...Bedside Report from the Emergency Department. Translational Research March 31, 2016 The modern day emergency room is a department that is constantly busy. In the hustle of caring for patients, there are some details of the patient’s care that can be overlooked in a standard phone report to the accepting nurse. With this in mind, a change is needed so that there is an optimum patient outcome for each and every one of the people that walk through the doors of the emergency room and get admitted. A1. The current practice in the emergency department that I work in when admitting a patient to the medical floor goes something like this. 1. Emergency department doctor enters orders for a consulting doctor to come and look at the patient to determine if an admission is warranted. 2. The consulted admission doctor assesses the patient and determines admission diagnosis. 3. Orders are written for admission. 4. Admission orders and chart is assessed to determine if the patient meets inpatient or observation criteria by case management registered nurses. 5. Once inpatient vs. observation status is determined, case management puts up an indicator on patient chart that bed can be ordered. 6. Primary RN requests bed from bed board using computerized bed request form. 7. Bed board assigns room to patient and places an indicator on patient chart with room number. 8. Primary nurse calls floor that patient is assigned to and asks to speak to...
Words: 2701 - Pages: 11
...3.3 CHARACTERISTICS OF HANDOVER Laxmisan et al (2007) conducted an ethnographic study involving analysis of emergency department handover in a US hospital. The study found that interruptions within the emergency department were prevalent and diverse in nature and that there were gaps in information flow due to multi-tasking and shift changes. The communication process is complex and cognitively taxing during and after team handover, that can compromise patient safety. The study also discusses the need to tailor generic electronic tools to support adaptive processes like multi-tasking and handoffs in time constrained environments. Arora et al (2005) conducted interviews using the critical incident technique to handover failures between inpatient physicians in a US hospital. The study interviewed 26 interns and found 25 discrete incidents. The 21 worst events are described. Omitted contents and failure prone communication processes were identified as a major category of failure in communication. These may result in inefficient or sub-optimal care, leading to patient harm....
Words: 1589 - Pages: 7
...Evidence Based Practice Task 1 Western Governors University Evidence Based Practice and Applied Nursing Research The nursing topic of interest is bedside handover, which is the concept of conducting shift handover at the patient’s bed instead of doing it at the front desk. Part A The article being analysed is: Tobiano, G., Chaboyer, W. & Murray, A. (2012). Family Members’ Perceptions of the Nursing Bedside Handover. Journal of Clinical Nursing, 22, 192-200. The analysis of the primary research report is done in the form of a graph (figure 1). Each of the four analysis areas is rated within a scale of 1-10; 1 denotes extremely weak while 10 denotes very strong. Table 1 then gives justifications for the rating by explaining why each area of analysis was rated that way in the analysis chart. [pic] Figure 1 Table 1 |A1 Article: Tobiano, G., Chaboyer, W. & Murray, A. (2012). Family Members’ Perceptions of the Nursing Bedside Handover. Journal | |of Clinical Nursing, 22, 192-200. | |A2 Background or introduction |The researchers provided an in depth introduction of the research topic outlining | | |important issues, previous research on the topic and their findings. The introduction | | ...
Words: 3773 - Pages: 16
...Change in Nursing Practice Jamie L. Eden Walden University NURS 4001-5, Research and Scholarship for Evidence-based Practice November 16, 2013 Change in Nursing Practice A patient who is admitted to a facility may be alert, oriented, and independent in ambulation. Add on intravenous (IV) tubing attached to a pole, a telemetry monitor, a foley catheter, and new medications for the patient. This patient now has fall risk factors. The purpose of this paper is to describe and evaluate change in preventing falls in the hospital setting. Falls in Hospitals Patient safety is number one in hospitals. Every staff member that comes into contact with a patient should always have the question, “Will the patient be safe?” in the back of their mind. Mistakes do happen just as patients do fall in hospitals even with prevention strategies. There are between 700,000 to 1,000,000 falls in hospitals in the United States (Preventing falls in hospitals: A toolkit for improving quality of care, 2013). If a patient falls any number of serious injuries could occur, such as bruising, lacerations, fractures, hemorrhaging, and even death. The costs of treating a patient for injuries as a result of a fall while in the hospital is not reimbursed by Medicare as of 2008 (Preventing falls in hospitals: A toolkit for improving quality of care, 2013). Not only will the facility not get reimbursed for costs related to the fall, the patient may likely have a longer length of stay and could potentially...
