...Education on Wound Care for Diabetic Patients Education on Wound Care for Diabetic Patients Abstract Non-compliance of wound care management has increased the risk of infection and amputations. Diabetes wound care management is an important and fundamental aspect when it comes to diabetes teaching and education. Assessment of the feet daily and at a primary care office will provide information such as noncompliance, risks for neuropathy, peripheral vascular disease, macro-vascular disease, and possible amputation. Education provided by health care practitioners to the diabetic population will promote decrease in risk for further complications and the patient to be involved in their own care. Assessment, treatment, and education on wound care management with the involvement of the patient will increase the patient’s quality of life and be very beneficial to both the practitioner and the patient. Keywords: diabetic wound care management, diabetic ulcer care, outpatient diabetes management, diabetic care management Introduction Working in a primary care setting will involve a multitude of disease processes- diabetes mellitus being one of them. Diabetes is a disease that is characterized by high levels of blood glucose with a defect in insulin secretion and cell resistance. Without proper management, diabetes may lead to other issues in health. Examples of such, would be, delay in wound healing, leading to foot ulcerations, which thus increases the risk for amputations...
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...improving Quality and Value in the U.S. Health Care System August 2009 Preamble The Bipartisan Policy Center (BPC) is a public policy advocacy organization founded by former U.S. Senate Majority Leaders Howard Baker, Tom Daschle, Bob Dole, and George Mitchell. Its mission is to develop and promote solutions that can attract the public support and political momentum to achieve real progress. The BPC acts as an incubator for policy efforts that engage top political figures, advocates, academics, and business leaders in the art of principled compromise. This report is part of a series commissioned by the BPC to advance the substantive work of the Leaders’ Project on the State of American Health Care. It is intended to explore policy trade-offs and analyze the major decisions involved in improving health care delivery, and discuss them in the broader context of health reform. It does not necessarily reflect the views or opinions of Senators Baker, Daschle, and Dole or the BPC’s Board of Directors. The Leaders’ Project was launched in March 2008. Co-Directed by Mark B. McClellan and Chris Jennings, its mission is (1) to create a bipartisan plan for health reform that can be used to transform the U.S. health care system, and (2) to demonstrate that health reform is an achievable political reality. Over the course of the project, Senators Baker, Daschle, and Dole hosted public policy forums across the country, and orchestrated a targeted outreach campaign to...
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...| Developing Effective Diabetes Care Interventions in Rural Populations Salem International University Traci L French May 20, 2013 Abstract: Diabetes mellitus wreaks a high toll on Americans in regards to shortened life expectancy, decreased quality of life and staggering health care expenses. Prevalence of this disease in some populations can reach nearly 30%, with 11.3% of the total population affected in 2010 (Texas Diabetes Institute, San Antonio, TX). In Arkansas, prevalence rates of the illness in some counties exceed 20% (Bradley, 2010). Recent statistics show that annual direct expenditures on diabetes care total $116 billion dollars per year with an additional $58 billion per year in indirect costs due to lost productivity and increased mortality (Texas Diabetes Institute, San Antonio, TX). The goal of this paper is to assess the development and implementation of current interventional strategies for diagnosing diabetes mellitus in affected populations in the southeastern United States. Outcomes of current programs will then be evaluated on a local, regional and national level. The final area of study will examine possible improvements to existing programs using culturally sensitive methodology to increase access to care within these populations and improve clinical outcomes while following evidence-based care guidelines. Diabetes mellitus is a costly illness, both in the number of lives affected as well as actual expenditures on health care and lost wages...
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...Promoting Healthy Living by Preventing Illness Abstract This paper discusses the many different health issues that nurses face and preventative measures that they can take. Nutrition plays a huge part in a person’s overall health and wellness. Routine wellness checks are critical to maintain awareness of one’s body. As well as adequate sleep being a very important part of your body’s recovery. Also having a source of release like yoga or a way to relax such as a hobby is very important. A healthy nurse is one who creates and maintains a balance of physical, spiritual, emotional, intellectual, social, personal and professional wellbeing. Nurses who select nutritious foods and maintain an active lifestyle, live a tobacco-free lifestyle, learn to manage stress and get preventive immunizations and screenings, can set an example on how to be healthy nurse who is proactive in their health. Nutrition is a very important part of being a healthy nurse. Often the first things we think of when we talk about health and wellness is nutrition and its important aspects on your overall health. We sometimes tend to associate nutrition with fruits and vegetables, no junk food, high proteins and get turned off by the restrictive dieting. However, eating healthy is a lifestyle and is an important factor in increased energy, improved self-esteem and one’s healthy weight. A healthy weight is important and can prevent and control many diseases and conditions, such as respiratory problems,...
