...Patient-Centered Care Delivery Model, a Multidisciplinary Team Approach NR532 Healthcare Operational Planning and Management Patient-Centered Care Delivery Model, a Multidisciplinary Team Approach Increased emphasis from the Institute Of Medicine (IOM) and the Patient Protection and Affordable Care Act (PPACA) on improving quality, safety and reducing care cost has brought forth challenges among hospital executives (Cama, 2009). Nurse executives must develop low cost, innovative and effective ways to deliver patient care. The focus of this manuscript is to develop and implement a care delivery model emphasized in a patient-centered care delivery model using multidisciplinary team approach. Patient-centered Care Delivery Model According to the Institute of Health Improvement (IHI), “patient-centered family care is care through a patient’s experience that is coordinated, informed and grounded in respectful interactions with providers that are consistent with the patient’s values, expectations and care decisions” (Balik, 2011). Evidence-based practice has drastically increased this past decade with one of its cornerstones being “patient-centered care and nursing being at the frontline to lead this change. Professional nurses are prepared to effectively lead the healthcare team to achieve patient and organizational goals. Patients are unique in every facet of their needs and therefor multiple disciplines are critical to best deliver patient-centered outcome (Cama, 2009)...
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...Task 1 Nursing-sensitive Indicators Nursing- sensitive indicators are defined as those outcomes that improve in the presence of greater quantity(higher staffing ratios) or quality(educational levels and competence of nursing staff) of nursing care (www.nursingworld.org). These nursing-sensitive measures help healthcare organizations to analyze the quality and quantity of nursing care services. (www.americansentinel.edu )Nursing sensitive-indicators (NSIs) are characterized by measures that are in the realm of nurses to improve and control. According to the website www.nursingworld.org , in 1998, the National Database of Nursing Quality Indicators was established by the ANA so that nurses would have a national benchmark to reach they can compare the outcomes. This has given the profession of nursing a solid core of benchmark capital nursing sensitive indicators that are totally nursing care dependent. This database provides benchmark performance with which the individual healthcare institution can compare its performance to similar institutions across the nation. These nursing sensitive indicators result in patient outcomes that are influenced by nursing care decisions and actions. Research has indicated that patient outcomes improve, complications and mortality are reduced, costs can be reduced, and patient and professional nurse satisfaction can be enhanced with strong performance on nursing-sensitive indicators. These patient outcomes may not because the nursing but is associated...
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...Nursing is a widely respected and greatly needed occupation in our country today. Healthcare is constantly growing and evolving. Registered Nurses are a vital part of the existence of all communities. Nurses are required not only at inpatient hospital settings, but in schools, offices, community health settings, nursing homes, administration, and the list goes on! Despite both baccalaureate and associate prepared nurses taking the same board exam to practice nursing, educational advancement can contribute to the care of patients in all of these settings and aide in a more optimal outcome. The bachelors- prepared programs educate students on all the same topics as an associate- prepared program does. However BSN programs teach in further depth and promote professional growth. The difference in quality of patient care between the two degrees may not easily be observed to the clientele. However, much research proves that there is a correlation in patient outcome and the level of nursing education. One example of differing in the outcome of patient care is education. Promoting wellness and educating against disease and illness is an integral part of the nursing field. The baccalaureate- degree nurse is further prepared to promote wellness within communities and targeted populations. By individualizing a plan of care with interventions such as screenings, education and immunizations, a nurse can aid in the prevention of increased diseases and conditions (Sept., 2014). In order to...
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...culture of an organization involving their beliefs, values, theories, and systems for nursing practice. A PPM outlines the elements of nursing practice in a way that brings meaning and significance to our daily work. Reinforcing the relationship between nurses and patients is the primary goal of a PPM. The Magnet Model provides a framework to achieve excellence in nursing practice and serves as a road map for organizations seeking Magnet recognition (American Nurses’ Credentialing Center website, 2015, para. 1). What is a Magnet Hospital? The American Nurses’ Credentialing Center (ANCC), which is an affiliate of the American Nurses Association (ANA), recognizes hospitals that comply with standards intended to assess the quality and strength of their nursing. These hospitals are known as Magnet hospitals. By achieving Magnet status, a hospital is affirmed to be one with a high level of job satisfaction, a low staff nurse turnover rate, and proper grievance resolution. There is also a great emphasis placed on staff nursing involvement in data collection and decision-making in patient care delivery. Nurse leaders are encouraged to value clinical feedback from staff nurses to help establish and advance researched-based nursing practices. Magnet hospitals are expected to obtain best patient outcomes by establishing appropriate personnel mixes and fostering a culture of open communication between all members of the health care team. What is the Magnet Model? The Magnet...
