Clinical operation issue
Supplies expenses accounted for 25.4% of the total expenses and 85.5% of the supply expenses is from other medical supplies. The current practice allows each physician group to make independent decisions, how to run their group. As a result, the hospital is suffering from high medical cost and losing money by not utilizing nurse practitioners and case managers. The quality of care greatly affected by not utilizing of a case manager in coordinating medical services that a patient may require for recovery after hospitalization. Nurse practitioners (NP) can also aid in patient care without compromising the quality of care and enhance orthopedic surgeon’s productivity. When NPs do some of the patient care, the orthopedic surgeons will have more time to do more surgeries which will generate more revenue. Non-standardized protocol created a financial burden to the hospitals, related to medical supply. The physician’s vendor preference could be influenced by vendor relationship and personal benefit rather than evidence that benefit patients and contain costs. The patient’s outcome is going to suffer due to a lack of standardized protocol.
Evidence and Innovation summary
The medical supply used in a surgical procedure can make a significant contribution in
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An article titled where to look for supply saving (2009) identified physician preference items a great area for saving. How is the preferred item selected? A survey by Leah (2013) studied what influence the orthopedic surgeon decisions when choosing medical supply. The survey result is a follow: vendor relationship 45%, advance technology 45%, contracted vendor 5% and cost of implant 5%. Therefore, only 5% of orthopedic surgeons consider cost when the choosing supply. A standardized treatment protocol will improve a better decision making with choosing a
Nurses and physicians need to become partners in health care reform. We have a responsibility to provide competent care to our patients. National standards need to be put in place to decrease the inconsistencies in APN practice. Overwhelming data supports the APN over the physician in cost effectiveness, quality and access to care and many other aspects.
A clinical area of concern in the nursing discipline on 8 West orthopedics at Mount Carmel West is hourly patient rounding. Currently the nursing staff on 8 West does not do patient hourly rounding when providing patient care even thou the nursing manger has tried to implement hourly rounding. There have been many research studies that have shown that hourly rounding has improved patient outcomes and improved quality care nurses give to their patients. Hourly rounding can help address a potential patient problem before the problem occurs (Ford, 2010).
Catheter Acquired Urinary Tract Infections (CAUTIs) has become to be classified as one among the leading infections which most individuals end up being susceptible to acquire while at the hospital. Healthcare-associated or acquired infections (HAIs) are a significant cause of illness, death, and more often than not, have resulted to cost the tax payers potentially high medical expenses in most health care settings. ("Agency for Healthcare Research and Quality," para. 1) Due to this, 1 out of every 20 patients will end up with CAUTI within the US hospitals and this has caused Agency for healthcare research and quality (AHRQ) to embark on nationwide plans to help in the eradication and control of CAUTI incidences. ("Agency
What is meant by evidence-based practice and how is this different from an historical standpoint.
To resolve the problem of patient dissatisfaction, patient falls, increase use in nurse call light and interruptions; 8 West Orthopedics would need to implement hourly rounding into their patient care and preform patient rounding every hour. Implementation of hourly rounding can be a difficult process but with the adequate nursing staff and leadership it can be an uncomplicated
The nurse to patient ratio is unrealistic in many hospitals. In most cases it is almost impossible to give each patient the true amount of detailed care they really need. This is seen in most cases where there is one nurse assigned to 16 patients and each patient requires a different level of attention. Nurses are pressed for time, forcing them to cut corners, resulting in an increase in nosocomial infections and patient deaths. “The past decade has been a unsettled time for many US hospitals and practicing nu...
Nurses must, at all times, put the wellbeing of the patient at the forefront of care
Nursing research is a systematic enquiry that seeks to add new nursing knowledge to benefit patients, families and communities. It encompasses all aspects of health that are of interest to nursing, including promotion of health, prevention of illness, care of people of all ages during illness and recovery (or) towards a peaceful and dignified death (ICN 2009)
Case Management Case management has become the standard method of managing health care delivery systems today. In recent decades, case management has become widespread throughout healthcare areas, professionals, and models in the United States. It has been extended to a wide range of clients (Park & Huber, 2009). The primary goal of case management is to deliver quality care to patients in the most cost effective approach by managing human and material resources. The focus of this paper is on the concept of case management and how it developed historically, the definition of case management, the components of case management, and how it relates to other nursing care delivery models.