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...Chapter 33. Professional Communication and Team Collaboration Michelle O’Daniel, Alan H. Rosenstein Background In today’s health care system, delivery processes involve numerous interfaces and patient handoffs among multiple health care practitioners with varying levels of educational and occupational training. During the course of a 4-day hospital stay, a patient may interact with 50 different employees, including physicians, nurses, technicians, and others. Effective clinical practice thus involves many instances where critical information must be accurately communicated. Team collaboration is essential. When health care professionals are not communicating effectively, patient safety is at risk for several reasons: lack of critical information, misinterpretation of information, unclear orders over the telephone, and overlooked changes in status.1 Lack of communication creates situations where medical errors can occur. These errors have the potential to cause severe injury or unexpected patient death. Medical errors, especially those caused by a failure to communicate, are a pervasive problem in today’s health care organizations. According to the Joint Commission (formerly the Joint Commission on Accreditation of Healthcare Organizations, JCHAO), if medical errors appeared on the National Center for Health Statistic’s list of the top 10 causes of death in the United States, they would rank number 5—ahead of accidents, diabetes, and Alzheimer’s disease, as well as AIDS, breast...
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...NEWER ANTIDIABETIC DRUGS A. Sundaram* , C. R. Anand Moses*, S. Ilango*, V. Seshiah** INTRODUCTION The basic defects in Type 2 diabetes consist of (1) Insulin deficiency (2) Insulin resistance and (3) increased hepatic glucose production (HGP) leading to glucotoxicity, beta cell exhaustion and finally beta cell failure. The treatment strategies to overcome these defects are: 1) Modified meal Plan 2) Exercise 3) Blood glucose lowering drugs and 4) Insulin The current oral blood glucose lowering agents and dietary measures only partially correct the multiple metabolic defects in NIDDM with insulin resistance remaining relatively impervious to treatment Hypoglycaemia and secondary failure are common with presently available sulphonylureas and hence the need for newer blood glucose lowering drugs. In case of NIDDM, a successful new drug should correct atleast one of the major underlying metabolic disturbances. i.e. reduce insulin resistance, enhance insulin production and secretion in response to glucose, suppress exessive hepatic glucose production or improve glucose uptake and utilisation in peripheral tissues particularly, skeletal muscle. Within the last few years three new groups of drugs have been identified and they are: a) Alpha glucosidase inhibitors, eg. Acarbose b) Insulin Sensitizer, eg. Troglitazone. c) Insulin secretoguogues, eg. Glimepiride and Repaglinide The following review will discuss each of these groups of drugs in detail. ALPHA-GLUCOSIDASE INHIBITORS In human...
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...Changing the System Abstract The Affordable Care Act was signed into law in March of 2010 by President Obama, these set of new laws and regulations is designed to provide ethical changes to a fragmented health care system. Cultural bias and social stigmatism have hampered the acceptance of such sweeping changes to the American health care system. Culturally some Americans feel they are handing over their health care choices to government control, socially some Americans believe that the government it reducing free trade, taking control of health care and limiting capitalism in the health care market. This argument is to disprove those stances hoping to provide an outline of what Americans should accept as reasonable ethical, cultural and social changes to a system that was, and is, still fragmented in many ways. There have been many changes to the health care system thus far, but there are many more that need to take place. It is no longer ethically acceptable to just meet the medical needs of Americans, but to pursue greater levels of standards of care practices for those in need. Ethically it is time for Americans to start to question some of the cultural and social “norms” I believe and start to be more socially responsible for themselves and others regarding the health care system as a whole. By following this outline and looking at the examples I think that many Americans would agree that this would be an easy task to accomplish, it may take us as a society out...