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...Transforming Nursing and Healthcare Through Information Technology Instructor: Dr. Wagner March 27, 2016 Using the Data/Information/Knowledge/Wisdom Continuum Introduction Many organizations now have clinical documentation improvement programs (CDIs) designed to help an organization accurately reflect the quality of patient care, prove healthcare services, and make accurate reports of diagnosis and procedures (Cassano, 2014). A Clinical Documentation Specialist (CDS) is a registered nurse who manages, assesses, and reviews a patient’s medical records to ensure that all the information documented reflects the patient’s severity of illness, risk of mortality, clinical treatment, and the accuracy of documentation. Part of the role is to perform concurrent reviews of medical records, validate diagnosis codes, identify missing diagnosis, and query physicians and other healthcare providers for more specifics so documentation accurately reflects the patient’s severity of illness (Cassano, 2014). Health Information Management (HIM) professionals advocate for a strong commitment to accurate and timely clinical documentation as hospital initiatives push forward with programs such as ICD-10-CM/PCS implementation, Accountable Care Organizations reimbursement models, Fraud and Abuse compliance programs, and implementation of electronic health records (EHRs) (AMIHA, 2010). HIM professionals also impact CDI programs by providing education regarding compliant documentation to physicians...
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...Politics, Legislation, and Implications to Patient Care Abstract There are constant changes to laws and legislation regarding patient care and safety. The purpose of this report is to inform the reader of recent and upcoming changes to legislation that may affect nursing care of patients. Research by L. Aiken, et al. and A. Tourangeau, support the need for higher education of registered nurses. Their research proves that patient outcomes are improved when registered nurses carry a bachelor’s degree in nursing. Research conducted by J. Needleman, et al., concluded that reducing the nurse-patient ratio resulted in the patient being at less risk for developing hospital-acquired illnesses as well as a reduced risk of inpatient mortality. The reader will also be informed about the Joint Commission’s protocol for reducing the occurrence of wrong-patient, wrong-site, and wrong-procedure during surgical procedures. Politics, Legislation, and Implications to Patient Care As the American population ages, healthcare and its resources are in greater demand. As the demand for healthcare increases, the topic of patient safety has become increasingly important. Laws and legislation regarding patient care are changing almost constantly to maintain patient safety while still providing comprehensive patient care. This report will focus on informing the reader of recent and upcoming legislation regarding patient care, what has brought those changes about, and the effects it can...
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...Running head: HEALTH PROMOTION COMPARISON 1 Comparison of the Three Levels of Health Promotion Queeny M. Carmouche Grand Canyon University: NRS-429V-0102 January 19, 2014 Comparison of the Three Levels in Health Promotion in Nursing Practice Health promotion and disease prevention are appropriate for everyone. High-quality health promotion and disease deterrence can slow disease process, improve one’s ability to live independently and lead an active life, even with people with major health issues. During the 1970’s the concern about the physician shortage lead to the expansion of education in the health profession. Health care professionals are at the core of health promotion by engaging in the educational process with the patient. Health promotion and prevention are what will lead the individual to an improved quality of life. Making healthy choices towards health care will impact lives dramatically. The goals for Healthy People 2020 are “1) eliminate preventative disease, disability, injury and premature death; 2) achieve health equity and eliminate health disparities; 3) create social and physical environments that promote good health for all; and 4) promote healthy development and healthy behavior at every stage of life.” (Healthy People, 2010). Goals set in Healthy People 2020 are an attempt to create a paradigm shift from traditional care of treating illness to preventative care. Definition of Health Promotion Health promotion...
