Patient Care | Distance Learning Systems (DLSI)

Strengthening Nursing Education thru Collaboration

In keeping with national recommendations to improve nursing education and practice and help nurses become well-positioned to lead change and advance healthcare, the University Of Florida College Of Nursing and the UF Health system’s division of nursing will collaborate more closely in education, analysis and patient care, UF Health president David S. Guzick, MD, PhD, declared in April.

nursing_education As part of this collaboration, both Anna McDaniel, PhD, RN, dean of the College of Nursing and Irene Alexaitis, DNP, RN, NEA-BC, chief nursing officer and vice chairman of patient care services at UF Health Shands Hospital, will now hold positions and active roles within the wellness system and college, respectively. Aside from serving as dean, McDaniel will serve as the UF Health assistant vice chairman of academic practice partnerships and Alexaitis will serve as the College of Nursing associate dean of academic-practice partnerships. Moreover, nursing positions at UF Health are being created that combine obligations for teaching in the College of Nursing and active practice at UF Health Shands Hospital and other UF Health faculty office sites.

“I am pleased that our academic, research and clinical tasks in nursing will continue to forge strong partnerships through an established academic-practice collaboration,” said Guzick, senior vice chairman for health affairs and president of UF Health. “Strengthening the relationships between education, research and patient care is in maintaining with our overall strategic goal of putting patients at the center of everything we do.”

Joint appointments in the college and UF Health features will allow the college to better fulfill the academic needs of learners in the college’s academic programs, assist with UF Health nurse employment and preservation and enhance the link between clinical practice and nursing education. In addition, plans include exploring ways to offer advanced academic possibilities for nurses in UF Health facilities and aligning both organizations’ strategic goals and activities.

“We are pleased to further enhance the partnership between our college and UF Health and we are excited about many upcoming possibilities this will provide our nurses and faculty,” McDaniel said. “This move brings us back full circle to our pioneering culture as our founding dean Dorothy M. Smith was one of the earliest nursing leaders to completely incorporate nursing education, practice and research. By working more closely with UF Health, it confirms that we are teaching the next generation of nursing professionals completely prepared to fulfill the needs of our medical care system.”

Patient Care and Retail Based Clinics

The American Academy of Pediatrics (AAP) recently released a strongly worded policy declaration re-enforcing its place that retail-based treatment centers (RBCs) are unsuitable locations for pediatric patient care. Many workers in pediatrics are also up-in-arms over the increase of RBCs as many practices feel they are taking valuable sufferers. The fact is that RBCs are an excellent supplement to the micro practice design that our practice is depending on. For us, the advantage of RBCs is that they do what we do not want to do. Namely, they open on evenings, Saturdays, Sundays and vacations. But one major adverse is that they cannot staff as many hours as the bigger, multi-provider practice.

A recent cover story at The Harvard Business Review said to forget about work-life balance and it described that life is about hard choices; this is a fact. Employees want to be home for supper with their family and invest their time in their children’s days off from school having fun. We like knowing that the RBCs are there to fill in for the bigger practices when they are closed. It should be said that RBCs offer a convenience; medically, there is usually no reason why someone with symptoms cannot get some over-the-phone patient care from the health professional or physician on call and then wait for their office to open at 9 a.m. the next morning. But for those who choose not to wait and in some situations are willing to pay a premium for the comfort, why should not they go see an experienced and certified health professional specialist at an RBC? Whether the strep test is run by bigger practices or RBCs, provided that there is interaction, there shouldn’t be an issue with RBCs offering mid-level triage for us.

They key is, as with most issues affecting personal and community health, has to do with RBC rules. How much can a patient really value the guidance of a company who works for an organization that makes money when you buy over-priced over-the-counter snake oil? Government departments have a responsibility to make sure that RBCs are not favoring client care over quality clinical judgment. Think about it: Patients looking for needless medications are more likely to buy over-priced products when they have gladly obtained the medication they desired but probably did not need. As a primary patient care provider, one of the greatest values of RBCs is the ability to diagnose illness as early as possible in order to treat the patient for the best possible outcome.

