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O'Meara stresses that a system known as a Decision Support System of DSS can be integrated into existing it to identify potential errors that could be made on any given case and provide the staff with flags to help them avoid such errors. (December 2007, pp. 970-979) DSS technology can seriously improve the chances that patients will not receive inadequate care or that services and potential challenges to them get noted and flagged appropriately to alert nurses to ways in which common mistakes can be made. DSS systems could alert the nurse of patient allergies, noted mechanical checks, crosschecking medication administration and any number of things that support patient safety.
Conversely Giordano, stresses that patient safety, in spite of it and other technology now utilized for patient care is essentially the nurses responsibility, therefore it is absolutely essential that the nurse advocates for safety and does not rely so much…
Cobb, D. (August 2004) Improving Patient Safety -- How Can Information Technology Help?
AORN Journal 80 (2) 295-302.
Giordano, B.P. (February 1995) High-tech health care is great, but our first duty is to do no harm. AORN Journal (61(2) 314.
Lewis, R.F. (2002) the Impact of Information Technology on Patient Safety. New York: Healthcare Information and Management Systems.
They added newer constructs to a PC model developed earlier by Gershon and his colleagues (2000), which unveiled the relationship of safety and security aspects and linked it with work performance. They found that when hospital staff used the Gershon tool there was considerable increase in the patient safety culture. They concluded that the health care decision makers when using Gershon safety tools, which appear to have sufficient reliability and validity, can effectively analyze the perception of the employees about patient safety in their organization and can use the tool as an indicator of the employee satisfaction with current procedures adopted for patient safety (as cited in Turnberg and Daniell, 2008).
Another PC quantitative model was developed by Leonard and Frankel (2010), who stated that the main goal of all health care systems is to bring safe and reliable healthcare services to the registered patients. The organizations are required to…
Stocka, G.N., McFaddena, K.L. And Gowen III, C.R. (2007). Organizational culture, critical success factors, and the reduction of hospital errors. Int. J. Production Economics 106, 368 -- 392.
Turnberg, W. And Daniell, W. (2008). Evaluation of a healthcare safety climate measurement tool. Journal of Safety Research 39, 563 -- 568.
Vira, T., Colquhoun, M., & Etchells, E. (2006). Reconcilable differences: correcting medication errors at hospital admission and discharge. Quality & Safety in Health Care, 15(2), 122-126. Taken from: Bonner, Certified Nursing Assistants' Perceptions of Nursing Home Patient Safety Culture: Is There a Relationship to Clinical or Workforce Outcomes?: A Dissertation. Graduate School of Nursing, University of Massachusetts Worcester. GSN Dissertations.
Patient care and recovery statistics demonstrate that the United States has a medical care system with which Americans are less satisfied than other citizens in developed countries. There are many reasons for this: correlation between health and socioeconomic status; non-universality; federal government is not involved in medical planning although it purchases a large percentage of the 14% health care GNP; lobbying and special interest group interference; and political opposition to restraining medical developments.
Life expectancy for men is valuated at 71.8 years and for women, 78.8 years. From a natural lifespan perspective, this is one of the lowest survival rates of any developed country in the world. Preventable medical errors must then be factored in for the 44 to 98,000 people who die each year and the lowered survival rate is forced even lower -- and is preventable.
Medical errors account for nearly $29 billion in annual revenue, making this…
Brennan, T.A., Leape, L.L., Laird, N.M. et al. (1991). Incidence of adverse events and negligence in hospitalized patients. Results of the Harvard Medical Practice Study I. N Engl J. Med, 324(6), 370-6.
Centers for Disease Control and Prevention. CDC antimicrobial resistance and antibiotic resistance -- general information. Retrieved December 11, 2004, from Center for Disease Control database.
Fourth Decennial International Conference on Nosocomial and Healthcare-Associated Infections. (2000). Morbidity and Mortality Weekly Report, 49(7), 138.
HCUPnet, Healthcare Cost and Utilization Project. Agency for Healthcare Research and Quality, Rockville, MD. Accessed December 11, 2004 .
Patient Safety and Security
Patient information, privacy and security are at the heart of providing a high level of medical services. These issues are vitally important if patient confidence is to be retained, in addition to ensuring that no potential harm comes to the patient. Hence, the information systems at any hospital should be managed in such a way as to retain the confidentiality of patient information, particularly where such information is still disseminated in hard copy form. Although St. John's Hospital prides itself on its ability to retain patient confidentiality, potential security breaches should be prevented where possible and dealt with immediately where they are unforeseen.
The issue of discarded printouts is very serious on a number of levels. There is no confidentiality if cleaning staff can simply take the printouts and read them. On a more serious level, the discarded printouts are widely available once they leave the…
Kolodner, R. (2007, Jun. 19). Statement. Retrieved from: http://www.hhs.gov/asl/testify/2007/06/t20070619b.html .
Maerian, L. (2010, Jul. 8). Feds propose rules to strengthen patient privacy rights. Retrieved from: http://www.computerworld.com/s/article/9178997/Feds_propose_rules_to_strengthen_patient_privacy_rights
MHA UAP Toolkit (2008, Sep. 2). Unlicensed Assistive Personnel Training Policy. Retrieved from: http://web.mhanet.com/userdocs/articles/UAP_training_policy.pdf
Radiological Society of North America, Inc. (RSNA). (2011). Patient Privacy and Security of Electronic Medical Information. Retrieved from: http://www.radiologyinfo.org/en/news/newdetarget.cfm?ID=19
Patient Safety Through Medication econciliation
The adoption of the Affordable Healthcare Act has assisted an increasing number of Americans to have access to health insurance. Despite the benefits associated with the new law, the quality of health delivery is still low because of the issue such as medication errors. The poster recommends an implementation of medical reconciliation to improve the quality of healthcare delivery in the United States. The method of achieving the medical reconciliation is to use the tools such as OASIS, HHCAHPS, Quarterly eports, Supervisory Visits, and Organizational Performance Improvement. Application of these tools will assist in enhancing a quality of healthcare delivery.
In the contemporary health environment, the U.S. is undergoing some fundamental changes because of an adoption of ACA (Affordable Healthcare Act) generally known as Obama Care. The new law is rapidly increasing the number American residents having a health insurance and raising the number…
Beatrice, T. (2014). Improving Patient Safety by Improving Medication Communication. Orthopaedic Nursing. 28 (3): 153-154.
Cornu P, Steurbaut S, Leysen T, et al. (2012). Effect of medication reconciliation at hospital admission on medication discrepancies during hospitalization and at discharge for geriatric patients. Ann Pharmacother. 46: 484-494.
Greenwald, J.L., Halasyamani, L., & Greene, J., et al. (2010). Making inpatient medication reconciliation patient centered, clinically relevant and implementable: a consensus statement on key principles and necessary first steps. J Hosp Med. 5:477
Musgrave, C.R. Pilcha, N.A. Taberb, D. J. (2013). Improving transplant patient safety through pharmacist discharge medication reconciliation. American journal of transplantation. 13(3): 796-801.
Patient Safety Outcomes to ADN and BSN Nurses:
As evident in theme of national reports in the health care field, promoting higher education for registered nurses has been a topic of increased concern. These recommendations are primarily based on overwhelming evidence that nurses with Bachelor of Science in Nursing (BSN) degrees tend to pursue education at masters or doctoral levels to enhance the effectiveness of the practices. The pursuit for high levels of education provides is an essential component for maintaining an adequate number of nurse practitioners, clinical nurse specialists, midwives, and nurse educators, which in turn contribute to improved patient safety outcomes.
The need to increase the educational levels of registered nurses is fueled by the growing research that links patient safety and outcomes to the percentage of ADN-level and BSN-level nurse practitioners on a unit (Scott & Brinson, 2011, p.300). Due to the increased emphasis on the need…
"Frequently Asked Questions -- Doctor of Nursing Practice." (n.d.). School of Nursing. Retrieved from The Catholic University of America website: http://nursing.cua.edu/graduate/dnp/faq.cfm
Loomis, J.A., Willard, B. & Cohen, J. (2007, January). Difficult Professional Choices: Deciding
Between the PhD and the DNP in Nursing. The Online Journal of Issues in Nursing, 12(1). Retrieved from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume122007/No1Jan07/ArticlePreviousTopics/tpc28_816033.html
Scott, E.S. & Brinson, H. (2011). Escalating the Pathway from the Associate's Degree in Nursing to the Bachelor of Science in Nursing and/or the Master's of Science in Nursing: What is Standing in the Way? North Carolina Medical Journal, 72(4), 300-303. Retrieved from http://www.ncmedicaljournal.com/wp-content/uploads/2011/07/72411-web.pdf
Tissue Tracking and Patient Safety
Systemic Tissue Tracking Deficiencies emain a Serious Threat to Patient Safety
Systemic Tissue Tracking Deficiencies emain a Serious Threat to Patient Safety
The Joint Commission established standards for the handling of tissues for allograft procedures in 2005 (Meeting JCAHO's new tissues standards, 2005). The three main areas of concern were creating a standardized process for handling tissues, investigating adverse events, and tracking the tissue from donor to recipient. The details of these rules can be found on the website for the U.S. Food and Drug Administration (FDA, 2013). The International Council for Commonality in Blood Banking Automation (ICCBBA, 2013) has produced a set of international coding standards for medical products derived from humans, including blood, tissues, organs, milk, cellular therapy products, and plasma products that must be ABO typed before use. These standards are used in more than 75 nations on six continents…
Brubaker, S.A. (2010). Tissue tracking failures and lessons learned: Hope for the future. Retrieved 15 Apr. 2014 from http://www.aatb.org/aatb/files/ccLibraryFiles/Filename/000000000234/scott-brubaker-mc-n_tissue-tracking-failures-lessons-learned.pdf .
