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Patient Satisfaction in Quality of Managed Care
Aspect to be compared
Gender and Patient
Satisfaction in Managed Care, etc.
Stakeholder Perceptions of Quality in Managed Care Plans
Two Steps to Enhance Managed Care Quality
Emily eisman, MS
Jacobs Institute of omen's Health
Carolyn M. Clancy, MD
Paul L. Grimaldi, Ph.D.
To determine what the differences are and what variables might affect women patients' perceptions of the quality of managed care
To find out what attributes three different health care stakeholders, physicians, employers and consumers, value most in determining their assessments of the quality of managed care health plans
To explain the ramifications of two developments in managed care: the new application form for MCOs to become Medicare risk contractors, and the National Committee for Quality Assurance plan to begin performance-based accreditation.
Determining what the differences between men's and women's perceptions of the quality of…
Grimaldi, Paul L., Ph.D. "Two steps to enhance managed care quality." Nursing Management, August, 1998.
Thompson, Jon M. "Stakeholder perceptions of quality in managed care plans."?
Weisman, Carol S. et al. "Gender and patient satisfaction in managed care plans: Analysis of the 1999 HEDIS/CAHPS 2.0H Adult Survey."?
You have been appointed to chair a hospital-wide committee to develop and implement a plan to improve patient satisfaction in your facility. Your Chief Nursing Officer has provided you a summary report indicating a steady decline in patient satisfaction over the previous six months. You will need to identify the various resources available for tracking patient satisfaction, establish a clear bench mark and design a specific plan of action for reversing this trend. It is essential to note in your development that research has shown nurse communication and hourly rounding to be key drivers in patient satisfaction metric improvements. These points should be a focus of your change initiative.
Roger's Change Theory
The diffusion of innovation theory, or Roger's change theory, was first proposed by Everett Rogers more have a half a century ago. Despite the theories age, it remains relevant to any change process today. The premise of this…
patient satisfaction with the care provided by nursing staff and physicians, as well as how satisfaction can be improved through better communication among physicians and nurses, and with their patients. It will, in particular, deal with a nursing student's own clinical experience with patients and their perception of healthcare provider-patient communication. In addition, the paper will examine the student's project which considered the strategy of updating white boards in patient rooms regularly for better communication.
Ten medical surgical ward patients were interviewed during rounds by a student, who rated patient satisfaction and tried to discover some common theme. While patients expressed satisfaction with how nursing staff delivered care, they felt physicians didn't keep them informed. A number of patients were visited by two or more doctors. However, there was no communication between doctors, leading to issues such as a patient being marked "not ready for surgery" by the cardiologist, owing…
(2008). Home - Robert Wood Johnson Foundation. Improving Patient-Staff Communication Through White Boards - Robert Wood Johnson Foundation. Retrieved August 6, 2016, from http://www.rwjf.org/en/library/articles-and-news/2008/06/improving-patient-staff-communication-through-white-boards.html
(n.d.). Institute for Healthcare Communication. Impact of Communication in Healthcare - Institute for Healthcare Communication. Retrieved August 2, 2016, from http://healthcarecomm.org/about-us/impact-of-communication-in-healthcare/
(2011). JBI COnNECT+. Effective communication between registered nurses and adult oncology patients in inpatient settings. Retrieved August 2, 2016, from http://connect.jbiconnectplus.org/Viewsourcefile.aspx?0=7112
(n.d.). Journal of Nursing - RN Journal. The Importance of Communication and Education toward Patient Literacy. Retrieved August 2, 2016, from http://rnjournal.com/journal-of-nursing/the-importance-of-communication-and-education-toward-patient-literacy
The baseline data for the study was recorded during the first 2 weeks of the 6-week study period. The study design consisted of analyses of the data collected from the experimental (1-hour rounds and 2-hour rounds) versus the control nursing units with a nonrandom assignment of hospital units to these respective groups (the assignment was the responsibility of chief nursing officers and nurse managers). Although the determined to conduct 1-hour or 2-hour nursing rounding was left up to the nursing executives at the participating hospitals, the principal investigator ensured that the sample was stratified as to type of unit (i.e., medical, surgical, or combined medical -- surgical), unit size, and frequency of nursing rounds.
Adequacy of the Sample
The researchers identified 26 different reasons for the use of call lights by patients in their review of the literature and coded data from the 14 hospitals whose data satisfied the…
Nursing Unit Turnover on Patient Outcomes in Hospitals
While it might seem intuitive that higher rates of turnover within a unit are problematic, the study by Bae, Mark, & Fried (2010) attempts to show using a quantitative study the extent to which turnover has had a negative impact upon patient care. This study compared the levels of turnover at 268 units from 141 hospitals and assessed its relationship to both patient satisfaction and the nurse's own perceptions of cohesion, relational coordination, and learning. The study is quite distinct in design from qualitative studies which often have an anecdotal approach and emphasize experience vs. data in evaluating policies.
One problem, however, with the use of such a study which emphasizes numbers over narration is the difficulty of quantifying subjective variables like efficacy. In this instance, nurses' own perceptions of what policies were useful were assessed as well as patients' perceptions to…
Bae, S., Mark, Barbara, Fried, Bruce. (2010). Impact of nursing unit turnover on patient outcomes in hospitals. Journal of Nursing Scholarship, 42 (1): 40-49.
Hutcheson, G.D. (2011). Ordinary least-squares regression. In L. Moutinho and G.D.
Hutcheson. The SAGE Dictionary of Quantitative Management Research, 224-228.
hourly nurse rounds help to reduce falls, pressure ulcers, call light use and contribute to rise in patient satisfaction base on evidence base practice
The healthcare center is faced with numerous challenges affecting clinical results and client satisfaction (e.g., ulcers, use of call light and falls). The above challenges have brought on the need to develop and institute an appropriate framework to improve patient care delivery by means of better and increased interaction between patients and nurses. Chiefly, the creation of this sort of system necessitates striving for required authorization and assistance from leaders and staff members in the organization. This involves meeting with top management at organization appraisal board meetings, in addition to collaborating with peers concerning existing best practices for handling the issue. Taking into account organizational issues and nursing-related evidence-based practices (EBPs), the best answer to dealing with current issues is hourly nurse rounds. Implementing this recommended…
AIPPG (2011). Comfort theory. Nursing Theories. Retrieved September 5, 2015 from http://currentnursing.com/nursing_theory/comfort_theory_Kathy_Kolcaba.html
Brosey, L., & March, K. (2015).Effectiveness of Structured Hourly Nurse Rounding on Patient Satisfaction and Clinical Outcomes. Journal of Nursing Care Quality, 30(2), 153-159. doi:10.1097/ncq.
Carroll, D., Dykes, P., & Hurley, A. (2010). Patients' perspectives of falling while in an acute care hospital and suggestions for prevention. Applied Nursing Research, 23(4), 238-241. doi:10.1016/j.apnr.2008.10.003
Deitrick, L., Baker, K., Paxton, H., Flores, M., & Swavely, D. (2012).Hourly Rounding. Journal of Nursing Care Quality, 27(1), 13-19. doi:10.1097/ncq.0b013e318227d7dd
Application: Systems Theory
Healthcare organizations provide nursing services centered on multiple theories. For instance, the Open Systems Theory established in 1978 by Katz and Kahn considers the healthcare organization as social systems divided into interconnected subsystems (Meyer & O’Brien-Pallas, 2010). Meyers and O’Brien-Pallas (2010) provide that these interrelated subsystems include outputs, throughputs, inputs, negative feedbacks and a cycle of events. The primary care hospital environment has various units that handle different cases including the intensive care, intermediate care, medical-surgery, emergency department (ED) etcetera. This paper delves into system theory in the emergency department, identify goals and challenges in this department and establishes an appropriate structural outcome.
