...Vulnerable Populations in Current Events As the cold winter months approach so does another cold and flu season. Individuals, communities and the nation itself must prepare in advance for the possibility of the flu striking home. Especially susceptible are vulnerable populations unable or unwilling to provide themselves the necessary care to prevent getting the flu. Or caring for themselves in the event they do get the flu. Vulnerable populations are individuals, families, or communities ho lack the necessary resources or capabilities to protect their own health. These “populations” are vulnerable because of factors such as socio-economic resources, limited financial means, age, gender or, limited knowledge of the English language. Women, children or the elderly are especially vulnerable The flu is an extremely contagious disease passed from person to person. A society or community ill prepared or failing to act in a timely manner in regards to vulnerable populations will only tend to increase the risk of infection for all people by increasing the number of people can spread the disease (Hutchins, Truman, Merlin & Redd, 2009). Implementation of programs to provide vaccinations to vulnerable populations may help to prevent an outbreak of the flu or at least stem the tide in the event of an outbreak. In the facility that I work, Inova Mount Vernon Hospital, we have implemented such a plan. We provide free flu shots to low income families and children. All...
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...Exception or Donation? Highland Electricity is well-known for supporting community projects, and in recent years has increased its corporate giving. The company has also recently defined its giving strategy, particularly in how it relates to their business objectives. As part of this overall effort, Highland clarifies its giving guidelines. There are four broad funding areas (Job training and economic development, Education, Emergency preparedness, and Environmental stewardship), and grants are ideally awarded to organizations within the company's service area. Arts and cultural organizations, which are not included in the four funding areas, have received few grants in recent years. Numerous arts organizations have been turned down with the explanation that the company is focusing its resources in its strategic funding areas. Requests from other organizations are turned down because they are outside the utility's defined service territory. Contributions manager Clarissa Watt has recently received two funding requests from high-level managers within the company. The first is to provide a large (up to $25,000) grant to an arts center in a small town in the service territory. A chief regulatory official's wife serves on the art center's board. The second request is for a grant to a nonprofit organization outside the service territory, but within the district of a very influential state legislator. Both organizations are deserving of funding, and the activities to be funded...
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...18 Progress in Cardiovascular Nursing Winter 2008 www.lejacq.com ID: 6611 Heart failure (HF) is the leading cause of hospitalization for persons older than 65 years and often necessitates assistance from family caregivers.1,2 Approximately 40% of older adults are readmitted within 3 months postdischarge, resulting in significant health care costs.2,3 Indeed, more than one million hospitalizations attributed to HF cost the patient and United States health care system over $27 billion a year.1 Hospitalizations related to HF are complicated by the aging process, comorbidities, and psychosocial concerns that affect successful management.2 In a study of patient outcomes post– hospital discharge, Naylor and colleagues4 demonstrated that the use of advanced practice nurses (APNs) was effective in improving outcomes for patients with HF. The feasibility of adapting this approach is limited, however; costs for home visits by an APN are high, a shortage of APNs employed in home care exists, and funding for home care has decreased with the Medicare Prospective Payment System.5 An alternative strategy for promoting self-management of HF is the use of electronic home monitoring (EHM). EHM is a form of telemedicine in which medical/nursing management interventions are provided to individuals at a distance from the health care provider.6 The primary objective of this pilot study was to examine the effectiveness of postdischarge telemonitoring by an APN...
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...Wesley D. Pointjour Final Research Paper: Telehealth In Nursing Homes Health Quality Management April 02, 2015 Introduction In many nursing home facilities, patient safety is little to non-existent and if they are, there displayed on a need be and not obliged basis. They are displayed case by case rather than nursing home protocol. Even with changes in regulations, reporting systems, and documentation over the past couple of years, the nursing home industry still has its share of problems. Patient safety is meant to provide patients freedom from healthcare associated preventable harm, meaning when things go right, nothing bad happens. Nursing home organizations have been constantly trying to improve their reputation and the way people view them, but how? Don’t patients make up a nursing home? What about their safety? Shouldn’t we start there? How do we make improvements? Telehealth, a new approach to improving patient safety in nursing homes, will use telecommunication technologies to deliver health related services and information that support patient care, administrative activities, and health education (Dixon, Hook, McGowan, 2008). In this paper I will explore the major benefits of Telehealth and how its implications can improve patient safety in nursing home care. What is Telehealth and why is it important? Telehealth is the means and methods to improving access to care and reducing healthcare associated costs. It is also a system that can be used for education...
