Week 4 Discussion:
What is the difference between emergency services and critical care? Give examples of each.
There are many differences in emergency services and critical care services. Below is a comparison:
Emergency Room/Department-Is located in a hospital but separately maintained and billing and coding are very different from the hospital setting as it is outpatient versus hospital is inpatient. It provides disaster management in times of a hurricane, earthquake, explosion, tornadoes, shootings, etcetera. Their patients are unlimited because normally their patients are seen and released either to their home or admission to the hospital as an inpatient. They provide short term care even for observation it is normally only 24 hours. The atmosphere is chaotic as people
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Critical care services provided by medical staff in an emergency department setting have to be coded very strictly due to CMS rules and regulations. These two services are coded completely differently so therefore adjustments and documentation have to be completed accurately. “First, a patient has to be critically ill or injured and at risk of death, loss of limb, or will decline rapidly if treatment is not provided.” “Time must be documented for any critical care services” as this is one of the guidelines for coding critical care and not emergency services. Critical care services are paid at a higher rate than emergency services if documented accurately. “The time documented must be for this patient only, and at the patient's bedside or close by.” The physician cannot leave the room or go to another patient or billing and coding will not be correct. Also, “critical interventions such as treatment or prevention of vital organ function/failure, or treatment of any critical condition must be
The roles of emergency services consist on the medical team who is responsible for scene assessment of personnel and equipment requirements, coordinating information to and from hospitals, oversee treatment from medical and nursing personnel, the ambulance crew will do the triage, patient transfer from the scene, and health service communication. The fire services are responsible for eliminating the fire and rescue trapped casualties using specialist equipment, the police team will control the traffic to aid evacuation, identify and move the dead, maintain law and
Long Term Acute Care Hospital With today’s technology and the specialized skills of doctors, nurses, and therapists, patients who need long term care for acute problems can obtain these services at institutions known as postacute care providers. One type of facility that falls under this title is the Long Term Acute Care Hospital (LTACH) (Munoz-Price, 2009, p. 438). This paper will discuss services provided by LTACHs, the role of the Chief Nursing Officer (CNO) in these facilities, and Medicare reimbursement effected by patient satisfaction surveys. For patients requiring longer acute care than what is generally given at an inpatient acute care hospital, the Long Term Acute Care Hospital is an option. To be admitted to an LTACH, patients are required to have “medically complex situations with a mean length of stay > 25 days” (Munoz-Price, 2009, p. 438 ).
Depending on the type of nurse, they will have different specific tasks and duties. For example, “An inexperienced nurse may get more busy and or easier work; but new emergency nurses get the same work that an experienced emergency nurse would receive” (Roark). Emergency nurses, being on the job for any amount of time, get the same amount of work because they will have to know eventually. “If there is a severely ill, or injured patient, all available nurses will work together to hopefully save the patients life”(Roark). A registered nurse in an emergency room will often have to administer local inhalation, intravenous, or other anesthetics (CareerOneStop).
D2 followers are those who are new to the job but have some understanding of how to achieve the tasks that are asked of them. D2 followers also demonstrate low commitment to the job or task. Behaviors may include a lack of motivation or a lack of interest.
Caring is the biggest aspect in the nursing field. Aspiring nurses choose to become nurses because they want to care for people in ways that most professions cannot do. Without caring nursing would not be the field it is today. The culture of caring involves intervening programs that help to build caring behaviors among nurses. As nurses become stressed and become down on their life it has shown that caring for oneself before others is key in caring for patients. Lastly, throughout the years many theorists have proven that caring has come from many concepts and ideas that relate directly to ICU nursing.
Although there are some similarities between an ambulatory care and an acute care facility there is a difference among the skills needed to provide the level of care. When thinking about clinical care there is additional training and education that is needed for clinical staff members who transition between caring for patient within the two different settings. Ambulatory care is more outpatient setting including clinics that operate during the day treating non-emergent patients. Acute care is inpatient care provided at bed side because they require continuous care. Their work mainly driven by hospital protocols and physician orders (Swan, 2007).