Subsystems in Emergency Department
In the emergency department, the inputs include financial resources, supplies, and staffing needed for the unit to be functional. The emergency department is in operation all day and night and needs sufficient nurses and subordinate staff to give a throughput…
Stagnant Health System Meets an Aging Population, Disaster Await
The Globe and Mail
Published Friday, Jan. 16, 2015
Most Canadians have expressed dissatisfaction with the manner that the health-care system looks after the elderly in society. A study carried out indicated that out of five individuals; four stated of their lack of confidence in accessing needed health care services. Lack of confidence reflects the depleting quality of care offered by nurses based on factors such as understaffing and the lack of resources to cater for the surging aging population. The study indicates that three-quarters expressed worries of inability to meet medical bills after they retire an indication of unsustainable policies that stretches hospital resources.
About 61% doubt the ability of the nation's long health-care facilities and hospitals in meeting the surging aging population in Canada. The challenge indicates a deteriorating state of quality of care offered by nurses due to…
Roy, Avik (Jun 13, 2014). "If Universal Health Care Is The Goal, Don't Copy Canada" Forbes. Retrieved from http://www.forbes.com/sites/theapothecary/2014/06/13/if-universal-health-care-is-the-goal-dont-copy-canada/
Flood, C. (July 22, 2014). Canada should look to Europe for health care, not the U.S. The Globe and Mail. Retrieved from http://www.theglobeandmail.com/globe-debate/canada-should-look-to-europe-on-health-care-not-the-us/article19706492/
The Globe and Mail (Jan 16, 2015). When a stagnant health system meets an aging population, disaster awaits. The Globe and Mail. Retrieved from http://www.theglobeandmail.com/globe-debate/editorials/when-a-stagnant-health-system-meets-an-aging-population-disaster-awaits/article22487481/
Sibbald, Barbara (Oct 15, 2015). Election 2015: party platforms on health issues. Canadian Medical Association Journal. Retrieved from http://www.cmaj.ca/site/earlyreleases/15oct15_election-2015-party-platforms-on-health-issues-cmaj.109-5178.xhtml
There are a number of concerns faced by patients in the hospital. One that is not often discussed but that can play a real factor in treatment is the burnout experienced by nurses. Even during short-term hospitalization, the burnout that nurses face can potentially result in improper care to the patient. Addressed here is whether this is something that has been seen with patients experiencing short-term hospitalization, based on how satisfied they are with their nurses. Literature regarding burnout will be examined, and a survey will be undertaken in order to discover whether patients are having good experiences with the nurses who care for them during their short-term hospitalizations. By discovering whether the patients are happy with the care they are receiving and determining whether that nurse may have been suffering from burnout, it will be possible to draw conclusions regarding whether the nurse's burnout status affected proper…
Bianchi, R., Boffy, C., Hingray, C., Truchot, D., & Laurent, E. (2013). Comparative symptomatology of burnout and depression. Journal of Health Psychology, 18(6), 782 -- 787.
Freudenberger, H.J. (1974). Staff burnout. Journal of Social Issues, 30(1), 159-165.
Freudenberger, H.J. & North, G. (1985). Women's burnout: How to spot it, how to reverse it, and how to prevent it. NY: Doubleday.
Lussier, K.G. (2006). Taming burnout's flame. Nursing Management, 37(4): 14.
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.
Patient Perceptions of Participation in Treatment
Several studies have revealed that patients generally prefer to learn everything they can about their illness and the proposed treatment plan, and even have some control during the planning stage (reviewed in Lund, Tamm, and Branholm, 2001). On the other hand, studies have found that occupational therapists typically underestimate this desire and tend to perceive patients as passive and uncooperative. The gap between the patient's wishes to actively participate and the therapists' perceptions of that willingness can result in a number of problems, including patient compliance with treatment plans and goals. Strategies to minimize the size of this gap could therefore lead to more effective rehabilitation of the patient's disability.
A study was conducted in Sweden that examined patients' experiences as a rehabilitation patient and the professional's view of the interaction (Lund, Tamm, and Branholm, 2001). Patients were enrolled from acute care in surgery,…
Lund, Maria Larsson, Tamm, Maare, and Branholm, Inga-Britt. (2001). Patients' perception of their participation in the rehabilitation planning and professionals' view of their strategies to encourage it. Occupational Therapy International, 8(3), 151-167.
Skidmore, Elizabeth R., Whyte, Ellen M., Holm, Margo B., Becker, James T., Butters, Meryl A., Dew, Mary Amanda et al. (2010). Cognitive and affective predictors of rehabilitation participation after stroke. Archives of Physical Medicine and Rehabilitation, 91(2), 203-207. Retrieved May 3, 2011 from http://www.ncbi.nlm.nih.gov .ezproxy1.lib.asu.edu/pmc/articles/PMC2824912/pdf/nihms153354.pdf
Patient-centered care is the goal of many healthcare organizations, but the ability of an organization to deliver patient-centered care is influenced by a number of factors both internal and external. Business practices, regulatory requirements, and reimbursement all can impact patient-centered care in any healthcare organization. Promoting patient-centered care requires an organizational culture committed to this paradigm, which also needs to be embedded in the mission and values of the organization.
Executives and administrators create the organizational culture that promotes patient-centered care. All leaders in the organization are responsible for using patient-centered practices and communications styles in their interactions with patients and their families. Furthermore, administrators oversee the policies and procedures that directly impact the culture of care. Analyzing areas of weakness within the organizational structure and culture via established assessments like the Patient-and Family-Centered Care Organizational Self-Assessment Tool, it is possible to create multidisciplinary teams that promote the organization’s…
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
Piney Woods Hospital
Satisfaction is the pivotal problem for Piney Woods Hospital to address. Satisfaction across all stakeholders has a substantive impact on the other key challenges the hospital is facing. When customers are satisfied with the service and care they receive at hospital, they let others in the community know about it. When hospital employees are satisfied, they provide superior hospital services. When physicians are satisfied, they provide excellent medical care. It is an obvious and intractable cycle. Further, levels of satisfaction are indicators of other symptoms or successes regarding the operations of the hospital and its relationship to the community. This paper will focus on the challenges of increasing patient and employee satisfaction within the Emergency Department at Piney Woods Hospital.
The health care industry has in common with other service industries the pivotal importance of employee engagement on the customer-facing -- or patient-facing, as the case may…
Atkins, P.M., Marshall, B.S., and Javalgi, R.G. (1996), Happy employees lead to loyal patients, Journal of Health Care Marketing, 16, 4, 14-23.
Brown, C.L. (2002), A theory of the process of creating power in relationships, Nursing Administration Quarterly, 26, 2, 15-33.
Cunningham, P. (2011, May11). Nonurgent use of hospital emergency departments. Center for Studying Health System Change (HSC) [BEFORE THE U.S. SENATE Health, Education, Labor and Pensions Committee Subcommittee on Primary Health and Aging Hearing on ?Diverting Non-urgent Emergency Room Use: Can It Provide Better Care and Lower Costs?]. Retrieved http://hschange.org/CONTENT/1204/1204.pdf
Electronic Health Records Overview (2006, April). National Institutes of Health National Center for Research Resources.
Nurse Patient atios and Quality of Care
This study reviews the broad level of issues that surround the nurse/patient ratio: a critical shortage of trained and experienced nurses; increased political and fiscal demands from all sectors of society; rising costs internally and externally combined with a rising number of under-insured; and the conundrum of nursing ethics and the ability to foster excellence in care and patient advocacy. We note that there remains an issue about hiring more nurses -- where will these nurses come from if the nursing schools do not increase their recruitment efforts and broaden their curriculum. In addition, we note that the large majority of patients and stakeholders primarily want two things when admitted to a healthcare facility: better paid nurses and more highly-trained professionals who are satisfied with their vocation.