CDC. (2011). Transmission of hepatitis C virus through transplanted organs and tissue: Kentucky and Massachusetts, 2011. Morbidity and Mortality Weekly Report, 60(50), 1697-700.
FDA. (2013). Vaccines, Blood & Biologics: Biologics Rules. Retrieved 15 Apr. 2014 from http://www.fda.gov/BiologicsBloodVaccines/GuidanceComplianceRegulatoryInformation/ActsRulesRegulations/default.htm .
Giachetta-Ryan, D. (2008). On the trail of tissue tracking. OR Nurse, 2(9), 27-9.
Evolving ole of Call Lights and Nursing ounds in Hospitals
The use of call lights in hospital settings has increasingly come under study as a function of nursing shortages, changes in nursing rounds, and robust studies of patient outcomes. The scheduling of regular nursing rounds may be pivotal to the ability of nurses to address common, mundane patient issues compared to more critical needs that have been considered the primary target for patient call light use. In addition to patient safety and general well-being while hospitalized, nursing staffs are concerned with patient satisfaction. On a fundamental level, patients who experience peace of mind may heal more quickly, may relay fewer stressful communications to their family members, and may attain a clarity of perspective that enables them to differentiate among their many needs and desires while confined to their beds. The institutionalization of regular and frequent nursing rounds may alleviate patient…
Meade, C.M., Bursell, A.L., and Ketelsen, L. (2006, September). Effects of nursing rounds: on patients' call light use, satisfaction, and safety. American Journal of Nursing, 106(9), 58-70. Retreived from http://www.ncbi.nlm.nih.gov/pubmed/16954767
Saleh, B.S., Nusair, H., Al Zubadi, N. Al Shloul, S., & Saleh, U. (2011, June). The nursing rounds system: Effect of patient's call light use, bed sores, fall and satisfaction level. International Journal of Nursing Practice, 17(3), 299-303. Doi: 10.111/j.1440-172X.20111.01938x. Retreived from http://www.ncbi.nlm.nih.gov/pubmed/21605271
The author of this report is to assess an ethical dilemma that involves a couple of important factors. The two main ethical issues are patient privacy and when the proper time to blow the whistle on a doctor truly comes, not to mention how to do it. Kendra finds out that a family member is about to get gastric bypass from a doctor that has had a staggering amount of people that have had complications or died post-surgery. She feels compelled to warn her mother even though this would be a breach of privacy laws and ethical guidelines. While privacy regulations are in place for a reason, patient safety is also a valid concern and that is clearly an issue with Dr. ussell and his practices.
Sue's internal forces would include the fact that Dr. ussell, her boss and employer, is facing a lawsuit due to the…
AACAP. (2014, July 11). Know Your Rights: Consent and Confidentiality. Know Your
Rights: Consent and Confidentiality. Retrieved July 11, 2014, from http://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/Facts_for
AMA. (2014, July 11). AMA's Code of Medical Ethics. AMA's Code of Medical Ethics.
Workplace Demands Influences Patient Safety
PICOT Question: How can the implementation of accurate safety standards reduce errors that hamper patients' safety in healthcare facilities in the short and long run?
P -- Patients in healthcare facilities
ecognition of Errors
Procedural and Human Errors
O -- Implementation of Safety Standards and Systems to improve Caretaker Efficiency and Patient Security
different interventions take different times, but results should be seen with a year from all interventions and comparison interventions
P -- Patient Population (Patients in healthcare facilities)
Healthcare in the U.S. is not as safe as it must be-- and can be. A minimum of 44,000 individuals, and possibly as many as 100,000 individuals, pass away in healthcare facilities each year as an outcome of medical mistakes that can be averted, according to estimations from 2 significant research studies. Even utilizing the lowered estimations, avoidable medical mistakes in medical…
Craig L. (2012). A prescription for safer care: medication reconciliation. Can J. Neurosci Nurs. 2012;34(3):5-6.
Kmietowicz, Z. (2013). Government will need to make health policy U. turns after Francis report, says safety expert. BMJ;346:f728.
Lee MJ. (2013). Quality: a process or an outcome? It's not what you may think. Clin Orthop Relat Res;471(4):1097-9.
McDonald KM, Matesic B, Contopoulos-Ioannidis DG, Lonhart J, Schmidt E, Pineda N, Ioannidis JP. (2013). Patient safety strategies targeted at diagnostic errors: a systematic review. Ann Intern Med;158(5 Pt 2):381-9.
Nursing ole in Patient Safety
The nursing workforce is the biggest workforce in the health care industry. The nursing staff in hospitals is primarily tasked with patient surveillance in both ambulatory settings and care facilities (seldom termed as patient monitoring / evaluation / assessment). Patient surveillance is important for recognition of errors and evading adverse incidents. Most patient safety experts believe in cultivating an impartial system which acknowledges a system's and individual contribution to both adverse incidents and successful efforts, facilitating decreased errors. This notion is mentioned in To Err is Human, which states that prevention of error and augmenting patient's safety is cultivated when a system is developed for individual approach which will target altering the conditions of a system giving rise to errors. Since nurses are biggest workforce of healthcare industry, and largely engaged with detection, commission and evasion of such errors and accidents, they and their environment…
Page, A., & Institute of Medicine (U.S.). (2004). Keeping patients safe: Transforming the work environment of nurses. Washington, D.C: National Academies Press.
Cherry, B., & In Jacob, S.R. (2014).Contemporary nursing: Issues, trends, & management.
White, P., & McGillis Hall, L. (2001).Patient safety outcomes. In D.M. Doran (Ed.),Nursing sensitive outcomes state of the science (pp. 211-242). Toronto: Jones & Bartlett
Cook, R.I., Render, M., & Woods, D.D. (2000).Gaps in the continuity of care and progress on patient safety. British Medical Journal, 320, 791-794
Improved communication was selected, because these issues are contributing to some of the different errors that have taken place. Training is when you are showing the staff how to trouble shoot, various issues that could occur. ackup systems are designed to create secondary alarms and other fail safes (in the event that one system is not working properly). These different strategies were selected, because they work in conjunction with one another, to address the underlying problems affecting patient safety at the facility. (Kowlayczk, 2010)
Describe the accreditation, licensure, or oversight for this type of organization, and explain the process or criteria used
The oversight for Massachusetts General is the Department of Health and Human Services. The process that they are using to achieve these objectives is: the Hospital Survey on Patient Safety. Like what was stated previously, this is a quality of care survey that all outgoing patients will complete.…
The Patient and Quality Improvement Act of 2005. (2008). Agency for Health Care Research and Quality. Retrieved from: http://www.ahrq.gov/qual/psoact.htm
Kowlayczk, L. (2010). MGH Spurs Death Review. Boston.com. Retrieved from: http://www.boston.com/news/health/articles/2010/02/21/mgh_death_spurs_review_of_patient_monitors/
Mitchell, P. (2005). Defining Patient Safety and Quality Care.AHRQ. Retrieved from: http://ahrq.hhs.gov/qual/nurseshdbk/docs/MitchellP_DPSQ.pdf
At present, Langley Mason Health (LMH) is in the process of sourcing for funds to actualize the facilities master plan (FMP). The funds that have been sourced so far are insufficient. For this reason, and as has been pointed out in the case study, LMH is seeking to raise additional funds from “revenue bonds, growth strategies, philanthropic efforts, and strong operational performance over the next ten years.” This effectively leaves LMH with very little it can do in the medium-term because a significant portion of routine capital funds are also being diverted towards this same endeavor. Thus, the amount to be spent on not only equipment, but also technology acquisition and other routine maintenance concerns is very limited.
At present, there have been efforts to replace LMH aging pumps with a smart IV pump. There is sufficient evidence to suggest that such a pump would come…
Spath, P. (2011). Error Reduction in Health Care: A Systems Approach to Improving Patient Safety (2nd ed.). Hoboken, NJ: John Wiley & Sons.
This paper provides a literature review of the topic of alarm fatigue and alarm management. The sources used were all published from 2016 onward and dealt in some way with alarm fatigue or with the challenges of alarm management. The papers were selected using databases ProQuest, PubMed, Springer, NCBI, and ScienceDirect. The keywords used for searching were “alarm fatigue,” “alarm management,” and “alarm fatigue patient safety.” The results of the review showed that alarm fatigue is represented as a serious problem for nurses for multiple reasons: 1) it prevents them from paying close attention to alarms that could be serious and thus there is a risk of not responding in a time of real crisis; 2) it can lead to patient safety errors, as nurses seek to avoid the constant wave of alarms by altering their volume or sensitivity; 3) it can cause problems with morale; and 4) there…
Baker, K., & Rodger, J. (2020). Assessing causes of alarm fatigue in long-term acute care
and its impact on identifying clinical changes in patient conditions. Informatics in Medicine Unlocked, 18, 100300. https://www.sciencedirect.com/science/article/pii/S2352914819304241
Cho, O. M., Kim, H., Lee, Y. W., & Cho, I. (2016). Clinical alarms in intensive care
units: Perceived obstacles of alarm management and alarm fatigue in nurses. Healthcare informatics research, 22(1), 46-53. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4756058/
Hravnak, M., Pellathy, T., Chen, L., Dubrawski, A., Wertz, A., Clermont, G., & Pinsky,
M. R. (2018). A call to alarms: Current state and future directions in the battle against alarm fatigue. Journal of electrocardiology, 51(6), S44-S48. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6263784/
Lewandowska, K., Weisbrot, M., Cieloszyk, A., Medrzycka-Dabrowska, W., Krupa, S.,
& Ozga, D. (2020). Impact of Alarm Fatigue on the Work of Nurses in an Intensive Care Environment—A Systematic Review. Int. J. Environ. Res. Public Health, 17, 8409. https://search.proquest.com/openview/23f7f6945718250d9afb6d5db5564120/1?pq-origsite=gscholar&cbl=54923
The role of patient safety in quality care should be front and center; however, as the IOM (2000) reported, too many patients are dying as a result of medical error. To protect patients, the IOM recommended several courses of action that the federal government could undertake in order to address this issue. This resulted in the development and application of several federal initiatives that are used to prevent unintentional death from medical errors.