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...Comparison of the Three Levels of Health Promotion Queeny M. Carmouche Grand Canyon University: NRS-429V-0102 January 19, 2014 Comparison of the Three Levels in Health Promotion in Nursing Practice Health promotion and disease prevention are appropriate for everyone. High-quality health promotion and disease deterrence can slow disease process, improve one’s ability to live independently and lead an active life, even with people with major health issues. During the 1970’s the concern about the physician shortage lead to the expansion of education in the health profession. Health care professionals are at the core of health promotion by engaging in the educational process with the patient. Health promotion and prevention are what will lead the individual to an improved quality of life. Making healthy choices towards health care will impact lives dramatically. The goals for Healthy People 2020 are “1) eliminate preventative disease, disability, injury and premature death; 2) achieve health equity and eliminate health disparities; 3) create social and physical environments that promote good health for all; and 4) promote healthy development and healthy behavior at every stage of life.” (Healthy People, 2010). Goals set in Healthy People 2020 are an attempt to create a paradigm shift from traditional care of treating illness to preventative care. Definition of Health Promotion Health promotion can be defined as “a process of enabling people to increase control over their...
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...effect on quality of patient care? This study addresses the topic of nurse staffing, which includes nurses (RN and LPN) and nurse’s aides. Research in Action: Agency for Healthcare Research and Quality (AHRQ) presents the study “Hospital Nurse Staffing and Quality of Care”. Nurse staffing is measured in one of two ways: nursing hours per patient day and nurse to patent ratio (Stanton, 2004). The article looks at periods of high vacancy rates, assesses the patients needs, the development of care plans and administration of medications and treatments in factoring the quality of care. It shows the effect lower staffing levels and its direct link to higher adverse outcome rates. The study of staffing and quality of care is essential, to link the two together, and prove that the issue needs to be addressed in all forums of nursing. The way to making improvements in nurse staffing is to present documentation/research that supports the issue at hand. With factual information, ways to improve the problem can be formed. Higher levels of nurse staffing at all levels showed a 2-25% reduction in adverse patient outcomes. In order to improve the quality and delivery of health care staffing needs to be addressed, and by performing research in this area, it offers evidence based information. Review of Literature Lower levels of staffing are associated with adverse outcomes. Patients are requiring a higher acuity of care, but the skill levels of nursing have declined and...
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...on Breast Care Christina Reid-Brown California Baptist University Foundations of Management BUS 503A February 9, 2015 Dr. Marc Weinger Abstract This research paper evaluated the relationship between navigation and navigator roles as they relate to the patient journey with breast cancer. The goal of the research was to determine if these care coordination models eliminated institutional barriers experienced by patients trying to coordinate breast care in a complex healthcare system. It also evaluated the effectiveness of the navigator role as it supports the elimination of barriers to care for minorities and women living in low-income and underserved communities. This study reviewed the results from surveys given to women being treated for breast cancer at different hospitals, and cancer clinics to determine if navigation improves patient access to appropriate evidence-based healthcare. The findings showed higher patient satisfaction and compliance, continuity of care, decreased anxiety levels, and increased social support systems from families and friends when navigation services were provided. Key Words: Patient Navigator; Breast Care Coordinator; Breast Care Patient Navigator; Breast Cancer in Women; Current Studies involving Breast Cancer Introduction Breast cancer is the second leading cause of death and the most common disease found in women living in the United States (Basu...
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...The High Cost of Horizontal Violence in Nursing Paisley Rojo Gen 200 July 21, 2015 Dr. Davidov The High Cost of Horizontal Violence In nursing, there is a growing concern called, horizontal violence. Horizontal violence is an act of aggression from one nurse to the other. Horizontal violence impedes teamwork, hinders patient care and causes a negative work environment (Becher & visovsky, 2012). Even though workplace politics exists in every profession, the effects of horizontal violence, or bullying, in nursing is a costly behavior. Nurses feel devalued in the workplace and experience psychological effects. Patients are likely to experience less favorable outcomes, and retention is difficult costing facilities large amounts of money to recruit and hire replacements. Types of violence Horizontal violence is physical and or verbal behavior that is believed by the recipient, to be degrading, threatening and considered inappropriate (Bartholomew, 2014). According to Doyle (2001), there are several ways to undermine one's dignity in the workplace. This list includes: humiliating and intimidating the victim, verbally assaulting, and implying threats. Intruding on co-workers, and stalking the targeted person, is another form of horizontal violence. Moreover, repeatedly imposing deadlines and tasks that are unfavorable or impossible is also considered as a form of workplace bullying. Dellasega (2009), states that the participants, willing...
