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Emergency oom Management
Diagnose the root causes of the complaints about the clinic.
In the recent number of days, the number of the patients visiting the clinic has slowly but drastically increased. In contrary to the past days, the sick patients requiring serious attention from the doctors and the available physicians have increased. In the past, most of the patients only consulted the doctor regarding the disease and infection and acquired appropriate advice and prescription of the most vital medication to use. For this reason, a small 15-bed Emergency oom designed and constructed to cater for the seriously injured patients that required full medical attention from the physicians (Kavaler & Spiegel, 2003). The lack in the number of patients that required operations and keen scrutiny from the doctors is what promoted to the construction of the 15-bed Emergency oom. The poor attendance of the sick patients to the hospital checkups…
Auerbach, P. (2007). Management Lessons from the E.R.: Prescriptions for Success in Your
Business. New York: Simon and Schuster
Egol, K.A., & Strauss, E.J. (2012). Emergency room orthopaedic procedures: An Illustrative guide for the house officer. New Delhi: Jaypee Brothers Medical Publishers.
Kavaler, F., & Spiegel, A.D. (2003). Risk management in health care institutions. Sudbury,
Another statement regarding the health problem of a patient is the possible diagnosis which tends to declare about a problem that the patient most probably has. Although due to lack of information an accurate diagnosis is not possible. Further on there is an actual diagnosis is the diagnosis of a health problem that the patient has and nursing care can be beneficial for the patient. Moreover a syndrome diagnosis and a wellness diagnosis is when multiple nursing diagnoses are observed and to describe the characteristic of the patient when at a high state of wellness respectively (Wikipedia).
Collaborative problem on the other hand "is an actual or potential health problem (complication) that focuses upon the pathophysiologic response of the body (to trauma, disease, diagnostic studies, or treatment modalities), and that nurses are responsible and accountable to identify and treat in collaboration with the physician" (Anonymous).
Hence it should be noted…
1) Henry L. Shapiro. "Collaborative Care Effective in Addressing Psychosocial Issues" [online website] Available at http://aapnews.aappublications.org/cgi/content/full/17/6/284 [Accessed on 05/09/2005]
2) Gregory E. Simon et al. "Cost-Effectiveness of a Collaborative Care Program for Primary Care Patients with Persistent Depression" [online website] Available at http://ajp.psychiatryonline.org/cgi/content/abstract/158/10/1638 [Accessed on 05/09/205]
3) Anonymous. "Collaborative Treatment (Split Therapy) vs. Integrated Treatment: A Clinical Monograph" [online website] Available at http://188.8.131.52/search?q=cache:8gVdYplbuWEJ:https://www.magellanprovider.com/providing_care/clinical_guidelines/clin_monographs/2005split.pdf+common+situation+in+which+collaborative+care+is+provided.&hl=en [Accessed on 05/09/2005]
4) Anonymous. "Nursing Diagnosis" [online website] Available at http://184.108.40.206/search?q=cache:Zv4NkXxXt-MJ:www.gc.edu/Library/e_reserves/TeamNursing/rnsg1171_F04/shea/diagnosis.pdf+nursing+diagnosis+and+collaborative+problems&hl=en [Accessed on 05/09/2005]
(Cole; amirez; Luna-Gonzales, 1999)
The Nurse Practitioner -- NP is a registered nurse -- N having additional education in health assessment, diagnosis and management of illnesses and injuries, inclusive of ordering tests and prescribing drugs. NPs deliver a range of health services to people across all ages, families, communities and groups. Their practice stresses on the health promotion and prevention of illness. They are regulated to undertake comprehensive assessment of health, diagnosis and treat health problems, to order and understand the results of diagnostic and screening tests like ultrasound and mammography and to suggest drugs and medication. NPs deliver care in varied health settings, starting from community clinics and health centers to hospitals, medical practices, nursing homes and home care environments. (Canadian Nurses Association, 2006)
6. Summary and conclusions:
ENA is the registered body of Emergency Nurses with the objectives of promoting excellence for emergency nursing and promoting quality emergency…
Canadian Nurses Association. (2007) "Becoming a registered Nurse." Retrieved 18 September, 2007 at http://www.cna-nurses.ca/CNA/nursing/becoming/asacareer/default_e.aspx
Canadian Nurses Association. (1999, Jun) "RN Education: Graduate Programs." Retrieved 18 September, 2007 at http://www.cna-nurses.ca/CNA/nursing/education/graduate/default_e.aspx
Canadian Nurses Association. (2006) "The Regulation and Supply of Nurse Practitioners in Canada." Retrieved 18 September, 2007 at http://www.cna-nurses.ca/CNA/documents/pdf/publications/Nurse_Practitioner_Workforce_Update_2006_e.pdf
Cole, Frank L; Ramirez, Elda; (2001, Feb) "Standards of Practice for the Nurse Practitioner in the Emergency Care Setting." Emergency Nurses Association.
ut let's look at this resolution in a bit more depth. riefly, processes like full capacity protocols, bedside registration, bypassing triage, adding staff during increased volume, setting up a separate "line" for treating simple fractures, lacerations, etc., establishing turn-around-time (TAT) goals for procedures and patients, can go a long way to begin to cure the problem of overcrowding (ACEP, 2008, p. 10).
Full-capacity protocols. Here is a typical full-capacity protocol from Stony rook University Hospital and Medical Center in New York:
"POLICY: When an adult patient requires admission to an Acute Care Unit from the Emergency Department and that area cannot accommodate that patient because of lack of sufficient beds, the patient will be admitted to the next most appropriate bed. In the event appropriate hospital bed utilization has been maximized, and the number of admitted patients holding in the Emergency Department has prohibited the evaluation and treatment of incoming…
ACEP. (2008, July 25). Emergency department crowding: High-impact solutions. Retrieved September 18, 2009, from American College of Emergency Physicians: http://www.acep.org/workarea/downloadasset.aspx?id=37960
ACEP 3. (2006, September). Approaching full capacity in the Emergency Department. Retrieved October 9, 2009, from American College of Emergency Physicians: http://www.acep.org/workarea/downloadasset.aspx?id=8852
American Hospital Association (AHA). (1999). Hospital statistics. Health Forum. Chicago, IL: AHA.
Bachenheimer, E. (2008, December 4). A necessity, not an option: Rethinking ED systems.
There is a need for the nurse to be proficient and efficient in her work, because ED's are experiencing an increasing number of patient visits, and there are normally more patient's waiting to be seen than is appropriate for the size of the facility's ED (GAO, 2008).
If we compare the patient flow and the speed with which the ED nurse must work in order to accomplish her responsibilities and duties with those of a surgical nurse; we would rapidly find that the pressure on the ED is much greater on a patient flow capacity. The surgical nurses' patients are scheduled, not random, except in the case of a surgical emergency. The ED nurse must often deal not just with the patient, but with the patient's family too. The surgical nurse has little interaction with the patient, or the patient's family, and does not see the patient flow that is…
GAO 2008. Hospital Surge Capacity: Not Ready for the "Predictable Surprise," United
States House of Representatives, Committee on Oversight and Government
Reform, March 25, 2008.
Numerator: number of patients for whom administration of low-dose glucocorticoids for septic shock was determined in accordance with a standardized ICU policy over the first 24 hours following the time of presentation
Denominator: total number of patients with septic shock
*Low-dose glucocorticoids refer to a daily dose of 200
300 mg of hydrocortisone or equivalent.
Quality Indicator No. 6:
Administration of drotrecogin alfa (activated) for severe sepsis and/or septic shock in accordance with a standardized ICU policy over the first 24 hours following the time of presentation.
The percent of patients for whom administration of drotrecogin alfa (activated)
for severe sepsis and/or septic shock was determined in accordance with a standardized ICU policy over the first 24 hours following the time of presentation.
Numerator: number of patients for whom administration of drotrecogin alfa (activated) for severe sepsis and/or septic shock was determined in accordance with a standardized ICU policy over…
Evans, C. & Tippins, E. (2007). The foundations of emergency care. Maidenhead, England:
Jacoby, D.B. & Youngson, R.M. (2005). Encyclopedia of family health, vol. 14. New York:
Khan, Z.U. & Salzman, G.A. (2006, November). Sepsis: Review questions. Hospital Physician, 27-28.
