At MGH the decline was 87.6% in 1988 to 78.4% in 1993 as well. Because of their high medical cost and lack of primary care physicians, 30% of the hospitals revenues were at risk, giving the opportunity to other hospitals to provide these services and create price competition based on Chapter 495. The reduction of gross patient service revenue at MGH and BWH were affected by the changes in government programs such as Medicare, Medicaid and the enactment of chapter 495. These programs along with many insurance companies adopted the Prospective Payment System (PPS) which began monitoring hospital charges and refusing payment for unnecessary services. The hospitals were receiving a standardized payment for each service
Fall Risks and Prevention Strategies Fall Risks and Prevention Strategies Falls are a problem for most of the elderly population in the home, acute care setting, and long term care setting. According to the Centers for Disease Control and Prevention (CDC;2013), there is one out of three people over the age of 65 who have fallen and suffered serious injuries and even death. This has become a problem for patients, families, and healthcare facilities that can be prevented through education and awareness of surroundings. Falls can be devastating to patients due to increased hospital stay and decreased mobility. The purpose of this paper is to discuss data associated with falls, and identify risks and prevention strategies.
ARF affects 1% of patients on admission to the hospital (Nursing, 2011). Acute renal failure generally has four stages: onset, oliguric, diuretic, and convalescent. Treatment depends on the stage and severity of renal compromise. ARF can be divided into three major classifications, depending on site. One site being prerenal failure is caused by interference with renal perfusion, manifested by decreased glomerular filtration rate.
The third and final stage is compassion fatigue. If a nurse reaches this stage it is likely according to Coetzee, that he or she may never fully recover their ability to nurture. This paper will focus on five concepts of compassion fatigue; including warning signs, causes, physical, emotional, and spiritual needs, and coping strategies and resources for those combating compassion fatigue. The first concept that this writer will focus on is burnout. According to a study published in Nurse Leadership in September 2006, an estimated 58 percent of nurses and 54 percent of nurse managers suffer from some level of burnout.
Press Ganey Associates Inc., is an in-based patient satisfaction and quality firm that over 75% of hospitals use today to measure patient satisfaction ratings (Convery, 2008). Hospital Consumer Assessment of Healthcare Providers (HCAHPS) is another patient survey hospitals use to determine satisfaction scores. Many hospitals are now using the value based purchasing which will determine payment to the hospital according to patient satisfaction, which is another reason for hospitals to have good scores. Patients whose expectations are met will be more likely to participate in treatment and care practices, will give a more positive opinion of the hospital to family and friends, and are more likely to choose that particular hospital for future care needs. There is a strong competition among healthcare institutions.
A classic example of this is the “Neary” case. Dr. Michael Neary had been a well respected and distinguished consultant obstetrician and gynaecologist at Our Lady’s hospital in Drogheda. He was struck off the medical register as it came to light of his practices in the hospital. Neary was performing an abnormal amount of postpartum hysterectomies usually after a caesarean section. 188 hysterectomies were said to have been carried out by Neary and his colleagues between the years 1973 and 1998.
Vulnerable Population in the Workplace Linae Hicks NUR/440 June 27, 2011 Sheila Vulnerable Population in the Workplace The purpose of this paper is to identify barriers in the workplace to understanding vulnerable populations and affecting the disparity in promoting health care delivery. This paper will focus on the American Indians as a vulnerable population. “The American Indian and Alaska Nativepeople have long experienced lower health status when compared with other Americans” [ (IHS Fact Sheets, n.d) ]. A lower life expectancy is noted in the Native American population, it is 5.2 years less than the U.S. all races population [ (IHS Fact Sheets, n.d) ]They experience an elevated death rate in tuberculosis (500%), alcoholism (514%), diabetes (177%), unintentional injuries (140%), homicide (92%), and suicide (82%) According to Indian Health Service (IHS), Indian health services are provided in over 670 IHS and tribal health care facilities in 36 states, most of these are in rural and isolated areas. Many of these facilities are overcrowded, in need of expansion or replacement.
Medication errors performed by health care professionals are the most common type of injury resulting in patient harm and death. According to "U.S. Food And Drug Administration" (2014), a medication error is "any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer (para. 1). This paper further discusses a critical regulatory issue in health care relating to a case law, which sent a pharmacist to jail for a medication error that led to the death of a child. In February 2006, Emily Jerry, a two-year old child was at a Cleveland hospital to complete her last series of chemotherapy treatment.
The third article focuses on a case study in which an elderly woman was abused and no proper investigation was completed within a nursing home setting. Analysis and conclusion of the research will be provided at the end of the paper. Problem Identification Identifying elder abuse within a long term care setting can be difficult. Nursing home residents often have poor safety awareness and a high rate of falls and related injuries. (Lachs & Boyer, 2002) It is sometimes hard to determine if a fracture or bruise comes from an unpreventable incident in a confused elder or if it came from abuse or negligence.
Orthostatic hypertension, increased workload, and thrombus formation contend as the three main players in the loss of cardiac function. (American Journal of Nursing, 1967, p. 781-782) “Like other muscles, the heart undergoes disuse atrophy when patients become inactive” (Corcoran, 1991 p. 537). Due to this issue, complications arise. Both articles state after three weeks, the poor effects on the