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...0 3 0 Electronic Health Records in the Physician Office CHAPTER OUTLINE Patient Flow in the Physician Practice Step 1. Pre-Visit: Appointment Scheduling and Information Collection Step 2. Patient Check-in and Payment Collection Step 3. Rooming and Measuring Vital Signs Patient Examination and Documentation Step 4. Patient Checkout Step 5. Post-Visit: Coding and Billing Post-Visit: Reviewing Test Results Coding and Reimbursement in Electronic Health Records Computer-Assisted Coding Clinical Tools in the Electronic Health Record Decision-Support Tools Tracking and Monitoring Patient Care Screening for Illness or Disease Identifying at-Risk Patients Managing Patients with Chronic Diseases Improving the Quality and Safety of Patient Care with Evidence-Based Guidelines E-Prescribing and Electronic Health Records Keeping Current with Electronic Drug Databases Increasing Prescription Safety Saving Time and Money LEARNING OUTCOMES After completing this chapter, you will be able to define key terms and: 1. 2. 3. 4. 5. 6. 7. 8. 9. List the five steps of the office visit workflow in a physician office. Discuss the advantages of pre-visit scheduling and information collection for patients and office staff. Describe the process of electronic check-in. Explain how electronic health records make documenting patient exams more efficient. Explain what occurs during patient checkout. Explain what two events take place during the post-visit step of the visit workflow. Describe the advantages of computer-assisted...
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...0 3 0 Electronic Health Records in the Physician Office CHAPTER OUTLINE Patient Flow in the Physician Practice Step 1. Pre-Visit: Appointment Scheduling and Information Collection Step 2. Patient Check-in and Payment Collection Step 3. Rooming and Measuring Vital Signs Patient Examination and Documentation Step 4. Patient Checkout Step 5. Post-Visit: Coding and Billing Post-Visit: Reviewing Test Results Coding and Reimbursement in Electronic Health Records Computer-Assisted Coding Clinical Tools in the Electronic Health Record Decision-Support Tools Tracking and Monitoring Patient Care Screening for Illness or Disease Identifying at-Risk Patients Managing Patients with Chronic Diseases Improving the Quality and Safety of Patient Care with Evidence-Based Guidelines E-Prescribing and Electronic Health Records Keeping Current with Electronic Drug Databases Increasing Prescription Safety Saving Time and Money LEARNING OUTCOMES After completing this chapter, you will be able to define key terms and: 1. 2. 3. 4. 5. 6. 7. 8. 9. List the five steps of the office visit workflow in a physician office. Discuss the advantages of pre-visit scheduling and information collection for patients and office staff. Describe the process of electronic check-in. Explain how electronic health records make documenting patient exams more efficient. Explain what occurs during patient checkout. Explain what two events take place during the post-visit step of the visit...
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...WHO Guidelines on Hand Hygiene in Health Care: a Summary First Global Patient Safety Challenge Clean Care is Safer Care a WHO Guidelines on Hand Hygiene in Health Care: a Summary © World Health Organization 2009 WHO/IER/PSP/2009.07 All rights reserved. Publications of the World Health Organization can be obtained from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: bookorders@who.int). Requests for permission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – should be addressed to WHO Press, at the above address (fax: +41 22 791 4806; e-mail: permissions@who.int). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable...
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...structure to ensure that patient care activities are addressed in a coordinated manner involving risk management and quality improvement functions. Seek legal counsel to ensure that the structure for risk management and quality improvement activities maximizes legal protections granted by state and federal statutes while allowing for the flow of information. Align risk management and quality improvement plans with the strategic goals of the organization. Educate stakeholders on the role of risk management and quality improvement functions. Design systems to coordinate and streamline data collection, analysis, monitoring, and evaluation. Risk Management, Quality Improvement, and Patient Safety In the past, the risk management and quality improvement functions often operated separately in healthcare organizations and individuals responsible for each function had different lines of reporting—an organizational structure that further divided risk management and quality improvement. Today, risk management and quality improvement efforts in healthcare organizations are rallying behind patient safety and finding ways to work together more effectively and efficiently to ensure that their organizations deliver safe and high-quality patient care. WHAT HRC FOUND Several initiatives in the last decade have helped to forge and improve an alliance between risk management and quality improvement. These include Joint Commission standards for patient safety, the federal government’s...
