When the CNA ambulated the patient to the bathroom the family noticed a reddened area to the patients back and due to the lack of education of the CNA, this was not taken seriously. If the RN was assisting the patient, a skin assessment should have been done and prevention processes put in place to prevent any further breakdown. The condition of the patient’s skin at the time the patient was ambulated to the bathroom should have been documented and escalated to the provider. This would have been a Hospital Acquired Pressure Ulcer (HAPU) and is reported to the state as well as affects hospital reimbursement. Data collection is important to monitor the ongoing quality of patient care (American Nurses Association, et all, 1999).
Patients should not have to wait 4 to 5 hours to receive treatment, see a doctor or have any test performed on them, unless there is an extremely valid issue. It shows a lack of courtesy, disorganization and insensitivity to the patient’s need and care. This institution is continuously striving to achieve better results with patient wait times by implementing various methods that can improve the overall quality of care delivered to patients and improving patient satisfaction. Three methods for integrating quality improvement strategies into performance measurements are patient stimulated quality, data driven and process oriented. Patients should always be the focus of an organization’s quality improvement strategy.
Research has shown that this can result in a decrease in quality of care and patient safety and increase adverse patient events (Tevington, 2011). However, some criticize this research because it does not show a direct link between nurse staffing levels and individual patient outcomes (Needleman, Buerhaus, Pankratz, Leibson, & Stevens, 2011). This paper will investigate if inadequate nurse staffing levels have a negative impact on patient outcomes on adult inpatient acute care hospital units? Adequate Versus Inadequate Nurse Staffing The American Nurses Association (ANA) defines adequate nurse staffing as an appropriate match between the nurse’s skill level and the needs of the patient ( American Nurses Association, 2012). To achieve adequate nurse staffing, it is known that balance must be achieved by properly staffing the unit with the appropriate number and correct mix of nurses to adequately care for the unit’s patient population (Sanford, 2010).
It can affect staffing ratios, quality of equipment and many other things we really don’t stop to think about. It affects what kind of patients we can treat and how long they can stay in the hospital. This affects nurses because we are the ones that have to explain to a patient why they are being discharged when they still have an infection and still need IV antibiotics to go home on but their insurance doesn’t cover for any homehealth agency to come and do infusions and we have to teach family with no medical experience how to do this. This can be very bothersome to some nurses and this is just one brief issue I am bringing up. Other political factors could be education and how we are in such a shortage of nursing but nursing school is so expensive and getting funding to send individuals to school and for the schools to have the funding to create competent nurses.
A minor disagreement can escalate quickly and, without resolution; could cause a divide in the team’s efforts to collaborate on medical necessities. Having a mentor who is trained in conflict resolution would identify the signs of conflict immediately to address the issue before personal feelings become involved. For example, a nurse reports to the Director of Nursing for an assignment, and is given the order to report to pediatrics. However, this nurse has no familiarity in this department, so she quickly becomes emotional. A mentor observing these happenings could provide solace to her, and ensure that the Director of Nursing was only unaware of her skill set and would gladly provide another assignment if informed.
This is to ensure that the patient is around people they know which boosts the rate of recovery. It has been proved that having someone who cares a lot about you in recovery helps improve the rate. In Esmin’s case, she had no one to help her seek for help and that gave the caregivers leeway to become negligent and this cost her life. If the caregivers had insisted for a family member to be present on regular basis, the doctors and nurses would have been alerted of the situation and maybe she would have survived. Lastly but not least, the code of conduct adopted should be one that focuses on the safety in areas as well competencies of the caregivers.
Skin breakdown can be prevented by turning Mr. J every 2 hours and by propping with pillows side to side. Skin assessments should be preformed frequently on this patient to assess for breakdown. Patients with dementia may not be able to verbalize pain. When the daughter observed the redness, it should have been reported to the nurse in charge. Most CNA’s do not have the knowledge to assess the skin breakdown to know the proper treatment plan.
This in turn only supports CT colonography as a better screening choice for colorectal cancer. The cons listed are bowel preparation for the patient prior to a colonoscopy is considered too harsh and can lead to other health problems, i.e. dehydration, electrolyte imbalance, cardiac irregularity. The evaluation of 49 studies showed positive patient outcomes with the use of CT colonography; however did not go further to mention if any future diagnostic testing was necessary. This is very important information for nurses to pass on to their patients informing them they should always ask more questions.
Using the ER for primary care is inappropriate states the president of the American Academy of Nurse Practitioners. The ER is obligated legally to treat all patients; health care providers eventually find ways to pass on the cost for treating the patients who are not insured to other patients such as to those who pay their medical expenses out of pocket. Technology is a major contributing fact to the growth of health care spending. Cutting fees will change a lot in health care spending but could be a negative on certain aspects and make all previous matters to be disregarded. Although a high value is often placed on the quality of nursing care, the skill of the physician, or the use of new medical technology, none of this matters much if the care is provided to the wrong person or at the wrong time.
There are good nursing homes, and there are some elderly that need them. Another thing that the article mentions is how some senior citizens need regular monitoring due to their conditions that assisted living can not provide. The writer states that “those whose use of blood thinners involves regular testing to adjust the dosage. Assisted living doesn’t provide much health care, so residents risk becoming ‘frequent fliers’ — they’re going in and out of hospitals for conditions that could perhaps be treated in a nursing home.” The main purpose of assisted living is to reduce clients from going in and out of hospitals. If professionals that are involved in assisting the elderly cannot fulfill that need of providing health care, then the best thing for the senior citizens is to place them in a nursing home.