Modern nursing is, by necessity, a mixture of complex balance: patient care vs. staffing; procedures…
More Nurses Make the Difference. (February 2012). The Lamp. 69 (1): Retrieved from: http://search.informit.com/au/documentSummary;dn=045435426132502;res=IELHEA
Safe Nurse Staffing: Looking Beyond the Numbers. (2009). Vantage Point, CNA. Retrieved from: https://www.nso.com/pdfs/db/newsletters/Safe_Nurse_Staffing_-_Looking_Beyond_the_Raw_Numbers_20094.pdf?fileName=Safe_Nurse_Staffing_ -_Looking_Beyond_the_Raw_Numbers_2009-pdf&folder=pdfs/db/newsletters
Aiken, L. (2001). The Hospital Nurse Workforce: Problems and Prospects."Draft
For the Council on the Economic Impact of Health System Change. Retrieved from: http://council.brandeis.edu/pubs/hospstruct / Council-Dec-14-2001-Aiken-paper.pdf
Patients deserve as much time and attention as a nurse can possibly provide but when a nurse is in charge of eight patients at once she or he can only spend a few minutes with each one. When a patient requires additional care, nurses are unable to provide it. Therapeutic care is ultimately compromised when nurses have a high case load. Nurses can be more attentive to each patient when case loads are low. When nurses spend more time with each patient, symptoms are noticed earlier, allowing for more rapid diagnoses and recovery times.
Health care administrators should consider lowering the nurse-to-patient ratio for the best interests of both patients and nursing staff. Patient care is compromised when nurses do not have enough time or energy to devote to all patients, especially those requiring special attention or care. Employee satisfaction and patient satisfaction both suffer when nurses care for eight…
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.
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.
Leading hange for Patient and Service Improvement Module
about service quality: Service quality concept in the current literature
The developed countries have given a significant importance to the service sector of the country. With every passing day the segment of employment is growing and increasing very rapidly. This ultimately gives the members of the society a life with high quality and setting high standards for the members to a live a good life. Service sector contributes as a major portion of the country and without it other sectors cannot also develop. It also faces competition with global world as the world has become global all the way. The main point of this competition is to bring free circulation of the services and products. Getting confidence of the consumers is an essential part and while facing competition they need to provide the best services in order to sustain in the market.…
Consultant dieticians are employed under an agreement with health related establishments or work privately. They execute dietary checks on their patients and propose diet related solutions to issues like being overweight and fat cutback. Some give their time to welfare organizations, sports groups, superstores, and such food related dealings. They may confer with food managers, supplying the skill necessary to carry out hygienic conditions, safety protocols, diet programs, and financial issues.
In the next few pages we will discuss the drivers aforementioned in detail and how they help in attaining viability, acceptability, feasibility and desirability of the change in home healthcare services.
In order to estimate the home healthcare working excellence, diet facilities must be looked on a continuous basis (Babakus & Mangold, 1992; Devebakan, 2005; Lee et al., 2000), including semblance of hospital and hygiene (Lee & Yom, 2007). Most important thing for the home healthcare and dietary staff is that they must be serviceable and comfortable. The overall environment must be organized in a way that provides freedom from anxiety to the patient. There must be proper supply of devices and dietary supplements in hospitals as
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]
Among the most important aspects to the health promotion plan will be the benefits associated with a care manager, who can ensure that all six core elements of CCM are implemented fully. If this is accomplished, there should be a significant reduction in health disparities for patient and caregiver outcomes across generations.
AHQ. (2012). National Healthcare Disparities eport, 2011. No. 12-0006. ockville, MD: Agency for Healthcare esearch and Quality. etrieved 16 Apr. 2014 from http://www.ahrq.gov/research/findings/nhqrdr/nhdr11/nhdr11.pdf.
Braveman, P.A., Kumanyika, S., Fielding, J., Laveist, T., Borrell, L.N., Manderscheid, . et al. (2011). Health disparities and health equity: The issue is justice. American Journal of Public Health, 101(Suppl. 1), S149-55.
Brodaty, H. & Donkin, M. (2009). Family caregivers of people with dementia. Dialogues in Clinical Neuroscience, 11, 217-28.
Castro, A. & uiz, E. (2009). The effects of nurse practitioner cultural competence on Latina patient satisfaction. Journal of the American Academy of Nurse…
AHRQ. (2012). National Healthcare Disparities Report, 2011. No. 12-0006. Rockville, MD: Agency for Healthcare Research and Quality. Retrieved 16 Apr. 2014 from http://www.ahrq.gov/research/findings/nhqrdr/nhdr11/nhdr11.pdf .
Braveman, P.A., Kumanyika, S., Fielding, J., Laveist, T., Borrell, L.N., Manderscheid, R. et al. (2011). Health disparities and health equity: The issue is justice. American Journal of Public Health, 101(Suppl. 1), S149-55.
Brodaty, H. & Donkin, M. (2009). Family caregivers of people with dementia. Dialogues in Clinical Neuroscience, 11, 217-28.
Castro, A. & Ruiz, E. (2009). The effects of nurse practitioner cultural competence on Latina patient satisfaction. Journal of the American Academy of Nurse Practitioners, 21(5), 278-86.
unninghead: UNNING AND WHITEBAOD USAGEOUNDING AND WHITEBOAD USAGEounding and Whiteboard Usage in Postpartum WomenFull Name and Credentials?Name of Degree: Doctorate of Nursing PracticeAcademic University?September 20172017Authors Full NameALL IGHTS ESEVEDAbstractThis paper explores the impact of hourly rounding and the implementation of a whiteboard in postpartum women in regards to the care received and outcomes achieved. Namely, this paper examines the question of whether hourly rounding and the use of a whiteboard in postpartum women increases patient satisfaction and pain management immediately after delivery to 72 hours of postpartum stay, particularly when compared to the absence of both rounding and a whiteboard.Keywords: postpartum, whiteboard, roundingTable of ContentsSection One: Introduction and Overview of the Problem....8Introduction to Problem?8Problem Statement?....8Current Practices?...8Purpose of the DNP Project?...8Project Objectives and Outcomes..9Background/Significance of Problem....9Clinical Question (PICOT)...9Conclusion...10Section Two: eview of Literature11eview of the Literature11Search Table?..12Appraisal of Evidence?12Table of Evidence (Appendix).12Limitations..13Conclusion..13Section Three: Conceptual Foundation.14Conceptual/Theoretical Model...14Constructs?..14Implications for Project?..15Concept Definition and Identification...15Evidence-Based Practice…
References.51Appendices....52Tables....53Figures...54IRB Approval55Permissions....56Letters of Reliance.57Measurement Instrument...58DNP Essentials..59
Mitigating isks from Dementia
Providing adequate care for an individual suffering from dementia presents many difficulties for nurses. Patients with dementia often have debilitating conditions such as Alzheimer's or similar neurologic diseases which are progressive, thereby making it challenging for them to remember, think lucidly, communicate effectively or complete activities of daily living. Furthermore, dementia can cause rapid variations in mood or even modify personality and behavior. With the tremendous number of elderly in society more and more nurses are required to care for patients with progressive dementias. It is imperative that a diagnosis be reached early in the course of the cognitive impairment and that the patient is closely monitored for coexisting morbidities. Nurses have a central role in assessment and management of individuals with progressive dementia. This essay provides some evidence-based practical strategies for managing the behavioral problems and communication difficulties often encountered in this population.…
Aud, M.A., Oliver, D., Bostick, J. And Schwarz, B. 2011. Effectiveness of Social Model Care Units for Dementia. International Nursing Research Congress 2005.
Care, N.D. 2010. Teaching and Learning. Pulse. Winter Edition.
Fletcher, S. And Zimmerman, S. 2010. Trainee and trainer reactions to a scripted dementia care training program in residential care/assisted living settings and nursing homes. Alzheimer's Care. 11(1): 61-70.
Goodman, C. 2011. The organizational culture of nursing staff providing long-term dementia care is related to quality of care. Evidence-Based Nursing. 47:1274-1282.