Revolutionizing Patient Care

From airlines trying to do something different, to a police department seeking to evaluate its effectiveness in the roads, Google Glass is constantly applied in many useful ways, even if there have been several difficulties. Even so, you can add Beth Israel Deaconess Medical Center (BIDMC) to the list of useful Google uses. On his blog, BIDMC chief information official John Halamka shared that his medical center ran a lead program that used Glass for an in-house patient information system that was designed in the emergency department. Here’s how they used Glass: A QR code is placed outside an emergency department room, which a physician can check out using Google Glass. After checking, Glass shows the physician everything there is to know about the individual in the room, such as vital signs, lab results, issues, and other info. This re-imagines the status quo up until now, which includes having to redirect attention away from a patient in order to use a computer and read any related details.

Integrated with the ED Dash panel, a program that medical centers use to observe patient circulation, the customized application uses Glass’ action support to communicate with the user interface, its camcorders to evaluate QR requirements and execute various speech instructions. The medical center made a few variations to Glass, such as iPhone pairing, including an exterior battery pack, allowing straight scrolling by slanting your head, and other optimizations.

Fortunately though, BIDMC is not the only medical center in the country that plans to change the way physicians take care of their sufferers the Rhode Island Hospital, which will use Glass in its emergency department. Both plan to provide their applications using Glass in the E. R., though RIH will originally restrict the program to E.R. sufferers affected with skin rashes or other skin-related issues and who are okay with a Glass-wearing physician.

Ultimately, both hospitals’ programs provide a lot of potential in enhancing patient care while also improving doctors’ performance. All of a sudden, having an ambulance team equipped with Glass, which would let a physician back at the medical center know exactly what to prepare to immediately provide patient care the moment they step in the medical center, is not that far-fetched of an idea. BIDMC will move out the program, which was in testing up until now, in a matter of weeks, while RIH will most likely move out its program after its following six-month study is over.

Psychology in Nursing Practice

Psychology is a study that includes the human mind, which is primarily concerned with behavior factors. This is an important part in improving nursing practices within the health industry. It includes the understanding of both spoken and non spoken interaction which is often used by sufferers. Performance and Work Delegation Nursing as a career is a profession that suits the population with capability to practice both sympathy and goodness in order to accomplish their responsibilities with passion. However, in nursing, it is enough to reiterate that an individual would not be able to carry out all the tasks effectively without psychological understanding of the individual’s conditions in regards to the nursing care and practice required.

If the nursing staff is not well versed with particular emotional perception of the individual, it is skilled to assign or seek assistance from another health professional with capability to completely understand how to deal with the behavior factors of the sufferers, especially the psychological sufferers. At times, a health professional would assign some responsibilities through supply of sufficient details, since the focus is to enhance, as well as save patients’ lives.

In this respect, information performs a great role in improving work efficiency in the health industry. Nursing staff are supposed to obtain info from the particular specialists and doctors, when there is no sufficient details in respect to work plan, the nurses would not perform their function as allocated. In addition, the human life is not renewable and should be handled very carefully. Hence it is correct to reiterate that interaction and psychology are important factors in nursing as a career. Patient care in most cases, nurses are not only required to manage individual care, but also assist in performing particular processes within the particular areas of specialized health institutions to which they are connected. For example, a health professional connected to the theater should adhere to the physician’s guidelines so that the process may be accomplished within the quickest time possible, as per the regulations that regulate the theater and particular process as scheduled.

Attitude Toward Patient Care

“American physicians need to be totally able to do what they have been trained to do, succeed at practicing medicine. American patients need to be totally able to choose the family health insurance coverage and medications that suit their needs, not something forced by a central power. This simply cannot occur under the imprisoning pressure of the Affordable Care Act.” – Richard A. Armstrong, M.D. “Under the Affordable Care Act, physicians who effectively work together with other suppliers to improve patient care results, the value of healthcare services and patient experiences will flourish and be the leaders of the healthcare care program.” – Robert Kocher, M.D.; Ezekiel J. Emanuel, M.D.; Nancy-Ann DeParle

Physicians have been caught in the middle of the transformation of the American healthcare care distribution program brought on by the Affordable Care Act. Doctors who battle the regulation and those who support it are trying to adjust to a fast changing healthcare environment. A Deloitte Center for Health Solutions survey of American physicians found 44 % thought the ACA was “a good start” and 44% reacted that “it is a step in the wrong direction.” Obviously, older physicians were more likely to be in the second group of participants than younger physicians.