Words: 1839 - Pages: 8
...EBT1 Task 1 Critique of a Nursing Research Article A1. Article Ford, Y. , Heyman, A., Chapman, Y. (2014). Patients’ perceptions of bedside handoff; the need for a culture of always. Journal of Nursing Care Quality, 29(4), 371-378. A2. Graphic Background Information | The purpose of this article was to identify patient perceptions of bedside handover through directly asking patients about their care. The study was done on a two in-patient medical-surgical departments at Borgess Medical Center in Michigan. They had implemented bedside handoff at shift change 18 months prior to this study. Then a sample of patient participants was chosen from the two nursing departments for the study. They had to meet certain criteria to be a participant and they had to experience three handoffs. Then they were given a survey to fill out after the beside handovers. Participants were positive about the RN bedside handoff process. The overall mean from the survey was 3.32 on a scale of 1 (strongly disagree) to a 4 (highly agree). | Review of Literature | There were multiple references that provided statistics and facts during this study. Most of these studies have focused on implementing bedside handoffs and nurse perceptions of the handoff. Published studies that focused on patients’ perceptions of beside handoff have been mainly qualitative. Recently, researchers have published...
Words: 4724 - Pages: 19
...According to Gorospe (2006) “The fact that fall prevention has taken on new urgency reflects one or more perceived performance problems in this area” (pg74). Therefore, it is essential to identify any variances between existing best practices and actual work practices. For instance, staff may identify policies of how all patients with abnormal gait should be accompanied while walking, but in reality this is not actually being done. The degree of these variances cannot accurately be determined until the existing practice is thoroughly examined. “Understanding how to make a change in fall prevention strategies starts from identifying gaps in knowledge and resources and will allow you to see how much progress is made” (Gorospe, J. 2006...
Words: 1233 - Pages: 5
...shortage of nurses has been totally different from what has been experienced in the past. The present problem of nurse shortage is due to the declining enrollment, the new requirements that are asked from medical aids to qualify for enrollment in nursing schools, also the aging of Registered Nurses (RN) in the workforce, and the restricted supply of vacancies available will be like a new element to an ancient problem that has to be fixed in the near future. Nurses need to be strong and proactive and help each other by securing their future and forming partnership and associations within their profession. (Goodin, 2003) The purpose of this paper is to demonstrate in a small way how some hospitals in the United States have found a solution to the nurse staffing shortage they have face in the past or are facing in the present or will face in the near future. This paper will also try to provide a recommendation, and solutions that have been implemented by other hospitals that faced the same problem that Renfrey Memorial Hospital is facing with their shortage of nurses. Solutions that is viable and easy to implement in the next two years, solutions that will cover a few of the stakeholders groups and their interests. Executive Summary This proposal is for the board of directors of Renfrey Memorial Hospital. The intention of this proposal is to generate an analysis that will demonstrate the issues that have influenced the shortage of nurses at Renfrey Memorial Hospital, and will...
