1. Improved Turned Compliance Rates
Frequent repositioning and progressive mobility have been shown to provide significant benefits to hospitalized patients. Recently released guidelines from the National Pressure Ulcer Advisory Panel (NPUAP) recommend repositioning all patients at risk of pressure ulcers, unless medically contraindicated. Using Leaf’s wearable patient monitors, we now know when a patient has been turned and how that patient has been turned.
2. More Effective Offloading
Mere repositioning of the patient does not reduce pressure ulcers. This repositioning must be effective. When we started using the Leaf patient monitors, we found out that we did not have all the necessary wedges needed to keep patients optimally turned. The wearable monitors help us to
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More Efficient Patient Care
One of the advantages Desert Valley Hospital has realized from the Leaf patient monitors is the value of the reports and the ability to focus on specific areas that can improve the efficiency of patient care. Using data from the patient monitors, our directors have been able to identify areas of care that need better attention or improved re-education of staff.
4. Monitoring At-Risk Patients
Emergency departments do not typically hold admitted patients for long periods of time. However, with the increased numbers of insured patients since the Affordable Care Act took effect, visits to DVMC’s emergency department have increased from about 35,000 visits four years ago to more than 43,000 last year. By monitoring at-risk patients in the emergency department, we may be able to prevent the development of pressure ulcers and ensure continuity of care once these patients are transferred to other units within DVMC.
5. Better Documentation
In reviewing patient charts with the data from the patient monitors, we have been able to determine when we have not had complete documentation. This may have occurred when the patient was off the unit or was undergoing a
El Camino Hospital is a 300-bed, state-of-the-art, nonprofit, multi-specialty acute care facility in Mountain View, California with a smaller branch in Los Gatos, California. Located in the heart of Silicon Valley, approximately 15 miles north of San Jose, and 45 miles south of San Francisco, the hospital is considered one of the most technologically advanced hospitals in the nation. Since the hospital is located in a relatively affluent community, it typically only serves a small number of indigent, and Medi-Cal (California's insurance program for low-income residents) patients. This is because most indigent, and Medi-Cal patients in the area are served by Santa Clara Valley Medical Center, which is a county hospital. Meanwhile, nearly 50 percent of El Camino Hospital's patients are covered by private insurance such as Blue Shield Blue Cross, United Healthcare, Aetna, and Cigna while roughly 45 percent are covered by either MediCare or a Medicare HMO. Since the opening of its doors in 1961, El Camino Hospital has valued, and embraced the important role of technological advancements in healthcare. In 1971, the hospital partnered with Lockheed to launch the original computerized medical information system. More importantly, due to its geographical advantage, the hospital is not only able to obtain the technology but to obtain the newest version of it because the company is down the street.
General Practices Affiliates is considering an offer from Titus Lake Hospital to join under a provider leasing model. Under a provider leasing model, Titus Lake Hospital is purchasing General Practices Affiliates’ services. The practice will retain control of personnel, management, and practice policies. Titus Lake Hospital submitted financial reports to assure transparency during the lease agreement process. The following analysis will discuss whether Titus Lake hospital is a viable financial partner for General Practice Affiliates, possible implications of the lease, and recommendations.
Currently health care facilities use individual, multi-component interventions, or series of interventions to prevent pressure ulcers. Either health care staff is not implementing these strategies into their patient’s care or some changes obviously need to be made. Interventions to prevent pressure ulcers consist of using the Braden Scale for initial and repeated skin assessments to determine the patient’s risks for pressure ulcers, specialized support mattresses, heel supports, and frequent repositioning for bed bound patients, encouraging mobility, moisture management, nutrition, hydration, and reducing friction or shear forces on parts of the body at increased risk for pressure ulcers (Sullivan & Schoelles, 2013).
With noticeable increase in chronic diseases, trauma, and increasing number of aging population, nurses are required to be in the position of providing pressure ulcer care and prevention. Immobility, advanced age, incontinence, prolonged pressure or friction, inadequate nutrition, dehydration, anemia, hypoxemia, multiple comorbidities, sensory deficiency, thin skin, prominent bony prominences, circulatory abnormalities, pain, and smoking are important risk factors. The barriers in the implementation of preventive measures are staff shortage, shortage of pressure relieving devices (e.g., foam or air mattresses), excessive workload, and uncooperative patients. The Centers for Medicare and Medicaid Services has classified the pressure ulcers as a preventable Hospital Acquired Conditions and stopped reimbursing for such hospital acquired conditions. In the United States, the cost of an individual patient care per pressure ulcer includes skin cleanser, moisturizer, dressings, wound debridgement, antibiotics, analgesics, turning sheet and support surfaces, nursing time for risk assessment, monitoring, and repositioning. It is the second most common claim after wrongful death and greater than falls or emotional distress. No matter what causes the pressure ulcers, the presence or absence of pressure ulcers is generally regarded as a performance measure of quality nursing care and overall patient health. Pressure ulcers can be avoided by applying simple interventions like factor assessment scales and regular turning of the patient. Proper hydration, a balanced diet, activity, wound care, and keeping patient’s skin and body dry are treatment, as well as, preventive measures of this problem. A thorough physical assessment, risk assessment (using a risk assessment tool like Barden scale), repositioning, patient and caretaker education, effective communication, and
The experience have had and learnt is that patient handling and movement works are physically demanding. This is because patients differ in weight, physical disability and also the level of co-operation of the patient. This becomes personal concern
Trzeciak, S. & Rivers, E. (2003). Emergency department overcrowding in the United States: An emerging threat to patient safety and public health. Emergency Medicine Journal, 20, 402−405. doi: 10.1136/emj.20.5.402
The purpose of this clinical journal entry is to elaborate on the details of lab day three. On lab day three, we had check-off for blood pressure and apical pulse. In addition, we took a safety test, and learned about mobility, immobility, how to use ambulatory devices, and reposition (C#4, C#6). Since we will be going to the nursing home, it is imperative that we know how to correctly assist a client with their ambulation. To begin with, Ms. D demonstrated how to use a wheelchair, cane, and walker.