Fact sheet on end-of-life care. American Psychological Association. http://www.apa.org/pi/eol/factsheet1.pdf
Fact sheet on end-of-life care, published by the American Psychological Association discusses the adult's mental health needs near the end of life and the obstacles they confront to having a comfortable death.
Foley, K.M., (1995). Pain, Physician assisted dying and euthanasia. Pain 4, 163-178.
Foley discusses how access to and delivery of pain treatment are seriously deficient in the present health care systems in the United States. The author advocates expanding services and resources to care for the dying patient.
Isaacs, S.L. And Knickman, J.R (1997). To improve health and health care. San Francisco, CA: Jossey ass.
Isaacs and Knickman examine programs of the Robert Wood Johnson Foundation, a health care philanthropy. They reports its history, evaluates its effect, and discusses lessons learned as well as provide a frank discussion of why some problems can't be easily solved.
Langer, G. (2003,…
Bernstein, S. (1997, September 30). An act of mercy or murder?
Bernstein includes opinions (both pro and con) on whether services be available to any patient who is terminally ill and facing certain death within six months.
Coleman, C.H. And Miller, T.E. Stemming the tide: Assisted suicide and the Constitution. http://law.shu.edu/faculty/fulltime_faculty/colemaca/pdf_docs/coleman_miller_watermark.pdf
In addition, there will be a follow-up interview process to capture specific area of low customer satisfaction scores. These scores will be used for process improvement and business process reengineering within the company. One of the most critical aspects of these measures is the need to use them to fundamentally re-architect the company and make it more customer-centric. This is critical for the Zapper to reflect customers' needs and requirements and for the company to have a very solid fidelity and transparency to its customers.
Measuring and Acting on Gaps Between Customer Expectations and Experiences
One of the innate strengths of the SEVQUAL methodology is the ability to quickly assess the differences between expectations and experiences quickly, and in very quantitative terms. These differences across expectations and experiences are measured with a minimum of 32 different variables, which can be highly effective in pinpointing just what areas of public relations,…
Allen, E., & Fjermestad, J. (2001). E-commerce marketing strategies: An integrated framework and case analysis. Logistics Information Management, 14(1), 14-23.
Genestre, a., & Herbig, P. (1996). Service expectations and perceptions revisited: Adding product quality to SERVQUAL. Journal of Marketing Theory and Practice, 4(4), 72-82.
Gurau, C. (2008). Integrated online marketing communication: Implementation and management. Journal of Communication Management, 12(2), 169-184.
Hopen, D. (2003). The message is clear. Quality Progress, 36(10), 50-58.
The main focus of this essay is going to concern the nurse-patient relationship idea, and why it is important. This was chosen because the researcher desired to achieve a better accepting of how a helpful nurse-patient relationship can be advanced and even from different theorists who have discovered this idea. In this essay, the researcher sets out to demonstrate what they have learnt regarding the nurse-patient relation concept and how this connection can utilized in the clinical practice setting. T The nurse patient connection, according to a study done by Press Gamey Associates Inc., creates the quality of the care experience and generates an influential influence on patient gratification. Nurses will a lot of their time with patients. Patients see nurses' relations with people among the care team and make their own conclusions about the hospital founded on what they are observing. Furthermore, nurses' approaches toward their vocation,…
Berdes, C. & . (2001). Race relations and caregiving relationships: A qualitative examination of perspectives from residents and nurses aides in three nursing homes. Research on Aging, 23(1), 109-126.
Biering, P. (2002). Caring for the involuntarily hospitalized adolescent: The issue of power in the nurse-patient relationship. Journal of Child and Adolescent Psychiatric Nursing, 16(2), 65-74.
Heijkenskjold, K.B. (2010). The patients dignity from the nurses perspective. Nursing Ethics, 6(3), 313-24.
LaSala, C.A.-B. (2007). The role of the clinical nurse specialist in promoting evidence-based practice and effecting positive patient outcomes. The Journal of Continuing Education in Nursing, 38(6), 262-70.
e., males and females per nurse specialty).
Variables & Measures
Variables for the study are as follows: workload management, work environment, burnout rate, and job satisfaction. In addition to these variables, instruments gauging the level of burnout experienced will be used, particularly the Maslach Burnout Inventory (MBI). An index of attitudes and perceptions on workload management, work environment, and job satisfaction will also be formulated, and will be tested for internal and construct validity.
FGD Guide / Survey Instrument
The FGD Guide will have four (4) sections, focusing on the following broad themes/topics: workload management as experienced by the discussants, work environment, burnout (concepts and experiences), and job satisfaction (as related to burnout). The survey instrument or questionnaire will also have the sections used in the FGD guide, with an additional section allotted for the Maslach Burnout Inventory (MBI).
Data analysis will make use of both bivariate and…
Ablett, J. And R. Jones. (2007). "Resilience and well-being in palliative care staff: a qualitative study of hospice nurses' experience of work." Psycho-Oncology, Vol.16.
Browning, L., C. Ryan, S. Thomas, M. Greenberg, and S. Rolniak. (2007). "Nursing specialty and burnout." Psychology, Health & Medicine, Vol. 12, No. 2.
Gawel, J. (1999). "Herzberg's Theory of Motivation and Maslow's Hierarchy of Needs." ERIC Digests Website. Available at http://www.ericdigests.org/1999-1/needs.html .
Gustafsson, G., a. Norberg, and G. Strandberg. (2008). "Meanings of becoming and being burnout -- phenomenological-hermeneutic interpretation of female healthcare personnel's narratives." Scandinavian Journal of Caring Science, Vol. 22.
Boulton, Martha (2005) Exploring alexithymia, depression, and binge eating in self-reported eating disorders in women. Perspectives in Psychiatric Care
Dahm, Lori (2005) Obesity update: are we getting any thinner?(Special Report)
Private Label Buyer
Merrick, Joav (2005) Psychosomatic reasons for chronic pains.(Editorial)
Southern Medical Journal
____(2006) Obese people may be more sensitive to pain.(NEWS Breaks)(Brief article) Nutrition oday
PORER, LAWRENCE C. WAMPLER, RICHARD S (2000) Adjustment to Rapid Weight Loss. Families, Systems & Health
Rubin, Jay J. (2005) Psychosomatic pain: new insights and management strategies.(CME opic: Psychosomatic Pain) Southern Medical Journal
ucker, Miriam E. (2005) Depression tied to poor adherence to cardiac Rx: results of two studies show that use of aspirin and [beta]-blockers was lower in depressed patients.(Psychosomatic Medicine) Clinical Psychiatry News
his study will seek to determine whether or not obese post operative patients have a higher incidence of psychosomatic disorders and illnesses than non-obese post op…
The need for this study is evident. The cost factor of psychosomatic illnesses may be reduced if it can be determined whether or not the obese patient population has a higher incidence of psychosomatic illness in post op. If it does then future steps can be taken to better prepare the obese patient population for surgery to reduce the incidence of post op psychometric illness.
Tucker, Miriam E. (2005) Depression tied to poor adherence to cardiac Rx: results of two studies show that use of aspirin and [beta]-blockers was lower in depressed patients.(Psychosomatic Medicine) Clinical Psychiatry News
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.
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.
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
Age Groups and the Nursing Profession
Job satisfaction in nursing related to generational age differences
Attrition among nurses has been a worrying topic to not only the society but the government and the related agencies in specific. This is due to the evident lack of interest in the nursing related field in the recent years, as more students opt for courses that are IT related rather than the nursing related courses. With the generation Y increasingly ignoring the nursing related courses and the baby boomers retiring each day, there is bound to be a gap in the nurses' numbers within the health care facilities, a trend that medics foresee just getting worse each passing year. Apparently, there is a generational influence or trend noticed in the perception of the nursing profession as will be further portrayed in the research data herein. This trend has led to a dire need for…
KaiserEDU.org. (2012).Nursing Workforce. Retrieved August 30, 2014 from http://www.kaiseredu.org/Issue-Modules/Nursing-Workforce/Background-Brief.aspx
Spetz J., et.al, (2002). Minimum Nurse-to-Patient Ratios in Acute Care Hospitals in California.