Electronic Health ecords in an Emergency oom Setting
Using EH in an Emergency room setting and its impact on patient safety
Using electronic health records in an emergency room setting and their impact on patient safety
Electronic health records or EHs are computerized systems by which medical records can be stored. They often improve quality of care provided by enabling health care workers to focus their energy and time to providing care rather than retrieving and filing records. They also provide other benefits including ease of storage, modification and retrieval of medical records. This is because they provide a search facility that is better than the paper-based record system. Secondly, they also require less amount of space to store records since the records are stored electronically. Another major benefit of electronic health records is that they allow sharing of records. These records can often be compressed and shared with other…
Greenhalgh, T., Potts, H.W.W., Wong, G., Bark, P., & Swinglehurst, D. (2009). Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-Narrative Method. The Milbank Quarterly, 87(4), 729-788. doi: 10.2307/25593645
Kumar, S., & Aldrich, K. (2010). Overcoming barriers to electronic medical record (EMR) implementation in the U.S. healthcare system: A comparative study. Health Informatics Journal, 16(4), 306-318. doi: 10.1177/1460458210380523
Pagliari, C., Don, D., & Singleton, P. (2007). Potential of electronic personal health records. BMJ: British Medical Journal, 335(7615), 330-333. doi: 10.2307/25690019
Raghupathi, W., & Kesh, S. (2007). Interoperable Electronic Health Records Design:Towards a Service-Oriented Architecture. e-Service Journal, 5(3), 39-57. doi: 10.2979/esj.2007.5.3.39
Atlanta Medical Center Emergency oom Discharge
According to reports approximately 9 out of 10 adults experience "difficulty using the everyday health information that is routinely available in health care facilities, retail outlets, media, and communities." (Health.Gov, 2011) Limited health literacy is linked to: (1) poorer health outcomes; and (2) higher health care costs. (Health.Gov, 2011) In addition, limited health literacy affects the ability of the individual in: (1) searching for and using health information; (2) adopting healthy behaviors; and (3) acting on important public health alerts. (Health.Gov, 2011) Health literacy is reported to be dependent on both individual and systemic factors including those as follows: (1) communication skills of professionals and laypersons; (2) professional and lay knowledge of health topics; (3) culture; (4) demands placed on public health and healthcare systems; (5) Demands arising from the situation or context. (U.S. Department of Health and Human Services, 2011) Cultural and linguistic…
Health Literacy Basics (2011) U.S. Department of Health and Human Services. Office of Disease Prevention and Health Promotion. Retrieved from: http://www.health.gov/communication/literacy/ quickguide/factsbasic.htm' target='_blank' REL='NOFOLLOW'>
Asthma and ER utilization
Asthma is a particularly debilitating condition. Asthma is characterized by a tightening in the chest with difficulty in breathing and wheezing. This difficulty in breathing can result, at best, in a decrease in quality of life and the inability of carry out normal function. At worst, the symptoms of asthma can lead to death. Incidences of asthma have increased significantly in the last twenty years. This is perhaps due to increase in urbanization, industrialization and the accompanying pollution. This pollution can also be due to the increase in dust and waste from automobiles. While the effects and symptoms of asthma are well-known and studied, the causes of asthma are not known. They are, at best, unclear. This is because indicators vary from person to person. It is important to understand the basic mechanism of an asthma attack. A discussion of the triggers of asthma will…
ALA. (1998). The American Lung Association Asthma Survey. Washington, D.C.: American Lung Association.
ALA. (2002). Trends in Asthma Morbidity and Mortality. Washington, D.C.: American Lung Association.
AsthmaInAmerica. (1998). Asthma in America., Ronca and Bucuvalas, Inc. And Glaxo Wellcome Inc. Retrieved January 4, 2004, from the World Wide Web: http://www.asthmainamerica.com/
Awadh, N., Chu, S., Grunfeld, A., Simpson, K., & FitzGerald, J.M. (1996). Comparison of males and females presenting with acute asthma to the emergency department. Respir Med, 90(8), 485-489.
Forecast Healthcare Volume
Forecasting is one of the most important activities or processes that guide decision making in several sectors including industrial, economic, and scientific planning. Despite its significance in decision making process, forecasting has obtained little traction in the healthcare industry. However, forecasting patient volumes in emergency rooms and urgent care clinics is important towards decision making regarding the changes in supply of healthcare resources as well as shifts in demand for emergency department resources. According to Batal et al. (2001), a logical approach to the delivery of urgent care services must incorporate considerations of current trends in demand for these services (p.48). The capability to forecast the number of patients in need of care in an urgent care clinic on any specific day is an important process towards promoting optimization of staffing patterns.
It is important to forecast volumes in emergency rooms vs. urgent care clinics since this…
Batal et al. (2001, January). Predicting Patient Visits to an Urgent Care Clinic Using Calendar Variables. Academic Emergency Medicine, 8(1), 48-53.
Weinick, R.M., Bristol, S.J. & DesRoches, C.M. (2009, May 15). Urgent Care Centers in the U.S.: Findings From a National Survey. BMC Health Services Research, 9(79), 1-8.
poor morale in emergency room (R) nurses and identify an empirical approach and research question involving factors that can improve morale in R nurses. Interestingly enough, the United States "has the most expensive healthcare system in the world, [yet] 47 million Americans have no health insurance. Healthcare is the country's largest economic sector…. Four times larger than national defense… yet millions cannot afford to take care of their health needs" (Farrell, 2009, 1). Despite being an international leader in science and technology, what has happened to the entire healthcare system in America? Fifteen years ago the subject was at the forefront of the new Clinton Administrator, but now, despite technological advances and increased modernization, America finds hospital emergency rooms stretched far beyond any reasonable capacity, the inability for many doctors to afford adequate malpractice insurance, costs for procedures escalating, and even those with insurance unable to afford the basic standards…
ER nurses supply care in an assortment of settings. At the extreme end of the continuum they must swiftly assess and then stabilize patients who have life-threatening conditions and also be prepared to care for less critical situations. Of course in the ER care is provided along the total age range from infants to the elderly. Thus, nurses in the ER need to be prepared for a fast-paced changing environment. Although most ER nurses work in hospitals they are also found in a variety of other situations ranging from urgent care centers to prisons to sporting events. The workload of ER nurses constitutes a major issue for the morale and efficiency of ER nursing staff as well as the clinical outcome of the patient and patient satisfaction.
There is a great deal of empirical research outlining the factors that can lead to poor morale in ER nurses. Burnout and not feeling appreciated are major contributors to poor morale in ER nurses and are most affected by the nurse's perception of being overburdened by a harsh and demanding workload (e.g., Freeman & O'Brien-Pallas, 1998; Aiken et al., 2002). Carayon and Gurses (2005) outlined four categorizations of workloads in nursing that could affect morale: the unit-level, the job-level, the patient -level, and the situation-level workload. The four levels are not mutually exclusive. For instance, the situation and patient-level areas are embedded within the job-level and the job-level workload can be categorized under the unit-level. Thus, the unit-level would be the macro-level, whereas situation and patient levels could be thought of as micro-levels (Carayon & Gurses, 2005).
As America changed, healthcare has not necessarily followed. Individuals are living longer, and as they age, require different healthcare solutions. In the 1940s, when the average age of death was far lower, many of the cancers and other illnesses of modernity and age had not yet become epidemic (Saad, 2007). So too, with the advances in technology that can discover disease and cure prior to it becoming debilitating have increased as well. Instead, the system has built layer upon layer of bureaucracy that, instead of streamlining the system, causes more bureaucracy and backlog. So, instead of simply establishing a set of universal care that is part of an even bigger bureaucracy, perhaps it is time to set into practice money spent on preventative care and education at the earliest levels, so that as the population
40-year male presented to the emergency room at 11 a.m. In the morning with complaint of pain all over his body. On history, he did not state that the pain was localized; rather he complained that his entire body was aching. The man was asked to lie down on the couch in the emergency room, while I started to review his vitals. His blood pressure was within the normal range; however his pulse and respiratory rate were slightly increased. I also noted that he was perspiring heavily. The moment I asked for his consent to do his physical examination, he started screaming with pain. When I asked him to describe his pain in terms of character and intensity, the main stated that the pain was excruciating and could be labeled as 8 on a scale of 1-10. Just then he asked for a Morphine injection. Right that moment, I was…
F. The uninsured are increasingly using the ED for their non-emergency needs.
III. The effects of emergency room overcrowding can be deadly.
A. Boarding patients, or keeping already treated or stabilized patients in the ED, prevents patients from receiving the inpatient care they need.