These initiatives were detailed in the FDA’s Federal Actions to Reduce Medical Errors and Their Impact. Some of the initiatives include incorporating a mandatory reporting system that would allow the Agency for Healthcare Research and Quality (AHRQ) to collect information on medical errors and resulting deaths from the more than 500 hospitals and clinics operated by the Department of Defense (serving 8 million patients) to better understand the phenomenon and why these accidents occur. Additionally,…
Patient Care and Hospital Management Systems
The given case study entails the difficulties faced by Langely Mason Health which is a major health services provider in the given district. The management of LMH has decided to upgrade its health services standards in the best interest of patient care. The whole process of upgrading involves extending hospital's facility as well automating the functions of the hospital's departments with the help of integrated system. For this purpose, lengthy planning, asset acquisition, fund raising activities and other activities are performed. The overall upgrading left the hospital management with limited budget for regular operations.
For the purpose of automating the hospital functions, EM system is purchased in the year 2006. This organization-wide system was expected to become functional and stabilized in the first phase of implementation and the subsequent implementation were dependent on its success. Due to…
Drazen, E., Feeley, R., Metzer, J., Wolfe, H. (1980).Methods for evaluating costs of automated hospital information systems. Department of Health and Human Services, National Centre for Health Services Research, PHS no. 233-79- 3000
Farlee C. (1981). Systems Evaluation: Problems and challenges. Proceedings, First National Conference on Computer Technology and Nursing Bethesda MD: U.S., DHHS, PHS (NIH Pubn0 83- 2124).
Herbst, K., LittleJohns, P., Rawlins, J., Collinson, M., & Wyatt, C. (1999). Evaluating computerized systems: hardware, software and humanware: experiences from the Northern Province South Africa, Journal of Public Health Medicine,3, pp.305-310.
Hendrickson, G., & Kover, C.T. (1990). Effects of computers on nursing resource use . Do computers save time? Computers in Nursing, 8: 16- 22.
Gonzalez (2007), discusses the company WellPoint Inc. that provides its members with the capability to develop their own personal health records, an option to receive test results online, provide a limited set of records to their providers and to allow other family members access to the information. In terms of security safeguards, WellPoint tracks who accesses information and has staff members to monitor the systems for potential breaches. This in turn offers users a certain level of security and quality in services rendered.
As pay-for-performance programs flourish, there is a fear that many EHs cannot accurately capture the data that is required to participate. The biggest obstacles for software makers are the sheer volume of performance measures and the lack of standardization among them. One pressing issue is that some EH systems are still text-based and are therefore not as powerful for reporting and extracting information. (McKinney, 2007)
Burda, D. (2007, June 4). Hey, you asked for it. Modern Healthcare, 37(23), p.25.
Cavolo, D.J. (2007, July). Electronic medical record system: know the cost of ownership. Nursing Homes, 56(7), pp. 17-19.
Evans, M. (2007, July 30). Push for Quality Starts with it. Modern Healthcare, 37(30), pp.22,24,28.
Freudenheim, M. (2005, September 19). Doctors collaborate to find less costly way to add electronic medical records. New York Times, p. C4.
Blueprint for Evaluating Patient Safety Competency in Nursing Students
Ever since the report To Err is Human was published in 2000 by Kohn and colleagues, healthcare stakeholders in Western countries have intensified reform efforts designed to increase patient safety. The report revealed that nearly 100,000 patients were dying annually from medical errors in the 1990s, a statistic that caught the attention of legislators, healthcare policymakers, clinicians, patients, and the general public. Additional research revealed that nurses were considered to be the source of most medical errors and also the best defense against errors, but nurses had little, if any, control over patient care planning (Lachman, 2007). Systems were therefore a major determinant of patient safety.
Patient safety and nursing ethics are also inseparable (Lachman, 2007, p. 401). While avoiding specific recommendations, provision three in the American Nurses Association Code of Ethics states that nursing professionals must protect the safety of…
AACN (American Association of Colleges of Nursing). (2012). Graduate-level QSEN competencies knowledge, skills, and attitudes. Retrieved from http://www.aacn.nche.edu/faculty/qsen/competencies.pdf .
Clark, C.C. (2008). Classroom Skills for Nurse Educators. Sudbury, MA: Jones and Bartlett Publishers.
IAR (Instructional Assessment Resources). (2011). Assess Students: Multiple-choice questions. Retrieved from https://www.utexas.edu/academic/ctl/assessment/iar/students/plan/method/exams-mchoice-bloom.php.
Institute of Medicine. (2010). The future of nursing: Focus on education. Retrieved from https://www.iom.edu/~/media/Files/Report%20Files/2010/The-Future-of-Nursing/Nursing%20Education%202010%20Brief.pdf.
Quality and Safety Education for Nurses
The issue of patient safety has been a concern to medics and the stakeholders in the health care system over many years. This has been propelled by constant emergence of life threatening injures to people visiting or working within the healthcare facilities s well as construction of buildings and entrances that do not meet the required standards of hospitals. This largely informs the basis of this paper to find out where the wrongs are and how these can be rectified to provide a good environment for patients.
The patient safety is as important as the rescue of the life of a patient when he walks into the hospital to seek medical attention. The nurses and doctors are hence required to adhere to the call of the Nursing and Midwifery Council of "Nurses and nursing staff manage risk, are vigilant about…
Florence L., et.al., (2008). Hallmarks of Unsafe Practice: What Preceptors Know. Retrieved April 18, 2014 from http://www.nursingcenter.com/lnc/CEArticle?an=00124645-200811000-00001&Journal_ID=54029&Issue_ID=830968
Kreimer S. (2014). 10 Best Practices for Patient Safety. Retrieved April 18, 2014 from http://www.nursezone.com/nursing-news-events/more-news/10-Best-Practices-for-Patient-Safety_33666.aspx
Royal College of Nursing, (2014). Patient Safety and Human factors. Retrieved April 18, 2014 from http://www.rcn.org.uk/development/practice/patient_safety
business plan provides a process change for bedside patient handoffs at Samaritan Medical Center, Watertown, New York. An overview of the medical center is followed by its mission and vision statements, and organizational values. A discussion of the assumptions involved together with a breakdown of associated costs involved in the business plan are followed by a discussion of the importance of timely patient handoffs and a description of the proposed bedside handoff protocols for Samaritan Medical Center.
Overview of Samaritan Medical Center:
"Samaritan Medical Center (Watertown, New York) is a 294-bed not-for-profit community medical center, offering a full spectrum of inpatient and outpatient healthcare services. From primary and emergency care to highly specialized medical and surgical services, such as cancer treatment, neonatal intensive care, behavioural health and addiction services, and imaging services, Samaritan Medical Centre and its team of healthcare professionals proudly serves the medical needs of our civilian and…
Centers for Medicare & Medicaid Services. (2008). Facts sheet: HCAHP facts. Retrieved from http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2008-Fact-sheets-items/2008-03-28.html?DLPage=4&DLSort=0&DLSortDir=descending
Centers for Medicare & Medicaid Services. (2013). HCAHPS facts sheet (CAHPS hospital survey). Retrieved from http://www.hcahpsonline.org/Facts.aspx
Friesen, M.A., White, S.V., & Byers, J.F. (2008). Handoffs: Implications for nurses. In Hughes, R.G. (Ed.). Patient safety and quality: An evidence-based handbook for nurses,
(pp. 2-285 -- 2-332). Rockville, MD: Agency for Healthcare Research and Quality.
Assessment 3: Professional Accountability and Patient Safety
Defining the Issue: Violence from Patients towards Nurses:
In this discussion, I concern myself with ‘violence from patients towards nurses.’ It is important to note, from the onset, that violence meted to nurses by patients is one of the least discussed contemporary nursing issues. In the words of Stevenson, Jack, O’Mara and LeGris (2015, p. 32), “registered nurses (RNs), compared to other healthcare providers are at a higher risk of experiencing violence in the workplace that is initiated by patients and families.” In essence, violence from patients towards nurses includes any act of aggression initiated by the patient and (or) their relatives and friends and directed at the nurse. Acts of aggression in this case could include, but they are not limited to, grabbing, scratching, hitting, and in some cases shouting down the nurse in a threating manner. It is important to note…
Electronic Medical ecords (E-SIHI) in King Khalid University Hospital on Patient Safety
The objective of this study is to demonstrate the impact of e-SIHI (Electronic Medical ecords) on patients with regards to their security and safety. The King Khalid University Hospital has implemented the e-SIHI since May 2015 for all departments. Two weeks after the implementation, QMD (Quality Management Department) conducted an audit to measure a compliance for the system and ascertain whether the e-SIHI can improve health and safety of patients. However, the QMD found that there are many areas requiring improvement in the system. The paper discusses the methodology used to evaluate the system to ascertain whether e-SIHI is beneficial to the patient.
The research methodology reveals research design discussing the method of data collection, sample population, sample size, and project tool.
Study Design: The team audits the e-SIHI using a checklist to verify whether the…
AlAswad, A.M. (2015). Issues Concerning the Adoption and Usage of Electronic Medical Records in Ministry of Health Hospitals in Saudi Arabia. School of Health and Related Research (ScHARR) the University of Sheffield.