I gave comfort care educations for patient’s family. I taught patient and family how to reposition in order to prevent pressure ulcer. In addition, I taught them the benefit of placing pillows behind the patient 's back so that he stays in position and also placing a pillow between the legs to prevent friction. In addition, I show them how to put elbow and heel protection.
Michelle Knuckles, RHIA is the manager of Inpatient Clinical Documentation Improvement and Coding at the University of Utah Hospital. Clinical Documentation Improvement is the vital process of ensuring that records are complete and accurate. There are many types of problems that can occur in patient records, such as conflicting information, inconsistent diagnoses, vague documentation, or illegible information. The accuracy of severity of illness and risk of mortality are also important factors for a CDI professional and the organization itself. If a record has inaccurate MS-DRGs, CCs, MCCs, APR-DRGs, or mortality index; the hospital is unable to truly participate in hospital compare through Medicare and cannot create an accurate picture of their stance compared to state and national benchmarks. The role of a CDI professional is to catch these problems and assist in resolving them which results in a complete and accurate record at the time of the patient’s discharge. CDI is an important part of a patient’s quality of
The field of nursing is one that requires much passion, hard work and critical thinking. It is a nurses job to promote the well being of their patients and help the return to normal function. However unfortunate events occur, resulting in patients receiving adverse health conditions as a result of being in a medical facility One of the most prevalent of these nosocomial conditions are pressure ulcers. Not only do the patients suffer from the pain of pressure ulcers but the hospitals and medical facilities are effected as well. A randomized controlled trial conducted by Pickham et al. reported that “ Pressure ulcers are insidious complications that affect approximately 2.5 million patients and account for approximately US$$ 11 billion in annual health care spending each year” (2016). Pressure ulcers not only cause the patient pain but “even contribute to disability and
this will cause healthcare providers with the training and education needed for clinical documentation improvements to be installed effectively. It is important that having a specialized team who can create solutions towards Clinical Documentation Improvement (CDI) in order to minimize the failures that may occur. In this case, investing in training for the materials/tools necessary for healthcare providers to excel in their work with CDI. Essentially, Clinical Documentation is used throughout the healthcare system for the analysis of care, communication, and medical records. This is important because the information of medical records that healthcare providers are able to access, will help patients track their health conditions. Thus, clinical documentation improvement has a direct impact on patients by providing quality information. On the other hand, the new technological advancements will also be able to address the efficiencies in health care system that differ from paper-based charting. Improving on the quality of information will also have the effect upon the ethical and effectiveness of care that is being provided. This has a significant impact in order to maintain patient care that ensures the documentation is accurate, timely, and reflect within the services provided. Documentation assessments can be utilized so there can be improvements on the education for healthcare providers as they intend implementation standards take effect immediately. In this case, failures must be analyzed so that they will have the ability to comprehend and determine an organization’s strengths and weaknesses
The staff will now have to rely heavily on technology to monitor delicate vital signs and feeding schedules as well as charting assessments. The large panoramic view of a room has been replaced with walls and a nurse watching a com...
The patient, in order to have confidence in the health care provider demands that medical chart is accurate
As an ICU nurse I constantly watch how patients develop pressure ulcers, a pressure ulcer is an area of skin that breaks down due to having constant friction and pressure, also from having limited movement and being in the same position over a prolonged period of time. Pressure Ulcers commonly occur in the buttocks, elbows, knees, back, shoulders, hips, heels, back of head, ankles and any other area with bony prominences. According to Cox, J. (2011) “Pressure ulcers are one of the most underrated conditions in critically ill patients. Despite the introduction of clinical practice guidelines and advances in medical technology, the prevalence of pressure ulcers in hospitalized patients continues to escalate” (p. 364). Patients with critical conditions have many factors that affect their mobility and therefore predispose them to developing pressure ulcers. This issue is significant to the nursing practice because nurses are the main care givers of these patients and are the ones responsible for the prevention of pressure ulcers in patients. Nurses should be aware of the tools and resources available and know the different techniques in providing care for the prevention of such. The purpose of this paper is to identify possible research questions that relate to the development of pressure ulcers in ICU patients and in the end generate a research question using the PICO model. “The PICO framework and its variations were developed to answer health related questions” (Davies, K., 2011).
The reduction of pressure ulcer prevalence rates is a national healthcare goal (Lahmann, Halfens, & Dassen, 2010). Pressure ulcer development causes increased costs to the medical facility and delayed healing in the affected patients (Thomas, 2001). Standards and guidelines developed for pressure ulcer prevention are not always followed by nursing staff. For example, nurses are expected to complete a full assessment on new patients within 24 hours at most acute-care hospitals and nursing homes (Lahmann et al., 2010). A recent study on the causes of pressure ulcer de...