B. Long wait times and inefficient service can mean loss of life
IV. Possible solutions demand health care system overhaul.
A. More efficient hospital registration would streamline emergency room procedures.
B. Standing orders would allow nurses and EMTs to proceed on critical care without doctors.
C. Special fast-track and sub-waiting areas would alleviate hallway overcrowding.
D. Re-budgeting will allocate more funds to emergency admissions.
E. Reducing non-urgent visits via universal healthcare initiative would reduce unnecessary use of the emergency room.
F. Increasing hospital capacity for acute inpatient needs would replace boarding.
G. Hospitals can add support staff during critical hours.
The exercises and training divisions work with similar divisions in Delaware, Pennsylvania, and Virginia, a Continuity of Operations department designed to work with the federal Department of Homeland Security, and an Office of Domestic Preparedness and Law Enforcement Liaison work with local and federal authorities to coordinate comprehensive disaster planning efforts. (Maryland Emergency Management Homepage, 2006, Official Website)
Different organizations that are involved, how the organizations interact with or are apart of the EOC/What is the responsibilities of each member to the EOC
The federal government, including FEMA (Federal Emergency Management Authority), the Department of Homeland Security, and the state Emergency Management offices of Delaware, Virginia, and Pennsylvania are all involved, as is the National Guard. These organizations do not have specifically delineated legal responsibilities to the state of Maryland's EOC, other than to serve the citizens of the U.S. In the case of the federal government. (Maryland Emergency Management…
Droneburg, John. (2006) "Letter from the Director: John Droneburg III." Maryland
Emergency Management. Retrieved 3 Nov 2006 at http://www.mema.state.md.us/MEMA/content_page.jsp?TOPICID=domprepare#
Florida State Warning Point." (2006). Florida Division of Emergency Management. Retrieved 3 Nov 2006 at http://www.floridadisaster.org/bpr/Response/Operations/swp.htm
Maryland Emergency Management Homepage. (2006) Official Website. Retrieved 3 Nov 2006 at http://www.mema.state.md.us/MEMA/index.jsp
Therefore, Johnson weaves clever and poignant paradoxes in the language as well as the overarching themes. The one-eyed man could have died or lost his good eye, as the Nurse points out. He survives unscathed, and sees what his wife forbade him to see. Likewise, Hardie could have faced immanent death in the war but he survives by going AOL. In both cases, subverting social convention is a key to liberation.
The paradox of religion is also conveyed via deft use of language. In "Cathedral," the title image represents the symbol of religious strivings. A cathedral is a house of God; but that house does not necessarily lead to spiritual awakening. On the contrary, the house in which the story takes place does become a zone of spiritual awakening. The blind man and the narrator use the ancient sacrament of cannabis to explore the real meaning of human existence, which…
Carver, Raymond. "Cathedral." Retrieved online: http://nbu.bg/webs/amb/american/6/carver/cathedral.htm
Johnson, Denis. "Emergency." Retrieved online: http://archives.newyorker.com/?i=1991-09-16#folio=030
Business Name: MWV located in Covington VA
Number of Employees 190
Emergency management plan entails a system of managing resources, information analysis and decision making in the event of a tornado hitting the facility (Hubbard, 2009). The emergency management plan acts a guide to the responsible personal, the staff and residents within the facility on the steps to take upon the occurrence of a tornado. The emergency plan gives a description of the role that the pre-appointed Emergency Management Group (EMG) is expected to carry out in the event of a tornado. The Emergency Management group will serve as the overall authority over the activities in the facility relating to the occurrence of a tornado.
The emergency management policy is to ensure the safety of every individual within the facility and bring the facility to normal operations after an accident.
The head of the Emergency Management group is…
Hubbard, C. o. (2009). Emergency Response, Windshield Survey; Hubbard, . City of Hubbard Oregon.
Safety, C. f C.P. (2002). American Institute of Chemical Engineers. Guidelines for Technical Planning for On-Site Emergencies. . New York: CCPS-AICHE.
School Nurse Conflict Mission
Mary Jackson did exactly what a professional RN should do -- she tended to the injured children that were her responsibility. It happened that her efforts spilled over into a hospital emergency room, which technically she did not have the legal right to practice in. But still, she acted according to the values that she was trained in and moreover, as a professional healthcare employee of a school, she knew these children and her instincts were to boldly provide triage and other emergency procedures to help the children. In addition, Mary is not just an RN, she is a Nurse Practitioner specializing in pediatrics, and her skills and training are well beyond those of an RN. Hence, she deserves respect and she deserves the benefit of the doubt when she acts in behalf of the children she is contractually and morally obliged to protect and care…
Klein, C.A. (2006). Nursing Responsibilities in a Disaster. The Nurse Practitioner, 31(11), 56.
Northrop, C.E. (1990). How Good Samaritan Laws Do Protect You. Nursing90, 20(2), 50-51.
Riverbend City: School Nurse Conflict Mission. Washington Allston Elementary School.
(Shactman; Altman, 2002)
4. ecommendations for Overcoming these Barriers:
Some of the suggestions for overcoming these barriers are (i) appointment of a General Practitioner -- GP officers to work as a Liaison Officer between the ED and the community so that the communication is streamlined as well as processes of referral and feedback and development of clinical pathways. (ii) Expansion of community off-peak facilities, including the setting up of the capacity for community access to X-rays, Scanning, ultrasound, blood tests and observation beds. (iii) Initiation of a project to deal with frequent attenders to the ED through the development of management plans contributed to by the patient, their GP, the ED as also their specialist (iv) Education of the local community such that are aware as to when and under what situations to access ED care or alternative care in the community. (Ardagh; ichardson, 2004)
Ardagh, Michael; ichardson, Sandra.…
Ardagh, Michael; Richardson, Sandra. (2004) "Emergency department overcrowding- can be
fix it" Journal of the New Zealand Medical Association, vol. 117, no. 1189, pp: 27-31.
Brewster, Linda R; Rudell, Liza; Lesser, Cara S. (2001) "Emergency Room Diversions: A
Symptom of Hospitals under Stress-Increased Demand for ER Services" Center for Studying Health System Change. Issue Brief No. 38. Retrieved May, 2009 from http://www.hschange.com/CONTENT/312/
Wait Time in the Emergency Center Can Be Decreased
How Could the Wait Time in the Emergency Center be Decreased?
This paper discusses how long wait times and overcrowding can be reduced in emergency centers as a way of improving healthcare quality for all patients.
Physicians working in emergency departments are dedicated to offering high quality emergency care, as fast as possible, to all the patients brought into the emergency center. However, long wait times and crowding hamper patient safety. The ever increasing emergency patient numbers, coupled with critical shortages in the entire system of emergency medical care, play a role in limiting patients' access to emergency care on a timely manner. Patients with the need to see physicians in 1 to 15 minutes get attended to in 37 minutes, a figure twice the expected timeframe. The long wait times and crowding in emergency departments have been attributed to patients…
Brimhall, J. (2012). SQL server 2012 T-SQL recipes: A problem-solution approach. New York: Apress.
Chan, P. L.-K. (2010). Predictive Modeling of Emergency Department Wait Times for Abdominal Pain Patients.
Hernandez, M. J. (2013). Database design for mere mortals: A hands-on guide to relational database design.
Kindt, E. J. (2013). Privacy and data protection issues of biometric applications: A comparative legal analysis.
In conjunction with these car ads, car insurance companies took advantage of this by advertising their services as well. Car insurance companies that I noticed advertising through billboards were Safeco, Progressive, and All State. Progressive provided a catchy and positive note to its ad by having the slogan, "Happy drivers make good drivers." From what I can recall in the All State ad, it mentioned something about safe driving, again with a catchy phrase: "Safe driving bonus for not driving like a paparazzi." These car insurance ads, particularly for Progressive and All State, tackle issues relevant to motorists, their target market: both chose to discuss driving behavior, using different ad 'treatments.' Progressive addressed reckless/irresponsible driving by focusing on the ideal driving behavior and its positive outcome, that is, drivers must have a happy temperament in order to be a good driver. All State, meanwhile, chose to go the opposite route…
Memoir of a Public Information Officer: When an Earthquakes Strikes: The First Five Days
On Thursday the 15th of last month, at 7:31 A.M., an earthquake of 5.9 Moment Magnitude struck Southern California. The epicenter was near Santa Clarita, a small suburban community about twenty miles north of Los Angeles along the I-5 freeway. I am the Public Information Officer for the Emergency esponse Office for the City of Santa Clarita. The following is an account of the five days following that earthquake.
I was attending a breakfast meeting with City and County officials discussing items in the proposed budget for our Emergency esponse Office. Over danishes, bagels, coffee, and juice, we were itemized the needs required by my office. The main sticking point was the cost to training more CET (Community Emergency esponse Team) graduates. It is an 18-hour course taught by U.S. FEMA (Federal Emergency Management Agency). Our…
Drabek, Thomas E. Emergency Management: Principles and Practice for Local Government. Washington, D.C.: International City Management Association. 1991.
Sylves, Richard T., and Waugh, William L. Jr. Disaster Management in the U.S. And Canada. Springfield: Charles C. Thomas Publisher Ltd. 1996.
An emergency and disaster preparedness plan and program is an important aspect for an organization due to its significance in promoting workplace safety. The preparedness program helps in enhancing safety in the workplace through inclusion of initiatives for lessening injuries and loss of lives, minimizing insurance claims, lessening property damage, and improving employee morale. While emergencies still happen despite of measures to prevent them, an organization's preparedness plan is critical in preventing the frequency of their occurrences, minimizing injury and property damage, and establishing ways for mitigating their impacts. This is largely because the plan consists of basic procedures to handle emergencies in the workplace. In most cases, organizations use preparedness plans and programs to protect workers from fire incidents and other emergencies.