Bowman, S. (2013). Impact of Electronic Health Record Systems on Information Integrity: Quality and Safety Implications. Perspectives in Health Information Management, 10.
Jang, J., Yu, S. H., Kim, C., Moon, Y. et al. (2013). "The effects of an electronic medical record on the completeness of documentation in the anesthesia record, International journal of medical informatics, 82(8):702-707.
Kazley, A. S. & Ozcan, Y. A. (2009). Electronic medical record use and efficiency: A DEA and windows analysis of hospitals, Socio-economic planning sciences, 43(3): 209-216.
Mr. B. was left in his room without appropriate monitoring following the administration of diaxepam and hydromrophone in order to permit reduction of his hip following a fall. The 67-year-old Mr. B. presented with several health concerns in addition to his recent fall that injured his hip.
was on a regimen of oxycodone for chronic back pain and atorvastatin, presumably for elevated cholesterol and lipids, has impaired glucose tolerance and prostate cancer. His injury notwithstanding, Mr. B.'s overall health was not optimal at the time of admission, and included risk of heart problems. The hospital policy for moderate sedation / analgesia or conscious sedation was violated. According to the policy, Mr. B. should have received continuous monitoring of B/P, ECG, and pulse oximeter throughout the procedure and until he met the specific discharge criteria, which include: fully awake, VSS, no N/V, and able to void. An experienced critical care nurse…
RCA Train. Retrieved http://vaww.ncps.med.va.gov/RCAtrain.html
Patient Safety. Gov. Retrieved
Quality One. Retrieved
Policy of choice: Patient Safety
The provision of healthcare services is a complex responsibility that the professionals in healthcare risk management must never take lightly. Hospital regulations and accreditation standards make the safety requires complex and inevitable (PSQH, 2014). With formal procedures and policies, it is possible to promote and encourage compliance with regulation and high safety standards in the workplace. These policies also make quality healthcare and patient safety easier to deliver. Well articulate policies will alleviate variability in nursing practice that is likely to lead to compromises in care and eventual harm to the patient. The financial situations that require more attention for patient care may make it difficult to continuously review procedures and policies. Failure to update and develop policy can cause negative consequences for the patients (PSQH, 2014).
Patient safety policy is significant for the fulfillment of several professional requirements including:
· Adherence with the set…
The Joint Commission outlines Patient Safety Goals for a number of different areas of health care service. One of those areas is behavioral health. The 2012 National Patient Safety Goals include the accurate identification of clients using name and date of birth. This is suggested "to make sure that each client gets the correct medicine and treatment," (NPSG.01.01.01). This Patient Safety Goal is important for increasing patient safety and outcomes. A mistaken identity can mean giving the wrong treatment at the wrong time to the wrong patient, which could be disastrous or deadly. Similarly, misidentification can lead to medication errors that can also be deadly. This Patient Safety Goal is important from an administrative standpoint, because it suggests that nurse practitioner and all healthcare workers be aware of intake procedures.
In addition to NPSG 01.01.01, the Joint Commission Patient Safety Goals for Behavioral Health includes the use of medicines…
Behavioral Health Care National Patient Safety Goals: http://www.jointcommission.org/assets/1/6/2012_NPSG_BHC.pdf
Miller, R.H. & Sim, I. (2004). Physicians' use of electronic medical records: Barriers and solutions. Health Affairs 23(2): 116-126.
Steward, M. (2005). Electronic medical records. Journal of Legal Medicine 26(4): 491-506.
" (Morris & Woodcock, 2004)
V. Murakami et al. (2003)
In the work entitled: "Deep Venous Thrombosis Prophylaxis in Trauma: Improved Compliance With a Novel Miniaturized Pneumatic Compression Device" the authors state that: "Intermittent pneumatic compression (IPC) devices prevent lower-extremity deep venous thrombosis (LEDVT) when used properly, but compliance remains an issue." (Murakami et al., 2003) the study conducted by Murakami et al. (2003) is stated to be a."..prospective trial in which trauma patients (mean age, 46 years; revised trauma score, 11.7) were randomized to DVT prophylaxis with a standard calf-length sequential IPC device (SCD group) or a miniaturized sequential device (continuous enhanced-circulation therapy [CECT] group). Compliance rates for all subjects were averaged in each location: emergency department, operating room, intensive care unit, and nursing ward." (Murakami et al., 2004) the study results state that: "Total compliance rate in the CECT group was significantly higher than in the SCD group…
Kehl-Preutt, Wendy (2006) Deep Vein Thrombosis in Hospitalized Patients: A Review of Evidence-based Guidelines for Prevention. Dimensions of Critical Care Nursing March/April 2006. Vol. 25 No.2. Online available at http://www.nursingcenter.com/prodev/cearticleprint.asp?CE_ID=636024 .
Chang, David et al. (2002) Compliance with sequential compression device prophylaxis in at-risk trauma patients: a prospective analysis. Am Surg. 2002 May;68:470-3 Online available at http://lib.bioinfo.pl/auid:1350109.
Practice Alert: Deep Vein Thrombosis Prevention" (2006 American Association of Critical-Care Nurses Journal " Vol. 23 No. 1 January 2006.
Morris, Rhys J. & Woodcock, John P. (2004) Evidence-Based Compression: Prevention of Stasis and Deep Vein Thrombosis. Ann. Surg. 2004 February 239(2): 162-171.
Many advocates of the move feel that lower patient to nurse ratio would lead to additional savings because it would reduce nurse turnover rate, lawsuits, complications and length of stay. Nursing unions in the state of California have asked for a PTN ratio of 3 to 1. The health association however agreed on 5 to 1 which sound more reasonable than the originally proposed 10 to 1. (othberg, 2005)
Patient to nurse ratio when it is too high can definitely adversely affect care. And with baby boomers aging and needing healthcare, we know that number of people looking for healthcare will continue to rise in the coming years. However staff shortage continues to pose a serious problem. And unfortunately, the problem doesn't always lie with cost control. While it is true that most of the problems with staff shortage can be attributed to hospitals cutting down their costs and hence…
Michael Rothberg, 2005. Improving Nurse-to-Patient Staffing Ratios as a Cost-Effective Safety Intervention Med Care 2007;45: 571-578)
Patricia W. Stone, PhD,* Cathy Mooney-Kane,
Nurse Working Conditions and Patient Safety Outcomes.
The author also explains that the data stored in the system can be used to help public health officials identify medical issues facing the community as well as track various trends from the community and public health perspectives.
(How does this article relate to you as doctor?)
As a physician, I recognize that my time will be in very short supply. Therefore, any system or resource capable of saving time and increasing the efficiency of the healthcare services that I provide will be greatly appreciated. Similarly, patient safety, elimination of medical errors, and patient outcome are always paramount concerns for any physician. Therefore, I would welcome the opportunity to use EHR systems to the extent they address those issues positively. Moreover, as a physician, I am always interested in any approach that might be beneficial to human welfare and community and public health issues. According to the article,…
Structured interviews of the subjects were conducted at the end of each individual set of simulation runs to obtain triangulation data.
Video segments were coded by nursing experts.
Statistical and content analyses of the data were conducted.
All nurses were female. Males may have provided different response. The sample may have been too small; only 10 individuals of each handedness were involved. The sample was extracted from only one environment, the participants were familiar with environment. Replication of various other environments may have provided different response. The repeated measures design may have influenced response second time around.
I found details of structured interview to be too vague. The best accounts of experimental studies are those that reader can replicate. Many of the steps of this study were sufficiently elaborate for repllication, but I found details of interview questions vague and incompletely elaborated upon so that one left with…
patient was admitted due to a broken hip which required a total hip replacement (TH). This injury has required two weeks of in-hospital rehabilitation to this point, and Mr. Trosak will probably need more physical rehabilitation to completely recover from the injury. Since there are secondary concerns (such as some loss of cognitive function (text, 462)) after a fall, it will be necessary to monitor M. Trosak. The falling incident could also reoccur due to the fact that the patient resides on the second floor of his apartment building. It will be necessary to ensure that Mr. Trosak understands the risk of a recurrence, and that he has sufficient assistance.
Prior to being hospitalized for the fall, Mr. Trosak was not taking any prescription medication, and he has not had a physical examination for more than ten years. While admitted, the patient was found to have chronic hypertension, which is…
Smith, M., & Segal, J. (2011). Depression in older adults and the elderly. Retrieved from http://www.helpguide.org/mental/depression_elderly.htm
Vanwanseele, B. (2009). To rehab or not to rehab following a total hip replacement. Retrieved from http://sydney.edu.au/research/opportunities/opportunities/561
Patient acuity system provides the nurses and other healthcare practitioners in health cares' information that can guide them in their attention towards the patients. The nurses track information and then weigh them in accordance to the urgency of assessment. The basis that the nurses use is the complexity of the level to which patients are unwell. An example is the determination of whether the patients immediately require ventilation and those who do not need any. The nurses are able to pick on the various patients in the healthcare and then record the data. In a single healthcare, there are many patients with different degrees of illnesses. As a result, they all require varying levels of evaluations from the nurses. It is, therefore, imperative that the nurses spread their attention appropriately to avoid any inconveniences. This system helps the nurses to determine the attention that patients require within a short period.…
Brennan, C., & Daly, B. (2009). Patient acuity: a concept analysis. Journal Of Advanced Nursing, 65(5), 1114-1126. doi:10.1111/j.1365-2648.2008.04920.x
Garza, A., Gratton, M., McElroy, J., Lindholm, D., & Glass, E. (2008). The association of dispatch prioritization and patient acuity. Prehospital Emergency Care, 12(1), 24-29.