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...treatment for physical, mental, or age associated illnesses. Long-term care is also known as personal assistant services and is defined as an individual who requires health care assistance for more than 90 days. Personal assistants provided to a patient help them with the activities of daily living (ADL) as well as instrumental activities of daily living (IADL). These activities may include personal care services like bathing, doing household chores, and other activities to help the patient remain independent while still residing in or near his or her home while maintaining the quality of care the person is accustomed to if there are no medical hindrances preventing it. Long-term care also includes community services, such as meals, adult day service programs, and transportation services (Austin & Wetle, "The long term care continuum, Who needs long-term care?," 2012). Residential facilities, such as skilled nursing facilities and assisted living facilities, also provide long-term care services along with housing ("National Clearinghouse For Long Term Care Information,” n.d.). Continuum of care services are utilized by elderly individuals, individuals that have a chronic illness, or may be disabled either physically or mentally. It is estimated that 80% of the individuals who use long term care services are over the age of 65 (Austin & Wetle, "Chapter 8, Who uses LTC?," 2012). A facility-based service provides housing and housekeeping services. Some facilities manage...
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...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 be $1,184, because she stayed less than sixty days, as set forth in the Medicare guidelines. The skilled nursing portion would cost her no money, up to day 20, and then she would be assessed $148 per day, up to day 100. Medicare Part B Unlike Medicare Part A, “Part B” does have a monthly...
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...LTC 352 Unit 2: Lessons 4-6 G Garrett Lesson 4 1. Use the information you have gained in this lesson to identify key resident right issues in the case below: The resident is an alert, 65-year-old male. A fractured hip occurred when he fell at home. He lived alone up until this time. He was hospitalized following surgery and received physical therapy while in the hospital. He is alert and oriented. He shows no signs of mental illness. He suffers from COPD, occasional CHF, and osteoporosis. The nursing home facility’s physician explains the treatment plan to the resident, which includes physical therapy, occupational therapy, and a low salt diet. The resident has no complaints, except that he is happy to be wheeled around in the wheelchair by the staff. He refuses PT and OT. Also, he keeps a salt shaker in his shirt pocket and takes his meals in his room. What is your plan as the Administrator in the nursing home in caring for this resident while balancing his resident rights? As the Administrator I will ensure the resident rights for this resident are provided and that the facility’s staff follows policies and procedures. Upon Admissions the resident would be provided a copy of the facility’s admission packet/contract, including payment sources and written information regarding his rights and facility policies. At the time of admissions the resident would be given written information concerning his rights to make decision concerning medical care, including...
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...Community Health Nursing: Quality of Life and Functioning A. Personal Perceptions After reviewing the case of Mrs. Thomas and her situation, there are many feelings I have about the final outcome. As nurses, we always have to take our feelings into account and rationalize what we feel about the health and well being of our patients. After a BRAC analysis was performed, significant results were indicated. I feel empathy for Mrs. Thomas because this technology showed what her odds were for future recurrence of breast cancer. I’m disappointed that a radical mastectomy was not suggested to be performed with Mrs. Thomas’ first surgery to help avoid a further decline. It appears almost obvious that this should have been encouraged by her medical team. I do, however, understand that it is easier to look back on this than to look forward with what options remain. What is most important is Mrs. Thomas’ quality of life for the duration of what time she has left. I define quality of life as the ability to be as emotionally, physically and mentally fulfilled as possible. Quality of life is finding all the moments that matter and cherishing them on a daily basis. There will be better days than others, but what is key is to understand the big picture. The major challenge is promoting the best quality of life when the big picture ultimately has a poor outcome. Health promotion is crucial to increase Mrs. Thomas’ quality of life. Interventions will be initiated in all areas...