Orton Sophie (2011). Re-thinking attrition in student nurses. Retrieved August 30, 2014 from https://wlv.ac.uk/PDF/Rethinking%20Attrition%20in%20student%20nurses%20Sophie%20Orton.pdf
human resources and psychology is job satisfaction. Not surprisingly, people have noted that higher levels of job satisfaction are linked to improved job performance. Hackman and Oldham were some of the first researchers to really highlight the relationship between job characteristics and job satisfaction. "Their Job Characteristics Model (JCM) argued that, essentially, enriched or complex jobs are associated with increased job satisfaction, motivation, and work performance. More specifically, they assumed that five core job characteristics…influence three critical psychological states…which in turn affect work outcomes (Fried & Ferris, 1987). The five core job characteristics include skill variety, task identity, task significance, autonomy, and feedback from job (Fried & Ferris, 1987). The three critical psychological states include the experienced meaningfulness of the work, the experienced responsibility for outcomes of the work, and knowledge of the actual results of the work activities (Fried & Ferris, 1987). The work outcomes that are impacted by…
Cengage (2010). Skills application 4.2: Job diagnostic survey. Retrieved January 18, 2012 from:
Fried, Y. & Ferris, G. (1987). The validity of the job characteristics model: A review and meta-
-analysis. Personnel Psychology, 40, 287-322.
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
Self-Perceived Oral Malodour Among Periodontal Patients:
One of the most common dental consultations is perceived oral malodour that suggests that thorough evaluation of oral malodour in dentistry. Generally, oral malodour is considered as a widespread, horrible, medical condition that is characterized with emergence of unpleasant odour from the mouth because of gram-negative anaerobic bacterial putrefaction of proteinaceous substrates containing sulfur. According to Azodo & Umoh (2013), oral malodour is basically caused by hydrogen sulfide, dimethyl sulfide, volatile sulfur compounds, and methyl mercaptan (p.125). These elements have also been associated with the pathogenesis of periodontal disease because of their toxicity to oral tissues.
Based on this background, the authors agree that oral malodour is a huge concern to the general population since it has unfavorable consequences on both the private and professional life. Therefore, it's a significant health issue with negative effects on the quality of life, especially with regards to…
Azodo, C.C. & Umoh, A.O. (2013, August). Self-perceived Oral Malodour among Periodontal
Patients: Prevalence and Associated Factors. International Journal of Medicine and Biomedical Research, 2(2), 125-132. Retrieved from http://www.ajol.info/index.php/ijmbr/article/download/92813/82237
Patients in hospitals often complain of pain regardless of the diagnosis. Several activities in a patient's life contribute to pain. Some of the activities include amount of sleep, daily chores and quality of life (Alaloul, Williams, Myers, Jones, & Logdson, 2015). While health care expenses have increased significantly over the years, there have been great improvements in increasing both family and patient involvement in medical care. Hourly care is one of the strategies that have worked well in various healthcare settings. Hourly care has been a success in various areas but using it in urgent pediatric settings hasn't been well documented (Emerson, Chumra, & Walker, 2013). Opportunities still exist to look into pediatric family preferences and perspectives as pertains to the use of whiteboards (Cholli, et al., 2016). Several studies have been done in different setups and this paper references many of them. The research projects include in-patient surveys, quasi-experimental…
Alaloul, F., Williams, K., Myers, J., Jones, K. D., & Logdson, C. (2015). Impact of a Script-based Communication Intervention on Patient Satisfaction with Pain Management. Pain Management Nursing, 321 - 327.
Brosey, L., & March, K. (2015). Effectiveness of structured hourly nurse rounding on patient satisfaction and clinical outcomes. Journal of Nursing Care Quality, 153.
Cholli, P., Meyer, E., David, M., Moonam, M., Mahoney, J., Hession-Laband, E., . . . Bell, S. (2016). Family Perspectives on Whiteboard Use and Recommendations for Improved Practices. Hospital Pediatrics, 426 - 430.
Emerson, B., Chumra, K., & Walker, D. (2013). Hourly rounding in the pediatric emergency department: patient and family safety and satisfaction rounds. J Emerg Med, 99 - 104.
Patients are accountable for providing feedback, which is essential for a system of shared accountability to function correctly. Patients may also ask questions, of course and should be expected to follow instructions, because if they do not they are not upholding their part of the arrangement to share responsibility.
After all, shared governance can easily turn into anarchy without intelligible communication between all parties, and this communication is conducted by means of data, information that is gathered and readily interpreted. From this observation, it is easy to see how accountability can be incorporated into a shared governance model, because it can be done by increasing the access to this information -- letting patients, medical providers, payers and personnel "eavesdrop" on the conversation that permits shared governance to work in an orderly fashion, by giving them access (perhaps selectively) to the data that is most relevant to them.
But the sensible…
Patient Safety in the Medical Environment
Medicines cure various infectious conditions, avert chronic diseases issues, and alleviate pain. However, an incorrect dosage and usage of drugs could invite negative effects. Errors from incorrect medicine usage are unavoidable and can happen at home, doctor's place, pharmacies, or even at hospitals. Such erroneous activities are one of the prime triggers behind paediatric patients experiencing iatrogenic injuries. Triggers of such medication errors, as put forward by studies, include lack of adequate knowledge, work pressure, lack of awareness that such errors exist, and insufficient training. Avoiding such errors is a clinical and government necessity. Some strategies that have been employed to lower recurrences of such errors include better input from clinical pharmacists, changes in system by using critical incident analysis and using information technology (Simpson, Lynch, Grant, & Alroomi, 2004). This paper looks into two major healthcare system failures, how to lower and avoid…
Diamond, C.L., & Jacobs, A.E. (2010). Let's Not Contribute to Disparities: The Best Methods for Teaching Clinicians How to Overcome Language Barriers to Health Care. Journal of General Internal Medicine, 189 -- 193.
Quan, K., & Lynch, J. (2010). The High Costs of Language Barriers in Medical Malpractice. California: The National Health Law Program.
Simpson, J.H., Lynch, R., Grant, J., & Alroomi, L. (2004). Reducing medication errors in the neonatal intensive care unit. Arch Dis Child Fetal Neonatal Ed, F480-F482.
The Academy of Managed Care Pharmacy's. (2010). Concepts in Managed Care Pharmacy: Medication Errors? The Academy of Managed Care Pharmacy's.
Patient portals, electronic medical records, and personal monitoring devices are three of the most revolutionary technologies in the healthcare sector. Each of these technologies presents patients with the potential to empower themselves, taking control of their own healthcare outcomes, and taking part in their overall healthcare goals. These technologies also streamline healthcare administration and minimize medication and billing errors. However, each of these technologies is also constrained by a range of issues related to accessibility, with potent socioeconomic class disparities evident. Security and standardization of healthcare technologies are also proving problematic. Patient portals, electronic medical records, and personal monitoring devices are all technologies that have the potential to radically improve the quality of healthcare and patient outcomes, as well as improve overall patient experiences. Because of their abundant benefits, these technologies need to be embraced and promoted through effective public health policies. Otherwise, disparities will continue to threaten to exacerbate…
Reducing Patient Waiting Time for Better Patient Outcomes
Most healthcare institutions start their day with the intention of perfectly managing their time schedules. While the expected outcome is excellent patient outcome many practices often end up bringing in more patients into a schedule that is already overloaded hence requiring more time to attend to the scheduled patients (Capko, 2015). The outcome of the busy schedules is inefficiency, bottlenecks, frustration, and more waiting time for the patients. Patients are forced to spend more time in the exam room or reception area waiting for an opportunity to be attended to (Capko, 2015). For the patient things appear to be moving in slow motion.
