With a nurse shortage, patients are not getting the best quality care they should be getting. Archive stated that hospital nurse staffing, is a matter of major concern because of the effects it can have on patient safety and the quality care patients deserve. Nursing-sensitive outcomes is an indicator of the quality care and can be defined as variable patient or family caregiver state, condition, or perception responsive to nursing intervention. Some unfortunate patient outcomes potentially sensitive to nursing care are shock, urinary tract infections (UTIs), pneumonia, longer hospital stays, upper gastrointestinal bleeding, failure to rescue, and 30-day mortality. Research has focused on negative rather than the positive patient outcomes for the simple reason that adverse outcomes are more likely to be documented in the medical record.
Warren and Creech-Tart (2008) discussed that fatigue experienced by health care provider is one of the contributor factors to deficiencies in documentation. Since some health care providers work long hours and have demanding client assignments, they may not have clear thinking processes required during the process of documentation. Illegible writing is one of the most common complaints in written documentation as a result of messy handwriting (Rodríguez-Vera, Marín, Sánchez, Borrachero, & Pujol, 2002). A messy handwriting may occur if the nurses write the notes too quickly in order to save time or too many workloads on the same time. Messy handwriting can lead to misinterpretation of information and cause poor nursing care.
HBP- Hospital-Based Physician As per CMS a doctor is said to be Hospital-Based Physician if they spend 90 % of their working hours in either inpatient hospital or outpatient hospital or emergency care setting. Quite often there are specialized in anesthesiology, intensive care, cardiac care , pathology or radiology(24). EMR - Electronic Medical Record In contrary to traditional way of recording patient information on paper , EMR is the way of recording all patient information in electronic form which make physician work easy and helps to retrieve fast without any loss. HIXs- Health Insurance Exchange As per Obama care act HIXs provide scope to inter changeable exchange of qualified health plans which is strictly under federal and state laws. HIE - Health Information Exchange Exchange of patient health information in electronic form between various hospitals or within different departments of same hospitals to avoid unnecessary tests and improve the quality of health care (25).
Moreover, beginning in 2012, the NIS was redesigned from the “sample of hospitals” to the “sample of discharges” which are from all hospitals participating in HCUP. It contains about 300 million discharges data from races of white, black, Hispanic, Asian/Pacific Islander, Native American, and other with age of 0 to 124 years . NIS data types include primary and secondary diagnoses and procedures with ICD–9–CM code, patient demographic characteristics (e.g., sex, age, race, and median household income for ZIP Code), hospital characteristics (e.g., ownership), expected payment source, total charges, discharge status, length of stay, severity and comorbidity measures
Work stressors also anticipated with low job satisfaction, organisation inefficiency, excessive staff turnover and absenteeism due to staff falling sick (Borda & Norman, 1997; Clegg, 2001; Kirkcaldy & Martin, 2000). As compare to other professional groups, study has revealed that nursing profession often perceive as one of the “highly mobile occupational group” and has a much greater turnover rate (Yao,
Nurses often face ethical dilemmas and moral distress throughout various levels of direct and indirect patient care. According to Moon and Kim (2015), patients often die in the intensive care unit, and ethical conflicts frequently occur due to a variety of factors, such as verbal abuse, poor communication between health care providers, and increased incidences of end-of-life issues. I think this is a very important subject to think about, especially when these conflicts can significantly impact job satisfaction, burnout, and ultimately threaten the quality of care for patients. Furthermore, a qualitative study conducted by Henrich et al. (2017) shows that healthcare providers often experience negative emotional repercussions from moral distress in the ICU, and patient care is frequently perceived as being negatively affected.
62 patients who satisfy the inclusion criteria were recruited during the study period. Details about demographic, laboratory charges, nursing charges, physician charges and, cost of oral hypoglycemic agents received by study patients were collected from the patient’s medical sheet note. Information related to cost of each parameter were collected from the in-patient pharmacy as well as financial department. All of the earlier mentioned data were assembled in a specific pre-design collection form. The assembled data was introduced to cost effectiveness analysis to arrive at the cost of different treatments options.
This was conducted on an adult inpatient medical-surgical unit. The reason for conducting this study was could be limiting the overall effectiveness. This study identified barriers in the areas of workload issues, burdensome rounding logs, missing staff buy-in, patient acuity levels, lack of adequate staff education, and a lack of sustainability. All of these barriers are directly related to the staff caring out the hourly rounds, except the patient acuity level; meaning that if staff can be thoroughly educated on the correct process of hourly rounding, many of these barriers would be eliminated. This study identified that future studies are needed to address these barriers specifically to see if there would be an improvement in hourly rounding effectiveness, but this study recommends that it would be.
Interviewer: Yes. Interviewee: I think that the environment can be difficult because the patients are so sick, so things like ancillary staff to help. Like, we place a line to do CRRT, but the x-ray tech is busy and we need to verify the placement before we can start them. We send a lot of labs for CRRT and that can affect your workload and it can be difficult if we are waiting on labs to make these pretty important changes in their care. That type of thing can be a challenge environmentally.
Work-related stress is “the adverse reaction people have to excessive pressures or other types of demand placed on them at work.” (Burke, 2013). Work intensification, or work overload, is increasing due the diversity in patient’s acuity coupled with shorter hospital stays. These greatly affect the nursing staff because they face shorter deadlines, which leaves an unpleasant feeling if one or more goals are not met. Unfortunately, because of how facilities get reimbursed for care, nurses are faced with this problem and there is no immediate
It is based in Oakland, California but provide both insurance and health care services to patients across 8 states and the District of Columbia (Overland, 2013). As of 2014, it was reported that Kaiser had 186,497 employees, 18,652 physicians, 51,010 nurses, 38 medical centers, and 622 medical offices (Fast Facts, 2016).
These alarming statistics raise a huge concern with the effectiveness of the transitions of care. The main issue with transitions of care is that there are discrepancies that mistakenly occur during this process. As reported by Judith Kristeller, PharmD BCPS, “the transition between inpatient and community settings in particular is prone to medication errors related to a lack of communication between health care providers, missed patient follow-up, inadequate patient education, etc.” (6). Medicare services have even included a three percent fine on Medicare payment for hospitals that have unnecessary readmissions, and this percent has increased since 2014 (5). There are so many issues with patient safety that should not be occurring, so reforms must be made in transitions of
Interdisciplinary Team Paper Janet Borngesser University of Alabama at Birmingham Interdisciplinary Leadership Role Development NUR 737 Dr. Martha Lavender July 15, 2015 Interdisciplinary Team Paper The neurocritical care intensive care unit (NICU) team has certainly undergone much change and transformation since the first neurocritical care physician and nurse practitioner (NP) took over the team and seven bed unit in 1999. Prior to this initial ‘team’ the NICU was managed by the neurosurgery attending and residents in between surgeries. The NICU team’s purpose was to improve and provide better care to the variety of complex neuro critical ill patient population at a 605 bed academic center in Metro Atlanta. Over the course of
You will have at least 200 hours, two months – or 250 patient encounters which is dedicated to caring for acutely ill or injured adult patients in an emergency department setting. At least 100 hours, one month – or 125 patient encounters for caring of older