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...an aging population and shortage of medical personnel have brought challenges to the medical office and physicians somehow need to improve their access. Instead of limiting the time patients are able to spend with their physician discussing their medical concerns, why not increase the time and make it more effective for both the patient and the physician. Incorporating GMA’s may allow our physicians to see more patients, provide more care, and increase practice revenue. The patient benefits with increased access to the provider as well as receiving significant education with their peers that suffer from the same medical conditions (Rhee, 2013). This is a win – win situation for the organization and patients. Patients are typically allotted 15 to 30 minutes to discuss their concerns with the physician but with group medical appointments (GMA), patients are actually able to spend up to 90 minutes with their provider. GMA’s offer an alternative structure in the way effective and efficient care is delivered to chronically ill patients (Schmucker, 2006) and it allows greater interaction time with the provider. A GMA will typically involve approximately 8-12 patients while all of the components of individual appointments can be delivered to include: one-on-one medical evaluations, greater time for patient education, and promoting self-management (Jaber, Braksmajer, & Trilling, 2006). Regulatory (OSHA) Mandate According to the United States Department of Labor, “under the OSH...
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...Low Energy Laser as a Treatment for Refractory Diabetic Leg Ulcers By Wendy Price Wake Forest University Department of Physician Assistant Studies 4/10/2009 I would like to thank everyone at Coy C. Carpenter library help and reference desks. To Ekatrina Zachry who translated the Russian research papers, thank you is the very least I can say for such an excellent job. I would like to tell my girls how proud I am of them and thank them for their patience, pictures, and prayers. You make it all worth the while. I would also like to thank my mother for her support, coming to help with the girls while I have been in school, and her motherly faith in me that never waivers. Most of all I want to thank my husband Clay Price for being an amazing pillar of strength, encouragement, patience, understanding, and love. I know I COULD NOT have done it without you. UA&F Low Energy Laser as a Treatment for Refractory Diabetic Leg and Foot Ulcers ABSTRACT BACKGROUND: Diabetic leg and foot ulcers often lead to immobility, infection, and amputation, cost $7,000 to $40,000 per ulcer, and erode mental health and QOL. Lasers have been effectively utilized in medicine since the 60’s, from various surgical uses to the treatment of diseases. Although low-energy (also called low-power, low-level, and cold) laser therapy for “biostimulation” (or biomodulation) of ulcer healing has been studied extensively, quality data on diabetic wound healing is rare. This review seeks...
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...Strategies for Tuberculosis Control from Experiences in Manila: The Role of Public-Private Collaboration and of Intermittent Therapy INAUGURALDISSERTATION zur Erlangung der Würde eines Doktors der Philosophie vorgelegt der Philosophisch-Naturwissenschaftlichen Fakultät der Universität Basel von Christian Auer aus Bottmingen (BL) Basel, Mai 2003 Genehmigt von der Philosophisch-Naturwissenschaftlichen Fakultät der Universität Basel auf Antrag von Herrn Prof. Dr. Marcel Tanner und Herrn Professor Dr. Klaus M. Leisinger Basel, den 6. Mai 2003 Prof. Dr. Marcel Tanner Dekan DEDICATION In memory of Aling Tess and Mang Tony, former neighbours of mine, victims of tuberculosis, the unrestrained killer that terminates daily the lives of 5000 people. With the sincere hope and plea that some findings and thoughts of this dissertation will contribute to reducing tuberculosis and poverty. “The appalling global burden of tuberculosis at the turn of the millennium, despite the availability of effective control measures, is a blot on the conscience of humankind. For developing countries, the situation has become desperate and the "cursed duet" of tuberculosis and AIDS is having a devastating impact on large sections of the global community. The vital question is, can despair be turned to hope early in the next millennium?” John Grange and Almuddin Zumla, 1999 TABLE OF CONTENTS Acknowledgements Summary Zusammenfassung Abbreviations i iii vii...
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...------------------------------------------------- Clinical Preparation Worksheet- Information Necessary for Care ------------------------------------------------- ------------------------------------------------- Your Name _ Date of Care_3/17/2014_____ Pt. Initials__M.A.____________ ------------------------------------------------- Pt. age__51_______ Code Status _Full Code______________Braden /SKIN Score __K_____ ------------------------------------------------- Fall Risk- Fall risk with high injury probability __Level 2________________ ------------------------------------------------- ------------------------------------------------- Admitted from: Home/extended care facility? __Home___________________ ------------------------------------------------- ------------------------------------------------- Reason for admission - also called CC or Chief complaint: (This is in the pt.’s words. Ask them why they came to the hospital and record what they say as a direct quote.) ------------------------------------------------- Fell in the shower and became unconscious, tried to call girlfriend but couldn’t move left side ------------------------------------------------- ------------------------------------------------- Admitting Medical Diagnosis/Diagnoses: ------------------------------------------------- Stroke ------------------------------------------------- ------------------------------------------------- Medical and Surgery History:...
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