Lewis, R. (2008). Comparison of a 5-level triage classification system with a 4-level triage classification system as it relates to acuity assignment and predictability of patient outcomes. Southern Online Journal of Nursing Research, 8(2),
Perroca, M., & EK, A. (2007). Utilization of patient classification systems in Swedish hospitals and the degree of satisfaction among nursing staff. Journal of Nursing Management, 15(5), 472-480. doi:10.1111/j.1365-2834.2007.00732.x
Patient Centered Medical Homes (PCMH) are often confused as being actual "homes" for patients to be admitted in and given medical treatment and care. PCMH is actually a health care model based on which health care is provided to patients, under the supervision of physicians. The PCMH model of health care provides patients with continuous, comprehensive medical care, in order to increase the chances of achieving the goal of benefitting the patient with as much attention and medical care in order to maximize his/her health outcomes.
Over the years the PCMH model of health care has become widely adopted and preferred. This is because of the philosophy and approach that the model adopts in organizing and delivering the health care initiatives. The PCMH model is based upon delivering medical care and attention to patients with team-based health and medical experts that are focused strongly on the quality and the safety…
109-432, P.L. (2006, December 20). TAX RELIEF AND HEALTH CARE ACT OF 2006. Public Law 109-432 (109th Congress) .
Backer, L.A. (2009). Building the Case for the Patient-Centered Medical Home. Family Practice Management 16 (1), 14-18.
De Geest, S., Moons, P., Callens, B., Gut, C., Lindpaintner, L., & Spirig, R. (2008). Introducing advanced practice nurses/nurse practitioners in health care systems: a framework for reflection and analysis. Swiss Medical Weekly (138), 621-628.
NASHP. (2013, April). Medical Home & Patient-Centered Care. Retrieved from The National Academy for State Health Policy: http://www.nashp.org/med-home-map
Patient Centered Medical Homes
In the 1960s, the medical home concept referred to as patient centered medical home was developed.In order to reform the healthcare in the U.S.; the patient centered medical homes are evolving as a centerpiece of efforts (Bates, 2010). Basically, PCMH can be defines as a primary care model that offers coordinated and comprehensive care to the patients in order to improve health outcomes. PCMH is also recognized by the National Committee for Quality Assurance (NCQA). Patient centered medical homes can be portrayed as a team of people working together in form of a community. The purpose is to improve the health as well as healing of the people in that community. In comparison with the primary care, PCMH is more responsive towards the needs of local patients.
PCMH offers a number of benefits including complementary nutrition as well as wellness counseling along with providing prevention education…
Aysola, J., E.J. Orav, and J.Z. Ayanian. 2011. "Neighborhood Characteristics Associated With Access To Patient-Centered Medical Homes For Children." Health Affairs no. 30 (11):2080-2089.
Bates, D.W., and A. Bitton. 2010. "The Future Of Health Information Technology In The Patient-Centered Medical Home." Health Affairs no. 29 (4):614-621.
Nutting, Paul A., William L. Miller, Benjamin F. Crabtree, Carlos Roberto Jaen, Elizabeth E. Stewart, and Kurt C. Stange. 2009. "Initial Lessons From the First National Demonstration Project on Practice Transformation to a Patient-Centered Medical Home." Ann Fam Med no. 7 (3):254-260.
Patient-Centered Medical Home
How the Patient-Centered Medical-Home reducing cost and improving quality and safety for patients.
The patient centered medical home is a platform that fills a need in the current healthcare system. The U.S. healthcare system has been plagued for quite some time with a trend of substantially rising healthcare costs as well as another trend of slipping quality standards. These two trends are argued to be a phenomenon that has emerged at least partly from poor planning and ineffective use of resources. One solution to some of these issues can be found in the patient-centered medical home (PCMH) model of primary care. This model has been developed with the coordination of long-term physician-patient relationships in mind. Developing these relationships further can not only reduce costs in unnecessary procedures that are the result of the missed opportunity for preventive care, but also have been shown to improve…
Christensen, E., Dorrance, K., Ramchandiani, S., Lynch, S., Whitmeore, C., Borsky, A., . . . Bickett, T. (2013). Impact of a Patient-Centered Medical Home on Access, Quality, and Cost. Military Medicine, 135-141.
Ewing, M. (2013). The Patient-Centered Medical Home Solution to the Cost-Quality Conundrum. Journal of Healthcare Management, 258-266.
Kern, L., Dhopeshwarker, R., Edwards, A., & Kaushal, R. (2013). Patient Experience Over Time in Patient-Centered Medical Homes. American Journal of Managed Care, 403-410.
Nielsen, M., Olayiwola, J., Grundy, P., & Grumbach, K. (2014). The Patient-Centered Medical Home's Impact on Cost & Quality. Patient-Centered Primary Care Collaborative, 1-38.
These studies demonstrate that there are several factors associated with patient noncompliance, regardless of the disease being treated. Medication side effects represent only one of these issues. Nurse practitioners could help to resolve many of these issues by being proactive and asking questions about side effects in patients at risk for becoming noncompliant. They may also be able to predict noncompliance in patients that are prescribed medications with known side effects. By informing the patient of the side effects and giving them practical ways to cope with them, the nurse practitioner can play an active role in helping to eliminate patient noncompliance.
Education was found to play an important role in patient noncompliance. The overall educational level of the patient was found to be important. The nurse practitioner can take positive action by being aware of the patient's overall educational background. Extra care must be taken with those of low…
Barber, N., Parsons, J., Clifford, S., Darracott, R., & Horne, R. (2004). Patients' problems with new medication for chronic conditions. Quality and Safety in Healthcare. 13(3): 172-175.
Chatterjee, J. (2006). From compliance to concordance in diabetes. Journal of Medical Ethics. 32(9): 507-510.
Chisholm, M., Lance, C. & Mulloy, L. (2005). Patient factors associated with adherence to immunosuppressant therapy in renal transplant recipients. American Journal of Health- System Pharmacy. 62 (17): 1775-1781.
Eastern, J. "Dismissing Patients Properly." 1 Jun 2006. OB/GYN News. Accessed 11 Sept. 2008. http://findarticles.com/p/articles/mi_m0CYD/is_/ai_n26906768 .
The etiology of the majority of cases of Parkinson's disease (PD) is unknown. What is known is that the disease is a neurodegenerative disorder that results from a loss of dopaminergic neurons in the area of the brain known as the substantia nigra (Hatfield, 2013). In addition, it is speculated that the disease is related to some type of genetic susceptibility and environmental risk factors that largely remain unidentified. Epidemiological research has suggested that there may be an association between exposure to pesticides and the onset of PD; however, this research is very mixed with some studies indicating that there is such relationship and a number of others failing to demonstrate such an association (Dardiotis, Xiromerisiou, Hadjichristodoulou et al., 2013). Dardiotis et al. (2013) reviewed the research and made a case that perhaps the relationship between pesticide use and PD is moderated by a genetic susceptibility. However, one of…
Dardiotis, E., Xiromerisiou, G., Hadjichristodoulou, C., Tsatsakis, A.M., Wilks, M.F., & Hadjigeorgiou, G.M. (2013). The interplay between environmental and genetic factors in Parkinson's disease susceptibility: the evidence for pesticides. Toxicology, 307, 17-23.
Hatfield, R.C. (2013). The everything guide to the human brain. Avon, MA: Adams.
Liew, Z., Wang, A., Bronstein, J., & Ritz, B. (2014). Job Exposure Matrix (JEM)-derived estimates of lifetime occupational pesticide exposure and the risk of Parkinson's disease. Archives of Environmental & Occupational Health, 69(4), 241-251.
Effectiveness of Emergency Management and the eadiness of Trauma Centers
Emergency Management and the eadiness of Trauma Centers are fundamental facilities in any given State and country. These facilities come in handy in times of disasters and traumatic events. Most traumatic centers are health care facilities or departments, which offer immediate response in such times of emergency. Emergency management and trauma centers handle mitigation, response, preparedness, and recovery. Emergency management includes activities such as evacuation, decontamination, disaster recovery, and integration with other community emergency groups. These facilities play a key role in providing care to both natural and man-made disasters (Premier, 2012).
The phenomenon, issue, or condition to be researched
In order to create a safe surrounding in the community, emergency management and traumatic centers have to be established (Trunkey & Potter, 2006). Often, disastrous situations call for urgent and high demand for patient care. For instance, the traumatic…
Premier (2012). Emergency preparedness for healthcare facilities. Premier: Transforming Healthcare Together. Retrieved July 12, 2012, from https://www.premierinc.com/safety/topics/disaster_readiness/#top
Trunkey, D.D., & Potter, C.J. (2006). U.S. trauma center preparedness for a terrorist attack in the community. National Foundation for Trauma care, 1-43.
Typically, accurate documentation assists in limiting errors. (Stanford Hospital & Clinics, 2012).
Car et al. (2008) point out that integrating of electronic health within a healthcare organization enhances quality and safety of patients. The author argues that electronic health record assists the healthcare provider to readily access comprehensive information in order to minimize the incident of error as well as enhancing patient safety and quality of healthcare delivery. While Stanford Hospital and Clinics has made several efforts to enhance quality healthcare delivery and patient safety within the hospital environment, however, the issue of medical errors is still rampant within the healthcare sector in the United States. Meanwhile, there are several ways the issue of error incidents can affect the healthcare delivery.
Impact of Error incident on Healthcare Delivery
A major effect of error incident within the health sector is the decline in the quality healthcare delivery and the issue could…
Ballard, K.A.(2003). Patient Safety: A Shared Responsibility. ANA Periodicals. 8(3).
Car, J. Black, a. Anandan, C. et al. (2008). A Systematic Overview & Synthesis of the Literature. Report for the NHS Connecting for Heath Evaluation Programme.