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...were abused or neglected (Wallace, 2005). While the majority of abuse happens in the home by a family member, there is a rise in the amount of elderly abuse being reported in nursing homes. In 2000, states were asked to indicate the number of elder abuse reports received from nursing homes. Based on figures from 54 states, the total number of reports was 472,813 (Teaster, 2003). A study prepared by the minority staff of the Special Investigations Division of the House Government Reform Committee found that 30% of nursing homes in the United States, 5,283 facilities, were cited for almost 9,000 instances of abuse from 1999 to 2001 (Waxman, 2001). The report stated that 1,601 of these instances could have or did cause the resident serious injury or death. The instances reported ranged from physical abuse, verbal abuse, sexual abuse, bedsores, inadequate medical care, malnutrition, dehydration, preventable accidents, inadequate sanitation and hygiene. Some other shocking finds of the report were that more than 40% of the abuse violations were not reported until formal complaints was brought by residents or family members. 1,327 of the nursing homes were cited more than once for abuse violations during this two year period, 305 were cited for three or more violations and 192 were cited for five or more abuse violations (Waxman, 2001). If you have an elderly parent of relative in a nursing facility there are signs to look for to determine if your loved one is being properly...
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...Tylor Richardson Aging Optimally The people in the video that I though where aging the most optimally where all of the people at the nursing home, that did not have Alzheimer's. These people are good examples of people who are aging optimally. They are participating in activities and social interactions that help them maintain a good outlook on their remaining years. The people engage in activates and perform tasks to help them deal with the life in the nursing home. The nursing home provides help for whatever they need such as mobility, eating, and help with problem-centered and emotional-centered coping. These are all examples of what is needed for optimal aging; they help maximize the gains of old age and try to minimize their losses. They maintain social relationships with each other and their care giver’s which is an important characteristic of aging optimally it keeps their self-efficacy feelings high. People that are in the later stages of life don’t have a lot to look forward to so maintaining a good outlook on live is essential, this includes coping well with negative changes. People in nursing homes are more capable of this due to the support that the nursing home provides them. Rose Marry Hake is a prime example of someone that is not aging optimally. She has been diagnosed with Alzheimer's. This is caused by plack build up in the nurofibers of the brain, causing her to forget things and making aging optimally just not possible. Mrs. Hake cannot carry out a...
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... Delaware, New York, Rhode Island, New Hampshire, North Dakota, and Pennsylvania. The per capita spending for these 10 states ranged from 13 to 36 percent higher than the average U.S. per capita spending level and ranged from $7,730 for Pennsylvania to $9,278 for Massachusetts.” These ten states have the highest health care spending and they share a number of demographic and economical characteristics. Table 1. Real per capita spending and spending growth for select provider types, 1970–2008 Average annual growth rate (%) Total Public Private Total 8.5 9.1 7.9 Hospital care 7.9 8.0 7.8 Physician/clinical services 8.8 10.1 8.3 Nursing home care 8.7 9.7 7.5 Dental services 7.4 8.8 7.3 Home health care 15.0 16.5 12.3 Durable medical equipment 6.6 12.0 5.6 Prescription drugs 9.3 13.5 8.2 Source: Centers for Medicare and Medicaid Services, 2010a. National Health...
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...FINAL EXAM REVIEW Know which residents make up the majority of Long-term Care facility admissions [page 1] Difference between a policy and a procedure [page 5] Policy is a course of action that should be taken every time a certain situation occurs. (Example, a very basic policy is that healthcare information must remain confidential.) Procedure is a method or way of doing something. (Example, your facility will have a procedure for reporting information about residents. The procedure explains what form to complete, when and how often to fill it out, and to whom it is given.) Scope of practice for nursing assistants, specific tasks outside of the scope of practice [page 15] The things you are allowed to do and how to do them correctly. Tasks outside the scope of practice: NAs do not administer medications unless trained and signed to do so, NAs do not honor a request to do something outside the scope of practice, not listed in the care plan, or not on the assignment sheet, NAs do not usually perform procedures that require sterile technique. NAs do not diagnose or prescribe treatments or medication, NAs do not tell the resident or the family the diagnosis or the medical treatment plan. Describe the purpose of the care plan [page 16] A care plan is created for each resident by the nurse or doctor. The care plan is a guide to help the resident reach and maintain the best level of health possible. Long-term care survey process [page1] Surveyors study how well staff care...
