...“Feet what do I want them for if I have wings to fly.” – Frida Kahlo (1995, p.134) Frida Kahlo, a Mexican artist, lived all her life with physical illnesses, and her suffering is revealed plainly through her artwork. In 1953, her doctor decided to amputate her right leg at the knee due to gangrene. Frida expressed her fear in her diary with a painting of a yellowish cut leg and the above quote. Although the operation was successfully performed and she was able to walk with an artificial leg, an inevitable depression followed. She became deeply depressed and was no longer interested in her husband, Diego Rivera, who had been the entire world of her life. She lost the will to live and made suicide attempts (Herrera, 1963). A healthy mental state...
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...Introduction Over the last 50 years India has achieved a lot in terms of health improvement. But still India is way behind many fast developing countries such as China, Vietnam and Sri Lanka in health indicators (Satia et al 1999). In case of government funded health care system, the quality and access of services has always remained major concern. A very rapidly growing private health market has developed in India. This private sector bridges most of the gaps between what government offers and what people need. However, with proliferation of various health care technologies and general price rise, the cost of care has also become very expensive and unaffordable to large segment of population. The government and people have started exploring various health financing options to manage problems arising out of growing set of complexities of private sector growth, increasing cost of care and changing epidemiological pattern of diseases. The new economic policy and liberalization process followed by the Government of India since 1991 paved the way for privatization of insurance sector in the country. Health insurance, which remained highly underdeveloped and a less significant segment of the product portfolios of the nationalized insurance companies in India, is now poised for a fundamental change in its approach and management. The Insurance Regulatory and Development Authority (IRDA) Bill, recently passed in the Indian Parliament, is important beginning of changes having significant...
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...Leadership Vision A vision is an expression of a desired or passionate service one wants to achieve, which draws on ones innermost potential. It identifies what you are doing, why you are doing it and what you would like to do or see materialize in the future and the reason for that materialization. As leaders, in the healthcare industry, we all have visions that we would like to implement in order to improve the healthcare system we work and live in. “Nurses are central to the mission of promoting optimal levels of health and functional status. Information needs are constant and evolving; health professionals must be responsive and ready with facts and resources”, (Fetter, 1997). Nurses are not only patient caretakers but we are educators, as well. Therefore, one of my visions is for nurses to take on a more active role as a patient educator in efforts to prevent exacerbation, hospitalization and re-hospitalization. As a result of introducing this vision, patients will have a) improved quality of life, b) decreased exacerbation, hospitalization and re-hospitalization, c) increased knowledge and understanding of their disease, d) improved dignity and self esteem, and e) patients will have more autonomy in their care. In order for one to implement ones vision, there are many key concepts that need to be considered and put into place which should incorporate the importance and the impact these concepts will have on the vision. Communicating to patients about the specific...
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...psychological and spiritual needs of the patient and family. This paper will outline the history of hospice, the effect it has on healthcare today, why it is important to nursing, how nursing is impacted by the availability of hospice services, and finally, what nursing has done to affect change related to hospice. History of Hospice Hospice was first applied to specialized care for dying patients by Dr. Dame Cicely Saunders, who started working with the terminally ill in 1948 (NHCPO, 2015). Dr. Saunders later created the first modern hospice – St. Christopher’s Hospice in a residential suburb in London. Her approach was later introduced to healthcare professionals and chaplains in the U.S in 1963 during a lecture at Yale University. In 1969 Elizabeth Kubler-Ross contributed to the idea of hospice centered care in her book: On Death and Dying which highlighted the five stages of dying and a plea for home care as opposed to treatment in an institutional setting. In 1978, the United States’ Department of Health, Education and Welfare Task Force acknowledged the hospice concept as a means of providing more humane care for America’s terminally ill, while asking for federal support and reducing cost. By 1993 hospice became a nationally guaranteed benefit under President Clinton’s healthcare reform proposal and it is now an accepted part of the healthcare continuum of services. Hospice has faced resistance springing from various factors, including professional or cultural taboos...
