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.
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.
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.
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
Hourly rounding is indeed anticipating and meeting the needs of patients and ensuring their safety. According to Ford (2010), evidence based practice showed that hourly rounding improve patient outcome and safety by reducing the amount of times the call bell goes off and patient falling. When the nurse does round hourly he or she can ask the patient whether they need assistance with anything. The nurse can also make sure that everything is within the patient’s reach. At times patients may feel that they are a bother to the nurses and try to get up on their own to use the bathroom and fall, for example.
At NBRHC, if there is no neurologist on staff, ER physicians have to contact telehealth and request a consult with a neurologist via teleconference. This process is time consuming and inefficient. There is also a problem with not always having a neurologist available right away. By identifying the problems such as gaps and redundancies in the stroke protocol process, the team can assess and determine any possible improvements that can be created, even with the current cutbacks to NBRHC, the door-to-needle time for tPA administration can be decreased to Ontario
Reasons that can contribute to an inaccurate vital reading are overall sign reading. And some of the reasons to that is not understanding the right way to take vital sign or how to follow the right procedure. Being a Medical Assistant means having a lot in our plate, an can mean that we might have a lot of errors. Most common errors that are introduced by a medical assistant are vital signs. Either the MA was not well trained on taking blood pressure or has trouble understanding it.
In a recent article published in the MEDSURG Nursing journal it discussed the effects of hourly rounding to prevent falls for patients in acute care. Falls not only cause harm to patients, they cost hospitals money. In 2012 “the Joint Commission identified reduction of harm from patient falls as a national patient safety goal” (Hicks, 2015). In attempts to reduce falls, studies have been conducted on hourly rounding. “The main components of hourly rounds include reducing anxiety by using key words, addressing the four Ps (pain, potty, position, possessions), assessing the environment for safety issues and telling the patient when staff will return” (Hicks, 2015).
Marsha McMillen Unit 5 Math Discussion After researching the metric system uses in the medical field, I found quite a few uses just used in the billing and coding field. It is used for cost, production to reduce supply and labor costs, clinical performance, such as quality of patient care, also called “patient outcome” data. Other uses are, Patient Safety, nearly 100,000 Americans die each year, because of medical mistakes, that happened during their stay at the hospital, these accidents can lead to longer recoveries and permanent disabilities. We use metrics in-patient surveys after treatment/release, to measure patient satisfaction of their care.