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...is to explore an acute deterioration in the health of an adult I have encountered during a clinical placement, in an acute care setting. The essay will begin with a definition of acute care, followed by the introduction of my patient and predisposing factors. This essay will include an explanation of the significant pathophysiological changes and related clinical manifestations and a critical analysis of the nursing interventions implemented during the acute episode of care, focusing on holistic care, rationale and evidence base. It will then describe the actual deterioration in the patient’s condition, and discuss the nurse’s role in the recognition and assessment of the actual deteriorating condition following the trusts policies. Assessment tools, monitoring, detecting and reporting will be considered. Finally this essay will include a discussion of the importance of multidisciplinary team collaboration in the diagnosis and provision of care during the acute episode, and a discussion on whether the deterioration could have been prevented by identifying any areas of practice which could change in relation to evidence based practice. For the purposes of privacy and confidentiality, in accordance with NMC (2008) code of conduct, the name of the patient will be changed to Peter and the placement area will remain as an acute care setting. According to McFerran (2008) the term “acute” is described as a disease of rapid onset, severe symptoms, and brief duration. Acute Care refers...
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...Healthcare-Associated Infections (HAI), and 99,000 HAI- associated deaths in the hospital. The report stated that the four largest categories of HAI, responsible for more than 80% of all reported HAI, are central line-associated bloodstream infections (CLABSI, 14%), ventilator-associated pneumonia (VAP, 15%), surgical site infections (SSI, 22%), and catheter-associated urinary tract infections (CAUTI, 32%). HAI are a great financial costs to health care facilities. The Centers for disease Control and Prevention (CDC) estimates the medical cost of HAI in the U.S. hospitals as $6.65 billion in 2007, and that number has increased to almost $10 billion a year currently. Statement and Significance of the Problem One in 20 patients who are admitted to a hospital will be a victim to an infectious agent they are exposed to during their hospitalization according to the Centers for Disease Control (CDC) (Goodman, Brenda, 201, Hospital-Acquired Infections cost $10 Billion a year). The five most common infections are surgical site infections, infections associated with the use of devices like central lines, catheters, ventilators and clostridium dificile are costing the health care System in the USA almost $10 billion a year to treat. In the article Vitamin D has the potential to reduce the risk of Hospital-Acquired Infections, the writer stated that HAI is the leading cause of death in the USA with an overall estimated annual incidence of 1.7 million cases and 100,000...
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...Synthesis of Bariatric Surgery and the Effects on Comorbidities Abstract This synthesis of literature provides a summary of the data that has been collected over the years through experimentation, literature reviews, qualitative research, and the results that have been construed from that data will be presented. It discusses the concept of the effects of bariatric surgery and answers the question - do people who have the surgery have better health outcomes, specifically with hypertension and type II diabetes mellitus, than those who do not? A summary of research reveals that there is a significant reduction and/or total remission of both of these co-morbidities that were often life long. Other benefits, such as quality of life, social standings, and healthcare cost reduction are examined and positively reported. Review of current data to include strengths and weaknesses, conceptual frameworks, and the current state of knowledge reveal that bariatric procedures have shown the efficacy and safety in the treatment of morbid obesity and have gained wider acceptance in the medical world. Synthesis of Bariatric Surgery and the Effects on Comorbidities For years people have turned to diets in an effort to lose weight and get healthier. At no time has that been more the case than in America today. People spend billions of dollars a year trying to lose weight and the numbers are not encouraging. The prevalence in obesity with related Type...
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...third year student nurse, will be incorporated and collaborative team working addressed. The Department of health (2002) describes discharge planning as a pathway used to decide patient needs, for a smooth move from one level of care to another (Hunt 1996) and is the process through which patient’s needs are identified and plans are written, facilitating continuity of health care (Jackson 1994). According to the department of health (2000) discharge planning illustrates well, the role of the nurse within the inter-professional team the balance between goals set, care delivered and evaluation of care from a nurse and team perspective. Nurse involvement is considered integral and, aims to provide effective discharge plans (Department of Health 2000). The Royal College of Nursing (RCN 2002) supports the concept of nurses taking the lead and recommends the development of nurse led protocols in discharge planning. However the NMC (2004) highlights the importance of nurses being able to integrate within the team, seeking advice and sharing knowledge where appropriate. Effective and ineffective communication will be addressed, using the Victoria Climbie Report (Laming 2003) to highlight poor team communication. Effective discharge planning seeks to maintain the benefits of rehabilitation after the patient has been discharged from hospital (Department of Health 2003)....
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