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...Use of Whiteboards 1 Running head: USE OF WHITEBOARDS IMPROVES PATIENT Use of Whiteboards Improves Patient Communication Process during Hospitalization i Table of Contents Chapter One: Introduction Problem Statement ………………………………………………….. 3 Statement of Purpose ………………………………………………… 3 Significance of the Problem Scope and Importance of the Problem ……………………………… 4 Application to Practice …………………………………………….. 4 Contributions to Knowledge ……………………………………….. 4 Background of the Problem ………………………………………… 5 Significance of Study ………………………………………………. 5 Sell Idea ……………………………………………………………. 5 Target Audience …………………………………………………... 5 Accessible Audience ……………………………………………… 5 Chapter 2: Review of Literature …………………………………………... 6 Chapter 3: Interdisciplinary Theory Construction ………………………… 9 Disciplinary Theory One ………………………………………………….. 9 Disciplinary Theory Two …………………………………………………. 9 References ………………………………………………………………… 10 Appendix ………………………………………………………………….. 11 Use of Whiteboards 3 Use of Whiteboards Improves Patient Communication Process during Hospitalization Chapter 1: Introduction Problem Statement The communications process of patient care is a process that is most neglected. One would wonder how a process so simple and important could be overlooked. The communication process...
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...Medicare and You DeLee Glasser Western Governors University Medicare and You As we age, medical care is often needed. Medicare is government provided health insurance, available to those who are at least 65 years of age, and for those who are younger with certain disabilities. There are many different parts to Medicare, some requiring out of pocket expenses, and/or deductibles. Medicare Part A The rules for Medicare are often complex, requiring the nursing and/or social work staff to get involved, and help navigate the system. The hospitalization portion of Medicare is “Part A,” which will cover the acute care hospitalization, and the skilled nursing facility (SNF) portion, of Mrs. Zwick’s illness. If, at a later time, Mrs. Zwick was in need of home health care, and/or hospice care, Part A would also be responsible for the coverage of these services. Services, not covered, would be any long-term custodial or unskilled nursing care. After meeting the insurance deductible, Part A is usually a premium-free service, assuming the spouse, or patient, has paid into the system, while employed. As of 2013, the monthly cost for Part A is $441, for those who are not eligible for a premium-free policy. Mrs. Zwick, a permanent United States resident, who has been hospitalized for five days following a stroke, will require further care from a SNF, once she is discharged from the hospital. The deductible for her hospital stay, assuming that she has a premium-free policy, would...
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...The Rising of Healthcare Costs Over the past 30 years, the American healthcare system has been afflicted by the continuous rise of healthcare cost. One of the reasons for the increase in healthcare cost is that in today’s society people are living longer lives than they did in the past and the prevalence rates of contracting chronic diseases and developing life threatening injuries are causing the United States healthcare system to suffer a financial crisis. Another reason for the rise in healthcare cost includes but is not limited to expensive hospital visits, complex procedures, and cost of prescriptions. Consumers find several ways to reduce healthcare cost for the insured and uninsured individuals. Some patients questioned where most of the money goes when they pay premiums for health treatments. There are some occurring solutions to the ever-rising cost of healthcare. Decisions you make can determine how much you pay for healthcare. Review your health insurance plan, you can do this by getting involved in your open enrollment, there you may find better or more affordable options available that may fit your needs. If there is no need or emergency in going to see your doctor other than for an annual checkup, getting a different health plan will be beneficial. If your employer subsidizes your care versus that of your dependents, it might make sense to have the dependents get their coverage on the open market, if they only subsidize the employee’s coverage. Other opportunities...