Threats and Vulnerabilities in the Workplace:
Since an organization's workplace involves several employees, threats and vulnerabilities are likely to occur both from within and outside the…
Ball, J.L. (2001). Employee Fire and Life Safety: Developing a Preparedness Plan and Conducting Emergency Evacuation Drills. Retrieved May 25, 2012, from http://www.nfpa.org/assets/files/pdf/evacuation.pdf
"Fire Preparedness & Response: What the OHS Laws Require." (n.d.). Labor Tek Safety
Training Inc. Retrieved May 25, 2012, from http://www.labortek.com/images/articles/24.pdf
"Fire Prevention Plan." (2009, April 21). JSRCC Fire Prevention Plan. Retrieved from J.
Operating oom Efficacy
This section offers an analysis of available literature about operating room efficacy, and seeks to summarize the literature on the major problems experienced in operating rooms, and their proposed solutions. This review of literature will lead to the development of novel insights regarding the research topic.
The Operating oom
The operating room is supported trough a central location that is within or nearby the O, and it is known as "core." The core is usually physically limited through its storage space and as a result, it is resupplied periodically from a huge on-site storage and central processing location (Harper, 2002). The core sustains the operating rooms with the needed inventory for each procedure. Central procession holds an extensive variety of materials, and it serves as preparation region to organized, and develops procedure-specific kits. The kits are groups of items that are common to a certain surgeon's procedure.…
Anonymous. Community hospitals of California cuts 20% from its supply budget in the operating room with custom procedure trays. (1996). Hospital Materials Management, 21(2), 10-10.
Anonymous. Trend is down in cost per case in the operating room, but there is still room for driving out more cost; here's how. (1996). Hospital Materials Management, 21(3), 22-22.
Berry, M., Berry-stolzle, T., & Schleppers, A. (2008). Operating room management and Butler et al. (2012), Applying science and strategy to operating room workforce management. Nursing Economics, 30(5), 275-281.
Dexter et al. (2006). Mean operating room times differ by 50% among hospitals in different countries for laparoscopic cholecystectomy and lung lobectomy. Journal of Anesthesia, 20, 319-322.
Hospital Emergency Plan
According to a study, about 99% of hospitals have plans to cope with disaster, and 95% of them even had committees for that purpose. There were reports from 90% or more of the hospitals which showed that they were in collaboration with emergency treatment services (96%), emergency agencies for management (94%), agencies for law enforcement (95%), fire sectors (95%), along with health sectors (92%). 96% of the respondents sated that there were plans to cope with disaster throughout the hospital, and that they were accessible easily (Higgins et al., 2004, p. 328). Meridian Health has made it its responsibility to better the welfare and health of New Jersey residents. They do this by giving the best quality health services in the community, homes and hospitals, which put their focus on patients, and also by conducting clinical research and education for the enhancement of medicine (Meridian Health, 2016).…
GOI-UNDP. (2002-2008). Guidelines for Hospital Emergency Preparedness Planning. Government of India --United Nations Development Programme. Retrieved 22 July 2016 from http://asdma.gov.in/pdf/publication/undp/guidelines_hospital_emergency.pdf
Higgins, W., Wainright III, C., Lu, N. & Carrico, R. (Oct. 2004). Assessing Hospital Preparedness Using an Instrument Based on the Mass Casualty Disaster Plan Checklist: Results of a State-wide Survey. Department of Public Health, 32(6), 327-332. doi: 10.1016/j.ajic.2004.03.006
Meridian Health. (2016). Meridian Health: New Jersey's Leader in Integrated Care.Retrieved 22 July 2016 from https://www.meridianhealth.com/about-meridian/index.aspx
Merrill, M. (Jun 2011). Top 5 Security Threats in Healthcare. Healthcare IT News.Retrieved 22 July 2016 from http://www.healthcareitnews.com/news/top-5-security-threats-healthcare
Many women have today started to complain about their bitter experiences, and this has led to the creation of a birthing room at the hospital. The room is made to look more like a warm and cozy room at home, rather than a cold medically equipped room at a hospital. Since birthing is a warm and beautiful experience, most women do feel that they must be provided with an atmosphere conducive to give birth in. A birthing room therefore, would be equipped with articles like rocking chairs, cozy seats, warm lighting, a variety of different kinds of stools, and railings, all of which would allow a woman to try out different birthing positions, and finally choose the one that suited her the best.
All the equipment in a birthing room must be designed to accommodate the entire team of medical personnel attending to the woman, and also accommodate her family…
Brenner, David. (2003) "I think there's a terrorist in my soup: how to survive personal and word problems" Andrews McMeel Publishing.
Bruess, Clint E; Greenberg, Jerrold S. (2004) "Sexuality Education, Theory and Practice" Jones and Bartlett Publishers
Choudhri, Nihara K. (2005) "Parent Savvy, Straight Answers to your family's financial"
Our study is however geared towards the assessment of applicability of the universal triage system in emergency clinical work. The current triage systems are somehow one-sized-fits it all in their design (Veenema,2007).He points out that the main problem with the existing triage methodologies is the fact that they are not tailored for all situations such as weapons victims but are just normal pediatric scenarios. This therefore means that some of the components of the various triage systems are most likely to fail under certain circumstances as a result of the disparity in the physiological baselines used in coining the various triage systems.Veenema then ponders if the solution tom these dilemmas are held in the coining and adoption of a universal triage system.
The research questions that are to be used as the basis of forming hypothesis for the research they are:
Hypothesis 1: Does the use a universal triage…
Australasian College for Emergency Medicine.( 1993a) Triage (policy document).
Australasian College for Emergency Medicine (1993b)). A National Triage Scale for Australian Emergency Departments (position paper).
Canadian Association of Emergency Physicians. (1999) Canadian Emergency Department Triage and Acuity Scale. Journal of the Canadian Association of Emergency Physicians, 1, 1-24
George, J.E. (1995) Triage protocols. Journal of Emergency Nursing, 21, 65-66
Barriers and Facilitators
Effectiveness, Barriers and Facilitators of Using Computerized Charting in the Operating oom
The world is surging ahead with technological boom which is leaving its indelible imprints on almost all the facets of human life. Healthcare is also one of the significant sectors in which medical technology is advancing to provide better diagnostic techniques, examining facilities, and treatment procedures. These technological developments mainly encompass the equipments used in diagnosis and treatment, medical services offered by the healthcare sector, knowledge regarding different branches of biology and medicine, and so forth. However, the growing usage of information technology holds a prime position amongst all (Lorenzi, 2005).
Computerized systems in healthcare are gaining immense limelight in the current epoch; however, it has considerably assisted in provision of improved and efficient surgical services to patients in operating rooms. Computerized information system, specifically the one used for the purpose of administering surgeries, largely…
Lorenzi, N.M. (2005). Transforming health care through information. Second Edition. USA: Springer.
Maurer, P.R. (2013). They Do Well Who Do Good. Second Edition. USA: Trafford Publishing.
Nelson, R. & Staggers, N. (2013). Health Informatics: An Interprofessional Approach. USA: Elsevier Health Sciences.
Vacanti et al. (2011). Essential Clinical Anesthesia. First Edition. USA: Cambridge University Press.
search, and evaluation task.
The literature exhibited particular gaps with regard to the initial problem that I was considering. For example, I began thinking about the difficulties of emergency room nursing care and the jeopardy to morale and job satisfaction that was just part of on-the-job exposure to the emergency room setting. Patients were often very badly hurt, but they were just as often in need of routine medical care for common, albeit uncomfortable conditions. Treating patients in emergency room settings often meant dealing with people who were violent toward those who were trying to care for them. In addition, much of the literature -- for no apparent reason -- was based on data and studies from non-American hospitals and emergency rooms. Dwindling resources in some locations meant fewer staff members to do the same amount of work in general hospitals and in emergency rooms. Physicians were often the focus…
Nursing and the E
The Emergency oom is often one of the most visible parts of healthcare for political debate. It is also one of the most difficult environments for a modern nurse. It is interesting that one of the founders of modern nursing had emergency experience prior to developing her overall theories. Nightingale also looked at negatives and positives that are the conditions, which could help make people recover and reach their actual potential, as also noted by Maslow hierarchy of needs. She did not look or speak directly of the disease per se, but rather, looked at air, clean water, environment, and sanitation. She published her book in1860 with the title a "Notes on Nursing: What it Is and What it Is Not," connecting human beings and quality of human life, and comparing the stagnant sewage she saw in Scutari, as well as in London. She…
Americans at Risk. (March 2009). Families USA. Retrieved from:
Patient Perceptions in the Emergency Department: Physicians, Physician Assistants,
Nurse Practitioners. (30 August 2010). Retrieved from: http://idiopathicmedicine.wordpress.com/2010/08/30/patient-perceptions-in-the-emergency-department-physicians-physician-assistants-nurse-practitioners/
The results of this analysis highlight the need for hospitals to fine-tune their discharge process to reduce readmissions, and support the expenditure of additional resources for this purpose as a cost-effective intervention; as an example, author cites a hospital in Iowa that implemented a rigorous post-discharge planning process for patients with heart failure and 30-day readmission rates were reduced by 3-9% during the 3-month period following implementation.