Words: 2405 - Pages: 10
...Personal Philosophy of Nursing Jessica Pons NUR/391 January 28, 2013 Sharon Thompson Personal Philosophy of Nursing To formulate my personal philosophy of nursing, I had to look at what my core values were. I am a kind, compassionate, honest, and caring. I chose nursing as my profession because nursing is something that always has been in my blood. I believe human life is precious and is to be valued. Not only do I consider my patient’s wellbeing, but I also look at the wellbeing of the families. Families take care of the patient when they are discharged. I also look at my fellow health care workers. Without being able to work alongside them, I could not take care of the patient properly. Lastly, I consider my own health. An unhealthy nurse cannot properly do their job. Caring for patients and their families, working well with coworkers, and taking care of your own health is what makes a difference because no matter how small the task, little things add up to big things. That is why I believe the world will get better one small step at a time. My Patients My patients are human beings. They are people with feelings and souls, and they are to be treated with just as much respect as everyone does. It does not matter if they are on their deathbed or just coming in because they have a cough. Being a positive role model is an important philosophy. I was raised watching my mother be a nurse and always enjoyed going to work with her and helping with small things such as...
Words: 1494 - Pages: 6
...provide nursing care to an increasing diverse patient population with a nursing workforce that, in itself, is impacted by generational, ethnic and gender differences. The purpose of this paper is to present the importance of diversity in the workplace and delivering culturally competent nursing care, the impact of gender diversity, and the misrepresentation of minorities in the nursing profession. Importance of diversity in the workplace America is a kaleidoscope of cultures, religions, races, and nationalities. The USA Quick Facts from the US Census Bureau shows the following 2011 population statistics: White 63.4%, Hispanic/Latino 16.7%, Black/Afro-American 13.1%, Asian 5.0%, American Indian & Alaska Native 1.2%, and Native Hawaiian/Pacific Islanders. 0.2%. In 2012 minority population increased to 37% and is projected that minorities will be the majority by 2043. Mason, Leavitt & Chaffee (2012) pointed out that as our population “continues to grow and increase its diversity, it is important that the nursing workforce reflect these changes to effectively meet patient care needs and ensure cultural competency” (p. 378). Cultural assessments must be part of the nurse’s health assessment. To be culturally competent nurses need to be aware of their own culture, and the diverse culture of their colleagues and patient populations (Maier-Lorentz, 2008). Culturally competent nursing care is important for positive patient outcomes and patient satisfaction. Summary of one...
Words: 1515 - Pages: 7
...The Driving Force of Change: Magnet Designation The Driving Force of Change: Magnet Designation The healthcare industry has striven to advance the quality of care provided to patients for decades. Pursuing Magnet designation is a journey a hospital can take to acquire this level of excellence. The purpose of this paper is to explain an overview of components making up Magnet designation, the impact Magnet status has on change in healthcare and its organizations, and the benefits and challenges that go hand in hand. Overview of the Magnet Recognition Program The Magnet Recognition Program is not an award but a “performance-driven recognition credential” designed to achieve excellence in patient outcomes and satisfaction of nurses (Drenkard, 2010). Magnet Recognition is the highest and most prestigious distinction a healthcare organization can receive for nursing excellence and high-quality patient care. The Magnet program model organizes 14 Forces of Magnetism into five model components. The five model components are transformational leadership, structural empowerment, exemplary professional practice, new knowledge, innovation, and improvements, and lastly, empirical quality results. The first component, transformational leadership, identifies the need for more involvement with nursing in leadership roles. The second component, structural empowerment, provides an innovative environment where strong professional practice flourishes and relationships and partnerships...
Words: 1365 - Pages: 6
...A Critique of the Literature Effects of Nursing Rounds: on patients’ Call Light Use, Satisfaction and Safety. Introduction: The findings of this article will critically review the methods of research, population, systems and data used to obtain results regarding this study. This evaluation of the outcome would determine whether or not there was a need to change the nursing management of patient care. The study would determine if patients were happy with their care and if the rate of falls were minimised. In the health care setting, the call light is an important communication tool for the nursing staff and patients especially in an emergency situation. Title: The title clearly summarises the content of this Journal article which suggests there was either a qualitative or quantitative designed research data used to conclude the findings. There was limited context which was not clearly defined (Meade et al.2006, p 58). Abstract: This is succinct, meaning the writer has been brief and precise with the back ground information about the research article. This...