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...Reducing Rehospitalizations in Skilled Nursing Facilities Increases the Quality of Care Residents Receive and Decreases Unnecessary Health Care Cost Nurses have the power to increase positive patient outcomes by implementing changes in their practice based on the evidence found in the nursing literature. Utilizing evidence-based practice (EBP) increases nurses job satisfaction, increases communication across the interdisciplinary team, enables nurses to provide their patients with high-quality care and decreases health care cost. The purpose of this paper is to describe why readmissions from nursing homes (NHs) is a nurse practice problem, nurse practice changes to reduce hospitalizations in NHs, evidence found in the nursing literature that supports the change in nursing practice and how to evaluate the change in practice after implementation of interventions. The Problem Residents in NHs continue to experience potentially avoidable 30-day readmissions to hospitals. Rahman, Foster, Grabowski, Zinn, & Mor (2013) define 30-day readmissions as when the resident is readmitted to the hospital within 30 days of being discharged from the hospital to NHs and avoidable readmissions as conditions that can be managed safely and efficiently in NHs instead of the resident being transferred to the hospital (p. 1901) There are more than 1.6 million Americans living in NHs in the United States and 23.5% of these Americans experience readmission to the hospital within 30 days of discharges...
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...has increased from 1.20 births 1,000 hospitals births in 2009 to 3.39 births per 1,000 hospitals births in 2009. To put this this number into context, this means 1 infant born every hour the United states had signs of drug withdrawal. Furthermore, maternal substance abuse has increased over the past decade. About 5-10 percent of deliveries nationwide are to women abused substances during pregnancy. The incidence is even higher in inner cities. The two trends are likely intertwined, but many questions remain about the nature of the NAS “epidemic” and how best approach this problem. However, in order to understand the magnitude of this problem, it is vital that NAS is examined in public health, economical and medical viewpoint. This way healthcare providers will become aware of the rapidly rising rates of NAS and drug use among pregnant women and treat affected individuals properly and minimize the utilization of...
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...Economic Terms and Health Care History LaTasha Frost HCS/440 February 25, 2014 Instructor Name William Byrd Jr. Economic Terms and Health Care History Before the 1900’s healthcare had a different perception, now in the twenty-first century healthcare is an everyday thing to Americans. Economics is the science that contracts with the distribution, the material welfare of humankind, production, or the ad consumption of goods and services. Even though there are many different reasons why healthcare economics have changed over the years, the most effective reason is health care finance and the supply and demand of care. This paper will discuss the evolution of health care economics, the history and timeline of health care funding. [pic] Doctors had more power and were paid better than before in the early part of the twentieth century. Associations, for example American Hospital Association (AHA) and American Medical Association (AMA), started in the late 1800s, developed sturdier. Work unions then employers began offering a variety of aids to workforces, with funded health care. National health insurance became connected with collectivism and the idea became disliked in the United States, which opened entries to protect the increasing costs of medicinal care for secretive health insurance. Blue Cross was recognized at the end of 1920s and it was the first large medical insurance company established back then. The 1930s saw an increasing number of health...
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...This is a reflection on my experiences during my four weeks community clinical rotation at the Central Texas Veterans Healthcare System in Temple. I will begin by discussing the most meaningful aspects of my clinical rotation and why it was valuable to me. I will next discuss how my clinical experience helped me to identify my personal strengths, how the experience helped me grow as a student nurse, and how this experience will impact my future practice. The most meaningful part of this experience was meeting the different Case Managers, who track the Veterans’ care from their initial screening till they pass or get cured depending on their diagnosis. These RNs was kind, amusing and amazingly excellent in their field of expertise; they were smart, talented, headstrong and self-motivated leaders who are passionate about their job and saving the life of veterans. Although the case management position has limited funds, resources, and little to no data, these amazing case managers create guidelines, protocols, and are still in the process of creating extra programs that will better help the most vulnerable veteran’s population to obtain an improve level of healthcare to...
