...A. Compliance Status The following executive summary focuses not only on the identified gaps in the current process, but also the corrective action plan to support compliance in the noted areas of the Communications Standards as provided by The Joint Commission, (National Patient Safety Goals, 2013). The high risk associated with surgical procedures performed on the wrong site has driven a risk mitigating approach to the processes involved for these procedures. The goal is to prevent harm to patients having a surgical procedure. The following summary is the current compliance status if the Priority Focus Area of Communication for Nightingale Community Hospital. After review of the specific areas identified in the Priority Focus Area, the following have been identified as requiring further attention: time-outs are routinely performed prior to every procedure (UP 01.03.01) and procedure site is marked (UP 01.02.01). Based on the evaluation of the Nightingale Community Hospital National Patient Safety Goals for Communications the current compliance rate related to the Universal Protocol Time-Out processes performed hospital wide indicate a 95% to 100% compliance rate for the year. The graph provided in the Nightingale Community Hospital National Patient Safety Goals Communication assessment provides limited information as these are hospital wide percentages. No unit specific evaluations of performance have been provided in the report. Upon review of the Site Identification and...
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...just about 50,000 cases every year, in that, during 2008–2009, there were 36,097 reported cases of Clostridium difficile (Health Protection Agency, 2009). Almost the same rate is listed for Germany, highlighting a clear need for decisive action. This research examines the main causes if HCAIs, and discusses the relationship between compliance with hand hygiene guidelines and stress among nursing professionals in one German hospital (Knoll, Lautenschlaeger, & Borneff-Lipp, 2010). This paper explores the factors associated with hand hygiene compliance of nurses during routine clinical practice. The purpose of this research was to clarify whether external factors such as ward capacity, or level of nursing intensity had an influence on nursing staff compliance with hand hygiene guidelines. The research questions in this study are; does hand hygiene between healthcare workers decrease healthcare associated infections (HCAIs)? Does exterior factors influence on nurses compliance with hand hygiene guidelines? The hypothesis of this study is; workload factors like maximum ward capacity, severity of patient cases, have an influence on nurse’s compliance with proper hand hygiene guidelines. Study Variables A total of nine variants were used in this paper. Records from the descriptive interviews were used as dependent variables. The ward-specific workloads considered on one side as the rate of used ward capacity, and on the other as the degree of nursing intensity which were...
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...Accountability of Nursing Professionals Grand Canyon University: NRS ¬- 430V 07/08/2011 Accountability of Nursing Professionals Professional accountability means “ being answerable to someone for something done ” (ANA, 2002) Professional nurse is accountable to the profession, patient population, inter- disciplinary team, community, to the employer, and to self. The individual nurse retains accountability and responsibility for excellent care and conformity with evidence based practice. That includes bedside nursing, teaching, delegation, research and administration (ANA, code of ethics 2001). Advance in technology and evidence based practice brings perfection in nursing skills in order to provide competent and safe care to the patients. The level of responsibility and accountability varies as the professional role changes. The charge nurse has more responsibility than the registered nurse. Therefore their levels of professional judgment and practices are not same, but they assume same professional accountability. According to the Agency of Healthcare Research and Quality (AHRQ) Patient Safety Network web site expands upon the definition of prevention of harm: “ freedom from accidental or preventable injuries produced by medical care” (Mitchell, 2008). In 2001 (AHRQ) has given evidence based repot in different ways to improve patient...
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...Community Hospital for a bilateral myringotomy. The mother of the child stepped out during the surgery in order to run an errand involving her other child. The mother was told the surgery would take about 45 minutes. The mother relayed that she should be back after the surgery to pick up her child. The mother did not respond after the recovery, even though the recovery nurse called out to the waiting area and paged for the mother. The patient was then transferred to the discharge nurse. The child was agitated waiting for her mother to return. Coincidentally, the father was at the desk and the nurse invited him to see his child. The nurse was relieved as the child changed her affect to one of excitement and called him daddy. After waiting thirty minutes the father offered to take his daughter home. The nurse agreed and provided the discharge paperwork to the father. The child abduction was reported two hours after the patient’s discharge, upon the mother’s return. This was due to the fact that the patient was released to the father but the mother had sole custody of the child; unbeknownst to the discharge nurse....