Appling best practices should be the addendum within all organization. As problems arise within an organization it is up to the organization at that time to update, seize the opportunity, improve quality, and challenge conflicts. However, the hospital in question is the District hospital where W. G. Lester is the Chief Executive Officer. The hospital is experiencing a vast of problems. For example, staffing, complaints, conflicts, not offering training programs, revenue, staff not meet patient satisfaction, admission and visits decreasing. Also, within the paper decreasing admission, problem-solving is discussed, control mechanism and training for the Emergency Medical Technician (EMT) is discussed. The overall goal for the hospital is adopting
A nurse is required to be responsible and accountable, updating their knowledge and skills continually by using professional development (NMC, 2008). This requires an understanding and awareness of what Evidence Based Practice (EBP) is. Nurses make decisions about their practice using EBP. Ways in which this can be utilized in the improvement of knowledge and practice is, for example; using established sources of evidence. (Marquis et al, 2012). Nursing practice uses a range of approaches to improve and develop patient care so as a nurse the skill of evaluating sources of evidence is necessary to do this effectively. Evidence is gathered through research. EBP consists of research, data collection and nursing research. When searching for evidence to improve your practice the range of information available is vast. A distinction must be made between evidence that is reliable under scrutiny and evidence which is unreliable. Fitzpatrick (2007) asserts that, to understand evidence based practice is to understand where to look and what credible sources of evidence are. Sources that are credible include information published by a government body or academic institution. Fitzpatrick (2007) recommends identifying key aspects of information of the source to ascertain its credibility, for example; who is the author and where did the research come from? Is the article true or false and how long has it been there? (Fitzpatrick, 2007). A journal article is scrutinised by peers and editors and publishers, whereas in contrast a piece of information on a general website could be published by any person and make any claim and may not pass scrutiny under a peer review. Databases like EBSCO for example have articles that are peer reviewed.
Registered nurses perform a fundamental role in caring for a surgical patient. Effective clinical reasoning involves a method of planning and implementing interventions by processing information, collecting cues, understanding the patient situation, evaluating the outcomes and reflecting and learning from the procedure performed. ‘Failure to rescue’ is one of the key causes of adverse patient outcomes due to nursing compliance, the advances in medical technology, more complex conditions being faced and the increased patient to nurse ratios. Throughout this assignment, a patient has been admitted to hospital for a left knee replacement. This discussion will relate to the appropriate nursing actions performed by a nurse in order to prevent post-operative complications and promote discharge planning.
During the Evidence Based Nursing Practice course, virtual community became very important to me. Collaborating with my nursing fellow students helped me gain more knowledge about various nursing areas that I have no experience in such as mother-baby, home health, and case management nursing practices. The exchange of experiences with other nurses allowed me to view nursing profession in a new way. Having worked in one specialty since my graduation from nursing school, I often underestimated the influence the evidence based nursing practice. I used to believe that surgical nurses use evidence practice more often than other nurses. In nursing school, I was taught skills, and I always
The use of supplies is a problem because we are spending too much money on them. We are a world-renowned hospital with very high-end robots and equipment. Therefore, our surgeons demand the best and the higher valued machines and supplies. Cost and quality need to be considered. We do not want the quality of care for the patients to be jeopardized because of inadequate planning in regards to low quality supplies (Sullivan, 2009).
The goal of nursing practice is and was to achieve the most expected and desirable patient care out-come. For example, the concept of patient-centred nursing has been the goal for some time. To achieve the patient-centred nursing, nurses pay attention to each patient individually and make out the requirement what they need. For the record one patients needs never limited to their physical and biomedical but it may extend to their personal, social, emotional and psychological needs as well depending the patients.