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...breath.) * The prevalence of asthma among children changes with increasing age. As an example, boys have higher current asthma prevalence, compared with girls throughout most of childhood. * From 1980 through the mid-1990s, the asthma hospitalization rate steadily increased in children under 17 years of age. * Trend analysis identified an annual 2.9% increase from 1980 through 1991, but there has been no statistically significant trend after 1991. * Overall non asthma hospitalizations for children has decreased over that period, whereas the asthma hospitalization rate remained level. * In 2006 there were 21 asthma-related hospitalizations per 10,000 children, for a total of 155,000 hospitalizations; this represented approximately 5.6% of all hospitalizations among children in 2006. * Trend analysis found that, while asthma related mortality increased 3.2% per year from 1980 through 1996, a reversal thereafter led to an average decrease of 3.9% per year from 1996 through 2005. * In 2005 there were 2.3 asthma-related deaths per million children, for a total of 167 deaths. * Asthma creates a substantial burden for the estimated 9.6 million children, their families, caretakers, schools, families’ employers, and the healthcare system. The epidemiology of the increasing prevalence of asthma is still poorly...
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...Stokes et al. BMC Health Services Research 2011, 11:135 http://www.biomedcentral.com/1472-6963/11/135 RESEARCH ARTICLE Open Access Impact of bleeding-related complications and/or blood product transfusions on hospital costs in inpatient surgical patients Michael E Stokes1*, Xin Ye2, Manan Shah3, Katie Mercaldi4, Matthew W Reynolds4, Marcia FT Rupnow2 and Jeffrey Hammond2 Abstract Background: Inadequate surgical hemostasis may lead to transfusion and/or other bleeding-related complications. This study examines the incidence and costs of bleeding-related complications and/or blood product transfusions occurring as a consequence of surgery in various inpatient surgical cohorts. Methods: A retrospective analysis was conducted using Premier’s Perspective™ hospital database. Patients who had an inpatient procedure within a specialty of interest (cardiac, vascular, non-cardiac thoracic, solid organ, general, reproductive organ, knee/hip replacement, or spinal surgery) during 2006-2007 were identified. For each specialty, the rate of bleeding-related complications (including bleeding event, intervention to control for bleeding, and blood product transfusions) was examined, and hospital costs and length of stay (LOS) were compared between surgeries with and without bleeding-related complications. Incremental costs and ratios of average total hospital costs for patients with bleeding-related complications vs. those without complications were estimated using ordinary...
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...management, as it relates to the older adult, implies direct guidance to treatment that is both accessible and practical. Review of Literature To better understand management of diabetes as a concept in adults age 65 and older, a review of disciplines is necessary to offer clarity in obtaining a greater sense of knowledge of the burden this disease places on the patient. In examining this concept a review of literature from the disciplines of nursing, medicine and social science were selected to define the concept. Nursing Discipline Chia, Schlenk, and Dunbar-Jacob (2006) examined the non-adherence to medication regimens in the older adult patient that was linked to personal and cultural belief systems. The management through healthcare provider interventions that would address the...
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...Preventing Heart Failure Readmissions Henry D. Santos Purdue University Calumet I. Introduction High morbidity, mortality, and healthcare spending have been connected with heart failure management. As per Gheorghiade et al., every year, there are almost a million cases of hospitalization for heart failure, responsible for 6.5 million hospital days, and estimated expenditures of $37.2 billion here in the United States alone (2013). The incident of heart failure readmissions has increased over the last decades, distinctly related to the aging population and surpassed recovery after a myocardial infarction. Based on the Centers for Medicare and Medicaid Services (CMS) 2005 data, heart failure is the most frequent diagnosis among Medicare beneficiaries and the third highest reimbursement for hospitals (AHRQ, 2013). In 2009, CMS started the public reporting of readmission rates after being discharge for heart failure, and, the year after, the Patient Protection and Affordable Act inaugurated financial penalties for healthcare establishments with most rates of readmission within the 30 days after discharge. The elevated concern relating the want to decrease readmissions has been the biggest focused of national researchers and hospitals with the efforts of identifying and predicting which patients with heart failure are likely to be readmitted. Formulated designs and preventive strategies have been established, in order to avoid unnecessary readmissions. Heart failures risk...
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