In order to overcome the scheduling problems it is important to address the foundation of this patient scheduling problems. It may seem easy but it is more complex than many would think. It takes a lot of…
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.
Some patients might feel as though they are not getting all of the attention they deserve if they are not shaved before surgery. Because patient comfort is a high priority, the attending nurse could explain in layman's terms the rational for the change, and the surgical site could be clipped if needed to put the patient at ease and full his expectations.
Mellinger and McCanless's article on evidence-based nursing offers guidance on cultivating awareness of the research literature relevant to the nursing field (2010). It highlights the importance of learning how to access the literature and interpret it in order to define performance standards and work procedures that reflect the best practices support by scientific findings. Mellinger and McCanless demonstrate how nurses can use the same means other health care professionals use to advance their work. The Consumer eports on Health article helps implementation of the change in procedure by…
Infection control; usual practices in surgical site preparation do not reduce infections. (2006,
May 30). Medical Devices & Surgical Technology Week, 253.
Mellinger, E., and McCanless, L. (2010). Evidence-based nursing practice in the perioperative setting: a Magnet journey to eliminate sacred cows. AORN Journal, 92, 572-578.
Preoperative hair removal and surgical site infection. (2006). Australian Journal of Nursing,
Nurse managed care has many potential benefits in a largely taxed healthcare system such as found in the United States. One specific area of improvement could come from the reliance on the crowded emergency department. Many homeless and low-income individuals often rely on the emergency department (ED) as their primary health care source because they are not able to access alternative healthcare sources. One proposed solution to such overcrowding in the ED, is to promote nurse managed lower cost clinics that can assist a majority of this populations non-emergency needs as well as help them to access additional community resources that they may need to treat their specific conditions (Savage, Lindsell, Gillespie, Lee, & Corbin, 2008).
There are many different perspectives that have been applied to such a proposal. One is that it can help train and provide experience for young nurses. Another is that it could help to…
Savage, C., Lindsell, C., Gillespie, G., Lee, R., & Corbin, A. (2008). Blackwell Publishing Ltd. Improving health status of homeless patients at a nurse-managed clinic in the Midwest USA. Health and Social Care in the Community, 469-475.
In situations where outcome or decision control is ceded to a legitimate decision-maker, the available legal procedure may be judged according to whether it provides adequate 'voice' for the aggrieved, adequate process control, and/or the satisfaction of being respected and afforded an appropriate level of procedural justice as a litigant, defendant or citizen.
In any event, continued dialogue between lawyers and psychologists from both types of system is encouraging. To this end, van Koppen and Penrod (2003) have collected legal psychological analyses of American and European criminal justice procedure together in a recent volume allowing comparisons between adversarial and inquisitorial mentalities.(n10) If this type of work continues, we may better understand when each type of process works best and when people, be they socialised in Australia, America, England or continental Europe, react best to adversarial or inquisitorial systems of legal decision-making in particular contexts.
In many jurisdictions, the approaches of…
Balmford, R. 'The Life of the Administrative Appeals Tribunal: Logic or Experience' in R. Creyke (ed) Administrative Tribunals: Taking Stock (Canberra: Centre for International and Public Law, 1992) 50, 68-71
Bronitt, Simon; Mares, Henry. 2004. The history and theory of the Adversarial and Inquisitorial systems of law. (cover story). Legaldate (3): 1-3.
Lind EA et al. 1978. Reactions To Procedural Models For Adjudicative Conflict Resolution: A Cross-National Study. Journal of Conflict Resolution 22: 318.
Nolan, Mark. 2004. The Adversarial mentality vs. The Inquisitorial mentality. Legaldate 16 (3): 7.
The participants of the case study were the members of the medical surgical nursing staff and patients were in hospital since last 6 months. Data was collected and summarized by Gallup Organization, which surveyed 200 medical surgical patients in for two quarter. Patients were also interviewed during the rounding to get their feedback.
The results showed that rounding made a significant difference in the patients and nurses satisfaction. 4P program was also used in this study as it was used in last studies. It was also reported that patients used less call lights less than before and only for serious needs. Patient's complaints regarding staff also decreased to 43% during these two quarters.
Health care including Nursing are very sensitive issues and any conclusions made in this field have impact on the lives of people. Therefore it is not convenient at all to reach to conclusion only by analyzing…
Blakley, D., Kroth, M., & Gregson, J. (2011). The Impact of Nurse Rounding on Patient Satisfaction in a Medical Surgical Hospital Unit. MEDSURG Nursing (MEDSURG NURS), 2011 Nov-Dec; 20(6): 327-32.
Ford, B. (2010). Hourly Rounding: A Strategy to Improve Patient Satisfaction Scores. MEDSURG Nursing
(MEDSURG NURS), May- Jun; 19(3): 188-91.
Gardner, G., Woollett, K., Daly, N., & Richardson, B. (2009). Measuring the effect of patient comfort rounds on practice environment and patient satisfaction: A pilot study. Journal of Nursing Practice (INT J. NURS
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.
Team members should communicate all relevant information to the Project Managers for the University of Arizona Medical Center and the CM vendor chosen for the project.
Issues and risks should be communicated in writing via the Issues/isk Log or email to the Project Manager. If the issue/risk is urgent, immediate verbal communication of the issue/risk to the Project Manager is recommended. Once the issue is stabilized, written documentation will be developed to communicate the issues. The Project Manager will report Project Issues/isks eports on a weekly basis.
The Project Manager will distribute a Contact List to each team member to ensure that members have the necessary information to stay in contact with each other.
Quality management is the process of providing the necessary tools and project reviews to help ensure the business goals are achieved, issues are promptly identified and resolved, and the process employed to achieve the…
Almunawari, M.N., & Anshari, M. (2011). Improving customer service in healthcare with CRM 2.0. GSTF Business Review (GBR), 1(2), 228-234.
Burr, L.C., Patterson, R.A., Rolland, E., & Ward, K.F. (2007). Integration of E-CRM in healthcare services: A framework for analysis. International Journal of E-Business Research, 3(2), 1-6,8-12.
Boosting the bottom line with CRM. (2002). Marketing Health Services, 22(3), 39-40.
Sutton, G. (2009). Evaluating multidisciplinary health care teams: Taking the crisis out of CRM. Australian Health Review, 33(3), 445-52.
The aim of hospitals is to measure and improve the quality of health care service for the patients. Patient satisfaction is the foremost concern. However, to run a hospital, there are a lot of other factors are also involved; e.g. managing cost, budgeting, optimizing operations and increase patient satisfaction level. In order to achieve the desired level of performance, the hospital needs to be up-to-date with the latest technology.
In this era of technological advancements, every company has to maintain all their records on computer because it saves time and needs less effort than manual work. Our hospital has digitalized their data but every department has its own data base. In order to optimize the operations, hospital requires having a central data base system.
As Schuhmann (2009) stated in his article that the recent economic crisis has made it difficult for hospitals finance their capital expenditures. The capital…
Bailey, C. (2012). The Cost Reduction Imperative. Becker's Hospital Review.
Cleverly, W.O., Cleverly, J.O., & Song, P.H. (2010). Essentials of Health Care Finance. Jones & Bartlett Learning.
Devraj, S., & Kohli, R. (2000). Information Technology Payoff in the Heath-care Industry: A Longitudinal Study. Journal of Management Information Systems, 41-67.
Finkler, S.A., Kovner, C.T., & Jones, C.B. (2007). Financial Management for Nurse Managers and Executives W.B. Saunders Company.