Library Index (2012). Challenges Change and Innovation in Health Care Delivery -- Safety.
Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century-Summary. Washington, DC: National Academy Press, 2-4.
This is important, because it is showing how a lack of: following up and monitoring safety standards can increase the long-term financial problems facing a heath care facility. (Master, 2005, pp. 259 -- 285)
At the same time, there is also the possibility that the lack of focus on safety could expose the hospital to possible law suits. This is because the plaintiffs could use this information to show, how the staff is negligent in the quality care that they are providing to them. Once this occurs, it means that the costs for: medical malpractice insurance and other operating expenses will rise. While, the facility will have the negative publicity from: these lawsuits and there is the possibility of increased amounts of regulation (surrounding internal procedures). This is important, because it is showing how these kinds of issues will have an adverse effect on: the reputation and economic viability of…
Grol, R. (2008). On the Trail of Quality and Safety. British Journal of Medicine, 336, 74 -- 76.
Master, K. (2005). Role Development in Professional Nursing. Sudbury, MA: Jones and Bartlett.
Manser, T. (2009). Team Work and Patient Safety. Acta Anaesthesiologica Scandinavica, 53 (2), 143 -- 151.
Vincent, C. (2008). Is Health Care Getting Safer. British Journal of Medicine, 13, 337 -- 345.
.....clinician responses to alarms? For example: Physical barriers, physical layout of the unit, RN-pt ratio.
The observed influences include the type of alarm, such as whether it was a bed or bathroom alarm versus a technology alarm coming from something like the IV pump.
2. How, as a student, are you educated about alarms and your response to them? How might education regarding the various patient alarms be an issue associated with alarm response?
I have done some research on the clinical implications of alarms and alarm fatigue. For example, Cyach, et al. (n.d.) found that too many alarms causes alarm fatigue, and also creates a "false sense of security," (p. 5). The researchers also found that staff is sometimes not educated about the different types of alarms and what they mean.
3. Who is responsible for alarm response?
The delegation of authority for responses will vary from case to…
.....nurse assigned to care for this patient, I would strongly advocate on behalf of the patient's autonomy. The clash between patient autonomy and the healthcare system and its representatives like nurses can only be resolved by being honest in this situation. The patient is under a high degree of stress, not only because of his health condition and the fear that brings out in him, but due to other stressful life events including his financial situation. He was also supposed to get married immediately before the bypass surgery was scheduled, and this is bound to add to his level of stress. The primary issue here is providing what the patient needs to keep him safe during the procedure, and if he insists on using his own pump, which he has successfully used for the thirty years he has lived with the disease of diabetes, then he should use his own…
Management of Immunocompromised Patients
In beginning I writer specific nursing assignment. The Question: 2000 Words While clinical placement asked prepare a single room an admission. The patient requiring admission isolation room immunocompromised.
Immunocompromised patients usually require isolation in order to prevent them from becoming infected with infections from other patients which is known as protective isolation. For the immunocompromised patients, their immune system is unable to fight the infectious diseases. There are many diseases or conditions that lead to immunodeficiency in patients.
One is AIDS (acquired immunodeficiency syndrome). The pathophysiology of AIDS starts when the person's CD4+ T cell count begins to decrease as the disease kills these cells. This is HIV-induced cell lysis where the virus enters the CD4+ cells where it inserts its genetic information to the cell nucleus thus taking over the cell and replicating itself. The virus then mutates extremely rapidly thus making it more and…
Agusti, C., & Torres, A. (2009). Pulmonary Infection in the Immunocompromised Patient: Strategies for Management. New York: John Wiley & Sons.
Bodey, G.P. (2010). Managing Infections in the Immunocompromised Patient. Clinical Infectious Diseases, 40(Supplement 4), S239. doi: 10.1086/427328
Glauser, M.P., & Pizzo, P.A. (2009). Management of Infections in Immunocompromised Patients New York: Elsevier Health Sciences.
Hayden, R.T. (2008). Diagnostic Microbiology of the Immunocompromised Host. Washington, DC: ASM Press.
(3) Goal 13A states that the means for patients and their families should be defined and communicated in regards to reporting of concerning about safety and that encouragement should be provided for them to follow through on this.
(4) Goal 15 states that the organization "identifies safety risks inherent in its patient population; and (5) 15A states "The organization identifies patients at risk for suicide. [Applicable to psychiatric hospitals and patients being treated for emotional or behavioral disorders in general hospitals -- NOT APPLICALE to CRITICAL ACCESS HOSPITALS] (the Joint Commission, 2009)
Stated as the only change to the 2007 Disease-Specific Care National Patient Safety Goal is the noted change to 8 which adds that the complete list of medications is provided to the patient upon discharge from the health care facility. (the Joint Commission, 2009)
The work of Cooper (2009) entitled: "NYC Hospital to Educate Patients Using Opinionmeter Survey…
Stoessel, Kathleen B. (2009) the Joint Commissions' National Patient Safety Goals: Implications for Infection Preventionists. Virgo Publishing. 2009 July 08. Online available at: http://www.vpico.com/articlemanager/printerfriendly.aspx?article=252020
Powell, Stephen M. (2009) Can the Ambulatory Care Setting Learn Lessons from Other High Risk Domains. Advocate MD. Online available at: http://www.advocatemd.com/downloads/risk_management/CantheAmbulatoryCareSettingLearnLessons.pdf
2007 Home Care National Patient Safety Goals (2006) the Joint Commission 1 June 2006. Online available at: http://www.jointcommission.org/PatientSafety/NationalPatientSafetyGoals/07_ome_npsgs.htm
2007 Disease-Specific Care National Patient Safety Goals (2006) the Joint Commission 1 June 2006. Online available at: http://www.jointcommission.org/PatientSafety/NationalPatientSafetyGoals/07_dsc_npsgs.htm
Poor medical safety practices result in over 40,000 deaths per year, of that 7,000 deaths are attributed to medication-related medical errors. There is no excuse for negligence when it comes to human lives. It is imperative that the medical community introduce sound medication safety best practices to eliminate adverse outcomes related to medication prescriptions. Best practices include the implementation of standardization and protocols in addition to the use of technology to reduce errors.
Medical Safety Practices
Medical practitioners are relied upon to provide solutions, acting as the first and many times, last hope of those in dire need. But despite this great responsibility to patients whose lives are entrusted in medical staff studies show that out of every 100 patients admitted to a medical facility 2 patients will experience a medical error due to incorrectly prescribed or administered medication. The results can be mild but can also be…
Bates, David W.; Spell, Nathan; Cullen, David J., et al. (1997).The Costs of Adverse Drug Events in Hospitalized Patients. JAMA. 277:307 -- 311.
Centers for Disease Control and Prevention (National Center for Health Statistics). (1999). Births and deaths: Preliminary data for 1997. National Vital Statistics Reports.
Grissinger, M., Globus, N.J. (2004). How Technology Affects Your Risk of Medication Errors. Nursing2004. 34(1), 36-41.
Institute of Medicine. (2000). To Err Is Human: Building A Safer Healthcare System.
With the ever-changing health care sector, reimbursement has increasingly been tied to care quality and health care outcomes. The Centers for Medicare and Medicaid Services (CMS) have particularly been changing the way hospitals are reimbursed, with hospitals that deliver high quality care and report better health outcomes getting higher reimbursements than those that perform poorly. This has led to increasing prominence of the pay-for-performance approach. Under this approach, hospitals that report greater patient satisfaction, reduced error rates, lower readmission rates, and higher recovery rates for chronic illness get higher reimbursements than their poorly-performing counterparts. The implication is that health care organizations must pay greater attention to performance, especially in terms of quality, safety, and individual performance. Measurement and models used in the commercial world for these three aspects are considerably relevant to the health care sector. This paper discusses the usefulness of the total quality management (TQM) model, the Organization…
challenging environment that the world faces has placed much strain and stress on the health care industry and their many institutions. Despite the rapid advances in technology, nutrition and fitness, the world is in constant need of medical treatment and assistance. The role of the nurse and the professional duties that accompany this experience has also changed rapidly along with technology and medical advancement. It is important to investigate how nurses can take advantage of these newly developed systems to perform at a higher level and eventually ease the suffering and pain that accompanies medical procedures in today's day and age.
Informatics is a newly formed discipline that provides some of the solutions to the many problems that nurses are faced with. The purpose of this essay is to discuss and highlight the importance of informatics and its synthesis into the nursing profession. The essay will first give some background…
Healthcare Information and Management Systems Society (2008). Nursing Informatics: Scope and Standards of Practice, ANA 2008. Retrieved from http://www.himss.org/resourcelibrary/TopicList.aspx?MetaDataID=767
Oroviogoicoechea, Cristina, Barbara Elliott, and Roger Watson. "Review: evaluating information systems in nursing." Journal of clinical nursing 17.5 (2008): 567-575.
Thede, L., Schwiran, P., (February 25, 2011) "Informatics: The Standardized Nursing Terminologies: A National Survey of Nurses' Experiences and Attitudes - Survey I*" OJIN: The Online Journal of Issues in Nursing Vol. 16 No. 2.
ED Patient Boading |
Emegency Depatment Patient Boading
Emegency Depatment (ED) cowding is a nationwide cisis which affects the efficiency and the quality of patient cae (Sox, Bustin, Oav, et al., 2007). A huge contibution to patient ove-cowding is the boading of admitted patients in the ED. An altenative use of time which is lost in the admitting of patients is used to teat patients who ae waiting to be seen; this is seen typical in ove-cowded EDs. The ovecowding of EDs esult in isking patient safety and altenatives to this should be obseved.