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...Social Security Act (1935) With a dramatic increase in life expectancy and decreases in mortality rates, many old People live their later lives with chronic illnesses and disabilities. As a result, long-term care is becoming an important part of service to the elderly population. The US General Accounting Office (1994) reports that more than 12 million Americans need long-term care and 55% of them are people aged 65 or older (Binstock, Cluff, & Mering, 1996). Accordingly, the government spends substantial amounts of money to provide care through nursing homes and community/home based services. In 1994, more than $100 billion was spent on long-term care in the US in 1994, 72% of which went to nursing home care (Binstock, Cluff, & Mering, 1996). It was not until recently, however, that long-term care of the elderly received attention from the government and the health care sector. Throughout most of American history, the long term care of the elderly has been considered a responsibility of family households, especially a daughter of the person, rather than the society and its health system (Holstein & Cole, 1996). Now, public attention has increased due to the growing elderly population and their political influence, the economic and psychological burden of the family and caregiver is still substantial. According to 1994 statistics, it is estimated that individuals and their families pay out of pocket costs equaling 44% of the total amount of long-term care...
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...On-Line Medicaid Billing-Nursing Home Access the Texas Medicaid website, www.tmhp.com to bill Nursing Home claims. Select Providers link (top of screen) and then select Access TexMedConnect (right side of screen). 1. Medicaid a. If pt is utilizing hospice services and has Medicaid, we have to bill and pay for their room and board b. You will receive an email with new admitted patient information from each location c. The nursing home bills a patients private insurances for services d. only bills Medicare for hospice skilled services and Medicaid for Room and Board e. Drew and Troy took over Nursing home billing in July f. A folder for each location is called Medicaid, each office has its own folder, each office folder has a spreadsheet for each Nursing home i. There is also a spreadsheet for Medicaid Primary g. Medicaid hospice pays for different levels of rooms at different rates i. Tile or RUG rates: ranges from $100 to $250 a day depending on the level of care h. There are 25 levels of facilities (25 being the low end facility) i. deals with level 5-12 facilities i. Ex: tile level CA2 = $114 (refer to cross legend) j. Texas Medicaid Website is: www.tmhp.com – Below are features of the site i. MESAVE lets you check patient eligibility ii. Look for NURSING FACILIITY ROOM AND BOARD iii. NEED...
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...1. he impact of the IOM report on nursing education. 2. The impact of the IOM report on nursing practice, particularly in primary care, and how you would change your practice to meet the goals of the IOM report. 3. The impact of the IOM report on the nurse’s role as a leade The impact of iom report on nursing In 2011, the Institute of Medicine (IOM) collaborated with Robert Wood Johnson Foundation (RWJF) to publish The Future of Nursing: Leading Changes, Advancing Health. With the increasing changes in health care, it is up to the nurses to keep themselves updated and competent. The purpose of this collaborated effect put forth recommendation that allow nurses to “(1) ensure that nurses can practice to full extent of their education and training (2) improve nursing education,(3) provide opportunities for nurses to assume leadership positions and to serve as a full partners in health care system and (4) improve data collection for workforce planning and policy making”(The Robert Wood Johnson Foundation and the Institutes of Medicine[RWJF and IOM]. IOM has a great impact on nursing education. A higher level of education, training and experience could make a nurse competent in her level of pra. One of the statistic shows that 34.2% nurses have BSN, 33.7% have associates degree, and 17% have masters or a Doctorate degree (Cherry & Jacob, 2008, p.550). While there are changes made in our health care there should be changes in nursing education prior to licensing and post...
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