The ACA overhauls the healthcare care distribution program in the following ways:

It improves accessibility healthcare for more Americans
It creates incentives to promote better patient care synchronization and quality
It provides feedback to physicians on cost and quality of their patient care
It changes the payment program from fee for service to value based
It focuses on patient-centered care
It depends on increased use of electronic medical records
It attempts to increase access to primary care and allied health providers

Patient Care and ICU Visitors

What do you do if your mother, sister, husband or father lands in an ICU? Do you stay or do you go? There are more than 5 million sufferers admitted to an ICU a year. The ICU is a special unit where sufferers who have severe and deadly illnesses are given patient care by specialized doctors and nursing employees. These sufferers require constant monitoring and support with unique devices and medications to maintain normal bodily processes. The majority of U.S. healthcare centers have restrictions on visitation rights. Close relatives need open visitation rights because it decreases patient anxiety and improves their comfort.

Most adult intensive care units have some type of limited viewing hours that limit the number of family members who can visit and the time they can stay at the room. Across ICUs there is no standardization in viewing guidelines. Moreover, there may even be different visitation rights guidelines in various ICUs in the same hospital! Close relatives can be limited to 10 minutes of visitation rights every hour or be allowed to visit any time they want. Also, how healthcare center employees implement and understand the same visitation rights guidelines can be dissimilar. This variability is a cause of pressure for nursing employees, families and sufferers. Hospitals are attempting for excellence and are now focused on family-centered patient care. Close relatives play an essential part in the ICU individual’s recovery, so an essential part of family center care is open visitation rights. Patients place a high value on having family members at their room, offering them a sense of security in a highly technological innovation driven atmosphere.

The ICU is a stressful place full of sounds, unknown people and devices. Having a familiar face at the room can decrease individual pressure and duration of stay and help respond to questions in the ICU. Also, it improves individual quality, safety and satisfaction. To see relatives, it improves communication with healthcare employees, allows family members to be involved with patient care and contributes to better understanding of the healthcare world. In addition, families cannot affect the functioning of the ICU. Infection disease precautions may be needed that can restrict visitation rights. If an ICU patient is in a shared room and this can happen, guests may be asked to leave temporarily if immediate lifesaving measures are required or sensitive conversations need to occur with another patient.

Improving Patient Care with Technology

Citizens at the Kane Regional Centers will soon have a new friend in the physician’s office: “Telly,” a tele-presence digi-cam rig that can connect to a remote doctor and gather healthcare details during exams. The rig is part of a UPMC-run program called RAVEN or Initiative to Reduce Avoidable Hospitalizations Using evidence-based Interventions for Nursing Facilities in Western Pennsylvania, which is financed by a $19 million grant from the Centers for Medicare & Medicaid Services.

“Bringing tele-medicine to the Kane Centers will enhance the speed and performance of patient care with which residents receive healthcare consultations when there is a change in their health,” Allegheny County Executive Rich Fitzgerald said. “It will also slow up the need to transport residents to a medical center or E.R., which is difficult for some of them.” “Telly” will not substitute doctors, who will still perform routine exams. It’ll only be used when an individual’s condition changes, along with a shift in breathing, heart function or pain. The robot-like rig will be monitored by physicians and can examine the eyes, ears, nasal area, neck, respiratory system, heart, stomach, skin, arms and legs and neurological system.

The rig looks like a pc monitor on wheels with a digi-cam secured on top. It comes equipped with tools like a wireless stethoscope, which can pass on details to a doctor at another location. Close relatives will be able to listen in via PC and telephone. “We recognize that a patient’s doctor or health professional specialist is sometimes not available at the skilled nursing facility to assess and treat the citizen when there is a change in their usual health,” Kane Executive Director Dennis Biondo said. “The goal is to provide ongoing access to high-quality patient care and health-care professionals.”

Paperless Patient Care

Most people reading this probably grew up in an age of paper medical care details, hand-written medications, and faxed or sent by mail test results. A common sight at many physicians’ office visit was a wall of patient files containing just this kind of details, all alphabetized and marked with little colored tabs. However, to younger visitors and what will certainly be the case for your children, this program of handling your medical care information will look like it belongs in a museum. In a world where you can do everything from book, to pay your takes and even call a cab online, the idea of depending on document records to arrange important elements of your medical care and also one of the biggest sectors in the United States seems ancient.