Holding admitted patients in EDs always was known to be bad fo patient flow, but thee is a gowing body of eseach showing that it also hams patients. Thee is significant evidence which demonstates that ED cowding due to boading is esponsible fo poo outcomes (Sox, Bustin, Oav, et al., 2007). In many hospitals, it is…
references for boarding locations when hospitals are at full capacity. Ann Emerg Med.
Greene J. (2007). Emergency department flow and the boarded patient: how to get admitted patients upstairs. Ann Emerg Med. 49: 68-70.
Holliman CJ, Wuerz RC, Kimak MJ, et al. (1995). Attending supervision of nonemergency medicine residents in a university hospital ED. Am J. Emerg Med. 13:259 -- 61.
Richardson DB. (2006). Increase in patient mortality at 10 days associated with emergency department overcrowding. Med J. Aust. 184: 213-216.
Sox CM, Burstin HR, Orav EJ, et al. (1998) The effect of supervision of residents on quality of care in five university-affiliated emergency departments. Acad Med.73:776 -- 82.
There are various applications of the FID technology in the healthcare. These are explored by a HIBCC,(2006 ) report that studies the application of the FID technology in the healthcare setting with emphasis on its benefits, limitations as well as recommendations The report categorically pointed out that that the applications of the FID technology in the health care settings are numerous. They range from being used in the management of the hospital's supply chain to the management of the patients themselves. In terms of the supply chain management, the FID technology can be used in the organizing the delivery of supplies such as pacemakers, artificial limbs as well as defibrillators. This is because the supply chain of these crucial items is very complicated and requires the timely delivery of the consignments. The high degree of traceability that is needed to track the shipments from the supplier up to the time…
Anonymous (2004), RFID in the hospital, in RFID Gazette. July 15,
Aarts, J., Doorewaard, H., and Berg, M.(2004), "Understanding implementation: the case of a computerized physician order entry system in a large Dutch university medical center," Journal of the American Medical Informatics Association, vol. 11, no. 3,
Chin-Yin,(2000)RFID-Enabled Analysis of Care Coordination and Patient Flow in Ambulatory Carpp. 207-216.
Quality & Safety
The quality and safety of health care services has been a major issue in the recent past because of the significance of these factors in the improvement of patient outcomes and enhancing the effectiveness of the health care system. Health care professionals and practitioners have increasingly focused on the need to improve the quality and safety of their services given the constant increase in patient population. As a result, various measures have been developed and implemented in attempts to enhance the quality and safety of care services and improvement of practices. These measures include delivery of patient-centered care, safety initiatives, teamwork and collaboration, informatics, quality improvement, and evidence-based practice. There are several ways with which incidents or interactions in each of these components are handled and can be improved based on leadership/management theory content.
Patient Centered Care -- Interaction
A bedside report was not done at bedside…
Evanoff, Bradley, Patricia Potter, Laurie Wolf, Deborah Grayson, Clay Dunagan, and Stuart Boxerman. "Can We Talk? Priorities for Patient Care Differed Among Health Care Providers." Advances in Patient Safety 1 (n.d.): 5-14. AHRQ -- Agency for Healthcare Research and Quality: Advancing Excellence in Health Care. Hhs-logoU.S. Department of Health & Human Services. Web. 20 Apr. 2015. .
"How Fast Is Too Fast For IV Push Medications." ISMP Medication Safety Alert. Institute for Safe Medication Practices, 15 May 2003. Web. 20 Apr. 2015. .
Laws, Dawn, and Shelly Amato. "Incorporating Bedside Reporting into Change-of-Shift Report." Rehabilitation Nursing 35.2 (2010): 70-74. Rehabilitation NURSING. Rehabilitation NURSING, Mar.-Apr. 2010. Web. 20 Apr. 2015. .
He or she is also entitled to proper medication to deal with the disease.
It's not just the responsibility of medics to offer health care but the family members of the sick too play a very important role in caring about health. y accompanying the sick person to hospital and administering the prescribed medicine at home. As well, family members offer support by praying and giving the sick member company. Did you know that even loneliness is a health hazard.
Quality health care is individual responsibility. Every individual is supposed to make sure they have the best health always. Contagious diseases should be avoided at all costs, however, should we contact them then we should care for ourselves. A sick person should maintain bodily cleanliness and eat the right foods. Ones health should not also cause harm to neighbors at home and in public. Global concerns are also rising quickly…
Baum F (1998).The new public health: an Australian perspective, Oxford University Press,
Mannion R, Konteh F, Davies H (2008) Measuring culture for quality and safety improvement: a national survey of tools and tool use, Quality and Safety in Health Care (in press).
Mannion R, Davies H, Marshall M (2005) Cultural attributes of 'high' and 'low' performing hospitals. Journal of Health Organization and Management 19(6):431-9.
clinical cases and examine malpractice perspectives.
Concerns over mounting healthcare expenses have resulted in increased inquiry into medical practices. With the rise of malpractice risk and medical liability to unprecedented levels, the field of medical law has influenced defensive medical practice as healthcare providers endeavor towards liability risk mitigation (Nahed, et.al, 2012).
Elements Needed to Prove Malpractice
Medical malpractice is associated with four fundamental elements, all of which have to be present for forming the base for any claim. For any case of medical malpractice to succeed, an attorney is required to prove all four aspects, which are: duty, causation, damages, and breach (What are the Elements of a Medical Malpractice Claim? n.d.). The first element -- Duty -- implies that health care professionals owe their patients the duty to take reasonable and appropriate action; i.e., the practitioner is accountable for delivering some form of treatment or care…
Florida Healthcare Law (n.d.). - A Florida Medical Malpractice Blog - Shoulder Dystocia Erbs Palsy. What are the Elements of a Medical Malpractice Claim? -- Florida Healthcare Law - A Florida Medical Malpractice Blog - Shoulder Dystocia Erbs Palsy. Retrieved March 8, 2016, from http://floridahealthcarelaw.com/what-are-the-elements-of-a-medical-malpractice-claim/
Kurreck, & Twersky. (2012). Home -- AHRQ Patient Safety Network. Residual Anesthesia: Tepid Burn -- AHRQ Patient Safety Network. Retrieved March 8, 2016, from http://psnet.ahrq.gov/webmm/case/276
Nahed, B., Babu, M., & Smith, T. (2012, June 22). Malpractice Liability and Defensive Medicine: A National Survey of Neurosurgeons. Retrieved March 7, 2016, from http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0039237
Saltzman, J. (2008, January 29). Medical Malpractice Attorneys Lubin & Meyer -- Boston, MA, NH, RI. Family Sues in Operating Room Fall - Wrongful Death Lawsuit. Retrieved March 8, 2016, from http://www.lubinandmeyer.com/news/or_fall.html
cute care facilities try to maintain low costs and employ quality nurses. Within this statement is a double standard. How can we have quality nurses and cut costs at the same time? This is where the skill mix comes into play. In the skill mix, there are Registered Nurses (RNs), Licensed Practical Nurses (LPNs), and unlicensed staff. If the lesser skilled staff free RNs they can be better able to perform their nursing duties and assessments. If acute care facilities can agree on an appropriate number of each type of staff member within the facility, they might be better able to accomplish safe patient outcomes while keeping costs down.
Determining nurse-to-patient ratios is a complex issue where one solution is not sufficient to cover all circumstances. The merican Nurses ssociation assembled a panel of nursing and health professionals to research appropriate staffing levels. The panel developed the following Matrix for…
Aiken and colleagues have been pioneers in studying nurse patient ratios and their relationship to patient outcomes.
Aiken, Sochalski, and Lake (1997) demonstrated that nursing presence, whether measured as RN ratios or as RN hours relative to other nursing personnel hours, is significantly correlated to mortality. When studying patient outcomes in specialized AIDS units,
Aiken, Sloan, Lake, Sochalski, and Weber (1999) found that at 30 days post admission, mortality rates were 60% lower in magnet hospitals, and 40% lower in dedicated AIDS units than in conventional scattered bed units. The researchers concluded that higher nurse patient ratios were a major factor in these lower
Mildred's Case Study
Mildred's Story was made to form part of a 'ecognizing isk and Improving Patient Safety' course. The progression takes a novel method to educating healthcare professionals in regards to the significance of non-clinical services, behavior and attitudes in guaranteeing the safety of the patient. It attracts upon the experiences of patients that are within healthcare settings, and information achieved from other high-risk businesses, to come up with a strategy allowing healthcare workers to disapprovingly appraise and interfere in the development of patient danger. There are so numerous prospects of improvement in Mildred's case study, but the writers designated Effective communication & patient assessment to resolve the issue of (patient falls).With that said, instead the researcher has used the SPO model along with using formwork (FOCUS- PDSA) also using tools (Fishbone, 6 huts, flow chart and 5 whys) in order to improve effective communication and patient assessment to…
Alireza, N., 2014. Evidence of Using FOCUS PDCA. [Online]
Available at: http://npmcweb-en.tbzmed.ac.ir/Uploads/37/cms/user/File/54/MEP/Effectiveness.pdf
[Accessed 10 December 2015].
Anon., 2015. What is the quality improvement process?. [Online]
This would include more effective use of space and transfer strategies. There needs to be available strategies to help release some of the overcrowding within ED areas, especially within the context of peak periods.
Therefore, the research will look to find the most effective are to actually place these overflowing patients, where they are still in reach of ED services, while not overcrowding the actual ward itself. This research will explore the use of electric bed tracking systems as a way to effectively manage over populated areas and make the most advantage of other wards with less population. esearch suggests that "Electric systems for tracking bed status can be helpful in increasing the transparency of bed availability," (McLarty & Jeffers 2008 p 3). Are such practices feasible in an already tight hospital budget?