The research showed that many elderly patients who suffer from congestive heart failure also suffer from a wide range of comorbid conditions, including diabetes and hypertension. These patients can be reasonably expected to require periodic or even frequent treatment in emergency departments and/or hospitalizations for these conditions, making the need for effective and seamless post-discharge planning especially important. In this regard, the research also showed that there are some valuable evidence-based practice guidelines available, though, that can help clinicians better coordinate post-discharge…
Emergency room usage [...] why African-Americans utilize emergency departments instead of primary doctors. What are the age, gender, and income of the African-Americans that come to E.D? What type of insurance (if any) do they have? Why do they utilize the E.D. (chronic conditions vs. acute conditions)? How is the health system viewed by the African-Americans and what if anything is being done to change and/or correct their conception? What obstacles exist and what accommodations are needed in African-American teaching? The use of emergency rooms by African-Americans is well documented and studied. There are many reasons African-Americans turn to emergency rooms rather than their own primary care physicians, and many ways the United States could turn this healthcare problem around.
Studies have clearly documented that African-Americans on the average receive less health care than whites, and there are several reasons for this dissimilarity in the health care process. One of…
Belgrave, F.Z. (1998). Psychosocial aspects of chronic illness and disability among African-Americans. Westport, CT: Auburn House.
Daniels, S. (1996). 11 Reproductive rights: Who speaks for African-American women?. In African-American women's health and social issues, Collins, C.F. (Ed.) (pp. 187-194). Westport, CT: Auburn House.
Davidson, R.A., Giancola, A., Gast, A., Ho, J., & Waddell, R. (2003). Evaluation of access, a primary care program for indigent patients: Inpatient and emergency room utilization. Journal of Community Health, 28(1), 59+.
Rust, George, MD, MPH; George E. Fryer Jr., MSW, PhD; Robert L. Phillips Jr., MD, MSPH; Elvan Daniels, MD;Harry Strothers, MD, MMM; and David Satcher, MD, PhD. (2004). Modifiable determinants of healthcare utilization within the African-American population. Retrieved from the National Medical Association Web site: http://www.nmanet.org/OC1169.pdf8 Oct. 2004.
Assign to Occupy
CONGESTION ISSUES AND SOLUTIONS
Prolonged or increased waiting time for patients at the Emergency Department lead to an increase in both morbidity and mortality among critically ill adult patients admitted for inpatient beds. The gathering of ED records of the St. Margaret Mary Healthcare Centers of Dyer, Indiana, aimed at developing a report on overcrowding, identified the main causes as the lack of available inpatient beds and the lack of nurses to care for patients. Long-term solutions are identified and suggested.
ackground/Significance -- Overcrowding at the ED occurs primarily because of overwhelmed ED manpower and sheer physical incapability because of the massive number of patients requiring or receiving care. Overcrowding, lack of ED staff and the delay of transfer to assigned bed, the lack of physical beds and un-timely discharges lead to increased boarding times at the ED.
Problem Statement -- Patients with assigned medical/surgical…
Bramwell, J. (2012). Going with the flow: three strategies help improve throughput.
HFMA: Healthcare Financial Management Association. Retrieved on September 22,
2012 from http://www.hfma.org/ Templates/Print.aspx?id=29334
DeLia, D. (2007). Hospital capacity, patient flow and emergency department use in New Jersey. Institute for Health: Rutgers Center for State Health Policy. Retrieved on September 22, 2012 from http://www.state.nj.us/health/rhc/documents/ed_reports.pdf
Managing Complaints: Improving Service in a 15-Bed Emergency Room
As chief operating officer, you are responsible for a 15-bed Emergency Room (ER), which has received many complaints within the last year regarding inadequate patient care, poor ER management, long wait times, and patients being sent away due to lack of space, staff or physicians to provide appropriate care.
Diagnoses: Root Causes of Clinic Complaints
The complaints at hand in viewing the lack of success in the ER at hand can be largely traced back to poor internal management within the ER. Employees operating within the ER have long been confused about the standards and protocols that the hospital has implemented which poorly effects the running of the ER from the time a new patient enters the facility. Many of the complaints lodged toward the ER make mention of an incompetent and insensitive ER staff who have led patients…
Carrus, B., Corbett, S., and Khandelwal, D. (2010). "A hospital-wide strategy for fixing emergency department overcrowding." McKinsey Quarterly. Web. Retrieved
from: http://www.mckinseyquarterly.com/A_hospital-wide_strategy_for_fixing_ED_overcrowding_2505 [Accessed on 2 December
Louisiana State University. (2012). "Good Samaritan Laws." LSU. Web. Retrieved from:
In the emergency room, this distinction can have a determinant impact on the ability of the staff to preserve life and diminish pain and suffering.
The introduction of a bioethical perspective into this dialogue invokes a question as to the primacy of an interest in pursuing to the utmost the well-being of the patient. This speaks to one of the core values associating the principles of the ANA with the treatment outcomes desired in patiences. An examination of the ANA's Code of Ethics reveals that a theoretical basis exists to contend a direct correlation between the nurse's self-interest and that which is best for any given patient. There exists an essential obligation for such healthcare practitioners to "examine the conflicts arising between their own personal and professional values, the values and interests of others who are responsible for patient care and health care decisions, as well as those of the…
American Nurse's Association (ANA). (2004). The Nurses Code of Ethics. The Center for Ethics and Human Rights. Online at .
The American Organization of Nurse Executives (AONE). (2009). AONE Resource Center. www.aone.org.
Dimaria, R.A. & Ostrow, L. (2004). West Virginia University School of Nursing Makes the Move to Web-Based Learning. Technological Horizons in Education Journal, 31.
Emergency Nurses Association (ENA). (2008). Vision/Mission Statements and Code of Ethics. www.ena.org.
Based on that comparison, we outperformed our budget because of the increased nursing efficiency we experienced. However, our main output is the number of patients served. If we evaluate the supplies cost in terms of the number of patients served, those costs actually had a 1.7% variance last year. We spent more per patient on supplies than we had expected to, but because of the way it was measured, it was not easy to make this determination. The role of managerial accounting is to provide useful information and with respect to supplies expense, this has not previously been the case. The information presented can be much more robust.
Therefore, another recommendation is to tie supplies costs to patient visits, rather than to nursing hours. This is more appropriate than the current method because efficiency of supply costs is weighed against patient visits. As such, it makes no sense to budget…
Non-Cardiac Chest Pain
Background- Chest pain is one of the most common reasons people call for or visit the Emergency Room for help. Heart attack education has brought to light the urgency of seeking immediate medical treatment if one suspects they are having heart issues. However, chest pain does not always signal a heart attack, and may be totally unrelated to issues with the cardiovascular system. Often no clear reason for such pain presents itself during examination, but understanding the perception and pain experience can help medical professionals understand different experiences that lead to patient panic about chest pain (Jerlock, Gaston-Johansson, & Danielson, 2005). Typically, if chest pain is related to a cardiac issue it is usually associated with one of the following symptoms: 1) pressure, fullness or extreme tightness in the chest; 2) crushing or searing pain that radiates to the back, upward through the jaw, and especially through…
Unexplained Chest Pain Can be Due To Stress. (2009, February 9). Retrieved from Science Daily: http://www.sciencedaily.com/releases/2009/02/090209094551.htm
Cunha, J. (2011, March). Chest Pain - Overview, Causes, Symptoms. Retrieved from eMedicineHealth: http://www.emedicinehealth.com/chest_pain/article_em.htm
Hershcovici, T., Navarro-Rodriguez, T., & Fass, R. (2011). Non-Cardiac Chest Pain: An Update. CML Gastroenterology, 30(2), 37-54.
Jerlock, M., Gaston-Johansson, F., & Danielson, E. (2005). Living with unexplained chest pain. Issues in Clinical Nursing, 14(2), 956-64.
In addition to core studies, optional programs are available throughout Alberta, including art, drama, music, career and technology studies, Aboriginal studies, and 16 different languages. Provincial tests tell authorities how well students have progressed in relation to achievement targets. Overall, the tests tell Albertans how well students are learning the Alberta curriculum and which areas of the curriculum need improvement. Provincial tests are designed as one indicator of how well Alberta students are meeting provincial, grade-level standards. They complement the teacher's assessments.
This country has some definite problems with our educational system. One aspect of the Alberta system is measurement and accountability. Students should be required to meet objective standards in order to progress from one grade to another. Teachers should be required to pass standardized test in order to receive a teaching certificate. Continuing education should be mandatory. y holding people accountable for results, the results will improve.
