Frequently Asked Questions
Chapter 20: Acute Care

What is “acute care?”

Acute care is short-term hospital care provided to clients with conditions of short duration, requiring stays of less than 30 days.

What are the typical settings for acute care?

The typical hospital setting is either proprietary or not-for-profit. Most of the care provided in hospitals is acute care. However, post-acute skilled care or rehabilitation units are becoming more common.

What types of care do nurses practice in acute care?

Acute care nurses practice both primary prevention (preventing a disease from occurring) and secondary prevention (preventing complications), but they are increasingly involved in chronic illness management.

What are the four types of advanced practice nursing?

Advanced practice nursing specialties include clinical nurse specialist (CNS), nurse practitioner (NP), certified nurse midwife (CNM), and certified registered nurse anesthetist (CRNA).

Who provides certification for specialty nursing?

Certification for specialty nursing is offered by national organizations, such as the American Nurses Association (ANA) and the Canadian Nurses Association (CNA), or by specialty organizations, such as the American Association of Critical Care Nurses (AACN).

What are the differences between clinical guidelines, care maps, and evidence-based practice?

Clinical guidelines are documents developed to outline the best care for a certain condition. Clinical guidelines are used to standardize care, rationalize care planning, allocate resources, market programs of care, and facilitate cooperation across the community of providers. Care maps (clinical or critical pathways) are a form of clinical guideline used to reduce variations in care, reduce resource utilization, and improve client outcomes. Evidence-based practice is practice based on the latest research about the best interventions to use to achieve desired clinical outcomes.

What are some of the agencies or programs used to assure quality in acute care?

Agencies or programs used to assure quality in acute care include the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO), the National Committee for Quality Assurance, the Occupational Safety and Health Administration (OSHA), the clinical laboratory improvement amendments (CLIA), the Centers for Medicare and Medicaid Services (CMS), and managed care organizations.

What are the ethical issues influencing acute care?

Typical ethical dilemmas in acute care include how to determine who gets health care, where to put the most resources, whether the wealthy should pay proportionally more for health care, and whether to place emphasis on primary prevention rather than acute care intervention.

How does capitalization influence health care?

Though Medicare and Medicaid pay for a basic amount of health care for the aged and indigent, health care is a business in the United States. Those with the most financial resources or the most generous insurance policies have the best access to care. Furthermore, the amount of the Gross National Product (GNP) devoted to health care is increasing, leading to mechanisms to contain costs, such as managed care, and further restrictions on access to care.

What are the social issues influencing acute care nursing?

The social issues influencing acute care nursing include (1) human genome mapping, which has led to the identification of hereditary conditions for which insurance companies may refuse reimbursement for care; (2) the aging of the population, placing a strain on the system’s financial resources; and (3) third-party payment systems of insurance for some, but not necessarily for the indigent and working poor.

What are the professional issues currently affecting acute care nursing?

The professional issues currently affecting nursing include the nursing shortage, the need for nurses with critical thinking ability, the debate over the necessary education for entry into practice, the use of unlicensed workers in acute care, and the need to keep abreast of the latest advances in acute care to practice safely.