For decades now, medical care service suppliers have discussed the move from paper-based medical care information. Today, electronic medical care record techniques are finally becoming more popular. This is a pattern that has been growing over the past 10 years but that has significantly extended since 2009, when President Obama released the “Health Information Technology for Economic and Clinical Health Act”, an incentive program to motivate medical care centers and patient care suppliers to look at digital medical care information. To date, the stimulation bundle has provided immeasurable dollars to over one hundred thousand qualified medical care centers and qualified patient care suppliers who have confirmed adopting, called “meaningful use,” of qualified EHR technology. Improvement is being made, for example, a report by the Robert Wood Johnson Foundation found that the number of medical care centers using some kind of EMR has tripled in the last three years, bringing the total utilization up to 44 percent of US medical care centers.

The conversion away from paper-based methods to digital medical care information, however, has not been easy, or quick. Part of the problem has less to do with technology and more to do with culture. Applying an EMR program means that patient care suppliers and other medical center staff have to go about their work in a different way than in a paper-based environment. Applying an EMR invariably has an effect on clinical process since a new part is being added between the patient and doctor and how the doctor is documenting the individual’s information and developing a plan of proper care.

Patient Care and Staff Recognition

All staff, from administrators to porters, needs to experience recognition, thanks and support for the work they do. Yet far too few organizations truly pay attention to their staff or acknowledge the significance of their experience. Even less act upon what they hear to make staff feel it is worth speaking out, worth raising their head above the parapet to state that employment levels are risky or that they are being harassed. We need to pay attention to staff better and act upon what they say if we want them to feel respected, remain in their selected career and provide sympathetic patient care.

The majority of people get into professional doctor and nurse education and learning inspired by principles and a sense of altruism, at least originally, but these features can become worn away eventually by the requirements of the program and the job. There are particular difficulties associated with working with, and directly caring for, sufferers or patient care in other words. We ask them to do this all day, every day, in a fast moving atmosphere where they often feel unrecognized and in need of support and where some will encounter great stress and feel burnt out. It is little wonder that some units have problems with staff revenues and recruiting.

The patient care work has found that sympathetic high ideals and principles, held dear by graduating learners, can become discontinued and mashed, with nursing staff confirming some degree of burn out within two years of certification. Across all staff groups, the requirements of patient care work mean that cynicism can develop and staff can become less understanding and more distant from their sufferers. It is therefore crucial to secure staff from the problems of patient care work. Everyone needs support and restoration.

Strategies For Patient-Centered Care

Nearly 200 medical professionals from around the state gathered in Manchester to share their communities’ techniques to providing Vermonters with high-quality, patient-centered medical care. “With all the state and federal policy changes ongoing, medical service suppliers remain targeted on why we are so deeply engaged in this work, to create lasting improvements in patient care and community wellness,” says Bea Grause, President and CEO of the Vermont Association of Hospitals and Health Systems (VAHHS).

The conference provided an opportunity for members to understand about colleagues’ experiences with new techniques to clinical care, finance and governance issues. The meeting’s centerpiece was a “town hall” session in which members shared ideas and strategies medical service suppliers are employing to ensure Vermonters receive high-quality medical care. The session also targeted on giving sufferers and families a voice in their care. “Patients want authentic engagement in care choices,” says Ben Chu, Board Chair of the American Hospital Association. “It’s exciting to understand about the efforts ongoing in Vermont that will interact with sufferers in a way that educates them about their options and respects their needs and values.”

The VAHHS Annual Meeting took place during a time of rapid and significant changes. Medical centers and other suppliers around the state are developing OneCare Vermont, a provider network established to eliminate unnecessary care, use resources wisely and interact with sufferers in their wellness and fitness. In October, many individuals and small companies will begin purchasing health insurance coverage through Vermont Health Connect, the state’s new online health insurance coverage market. The state is also beginning work on a federally-funded State Innovation Model (SIM) project to test new patient care delivery and payment models. “Vermont continues to lead on medical care reform,” says Raymond Hurd, Regional Administrator for the Centers for Medicare & Medicaid Services (CMS). “We are excited that Vermont is using an innovation model as another way to improve high quality of patient care and individual experience while lowering the cost of medical care for its citizens.”