Berliner, D.C., and B.J. Biddle. The Manufactured Crisis: Myths, Fraud, and the Attack on America's Public Schools. Reading, MA: Addison-Wesley, 1995.
Emergency Room Overcrowding: Hospital implements new procedure." WOWT.com. 1 June 2005. http://www.wowt.com/news/features/2/1492392.html .
Emergency Room Visits Soar." Live Science. 26 May 2005. 1 June 2005. http://www.livescience.com/othernews/050526_emergency_visits.html .
Hospitals Can't Win on Immigrant Health Plan." The Detroit News. 30 August 2004. 3 June 2005. http://www.detnews.com/2004/editorial/0408/30/a08-257287.htm .
Christopher Montgomery Figueroa, ID #203594
Master of Science, Nursing Leadership & Management
Western Governor's University
A review of the research literature reveals that, though it is replete with studies related to nursing job satisfaction, there is a distinct lack of research applied to job satisfaction within the emergency department, and particularly within those settings in American hospitals. In this research study, the expressed job satisfaction and morale of nurses working in emergency departments will be studied using a survey and short questionnaire. The nurses' perceptions about patient care variables, workload, communication among staff, hazardous work conditions, patient attributes, and hospital leadership and administration will be explored. The study participants will be actively employed as emergency department staff nurses in American hospitals. The significance of various contextual variables specific to emergency department nursing care in relation to the morale and job satisfaction of the nursing staff is to be discussed and…
Interdisciplinary Teams and the Importance of Collaboration
By those who know, collaboration in the medical field is generally considered to be the future of medicine. It's important to acknowledge that in medicine today, there are still large gaps of knowledge in the ways that clinical practice is applied: this is why successful collaboration within interdisciplinary teams is so crucial and so fundamental for successful patient outcomes as it offers a means of closing the gap, and of insuring that patient outcomes are as high-quality as possible. "Healthcare has very disparate collaborative experiences. As individual providers, nurses, PAs, physicians, physician consultants and pharmacists all work closely together to treat a hospitalized patient. However, on the other hand, physicians are trained to be independent in thought and care and do not think of themselves as depending on others. In residency, asking for help is often viewed as a weakness" (Campbell, 2013). This…
Campbell, K. (2013). Collaboration in Medicine: Working Together to Improve Care and Land Disabled Aircraft. Retrieved from whvheart.com: http://www.whvheart.com/collaboration-in-medicine-working-together-to-improve-care-and-land-disabled-aircraft/
Curley, C., McEachern, J.E., Speroff, T (1998). A firm trial of interdisciplinary rounds on the inpatient medical wards. An intervention designed using continuous quality improvement. Evidence-Based Nursing 40-54
Mazzaferro, A. (2011, November 28). Collaboration and compassion are keys to emergency care. Retrieved from calaverasenterprise.com: http://www.calaverasenterprise.com/health/article_f5da98a2-19fc-11e1-8d68-001cc4c03286.html
O'Daniel, M.R. (2013). Professional Communication and Team . Retrieved from ahrq.com: http://www.ahrq.gov/professionals/clinicians-providers/resources/nursing/resources/nurseshdbk/ODanielM_TWC.pdf
Multisystem Failure in a Geriatric Patient
Multisystem Failure in a Geriatric
eflect on your analysis of the geriatric patient in multisystem failure by doing the following:
Explain key immediate assessments you should make that would help assess the patient's homeostasis, oxygenation, and level of pain.
There are various diagnoses undertaken in assessing the patient's homeostasis, oxygenation, and level of pain. The immediate objective that nurses prioritize on is checking the patient's vital symptoms. Vital symptoms form the baseline of the assessment by providing significant information that illustrates whether the most essential organs function as required.
The assessment may involve checking the health status of the patient in the laboratory (Kane, 2004). In the laboratory, there is an assessment of the patient's capillary tube, urine test and blood pressure. When there is simultaneous malfunctioning of the body organs, nurses refer to this condition as multiple organ dysfunction (MODs).
Multiple organ dysfunction…
Esteban, A., Anzueto, A., Frutos-Vivar, F., Alia, I., Ely, E.W., Brochard, L., et al. (2004).
Outcome of older patients receiving mechanical ventilation. Intensive Care
Medicine, 30(4), 639 -- 646. Evidence Level IV: Nonexperimental Study.
Happ, M.B., Baumann, B.M., Sawicki, J., Tate, J.A., George, E.L., & Barnato, A.E. (2010).
Bobby and achel Liability
There is potential liability on the part of the various parties in the scenario involving Bobby, the nurse, the surgeon and City General Hospital. In this essay, the author will consider each party's responsibility and potential liability/neglect separately. We will define comparative negligence and discuss its application to the analysis of liability in the scenario. As we shall see further on, there is an inherent contradiction between the cost containment of managed health care and the law, but this does not excuse the gross negligence of the medical staff or reduce the ability of the plaintiff for civil damages.
EMTALA (Emergency Medical Treatment and Active Labor Act) requires almost all hospitals to provide an examination and needed stabilizing treatment, without consideration of insurance coverage or ability to pay, when a patient presents to an emergency room for attention to an emergency medical condition that requires immediate…
Daniels, N., & Sabin, J. (1998). The ethics of accountability in managed care reform. Health Affairs, 17(5), 50-64.
Li v. yellow cab co. -- case brief. (n.d.). Retrieved from http://www.lawnix.com/cases/li-yellow-cab.html.
Rothenberg, K.H. (1989). Who cares?: the evolution of the legal duty to provide.
Houston Law Review, 26(21), 21-76.
Arnold Palmer Hospital Labor and Delivery Workflow Analysis
The Arnold Palmer Hospital (AHC) located in Orlando, Florida is considered one of the most efficient and patient-centric healthcare providers in the U.S. due to the customer satisfaction scores the facility receives and amount of patients the hospital sees on an annual basis. The AHC has been ranked fifth in patient satisfaction out of 5,000 hospitals and sees on average 1.5 million children and women annually. It is the fourth-busiest labor and delivery hospital in the U.S. And the largest neonatal intensive care unit in the entire Southeastern U.S. AHC has also put into place one of the most thorough and well-respected continuous improvement processes in the U.S. healthcare system. With the goal of 100% patient satisfaction, AHC has created an entire quality management and improvement organization which is now a critical part of its culture.
Of the myriad of processes that…
Ahsan, K., Shah, H., & Kingston, P. (2010). Location context for knowledge management in healthcare. International Journal of Healthcare Technology & Management, 11(1), 3.
Bertolini, M., Bevilacqua, M., Ciarapica, F.E., & Giacchetta, G. (2011). Business process re-engineering in healthcare management: A case study. Business Process Management Journal, 17(1), 42-66.
Hellstrom, A., Lifvergren, S., & Quist, J. (2010). Process management in healthcare: Investigating why it's easier said than done. Journal of Manufacturing Technology Management, 21(4), 499-511.
Whiteman, A.S. (2004). Applying quality management in healthcare: A process for improvement. Hospital Topics, 82(1), 37-37.
Discuss the information presented in this article in the context of Dr. Julnes' Knowledge Utilization Framework
Performance measurement utilization within an organization encompasses two particular stages. Taking this model into account, data is not significantly utilized. The first stage takes into account the initial adoption of performance measurement and the second encompasses implementation where information was actually utilized or employed. With respect to performance measurement as knowledge utilization, external political pressure, internal political pressure and organizational culture play a role. The information presented by Spath (2007) in the article can be conveyed in the context of Dr. Julnes' Knowledge Utilization Framework as follows:
In this case, formal requirements encompass the requirements set by healthcare executives with respect to the performance measurement. These requirements have an influence on the technical capability that can be undertaken internally within the organization. Secondly, organizational culture determines the alignment of the goals and objectives of…
Sunrise Clinical System Version 6.1
The Emergency Room: Hybrid System
Meetings and Collaborative Care Councils
orkflow of the EMR
The KBC ( Knowledge Bas Charting) 3.4 Upgrade 6
The Role of the Nurse Informaticist
Comprehensive Analysis of my Clinical Experience
After completing 100 hours of practicum in informatics, the following will show the time at the site with my preceptor. The practicum took place at Franklin Hospital - North Shore Long Island. North Shore-LIJ which is an award-winning health system that consist of world-class tertiary hospitals, a nationally well-known children's hospital, a notorious mental facility and an assortment of community hospitals, in addition to a range of wellness and health programs. North Shore-LIJ Health System consist of 16 award-winning hospitals and approximately 400 physician practice locations all through New York, as well as Long Island, Manhattan, Queens and Staten Island. North Shore-LIJ Proudly serving an area of seven…
North Shore-LIJ Health System. (2014, April 29). Retrieved from North Shore LLJ: http://www.northshorelij.com/hospitals/services-and-programs/bariatric-surgery
Russell, C.L. (2010). A clinical nurse specialist -- led intervention to enhance medication adherence using the plan-do-check-act cycle for continuous self-improvement. Clinical Nurse Specialist, 24(2), 69-75. doi:10.1097/NUR.0b013e3181cf554d
Seidl, K. L. And Newhouse, R.P. (2012). The Intersection of evidence-based practice with 5 quality improvement methodologies. JONA, 42(6), 299-304. doi: 10.1097/NNA.0b013e31824ccdc9
Smith, K., Tremblay, M.L., Richer, M.C., and Lanctot, S. (2010). Exploring nurses perceptions of organizational factors of collaborative relationships. The Health Care Manager, 29(3), 271-278. Doi:10.1097/HCM.0b013e3181e9351a
While it may not be just to hold an organization liable, absolutely, for every instance of employee negligence, there is a rationale for imposing such liability in many cases. For example, many types of industries entail potential danger to others that are inherent to the industry.