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...and ‘prn’ medication, OR with competent staff supervision OR appropriateness of RN exemption/delegation for medication administration (1hr/yr- LVN; 1hr/yr-RN) 2. Complete LVN focused nursing assessment on admission and semiannually to obtain current medical data to monitor decline/improvement of current medical and/or psychiatric diagnosis. (2 hrs/yr- LVN) 3. RN will perform QA review of chart annually to monitor compliance/recommendations of medical/dental/vision/consultant appointments, and intended effects of routine and ‘prn’ medications and to develop the RN Plan of Care for annual IP. (4hrs/yr- RN) 4. RN will perform a follow-up QA of chart within 90 days of annual QA to confirm compliance to DADS regulations and to RN Plan of Care. (1hr/yr-RN) 5. Perform verification of current MD orders on pharmacy printed MAR (3hrs/yr-LVN) 6. Perform verification of compliance to medication/treatment orders documented by unlicensed staff on MAR (3hrs/yr-LVN) 7. Nurse to monitor monthly weight and inform PCP of weight gain/loss > 8lbs (1hrs/yr-LVN)(1hrs/yr-RN). 8. Nurse to provide annual residential/day habilitation staff education/training on SAM’s process in order to deem staff competent to administer medications per BON-RN Delegation.(2hr/yr-LVN) (2hrs/yr-RN) 9. Provide RN on-call after office hours to triage/assess by phone/in person an immediate medical issue affecting consumers health status (2hrs/yr-RN) 10. Consult with PCP, DDS, Vision, MD-Consultants, and Allied Health...
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...sign this law to protect the right and privacy of the patients. Before 1996 there were many issues that has rise the concerning of patient privacy. The HIPPA Act includes “Health insurance portability, fraud and abuse control, tax related provision, group health plan requirements, revenue offset provision, and administrative simplification requirements (Physicians Billing Associates International, 2006). The article that I had read was about a woman who was a nurse and started to use the narcotic from the patient and it was also between an individual’s right to privacy. It shows the process of which the administrator determines a course of action is reviewed but his context of workplace realities through an ethical analysis. This article was about a woman named Jackie that was a nurse and she was overwhelmed with her job. She tried talking to her husband but was convinced to continue working because who pay check was making their saving grow extremely large. To make her husband happy she continues to work as a nurse. She was working in different units that she started to use the narcotic that were prescribing to the patient that she was caring for. She started to take the patient pain medications that weren’t asking for their medications. Then Jackie started to replace the medications with the saline. Jackie had an addiction to pain medication. The administrative Michelle found out because Jackie was working in the surgical unit and the pharmacist had notice there was errors...
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...to close a hospital doors, nor to deny the hospital to provide medical services. It should be used a tool for good operating standards for a hospital to conduct its business. It takes work and preparation to meet the standards and to make sure all departments are on board, but once nightingale meet the requirements it all about managing and monitoring the daily operations of standards. It is the Director of Accreditation job of Nightingale Hospital to make sure the hospital is prepared for the Joint Commission audit. It is the directors who reviews all standards and make sure each department within the hospital is compliance with them. It is also the director’s job to make sure the hospital is not placed in non-compliance status, have sanctions place on the hospital and payment withheld for not meet national patient care standards. A1. The Director of Compliance at Nightingale will conduct a Periodic Performance Review (PPR) which will help...