If this question can be answered effectively, it will have a huge positive impact on the healthcare…
McLarty, Jim & Jeffers, Lori. (2008). Is your patient throughput sending out an SOS? Healthcare Financial Management. Web. http://findarticles.com/p/articles/mi_m3257/is_7_62/ai_n28072667/
Zimmerman, Richard S. (2004). Hospital capacity, productivity, and patient safety -- it all flows together. Frontiers of Health Services Management. 20(4)33-35.
CPOE primary use to manage cost and quality in the physician and pharmacy interaction?
An electronic process that enables providers of health care to manage the results of orders entered in to a computer electronically is known as Computer Provider Order Enter or CPOE. In line with the reports of Institute of Medicine (IOM) titled, "To Err is Human: uilding a Safer Health System and Crossing the Quality Chasm: A New Health System for the 21st Century," CPOE has commanded increased attention. Hospitals should be rewarded for introducing prescription systems as recommended by Leapfrog Group, which is a coalition of private and public providers of health care benefits. In ever-rising numbers, Health care systems are implementing CPOE as a way of improving both the quality of patient safety and care. The implementation of CPOE is, however, not only an information technology innovation, but it also encompasses delivery of health care…
Agency for Healthcare Research and Quality. (2015, Febuary). Computerized Provider Order Entry. Retrieved from Agency for Healthcare Research and Quality: http://healthit.ahrq.gov/key-topics/computerized-provider-order-entry
Centre for medicare and medicaid services. (2012). Stage 2 Eligible Professional Meaningful Use Core Measures Measure 1 of 17. Centre for medicare and medicaid services.
Classen, D., Avery, A., & Bates, D. (2007). Evaluation and Certification of Computerized Provider Order Entry Systems. Journal of American Medical informatics Association, 48-55.
Eslami, S., Abu-Hanna, A., & De. Keizer, N. (2007). Evaluation of Outpatient computerised physician medication order entry systems: A systematic review. Journal of American Informatics Association, 400-406.
Safe Environment -- Patient Outcomes
hat are the best practices that nurses and nursing leaders can implement to assure safe working conditions and high quality patient care? This paper delves into those issues using the available literature -- scholarly articles -- as guiding references to reach an understanding of how to assure safe working conditions for nurses and patients.
Required time and staffing for safe and effective patient care
According to author Kathy Malloch, the task of creating safe practices for nursing staff "…continues to be illusive for nurse leaders" (Malloch, 2015). The problem is that discovering the amount of time needed in order for a nurse to provide proper patient care is still a work in progress; measuring that needed time is not in the "mature stage" yet, according to Malloch. As of the publishing of this article in Nursing Economics (2015), there was as yet no "gold standard…
Hunter, B., Branson, M., and Davenport, D. (2010). Saving Costs, Saving Health Care
Providers' Backs, and Creating a Safe Patient Environment. Nursing Economics, 28(2).
Malloch, K. (2015). Measurement of Nursing's Complex Health Care Work: Evolution of the Science for Determining the Required Staffing for Safe and Effective Patient Care.
Nursing Economics, 33(1), 20-25.
Myocardial Infarction Minimizing Hospital Readmission
Phase 1: EBP for Effective Patient Care Transition
Donald, an acute myocardial infarction (MI) patient, has undergone angioplasty, a procedure in which a catheter is inserted into clogged arteries in a patient’s heart to widen them and improve blood flow. To supplement the angioplasty, Donald has had cardiac stents placed to prop the affected arteries open and reduce their risk of narrowing again. Studies have shown that several complications could result from angioplasty procedures and the insertion of stents as in Donald’s case. The most common complications include bleeding or vascular complications (6 percent of patients), acute renal failure (5 percent of patients), and stroke (0.3 percent of patients) (Dunlay et al., 2012). A study analyzing readmission rates among MI patients in Minnesota found that bleeding was the most common complication after angioplasty, affecting 6 percent of patients (Dunlay et al., 2012). The most common…
Borghi, C., & Ambrosioni, E. (1996). Primary and Secondary Prevention of Myocardial Infarction. Clinical and Experimental Hypertension, 18(3), 547-58.
CMS (n.d.). Guide to Reducing Disparities in Readmissions. Center for Medicare and Medicaid. Retrieved from https://www.cms.gov/About-CMS/Agency-Information/OMH/Downloads/OMH_Readmissions_Guide.pdf
Dunlay, S., Weston, S. A., Killian, J., Bell, R. M., Jaffe, A. S., & Roger, V. L. (2012). Thirty Day Hospital Readmissions Following Acute Myocardial Infarction: A Community Study. Ann Intern Med, 157(1), 11-18.
Jones, R., Arps, K., Davis, D. M., Blumenthal, R. S., & Martin, S. S. (2018). Clinician Guide to the ABCs of Primary and Secondary Prevention of Atherosclerotic Cardiovascular Disease. American College of Cardiology. Retrieved from https://www.acc.org/latest-in-cardiology/articles/2018/03/30/18/34/clinician-guide-to-the-abc s
Karunathilake, S. P., & Ganegoda, G. (2018). Secondary Prevention of Cardiovascular Diseases and Application of Technology for Early Diagnosis. Biomed Research International, doi: org/10.1155/2018/5767864
Lambert, P., Chaisson, K., Horton, S., Petrin, C,…& Brown, J. (2017). Reducing Contrast-Induced Acute Kidney Injury: How Nurses can Improve Patient Safety, a Qualitative Investigation. Critical Care Nursing, 37(1), 13-26.
Safety net hospitals have traditionally provided medical services vital to public health. Unfortunately, the recent economic recession has dealt a hard blow to safety net hospitals, even to the point of forcing hospital closures. Fortunately, Health Care Reform has already positively impacted U.S. health care and will even revolutionize American health care in some respects.
The Effect of the Closure of Safety Net Hospitals on Public Health
Safety net hospitals, such as Grady Memorial Hospital, serve the public health through providing vital treatment of uninsured, underinsured, Medicaid, and Medicare patients, along with some privately insured patients (Dewan & Sack, 2008). In addition, some safety net hospitals are also teaching hospitals that train medical professionals who contribute considerably to public health. Unfortunately, economic pressures are forcing the closure of some safety net hospitals, resulting in the severe reduction of medical care in certain communities for the "poor and underserved" (Altman, Shactman,…
Altman, S.H., Shactman, D., & Efrat, E. (2006, Jan/Feb). Could U.S. hospitals go the way of U.S. airlines? Retrieved September 1, 2012 from Proquest.com Web site: http://search.proquest.com/docview/204650663/138ED25BFA63A547161/5?accountid=28844
Amalberti, R., Auroy, Y., Berwick, D., & Barach, P. (2005, May 3). Five system barriers to achieving ultrasafe health care. Retrieved September 1, 2012 from Proquest.com Web site: http://search.proquest.com/docview/222267835/138ED3FE9A36E21E74A/6?accountid=28844
Dewan, S., & Sack, K. (2008, January 8). A safety-net hospital falls into financial crisis. Retrieved September 1, 2012 from Nytimes.com Web site: http://www.nytimes.com/2008/01/08/us/08grady.html?pagewanted=1&_r=1
Felland, L.E., Cunningham, P.J., Cohen, G.R., November, E.A., & Quinn, B.C. (2010, January). The economic recession: Early impacts on health care safety net providers. Retrieved September 1, 2012 from Rwjf.org Web site: http://www.rwjf.org/files/research/55109.pdf
Patient Electronic Access
The objective of this study is to investigate the application of the electronic health record at the inner City health hospital. The goal of implementing the program is to allow patients to have easy access to their health data and information to assist them sharing their health information with other healthcare and personal care providers. This study investigates the application of Measure 1 Stage 1 for the City Health organization. Following the benefits of the electronic health records, the City Health has decided to implement the new program. The program will allow patients to access their information on demand through PH (personal health record). However, the City Hospital will be able to derive benefits from the program by setting aside $170,000 for the implementation costs and $90,500 maintenance expenses. Moreover, the City Hospital should organize a training program for the staff to make the program be successful.…
ASCRS (2015). Patient Portal Requirement in Meaningful Use Guidance for Providers. ASOA.
CMS (2016). EHR Incentive Programs in 2015 through 2017 Patient Electronic Access. EHR.
Department of Labor (2015). Computer and Information Technology Occupations. Occupation Handbook Outlook.
Fleming, N.S. Culler, S.D. Mccorkle, R. et al. (2011). The Financial And Nonfinancial Costs Of Implementing Electronic Health Records In Primary Care Practices. Health Affairs. 30 (3): 481-489.
S. Department of Health and Human Services et al., 2006). This first study will involve limited human exposure and extreme caution.
Most significantly, the study itself has to be based on sound scientific principles with a thorough knowledge of the properties of the chemical, and the potential results on the human subject. Standard clinical safety evaluations will include serial assessment of patient symptoms, physical signs, and clinical laboratory tests amongst other tests monitoring possible adverse effects. These tests will be of sufficient duration in order to catch potential negative effects. Safety hazards for patients and health care workers during and after administration of the radio labeled product will also be identified, evaluated and appropriately managed.
Finally, as prescribed by Section 505(d) of the Federal Food, Drug, and Cosmetic Act (the Act) (21 U.S.C. 355(d)), adequate tests must be taken on the drug first before applying to a human individual. The…
Farde, L. et al., 2007 Using Positron Emission
Tomography (PET) microdosing. Focus, The Organisation for Professionals in Regulatory Affairs,1-8
U.S. Department of Health and Human Services et al. (2006). Guidance for Industry, Investigators, and Reviewers Office of Training and Communication, http://www.fda.gov/cder/guidance/index.htm
U.S. Department of Health and Human Services Food and Drug Administration et al. (2004). Guidance for Industry Developing Medical Imaging Drug and Biological Products Division of Drug Information HFD-240