up for medical evaluation and adjustment of treatment modality, type and frequency of diagnostic testing and therapeutic regimens, instructions about diet/exercise/adaptation when appropriate Use of restraints for pregnant inmates - ANSPotentially harmful to inmate and fetus, especially in 3rd trimester, labor, and delivery Verification of credentials for new hires - ANSInquiry regarding sanctions and disciplinary actions of state boards, employers, and the National Practitioner Data Bank Waiting times - ANSShould not exceed average waiting times in the community What type of license is not in compliance with NCCHC credentialing standards? - ANSRestricted license that limits practice to correctional institutions When can health care professionals father forensic evidence from a victim?