Nursing Doctoral Business Proposal
The benefits of staffing Advanced Nurse Practitioners (ANP) as ANP Case Managers
A Nurse Practitioner (NP) is a registered nurse educated and certified to operate autonomously and collaboratively in an advanced and comprehensive medical responsibility. The practitioner has several additional roles under which they are to conduct diagnostic investigations, prescribe medications and undertake referrals to specialist clinical medications. esearch suggests that when nurses undertake prescription roles, it can result to increased efficiency, maximization of resources, and improve patient access to medicines and enable nurses to provide timely and extensive care packages (Cashin, Buckley, Newman & Dunn, 2009). In the advanced practitioner context, the roles that exist include the Clinical Nurse Specialist, the Certified Nurse Midwife, the Nurse Anesthetist and the Nurse Practitioner.
On the other hand, an Advanced egistered Nurse Practitioner (ANP) is also a registered nurse who possesses professional knowledge base, intricate decision-making skills and…
Cashin, J.A., Buckley, T., Newman, C., & Dunn, V.S. (2009). Nurse practitioner provision of patient education related to medicine. Australian journal of advanced nursing, 27(2), 12-
Carter, N. et al. (2010). The role of nursing leadership in integrating clinical nurse specialists and nurse practitioners in healthcare delivery in Canada. Nursing leadership, 167-185, doi:
vidence-Based Quality Nursing Practice
As a result of a variety of conditions, hospitalized patients may experience extended times in their hospital bed, unable to ambulate, and forced to rely on call buttons to communicate their needs or anxieties to nurses on duty. Not infrequently, patients who attempt to get out of bed may fall. And patients who cannot get out of bed, or adequately shift their positions in bed, may experience pressure sores as a result of their immobility.
Patients experience a number of emotions in response to these types of situations, any one of which can compel them to use their call button to summon help, or even express their frustration at their helplessness, discomfort, or heightened sense of vulnerability. The use of call bells by patients may occur more frequently than nursing staff consider appropriate, consequently, the probability that responsiveness to nurse call bells will diminish over time…
Evidence-Based Quality Nursing Practice
Dyck, D., Thiele, T., Kebicz, R., Klassen, M., & Erenberg, C. (2013). Hourly Rounding for Falls Prevention: A Change Initiative. Creative Nursing,
When it comes to fall prevention there is particular concern for the elderly population. This particular study looked at how hourly rounding is supported by literature but when not adopted initially, so in turn was examined and a plan developed that would ensure change with the help of nurses and allied health members. The summary lists key factors in developing a sustainable program.
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
INTENET'S IMPACT ON HEALTH CAE INFOMATION
The Internet's Impact on Health Care Information
The Internet's Impact on Health Care Information
This paper explores some of the best and well-known cites and sites around the world for information and health care. Early in the 21st century, the World Health Organization made its first attempt to rank the quality of health care in approximately 200 countries. (NYT, 2007) The WHO ranked the countries' health care based on factors such as fairness, quality, access, insurance coverage, patient satisfaction, and use of information technology among other factors. (NYT, 2007) According to this research, some of countries in the world that provide the best health care overall are France, Italy, Malta, Japan, and Monaco, among others. (NYT, 2007) As much as the United States of America boasts at being the best in the world at nearly everything, United States health care was not in…
Global Health Council. (2012). Health Linkages. Web, Available from: http://www.globalhealth.org/Health_Linkages.html . 2012 August 26.
Mayo Foundation for Medical Research and Education. (2012). Mayo Clinic. Web, Available from: http://www.mayoclinic.com/ . 2012 August 26.
National Institutes of Health. (2012). Health Information. Web, Available from: http://health.nih.gov/ . 2012 August 26.
No listed author. (2007). Editorial -- World's best health care? The New York Times, Web, Available from: http://www.nytimes.com/2007/08/12/opinion/12sun1.html?pagewanted=all . 2012 August 26.
Improving Customer Service on a Medical Surgical Nursing Unit
Quality Improvment Project-Customer service on the nursing unit
The hospital medical-surgical nursing unit is usually referred to as the "catch-all" department for different types of patients. This is because it includes renal patients, cancer patients, cardiac and surgical patient. It also includes other patients who do not particularly fall into any of these specialized units. The medical-surgical nursing unit is a conglomeration of all kinds of adults with all sorts of health problems and thus the nurses in this unit need to be dynamic, quick to respond and are almost on their toes at all times. Patients in the medical-surgical nursing unit are likely to develop changes in their condition quite rapidly and therefore they become more unstable even though they may have been admitted in a stable condition. This is because most patients in the medical-surgical nursing unit have unpredictable…
Amba-Rao, S.C. (1994). Human Resource Management Practices in India: An Exploratory Study. Indian Journal of Industrial Relations, 30(2), 190-202.
Dirks, K.T., & Ferrin, D.L. (2002). Trust in leadership: Meta-analytic findings and implications for research and practice. Journal of Applied Psychology, 87(1), 611-628.
Glickman, S.W., Baggett, K.A., Krubert, C.G., Peterson, E.D., & Schulman, K.A. (2007). Promoting quality: the health-care organization from a management perspective. International Journal for Quality in Health Care, 19(6), 341-348. doi: 10.1093/intqhc/mzm047
Judge, T.A., & Piccolo, R.F. (2004). Transformational and transactional leadership: A meta-analytic test of their relative validity. Journal of Applied Psychology, 89(1), 755-768.
This study is a theoretical framework exploring whiteboard use preferences and recommendations for patient-centered care and communication through whiteboard use.
This study is a theoretical framework exploring whiteboard use, script-based communication, and hourly rounding to evaluate effectiveness of care associated with pain management and patient satisfaction.
The study utilizes a conceptual framework.
This article uses a conceptual framework that provides a literature review
A 3-week pilot involving multidisciplinary whiteboard use
The setting is Stanford University Medical Center
Sample characteristics (# of patients) Patients available for the pilot were 104 patients: 56 from inpatient units with use of whiteboards and 48 from inpatient units with no use of white boards.
internal medical residents were also surveyed.
Design: The study involved a semi-structured interview.
Setting: The interview took place in a pediatric urban academic hospital inpatient surgical service
Sample characteristics (# of patients) The…
Alaloul, F., Williams, K., Myers, J., Jones, K. D., & Logsdon, M. C. (2015). Impact of a Script-based Communication Intervention on Patient Satisfaction with Pain Management. Pain Management Nursing, 16(3), 321-327. doi:10.1016/j.pmn.2014.08.008
Brosey, L. A., & March, K. S. (2015). Effectiveness of Structured Hourly Nurse Rounding on Patient Satisfaction and Clinical Outcomes. Journal of Nursing Care Quality, 30(2), 153-159. doi:10.1097/ncq.086
Cholli, P., Meyer, E. C., David, M., Moonan, M., Mahoney, J., Hession-Laband, E., . . . Bell, S. K. (2016). Family Perspectives on Whiteboard Use and Recommendations for Improved Practices. Hospital Pediatrics, 6(7), 426-430. doi:10.1542/hpeds.2015-0182
Emerson, B. L., Chmura, K. B., & Walker, D. (2014). Hourly Rounding in the Pediatric Emergency Department: Patient and Family Safety and Satisfaction Rounds. The Journal of Emergency Medicine, 47(1), 99-104. doi:10.1016/j.jemermed.2013.11.098
Bass, P., ilso, J. And Griffith, C. (2003). A Shortened Instrument for Literacy Screening. Journal of General Internal Medicine, 8(12), 1036-8.
Berger, J. (2000). Corporate Health Plan Strategies and Health Literacy. National Health Communications Conference. ashington, DC: ACP Fouindation.
Chew, L., Bradley, K., and Boyko, E.. (2004). Brief Questions to Identify Patients with Inadequate Health Literacy. Family Medicine, 36(8), 588-94.
Chew, L., Griffin, J., Partin, M., et al. (2008). Validation of Screening Questions for Limited Health Literacy. Journal of General Internal Medicine, 23(5), 561-6.
Davis, T. And olf, M.. (2004). Health Literacy Implications for Family Medicine. Family Medicine, 36(8), 595-8.
