A nurse is invited to join the utilization review team to help the agency avoid giving unnecessary care.Which of the following difficulties would the nurse most likely confront as client records are reviewed?
A) Alternative care options rather than agency care are often encouraged.
B) Not all clients fit the pattern and need more care than guidelines suggest.
C) The nurse suggests the agency provide guidelines to professionals giving care.
D) The agency is now accountable to its clients and their families.

Question

Quizplus · Accepted Answer

The major disadvantage of utilization review is that not all clients fit the classic picture presented by the criteria used to determine approval or denial of care.Alternative care options are many times not considered as it is assumed that clients fit the criteria that has been established.Utilization review does not provide agency guidelines as to how to provide care.Utilization review focuses on avoiding providing unnecessary care not on accountability to clients and families.

A Nurse Is Invited to Join the Utilization Review Team