The State Emergency Department Databases (SEDD) captures information such as visits to hospitals that does not result with the patient being hospitalize. The SEDD captures patients regardless of payer and provide a view of ED care in the State. A total of thirty-two states participate in SEDD. The SEDD includes clinical and resources such as injury surveillance, emerging infections, community assessment and planning and many more. SEDD are used in publications such as HCUP Statistical Brief, HCUP Publications Search Tool, HCUP Research Spotlights, HCUP Outstanding Article of the Year
The phrase, emergency medical services, did not exist as a familiar expression defining a specific application of medical care prior to the 1960s. Generally, it now means the provision of medical care by specially trained and authorized personnel to the suddenly ill or injured prior to, and in the absence of, a hospital setting. Contemporarily, it refers to anyone of a variety of clinically different levels of medical care, provided to those who become unexpectedly incapacitated, whether from a chronic or acute illness or injury. I could write about how Modern EMS is considered to have started with Jean Dominique Larrey, Napoleon’s chief
Emergency room nursing is an experienced registered nurse whose focus is providing critical care and dedicated treatment to patients that are either critically wounded or severely ill. These nurses specialize in rapid assessments and treatments of their patients conditions. It is with great responsibility that the Emergency Room Nurse work swiftly and responsibly under a variety of different circumstances. Due the stresses and required skill set of emergency room, nurses must do a good job of utilizing their abilities and must possess good time management skills, these demands ultimately leads to burnout.
“Nursing is an art, and if it is to be made an art, requires as exclusive a devotion, as hard a preparation, as any painter’s or sculptor’s work...” (Nightingale, 1868)
NHS has A&E departments. Accident and emergency department’s treat the patient with serious injuries or illness. The A&E treat people with loss of consciousness, breathing problems, severe bleeding that cannot be stopped, chest paints and many more. It is open 24 hours. NHS has other departments such as pharmacies, Operating department practice, nursing, x-rays departments, operation theatres and many more.
In addition, there is an accident and emergency service provides for public. Nevertheless, when patients arrive at the A&E Department, a trained triage nurse will help determining the relative priority due to patient's condition. There are five categories for nurse to classify such as critical (immediate treatment), emergency (waiting time within 15minutes), urgent (waiting time within a half hours), semi-urgent and non-urgent. Yet, it trend to be treated the triage nurse as a McDonald’s Customer Service Ambassador in charge of the system carries out smoothly and conveniently.
A hospital is an institution that provides medical services for a community. Hospitals can be looked at from many different aspects. The main ones are length of stay, kinds of service, and the type of ownership. Short-term hospitals make up most hospitals. The patients in these hospitals stay only less than a month. The community of a hospital make up how much recognition they might receive. Community and nonprofit hospitals always spend more money for patient care than they receive in fees.
In my first clinical rotation I worked in an Urgent Care clinic that has actually turned into the primary care site for a large number of patients. I met a young women age 24, who had been seen in the Urgent Care five times in the past year for Genital Herpes. She did not understand that the suppressive medication ( Famciclovir ) was prescribed to be taken daily to prevent the outbreaks. My preceptor was a bit irritated with the girl- because she was non compliant. She was also frustrated that the girl did not follow up with a GYN provider as she was told too. The girl had good insurance and could go to any GYN in the area. My conclusion was that she was too embarrassed to go to a single provider, and to be accountable for her own health. It was less intimidating to come to Urgent Care.
A typical emergency unit is a busy one and, to avoid confusion, care should be logically organized from the patient's entry until discharge. Walsh (1990:34) suggests that each patient has a primary nurse who will care for him or her from admission until discharge. This is in contrast with task based nursing, which Walsh suggests should have no place in the emergency unit. Primary care nursing has numerous advantages, namely, enhanced communication between administrative staff, nurse, patient and doctor, holistic care ensuring all care is rendered, increased patient security, knowing who he or she is dealing with and, finally, improved monitoring of the patient's condition.The hospital environment can be a confusing one so