Words: 2370 - Pages: 10
...2009 Nursing Turnover: Costs, Causes, & Solutions Steven T. Hunt, Ph.D., SPHR Director of Business Transformation SuccessFactors Inc. (www.successfactors.com) E-mail: shunt@successfactors.com Copyright © 2009 SuccessFactors, Inc. Invest in People …. Drive Business Results SuccessFactors Healthcare Executive Summary Nursing turnover is a major issue impacting the performance and profitability of healthcare organizations. Healthcare organizations require a stable, highly trained and fully engaged nursing staff to provide effective levels of patient care. The financial cost of losing a single nurse has been calculated to equal about twice the nurse’s annual salaryi. The average hospital is estimated to lose about $300,000 per year for each percentage increase in annual nurse turnoverii. Losing these critical employees negatively impacts the bottom line of healthcare organizations in a variety of ways including: Decreased quality of patient care Increased contingent staff costs Increased staffing costs Loss of patients Increased nurse and medical staff turnover Increased accident and absenteeism rates The primary causes of nurse turnover can be analyzed by I) understanding why nurses choose to work for an organization and ensuring this ‘employee value proposition’ is met; and II) identifying things that occur after nurses are hired that lead them to quit even though their initial job expectations were met. I. Primary factors that influence...
Words: 5301 - Pages: 22
...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...
Words: 2886 - Pages: 12
...Agency Nurse Orientation: A Case for Change EBT1-Task 3 Western Governors University A1) Procedure Nationwide there are currently 16,000 certified nursing homes caring for 1.4 million residents (Zhao & Haley, 2011). Due to high nurse turnover rates and persistent staffing shortages, many nursing homes utilize nurse staffing agencies to meet staffing needs. Holliswood Care Center (HCC), a 300 bed nursing home, with five residential floors, located in Hollis, New York is not exempt from such staffing challenges. In fact, according to Yves Pascal, Director of Nursing (DNS) at HCC, “Usually, 2-3 LPN’s per shift are required daily” (Y. Pascal, personal communication, December 15, 2013). Agency nurses are approved to work at HCC once they submit a current physical and complete an in-house facility orientation. During this orientation, agency nurses receive New York State mandated in-services, such as patient abuse and HIPPA. The nurses also receive specific instruction regarding emergency procedures, medication policy, employee conduct and procedures. However, specific unit policies and procedures, location of specific supplies are not included in the general orientation. Upon completion of the orientation, the agency nurse receives no further orientation or precepting. Thus when an agency nurse enters HCC for their first shift they are functioning independently and with limited knowledge. This is clearly a problem, which varies in degree of potential...
Words: 4422 - Pages: 18
...Kolcaba’s Comfort Theory Kelly Henderson Professional Transition I/HSC-175 September 30, 2013 Mrs. Suzanne Boese, RN-BC, PHN, MSN/Ed Explanation of the Comfort Theory The origin of the word nurse is derived from the Latin word nutricius, meaning “(person) that nourishes” (Merriam-Webster, 2013). Historically, the concept of comfort was recognized as an essential praxis of nursing because of antiquated medical practices and the lack of development of medications. Often times, comfort was all a nurse could provide. Presently, the progression of medicine has allowed us to focus on healing and curing our patients. While coordinating care and interventions, nurses often feel overwhelmed by the tenacity of the tasks required to return their patients to homeostasis. What they often overlook, is what their patients still desire the most—comfort. Although comfort has always been a defining characteristic within the nursing profession, the true meaning of the concept is subjective—per the patient’s perspective. Recognizing this, nursing scholar, Dr. Katharine Kolcaba developed the comfort theory. She defines comfort as “the immediate experience of being strengthened by having needs for relief, ease, and transcendence met in four contexts (physical, psychospiritual, sociocultural, and environmental)” (Kolcaba, 2003). Kolcaba further clarifies “relief as the state of having a specific comfort met; ease as the state of calm and contentment; and transcendence as the state in...
Words: 1100 - Pages: 5