Individual workers are not likely to be capable of compensating victims of their negligence, but the employer benefits and profits financially by engaging in the particular industry. Therefore, the employer should not necessarily escape liability for compensating all harm caused by their activities, regardless of fault in particular instances.
10.A nurse is responsible for making an inquiry if there is uncertainty about the accuracy of a physician's medication order in a patient's record. Explain the process a nurse should use to evaluate whether or not to make an inquiry into the accuracy of the physician's medication order.
Like other highly trained professionals, experienced nurses…
Abrams, N., Buckner, M.D. (1989) Medical Ethics: A Clinical Textbook and Reference for the Health Care Professionals. Cambridge, MA: MIT Press
Caplan, a.L., Engelhardt, H.T., McCartney, J.J. Eds. (1981) Concepts of Health and Disease: Interdisciplinary Perspectives. Reading, MA: Addison-Wesley
Starr, P. (1984) the Social Transformation of American Medicine.
New York: Basic Books
Since they have experience, they would serve as a great source and wealth of information for her as well as a sounding board when she is frustrated about certain aspects of the job. There will also be greater opportunities to meet, converse with and work with people from a variety of backgrounds.
The new cardiologist would also fare well by working in a clinic right after training. The pace of a clinic may sometimes be slower than that of a hospital and the patients treated there are usually not in a state of emergency. This does not diminish the importance of any cardiologist choosing to work in a medical clinic over a hospital. This slower pace may give the new cardiologist ample time to get acclimated to the procedures that she will be performing. It will also give her a longer time to perfect her surgery skills. Because clinics are…
Planning for Behavioral Emergencies on a Non-Psychiatric Unit
Hospital staffs are trained to deal with minor behavioral problems because they often occur when someone has some type of traumatic injury or occurrence. Especially patients who are confined to an ICU have issues which may cause them to exhibit adverse behavioral issues. Tesar and Stern (1986) list what should be examined as "(1) the presence of delirium or psychosis; (2) the type of ICU setting (e.g., coronary, surgical, respiratory, or medical); (3) a history of psychiatric disorder; (4) a history of central nervous system disorder; and (5) patients' personalities, which affect their reactions to illness and its treatment." Of course, there are many reasons why the staff in the ICU scenario was unprepared for the disruption caused by Mr. X, but by using the FOCUS model (Find a process to improve, Organize a team that…
American Hospital Association. (2007a). Case examples. Behavioral Health Challenges in the General Hospital.
American Hospital Association. (2007b). Recommendations. Behavioral Health Challenges in the General Hospital.
Cooke, M. (2010). The safe management of behavioral health patients in non- behavioral health settings. Alabama Safe Management.
DMHRM. (1997). Management of aggressive behavior. Women and Children's Hospital, Adelaide.
Rachel and Choo Hospital
Choo Choo's Liability
The fact that Rachel was initially discharged from the emergency department following examination by a physician with nothing more than a prescription for pain medication when she was in fact suffering form a very serious blood infection could definitely leave Choo Hospital exposed to litigation. There are several key elements of this case, as briefly as it has been described, that lead to this potential exposure to liability and tortuous action. First, the emergency room physician is expected to provide a certain level of care in his diagnosis, and if it was reasonable to foresee a more serious underlying problem of the general pain the patient presented with, the physician (and by extension the hospital) could be liable for failing to make proper recommendations and determinations. Second, then, a determination must be made as to whether or not the blood infection that was…
Nursing Case Study
The first concern is that Mrs. Baker is taking a new drug that has side effects such as she is experiencing. Although the other high blood pressure medication has similar side effects (Drugs.com, 2012), she has been taking it for a long period of time and should not be experiencing as much difficulty. It seems germane to ask her how long she has been taking the hydrochlorothiazide though. One of the first thoughts is how well do the two medications work together, which is something her doctor understands, and if she can have an increase in side effects because of the increase in medication. The second question the symptoms, especially the fact that she seemed "confused and beside herself" on the phone, is to determine if there are other symptoms of stroke. Her breathing difficulties could be a symptom of the medication, and so could the confusion,…
Drugs.Com. (2012). The side effect of Lisinopril. Retrieved from http://www.drugs.com/sfx/lisinopril-side-effects.html
knowledge statements on Cardiovasular Diseases among Minority Women in U.S.
Globally, cardiovascular diseases (CVD) accounts for the single largest cause of death among women, causing 8.6 million deaths annually (Keyhani et al., 2008). In the U.S., it is estimated that about 38.2 million women currently live with CVD and more women than men die each year from CVD (Mosca et al., 2007). Cardiovascular disease varies substantially not only across gender lines, but also across different ethnic groups in the U.S. For example, Hamner and Wildner (2008) noted that the prevalence of CVD is higher among African-American women (49%) when compared to Caucasian women (35%). According to Williams (2009), age-adjusted death rate to CVD in 2002 was significantly higher among African-American women (169.7 per 100,000) when compared to Caucasian women (131.2 per 100,000). Knowledge and awareness of cardiovascular risk factors is limited among African-American women as Williams (2009) citing a survey…
Hamner, J., & Wilder, B. (2008). Knowledge and risk of cardiovascular disease in rural Alabama women. J Am Acad Nurse Pract, 20(6), 333-338.
Keyhani, S., Scobie, J.V., Hebert, P.L., & McLaughlin, M.A. (2008). Gender disparities in blood pressure control and cardiovascular care in a national sample of ambulatory care visits. Hypertension, 51(4), 1149-1155.
Mosca, L., Banka, C.L., Benjamin, E.J., Berra, K., Bushnell, C., Dolor, R.J., . . . Wenger, N.K. (2007). Evidence-based guidelines for cardiovascular disease prevention in women: 2007 update. Circulation, 115(11), 1481-1501.
Williams, R.A. (2009) Cardiovascular disease in African-American Women: A health care disparities issue. Journal of National Medical Association, 101, 536-540
total I have 13 years in the nursing field. Throughout that combined time I have worked in nursing homes / assisted living facilities, home health, as well as in a hospital setting. During the time that I worked in the hospital I worked in a program called share the care. This entailed me working throughout the entire hospital as a nursing assistant, which gave me experience in various areas, i.e. The emergency room, intensive care, pediatrics, oncology and etc. By being apart of this program it has afforded me the opportunity to do what I truly love, be a part of the whole process of nursing sick patients back to health. This has always been a passion of mine.
A Nurse practitioner is a nurse who has completed a graduate nursing degree and training in providing preventive and medical health care to individuals and families in association with a physician.…
Greensboro AHEC Kids (2005). Nurse practitioner. Retrieved 09/23/05, from www.aheckids.com/nurprac.htm
U.S Department of Labor (2004-2005). Physicians Assistant. Occupational Outlook Handbook,, . Retrieved 09/23/05, from http://stats.bls.gov/oco/ocos081.htm
Also, as care is prioritized, those individuals deemed to be in a less urgent need of care are given a lower priority, which results in a wait list. Finally, as physicians are compensated on the same level of salary, fewer people may be attracted to the profession for its financial rewards. In a public system, patients shop around less for providers because most providers charge the same fees. ithin a public system there is less 'siphoning' of middle-income people to higher-cost physicians with short waiting lists.
Visit: http://www.csc-surgery.com/contact.php.hatexactly is this hospital? hat would your policy response be?
According to its website, the Cambie Surgery Centre is a private healthcare clinic. The site notes that the "BC provincial government looks to private health care facilities like the Cambie Surgery Centre to help ease the long public wait lists." The hospital is a paying hospital that uses sophisticated technology to perform its…
Cambie Surgery Centre." Official website. 7 Apr 2008. http://www.csc-surgery.com/contact.php
Economies of scale." Investopedia. 7 Apr 2008. http://www.investopedia.com/terms/e/economiesofscale.asp
Economies of scope." Investopedia. 7 Apr 2008. http://www.investopedia.com/terms/e/economiesofscope.asp
Green, David G., Ben Irvine & Ben Cackett. "Health care in Germany." 2005.