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...Hand Hygiene Compliance in Health Providers Grand Canyon University: NRS 433 11/17/13 The purpose of this article “The impact of workload on hygiene compliance in nursing” was to shade some light and reveal some of the findings the researchers come across during the previous questions posed. They wanted to know the reasons why nurses are noncompliant when it comes to hand hygiene. The study lasted twelve-month during which time the staff were observed in a hospital setting in six different settings. The researchers were set to find out the leading causes of nursing staff noncompliance with hand washing while hospital acquired infections were on the rise. Researchers surveyed multiple units in a large hospital and concluded the following the result as recorded. All staff members were interviewed and monitored by the same interviewer for consistency and accuracy. The interviewer then placed each subject in a category as compliant or noncompliant and the subsequent reason for such a placement was noted. Next the observer proceed to observe the participants in their normal environment while they were performing their routine duties, subjects were chosen at random without announcement to be studied. The evaluation consisted of 181 participants, it was divided into seven groups. The categories varied from nurses who did not performed proper hand washing because of the time restraint all the way to those who spoke up when they see another coworker...
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...Nursing Accountability of Implementing Changes Nursing accountability is often associated with specific expectations which include clinical care. It defines the nurse’s responsibility to practice ethically and competently. Nurses use evidence-based research as those presented by the Agency for Healthcare Research and Quality (AHRQ). This is an agency that supports health services research that will improve the quality of healthcare and promote evidence-based decision making (AHRQ, May 2009). It is zascsanecessary for nurses to stay up to date on clinical practices so that they can provide the best care possible to their patients. “The nurse assumes responsibility and accountability for individual nursing judgments and actions.”(ANA, 2001, p. 1) This paper will discuss evidence-based patient safety practices, focusing on the safety practice of: Prevention of Intravascular Catheter-Associated Infection by use of maximum sterile barrier precautions. There are pros and cons to the short-term use of central venous catheters (CVC) in the hospital. The benefit of having an intravascular catheter is that it allows you to give large volumes and high concentrations of fluids to patients. It also prevents a patient on long-term antibiotics from having multiple IV starts. However, there are also serious complications with the most common being infection.(Shonjania et al., 2001) According to AHRQ, the use of maximum sterile barrier precautions decreases the risk of catheter related...
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...Task 4 Regulatory Audit Organization Plans Compliance Facility Compliance The following represents the level of compliance in the pain assessment area of patient care that was audited for Nightingale Community Hospital: There were 3 departments audited for Pain Assessment compliance over a 12 month period, NIGHTINGALE COMMUNITY HOSPITAL averaged 86.94% compliance. Audit | Audit Period | Location | Compliance % | Pain Assessment | 12 Months | ED | 70.66% | Pain Assessment | 12 Months | 3E | 93.5% | Pain Assessment | 12 Months | PACU | 96.66% | There were 3 departments audited for Pain Reassessment compliance over a 12 month period, NIGHTINGALE COMMUNITY HOSPITAL averaged 80.415 % compliance. Audit | Audit Period | Location | Compliance % | Pain Reassessment | 12 Months | ED | 54.83% | Pain Reassessment | 12 Months | 3E | 92.916% | Pain Reassessment | 12 Months | PACU | 93.5% | The following are the results of the audit that was completed for use of prohibited abbreviations in an aggregate of ICU, Telemetry, 3E and 4E over a 12 month period: Audit | Audit Period | Abbreviation | Occurrences per 50 opportunities | Prohibited Abbreviations | 12 Months | “cc” | 33.75 | Prohibited Abbreviations | 12 Months | “qd” | 15.916 | Fire Dill History of drills held once per shift per quarter over a 12 month period: Quarter | Shift 1 | Shift 2 | Shift 3 | Compliance Analysis | 1st (Jan-Mar) | √ | √ | | No Fire drills on the 3rd...
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...Intervention Study to Enhance Medication Compliance in Community-Dwelling Elderly Individuals My research study was to determine whether daily videotelephone or regular telephone reminders would increase the quantity of prescribed cardiac medication taken in a sample of elderly individuals who have congestive heart failure (CHF) (Peteva, 2001). Within this research I would disseminate the new scientific knowledge with the help of the pharmaceutical company that makes the congestive heart failure medication. With the help and support of the pharmaceutical maker, I would provide a full in-service to the nursing staff of hospitals and doctor’s offices alike. In doing this, this would provide a friendly and educational atmosphere in a nursing practice setting to get complete understanding of the research findings and how they as nurses can make a difference in the consumption of prescribed medication. Secondly, I would write a journal article and have it published in the pharmaceutical’s bulletin to include a well-known nursing journal. These journal articles would contain the findings of the research and suggestions on how the nursing staff can help the patients improve the compliance of taking prescribed medication. Once the information is disseminated into the medical public, the nurses will apply the learned knowledge to their practice for the elderly patients who are taking congestive heart failure medication. First, the nurse will collect all the patients that are currently...