Davis, T., Long, S., and Jackson, R. (1993). Rapid Estimate of Adult Literacy in Medicine. Family Medicine, 25(1), 391-95.
Dowse, R., Lecoko, L. And Ehlers, M. (2005). Applicability of the REALM Health Literacy Test. Pharmacy orld, 32(4), 464-71.
Ibrahim, S., Reid, F., Shaw, A., et al. (2008). Validation of a…
Health Litarcy: Report of the Council on Scientific Affairs. (1999). Journal of the American Medical Association, 28(1), 552-7.0
Arozulla, Y., Benett, S., Soltysilk, T., et al. (2007). Development and Validation of a Short-Form, Rapid Estimate of Adult Literacy in Medicine. Medical Care, 5(11), 1026-33.
Bass, P., Wilso, J. And Griffith, C. (2003). A Shortened Instrument for Literacy Screening. Journal of General Internal Medicine, 8(12), 1036-8.
Berger, J. (2000). Corporate Health Plan Strategies and Health Literacy. National Health Communications Conference. Washington, DC: ACP Fouindation.
Establishing an NP Led Wellness and Recovery Center for Deinstitutionalized Individuals
Historically, nursing, and medicine professions have been loath to utilize tools commonly linked with mercenary aspects of business, such as market research and decision analysis. In the contemporary health care setting, however, consumers hold numerous options for care providers. The division of the market or market segmentation into different subgroups allows the determination of target markets and the buildup of marketing policies specific to the needs and interests of the selected subgroups. Market analysis allows the identification of policies for nurse practitioners to enhance their practice in a way that centers on the interests and needs of the selected market. While scores of the nurse practitioner's dream of operating their own businesses, those that have set up their own practice understand that it requires a compelling passion for owning a business, and for the profession.
A nurse practitioner is…
Arn Palm Hospital
The Arnold Palmer Hospital website pronounces the statement that the hospital employs the "most advanced technology, coupled with compassion and dedication" and that has made the hospital "one of the most trusted names in children's healthcare worldwide" (Arnold Palmer Hospital for Children, 2011). Complementing access to the most advanced technology with compassion and dedication sounds good on the company website, but maintaining a 100% patient satisfaction level takes more than just those three items; a couple of other considerations might also include a strong management level of quality of service as well as a process and supply chain that is conducive to excellent patient care. One recent article espouses the opinion that many hospitals and medical clinics are undergoing transformations that will change the face of healthcare in the United States and that many of the innovations being implemented are "being done with patients and the quality…
Arnold Palmer Hospital for Children; (2011) Welcome, accessed on September 19, 2011 at http://orlandohealth.com/arnoldpalmerhospital/index.aspx
Carpenter, D.; (2011) Transforming health care, H & HN: Hospitals and Health Networks, Vol. 85, Issue 5, pp. 46 -- 50
Fallon, A.; Gurr, S.; Hannah-Jones, M.; Bauer, J.D.; (2008) Use of the acute care hospital foodservice patient satisfaction questionnaire to monitor trends in patient satisfaction with foodservice at an acute care private hospital, Nutrition and Dietetics, Vol. 65, Issue 1, pp. 41-46
In spite of the struggling economy throughout the country, United Healthcare industries ascended in development and improved their year over year incomes by 9% in 2010. They had found a way to widen their customer foundation by 1.5 million people. The economy disorder was an important motive for the development in Medicaid program contribution increasing nearly to 16% from one year to the next one. Furthermore, the aging "baby boomer" age group supported in the point of 17% in Medicare Advantage customers in 2010 (Quinn, 2009). After travailing 1.8 million association damage in 2009; the commercial market had underwent an experienced an affected improvement that stemmed in a net gain of 185,000 individuals aided in 2010. "The developments were determined by fresher, more reasonable products, better client retaining, better service, and lesser employee abrasion trends that are among our customers" (CEO, 2011). ith that said, this essay will…
Quinn, G.P., Jacobsen, P.B., Albrecht, T.L., Ellison, B.A., Newman, N.W., Bell, M., & . "Real-time patient satisfaction survey and improvement process." Hospital Topics 18, no. 3 (2009): 26-32.
Safavi, K. "Patient-centered pay for performance: Are we missing the target?" Journal of 51, no. 4 (2006): 23-45.
Shi, L. & Singh, D. Essentials of the U.S. health care system. Sudbury, M.A.: Barlett Publishers, 2007.
Patient Satisfaction Scorecard
This dashboard page reviews and specifies how satisfied patients attending the hospital were, or were not, based on the service they received at the hospital. The data breaks down into specific areas of concern for patients in terms of the service they received.
There are 24 categories for patient input as to the quality of service they received. The hospital sent out 1,232 surveys and 954 people (former and presumably present patients) responded to the survey (450 males and 504 females; 250 new patients and 704 returning patients). The ages reflect a very diverse community of patients, including: 19 that were 10 years of age or younger; 57 between 11 and 20; 124 were between 21 and 30 years of age; 219 were between 31 and 40; 172 were between 41-50; 153 were between 51-60; 113 were between 60 and 70; and…
One of the immediate things that nurses and other healthcare professions do when a new patient arrives is to give that person aspirin. This was done 100% of the time in January, 2009. And 87% of the patients received aspirin (prescribed at discharge). Patients with heart trouble were given ACEI or ARB for their left ventricle systolic dysfunction (90% of the patients) and counseling for people who smoke cigarettes was given 67% of the patients in 2009. The list is quite long but of particular interest is influenza vaccination (75% of patients received it), blood cultures were taken for 78% of the patients, and 76% of patients that had undergone colorectal surgery received "immediate postoperative normothermia."
As to the how this hospital's core measures stack up on a national basis, the barometer graph on the lower right side of this dashboard shows that this hospital meets national averages 80% of the time.
Overall Summary: When a hospital goes to the trouble of presenting specific data regarding how it serves its patients -- and this should be required / expected in today's healthcare environment -- any potential or past patient can easily see the thoroughness therein.
Antiemetic Efficacy of Ipa Inhalation
Post-Operative Nausea and Vomiting
Antiemetic Efficacy of IPA Inhalation in High-isk PONV Patients
Antiemetic Efficacy of IPA Inhalation in High-isk PONV Patients
Post-operative nausea and vomiting (PONV) is considered a significant enough threat to patient health that surgical patients are often treated prophylactically to prevent its occurrence (reviewed by Murphy, Hooper, Sullivan, Clifford, and Apfel, 2006). PONV has been defined as an episode of nausea, vomiting, or retching (non-productive vomiting) that occurs within 24 hours following surgery, which can cause patient distress, post-operative complications, prolonged recovery times, and increase the cost of post-surgical care. The prevalence of PONV for the average surgical patient is estimated to be between 20 and 30%, but high-risk patients may have up to an 80% or higher chance of experiencing this condition. The high variability in PONV risk precludes standard prophylactic treatment, due to the cost and the increased risk…
Apfel, Christian C. (2005). PONV: A problem of inhalational anaesthesia? Best Practice & Research Clinical Anaesthesiology, 19(3), 485-500.
Cullen, Karen A., Hall, Margaret J., and Golosinskiy, Aleksandr. (2009). Ambulatory surgery in the United States, 2006. National Health Statistics Reports, 11, 1-28. Retrieved 9 Oct. 2012 from http://www.cdc.gov/nchs/data/nhsr/nhsr011.pdf .
Hines, S., Steels, E., Chang, A., and Gibbons, K. (2012). Aromatherapy for treatment of postoperative nausea and vomiting (review). Cochrane Database of Systematic Reviews, April 18(4), 1-52. Retrieved 11 Oct. 2012 from http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007598.pub2/abstract .
Lummis, Sarah C.R. (2012). 5HT3 receptors. Journal of Biological Chemistry, in press, October 4. Retrieved 8 Oct. 2012 from http://www.jbc.org/cgi/doi/10.1074/jbc.R112.406496 .