What torts are present in the scenario?
In the scenario with Phyllis there are several different kinds of tort that are present. These include: negligent and strict liability tort. Negligent tort is when a person is engaged in carelessness that resulted in bodily, emotional or financial harm. The way that this is affecting Phyllis, is with the restaurant ignoring the fact that she is bleeding profusely. Then, at the hospital the doctor amputated her foot vs. removing the piece of metal from her mouth. ("Types of Torts," 2012)
Strict liability tort is when the other party can collect damages from a particular activity being dangerous. In Phyllis' situation, she can use this to make a claim against the hospital. This is based on the fact that she is seeking out medical treatment (which is considered to be hazardous). ("Types of Torts," 2012)
Who are the potential plaintiffs and defendants…
Tort Damages. (2011). Law School Help. Retrieved from: http://www.west.net/~smith/tdamages.htm
Types of Torts. (2012). U.S. Legal. Retrieved from: http://torts.uslegal.com/types-of-torts/
What are the Four Elements of Tort. (2012). Finney Law Office. Retrieved from:
Issler is a patient who recently moved with his daughter-in-law who is no longer married to his son. As part of her interest in helping to take care of Mr. Issler, she noticed that he was pale and diaphoretic after a two and a half hour flight. The daughter-in-law took him to an emergency room where he was attended to by a cardiologist and set a follow-up check up for an echo cardiogram next week. Mr. Issler has complained of congestive heart failure and a history of deep vein thrombosis. The cardiologist recommended that he seeks out a primary care provider and check up of his thyroid. As the primary care provider, the patient has also expressed his uncertainties on whether he has hyper of hypo thyroidism though he has been under thyroid medication for several years. In addition to being very pale, he has a large bag of…
Bray, D.L. (n.d.). Thyroid Storm and the AACN Synergy Model. Journal of Nursing. Retrieved from http://rnjournal.com/journal-of-nursing/thryoid-storm-and-the-aacn-synergy-model
Drewes at. al. (2012, October). The Effectiveness of Chronic Care Management for Heart Failure: Meta-Regression Analyses to Explain the Heterogeneity in Outcomes. Health Services Research, 47(5), 1926-1959.
Hardin, S. & Hussey, L. (2003, February). AACN Synergy Model for Patient Care Case Study of a CHF Patient. Critical Care Nurse, 23(1), 73-76. Retrieved from http://ccn.aacnjournals.org/content/23/1/73.full.pdf
Kaplow, R. & Reed, K.D. (2008). The AACN Synergy Model for Patient Care: A Nursing
The expanding roles that nurses play in the healthcare field include taking the health history of patients. There are many important components to the task of taking patient histories, and this paper reviews those important aspects and components that are published in the Nursing Standard article by Lloyd H. Craig.
Craig says taking the history of patients is "…arguably the most important aspect of patient assessment" (Craig, 2007, p. 42). The reason it is so vital to the practitioner (or doctor) is that every healthcare issue or concern that the patient has encountered in his or her past -- recent or not -- may have implications for how the patient is to be treated.
Nurses do not always see the patient in a doctor's office or a hospital patient room. The nurse might encounter patients in the following environments, according to Craig: a) in an accident scene or…
Craig, Lloyd H. (2007). A guide to taking a patient's history. Nursing Standard, 22(13), 43-48.
Type I diabetes is usually diagnosed in children and young adults and results from the body's failure to produce insulin. Type 1 account for 5% to 10% of all diagnosed cases of diabetes (Centers for Disease Control, National Diabetes Fact Sheet, www.cdc.gov/diabetes/pubs/pdf/ndfs_2003.pdf). The most common form of diabetes is Type II, which accounts for about 90 to 95% of all diagnosed cases of diabetes (Centers for Disease Control, National Diabetes Fact Sheet, www.cdc.gov/diabetes/pubs/pdf/ndfs_2003.pdf). Pre- diabetes is a condition often present prior to the development of Type II diabetes. In pre-diabetes, blood glucose levels are higher than normal, but not high enough to be considered diabetic.
Pre-diabetes does not have to lead to the development of diabetes if a person diagnosed with this condition: Patients who work to control their weight and increase their physical activity can often prevent or delay the onset of diabetes. There are 41 million Americans…
American Diabetics Association. Retrieved 22 March 2010 from http://www.diabetes.org/diabetes-basics/diabetes-statistics/
Centers for Disease Control, National Diabetes Fact Sheet.Retrieved 18 March 2010 from www.cdc.gov/diabetes/pubs/pdf/ndfs_2003.pdf
Acute Scrotum Case Study
When a male presents with acute scrotum pain and swelling a number of different diagnoses are possible; however, if the diagnosis is testicular torsion then the patient needs to be evaluated by a competent surgeon immediately (reviewed by Kass and Lundack, 1997). Of the many possible diagnoses that can produce similar symptoms, including epididymitis, hernia/hydrocele, varicocele, epididymo-orchitis, torsion of a testicular or epididymal appendage (appendiceal torsion), or Henoch-Schonlein purpura, only testicular torsion represents a bona fide medical emergency. For this reason, a detailed patient history and physical examination should be undertaken at once in order to preserve testicular function. Every effort should be made to gather a complete urologic and surgical history for the patient to exclude other conditions, including a urinary tract infection and epididymitis.
A recent study examined the diagnosis distribution for 388 boys under the age of 17 who were treated at…
Kass, Evan J. And Lundak, Bruce. (1997). The acute scrotum. Pediatric Clinics of North America, 44(5), 1251-1266.
Makela, E., Lahdes-Vasama, T., Rajakorpi, H., and Wikstrom, S. (2007). A 19-year review of paediatric patients with acute scrotum. Scandinavian Journal of Surgery, 96, 62-66.
Nelson, Caleb P., Williams, JeffreyF., and Bloom, David A. (2003). The cremasteric reflex: A useful but imperfect sign in testicular torsion. Journal of Pediatric Surgery, 38, 1248-1249.
Ringdahl, Erika and Teague, Lynn. (2006). Testicular torsion. American Family Physician, 74, 1739-1743.
Even a day and a half can run thousands or even tens of thousands of dollars, because hospital prices are greatly inflated based on the care that the person actually receives. Of course, the other matter that comes along with these kinds of charges for medical care is on the side of the patient. He or she begins receiving bills for care that he or she feels was not received. Whether the patient pays these bills can have a serious effect on his or her credit rating, and can also cause other problems financially. There may come a time when the patient cannot meet his or her obligations to the hospital because of financial hardship, which produces an argument over whether the patient should even be paying for care that he or she believes has not been received while in the hospital.
A patient in the hospital should receive proper…
young, most of us do not think about making a conscious decision to die. e look forward to years of long and healthy life, and if death ever seems appealing it is as an antidote to depression. It does not often, if ever, occur to us that there will be a time when we look forward to the "good death" promised by euthanasia.
But it is inevitable that for many of us there will come a time in our lives when suicide may indeed seem appealing because we are fighting a losing battle against a certainly fatal disease that fills our remaining days with pain and despair. In such a position many of us may wish to have our doctors help us die by prescribing for us drugs that when we ourselves take them will prove to be fatal. Or we may wish that other people should have this option…
Callahan, Daniel, "Good Strategies and Bad: Opposing physician-assisted suicide," Commonweal, December 3, 1999, sec1. 7+.
Cassel, Christine K. "AMA Guidelines for Caring for Patients in the Last Phase of Life.," CQ Researcher 7 (1997): 774. ( http://www.ama-assn.org/sci-pubs/amnews/amn_97/edit0721.htm )
Humphrey, Derek. Euthanasia: Essays and Briefings on the Right to Die. Los Angeles: Hemlock Society, 1991. http://deathwithdignity.org/euth_us2htm .
Orric, Sarah. "House Judiciary Committee Rationale." Congressional Digest 77 (1998); 263-264.
However, college students are not an easily quantifiable demographic. Their age and other characteristics vary greatly, making it impossible to precisely categorize them. Second, it will be difficult to select random participants because, with the use of alcohol, the people most likely to participate in the study are those who enjoy drinking alcohol. This will effect the results because people who drink alcohol have a higher tolerance and thus will show less effect after consuming it. Third, because of the use of alcohol the company will have to ensure that all participants are legal. Further, the participants will have to be informed that they are drinking an intoxicating substance. This will make having a control and experimental group impossible because those drinking alcohol will have to know they are drinking, which could create a mental effect on their performance and thus effect the overall results. For these reasons, as chief…
Ensuring the Integrity of the Research Process." Responsible Science. Vol. 1:30, NAS, 1992.
Girdner, Ellen R.R. (2001): Evaluating Research Articles from Start to Finish. London: SAGE Publications.