Showing posts with label hospital policies. Show all posts
Showing posts with label hospital policies. Show all posts

Friday, February 18, 2011

Released hospital patients' many unhappy returns

Patients who are released from the hospital too early or without proper planning and instructions often wind up back in the hospital after a few days, a problem that's costly to taxpayers and distressing to patients.

A study released today calculated that reducing hospital stays by a single day for Medicare and Medi-Cal patients in California adds up to $227 million a year.

An estimated 81,000 Medicare patients in California - or 20 percent - end up back in the hospital within 30 days of being discharged for some reason related to the same condition, the study found.

"Right now, when you go to the hospital, it's the do-it-yourself model. It's up to you to figure out what to do," said David Grant, author of the study for the California Discharge Planning Collaborative, a group of labor, senior and other advocacy organizations.

Patients, especially those who are elderly and lack social support, are often readmitted because they don't understand their discharge instructions, fail to take their medications or have complications that they can't handle.

Click on the "via" link for the rest of the article.

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Thursday, January 13, 2011

CMS 30-minute rule for drug administration needs revision, ISMP.org

In our June 17, 2010 newsletter, we covered a precarious topic best known as the “30-minute rule”—a requirement in the Centers for Medicare & Medicaid Services (CMS) Conditions of Participation Interpretive Guidelines to administer scheduled medications within 30 minutes before or after the scheduled time (see pages 174-175 at: www.cms.gov/manuals/Downloads/som107ap_a_hospitals.pdf). In our July 2010 nursing newsletter, Nurse Advise-ERR, we asked frontline nurses who are most directly affected by the 30-minute rule to weigh in on the issue by completing a short survey. And WOW, did they ever! More than 17,500 nurses responded to our survey, providing more than 8,000 additional comments (see Table 1 on page 2 of the PDF version of the newsletter), making it very clear that the issue is of great significance to nurses.

Respondent profile and compliance rates
Almost half of the responding nurses work on medical/surgical units, and the other half work in critical care, telemetry, or specialty inpatient units. Most nurses feel that the 30-minute rule is unsafe, unrealistic, impractical, and virtually impossible to follow. Approximately three out of four respondents (70%) told us their organization enforces such a policy. Of these nurses, only five of every 100 (5%) were always able to comply with the policy, while more than half (59%) were infrequently or only sometimes compliant (see Graph 1 on page 6 of the PDF version of the newsletter). Why nurses find it difficult to comply with the 30-minute rule was expressed by many (see Table 2 on page 3 of the PDF version of the newsletter), including a nurse who sent a pragmatic yet eloquent account of a Day in the Life of a Nurse (see Sidebar that follows this article). 

Click on the link above to read the full article:

See also http://www.nursefriendly.com/addictions

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Andrew Lopez, RN
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38 Tattersall Drive, Mantua New Jersey 08051
http://www.nursefriendly.com info@nursefriendly.com ICQ #6116137
856-415-9617, (fax) 415-9618

150,000 + Nurse-Reviewed & Approved Nursing Links

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http://www.nursingexperts.com

Sunday, December 5, 2010

Hospitals should not ban access to social media

by Howard Luks, MD

“Instead of focusing on treating him, an employee said, St. Mary nurses and other hospital staff did the unthinkable: They snapped photos of the dying man and posted them on Facebook.”

What can you say about an article like this? I bet there is not a single physician or nurse who are not reasonably conversant about the basic tenets of the health care privacy laws under which they practice.

Stupid is as stupid does. Perhaps more appropriately, stupidity is demonstrated by the actions of the one — or in the case, the many.

It still amazes me that people do not realize what the implication of hitting the “Enter” or “Post” or “Like” button is in our connected global society. In the health care space it is obvious that there are still a handful of doctors, nurses, orderlies, and ancillary providers who still don’t get it.

But what should an institution’s policy be? Ban access on the network? Perhaps naive, but my answer to that is a resounding no. Most people still have smart phones with WiFi or 3G access and can just as easily post to Facebook or Twitter and I doubt that the hospital’s liability is diminished.

Hospitals need to embrace social media, develop a comprehensive social media engagement policy, educate their staff, set acceptable parameters, track or monitor usage, remain vigilant and continue with the education process in perpetuity as social media is fluid and evolving and changing everyday.

Education, clarity, transparency and engagement is the key.  Not banning access.

Howard Luks is an orthopedic surgeon who blogs at The Orthopedic Posterous.

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******************************************************

Sincerely,

Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
http://www.nursefriendly.com info@nursefriendly.com ICQ #6116137
856-415-9617, (fax) 415-9618