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... | |Any Town, US 55555 | | | |Dear Mr. Smith: | | | |As a an experience staff RN with experience as an assistant nurse manager, I am seeking to secure a | |position working within St. Joseph's Medical Center providing care to a pre- and post-operative patients. | |For your review I have attachment my resume. | |With combined experience as a highly capable, dedicated and compassionate staff nurse and assistant nurse | |manager. I am regarded as a hardworking, energetic and personable nurse who creates a positive, environment| |for patients and staff....
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...between ADN and BSN Nurses Although testing for one’s RN license is universal, the training background of an ADN versus a BSN nurse are very different. This has brought us to the discussion of the differences between an ADN and a BSN level nurse. As the needs of the patient population is changing, the demand for a more educated, skilled, resourceful practitioner is required (Smith, 2009). Personal Experience Example of how an ADN versus BSN nurse would treat a CHF patient. A specific patient case I reviewed, was readmitted to a hospital again within thirty days with a diagnosis of congestive heart failure. The ADN trained nurse could administer drugs, perform daily weights, ensure that the patient followed a cardiac diet, but was strictly task oriented (The Future of the Associate Degree in Nursing Program, 2013). The BSN trained nurse, would base the care provided using a more integrated system (Why the Push for BSN Nurses?, 2012). The focus of the BSN trained nurse would encompass more teaching, measuring compliance of instructions that were given, and ensure core measures would be met prior to discharge. The follow up care would include determining if the patient had access to meds, home health, understood the need to maintain dietary restrictions, and instruct the patient on keeping a daily weight log to ensure that weight trends would be monitored and recorded. ADN AND BSN DIFFERENCES 3 The college system today has defined an ADN nurse as technical...
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...the actions you would take Lena is in a complicated situation; there are several ethical principles at stake. Respect for her sister’s boyfriends’ autonomy in addition to the principles of beneficence, to do good as well as avoid harm. Nonmaleficence, the intention of doing good although some harm may come. The principles of justice, to protect her sister from a possible life threating disease. As a registered nurse we are bound by both legal and ethical obligations that we must contend with before we react to a situation. Laws are commands, the consequences for not obeying the law is a loss of a license to practice nursing. And ethics are the systematic study of morality with no room for opinions or gut reactions (Laureate...
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...Change Paper Nursing 427 By Jennefer Grady Table of Contents Introduction………………………………………………………………..3 Lewin’s Theory……………………………………………………………..4 Problem Statement………………………………………………………….5 Proposed Solution…………………………………………………………..6 Moving Forces………………………………………………………………7 Restraining Forces…………………………………………………………...8 Change Integration…………………………………………………………..8 Refreezing Process…………………………………………………………..9 Introduction On patients requiring bipap masks, what is the effect of applying duoderm to bridge of nose compared to not using any barrier to prevent skin breakdown while in the hospital? This paper is about a problem that has been identified in the nursing field and the change process. Patients who need to wear a bipap mask for better oxygenation are having complications with the mask causing a pressure ulcer on the bridge of the nose. This is not only painful to the patient but also increases health cost. This paper is about Lewin’s change theory and how to implement this new change and overcome resistance. It will talk about the freezing, moving and refreezing process, changes that need to be made and how to implement this plan. As well as what is necessary to enforce this change so that it becomes status quo. Lewin’s Theory Kurt Lewin was born in Germany and immigrated to the US in August of 1933, after Hitler came to power. He had originally been involved with schools of behavioral psychology before changing directions and going into research. He is well...
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