The term “no-show patient” is used to describe patients who fail to reschedule or cancel a scheduled appointment. In outpatient primary care setting dealing with no show patients is one of the biggest challenges that has a tremendous impact on productivity and efficiency of the clinic. Residency teaching clinics are making constant efforts by actively participating in research studies and applying various strategies to decrease no show rate at the clinics. At Kaweah Delta Family Medicine Center we are looking at past interventions to develop proactive and effective ways of reducing no-show rates. Though there are numerous projects and researches conducted, this remains a major issue at outpatient clinics.
When identifying areas which are affected, the problem spans from lack of assistance with activities of daily living, to major medical errors. One study focused on improved resuscitation rates related to appropriate nurse to patient ratios. Those involved in the study site the American Heart Association’s “chain of survival” to directly correlate their evidence. “Better Nurse Staffing and Nurse Work Environments Associated with Increased Survival of In-Hospital Cardiac Arrest Patients” argues that nurses with an appropriate patient load are able to make contact with their patients more frequently, and for longer periods of time, giving those with a potential for cardiac arrest a more “timely response” to their cardiac event. Since “timely response” is the initial phase in the “chain of survival”, the subsequent steps are more likely to yield favorable outcomes.
For instance, Tortorice (2014) says, “Studies have suggested that napping nurses suffer from less fatigue than non-napping nurses” (p. 3). In my paper, I will be sure to take information such as the quote I just previously stated and the many solutions the author provided and incorporate
The number of Certified Nursing Assistance (CNA) to patients or residents is becoming a horrible problem. Patients do not get all the care they need or deserve because the certified nursing assistant ratio to patient is not what it should be. Certified nursing assistant jobs are not an exciting or even a job you would think about perusing, but it is an important job for people that can not take care of themselves like they should. Especially for people with dementia, ole timers, or any other illness. Only California, Nevada, Texas, Ohio, Connecticut, Illinois, Washington, and Oregon have a law where you have only a certain number of patients to CNA’s for each shift.
(2008) found positive correlations between more attractive environments and higher levels of perceived quality, satisfaction, staff interaction, and reduction of patient anxiety. The comparison of actual observed time and patients' perception of time showed that patients tend to overestimate shorter waiting times and underestimate longer waiting times in both the waiting area and the examination room. Franklin Becker et al (2008) found that patients' perceived quality of care, and their perceptions of the quality of interaction with staff, was significantly better in the patient-centred facility. Few differences were found in actual patient-staff interaction behaviours. This study is consistent with other studies that examined the relationship among the physical attractiveness of healthcare settings, patient satisfaction, and perceived quality of care.
When the nurse to patient ratio is low, the nurse will not be able to perform this assessment. This will result in a reduction of patients’ outcomes, medical errors, frequent re-admissions, patient deaths. Nurses experienced unsatisfied work environment, fatigue, burnout and increased in career change leading to the nursing
Which is described and give a percentage amount in the article, “Relationships between nurse staffing and patient outcomes.” that, “Higher rates of RN staffing were associated with a 3- to 12-percent reduction in adverse outcomes, depending on the outcome” (Clarke para 19). This is a reiteration that explains how that when in cases where hospitals are well staffed then it is very likely for that institution to become less likely to contain very ill patients. And a tendency in which cases of improper patient care is not likely to be found. The care of these patients are quite important and with proper facilitated institutions than it causes a greater likelihood to produce great work which in turn shines light on how staffing is important. And this importance causes a double take to concur so that when hospitals are checking on patient care they must be cautious and mindful towards the people that are taking care of these patients.
Systems changes to re-focusing on sole health care philosophy and patient as a priority would need to take place. Electronic Health Record (EHR) use is taking provider’s time away from patient to computer, diminishing patient trust. Therefore, easy EHR use is needed to redirect provider’s attention (Fleming, 2017). According to Gawande (2009), consolidated resources arising from payments, and organization to relieve provider’s regulatory burdens and malpractice responsibilities a model employed by Mayo clinic. In this model, patient comes first, combines expertise through consulting with unhurried examination and time to
However, in smaller, regional hospitals, it may be more likely that patients are known to each other. The extent to which bedside handover is appropriate in these situations remains unknown. A previous survey showed that almost 30% of 74 patients perceived the presence of other patients in the room during bedside handover as somewhat disturbing.30 it appears that nurses need to carefully consider how sensitive information is shared during bedside handover. Nurses perceived bedside handover in a positive light, believing it improved the accuracy of the information they handed over, however no comparison was done with other handover types, so this perception may not be accurate. Our participants said that patients’ presence not only prompted outgoing nurses to remember information that should be passed on, it also prompted oncoming nurses to ask questions and seek clarification, which may account for the perceived accuracy of bedside handover.
In nurse’s perspective, the poor and inconsistent of pain assessment can lead to unrelieved pain and reduce patient mobility, resulting in complications such as deep vein thrombosis, pulmonary embolus, and pneumonia (Ed. Caltorn, 1997). Postsurgical complications related to inadequate pain management will affect the length of hospitalization; the risk of readmissions, and increase the cost care of treatment. Somehow, a poor documentation of current status pain assessment will delay the intervention and responses to the care plan (Gordon, 2005). Thus, to overcome this situation in clinical practice, The American Pain Society (2005), created the phrase “Pain: the fifth vital sign” to increased awareness of the important in pain management