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Health care industry supply and demand
About supply and demand in the healthcare industry
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Creating a Flow Chart: Bradycardia
Today’s healthcare environment is facing tremendous challenges in order to ensure safe, quality care, while simultaneously providing affordable care that is still able to produce revenue. With continuously escalating healthcare demands emerging from the population, healthcare providers and professionals have no choice but to accept these challenges and put forth the best possible approach to meet these demands involving patient care. New ideas for managing tests, medications, procedures, orders and delivery of care must continuously be considered by the healthcare organizations to ensure that the care they provide is appropriate, safe, efficient and cost effective. Periodically providers run into trouble by ordering unnecessary or duplicated tests and/or medication errors, which cause delays in care and have the potential of diminishing patient outcome. In these cases, an ongoing workflow process is essential to ensure that patients receive the best possible care and generate greater outcomes for both patient and the provider.
Incorporation of workflows in the clinical setting is necessary to facilitate effective implementation of information technology. Workflows are a process of showing how tasks are done, in what order and by whom. “Workflow analysis aims to determine workflow patterns that maximize the effective use of resources and minimize activities that do not add value” (Walden University Course Material, 2014).
The following is a demonstration of the workflow process for ICU patients that present with bradycardia. Analysis and recommendations for this workflow process will be discussed in this assignment.
Sample of Bradycardia Workflow Chart
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...ensure effective implementation of information technology. A workflow is a process of showing how tasks are done, in what order, by whom and can be used in the technology system. By evaluating a bradycardia workflow chart, one is able to simply visualize the process framework to assist one in managing the condition of a deteriorating bradycardic patient in timely and effective manner.
References
McLachlan, C. S., Ocsan, R., Spence, I., Hambly, B., Matthews, S., Wang, L., & Jelinek, H. F. (2010, October). Increased total heart rate variability and enhanced cardiac vagal autonomic activity in healthy humans with sinus bradycardia. Baylor University Medical Center Proceedings, 23, 368-370. Retrieved from http://www.waldenu.edu
Swift, J. (2013, January 30). Assessment and treatment of patients with acute unstable bradycardia. Nursing Standard, 27, 48-56.
During the 1980’s and 90’s there were many studies done that showed that medical errors were occurring in inpatient and outpatient settings at a very high rate. Computer Provider Order Entry (CPOE) systems were designed to reduce or eliminate mistakes made by using hand written orders. The CPOE system allows users to directly enter their orders into the system on computers which are then sent directly to the healthcare providers that will be implementing the orders. Previously orders were placed by writing on order sheets on patient charts. This was sometimes done by the doctor or by a nurse acting on behalf of the doctor. Order sheets were then signed by the doctor and then the information was input into the patient’s record. This left room for error due to misreading bad handwriting, confusing medications with similar names, etc.
Springfield General Hospital (SGH) is committed to high quality healthcare for patients, and providing tools to support physicians, nurses and pharmacists. SGH leadership approved the computerized physician order entry (CPOE) system as a solution to reduce prescription errors, and the results of the CPOE project are disappointing. The data show increased prescribing errors after implementing the CPOE; resulting in increased costs for adverse drug events, rather than the planned cost reduction (Spector, 2013). This change management plan provides the SGH board of directors and executive management team pragmatic steps to increase quality for patients by assessing the root issue of hospital
Analyzing Workflow for a Health IT Implementation by Lydia Washington, is a short shifted scenario published January 1, 2008 The inability to integrate electronic health records (EHRs) into clinician workflow is a well-documented barrier to implementing EHR systems. To address this problem, organizations must analyze their workflow processes before implementing an EHR system. Optimal workflow requires having the right information at the right time so that the individual performing a step or task can advance the process toward completion. To achieve optimal workflow, organizations must take a step back and analyze the flow of work.
According to Accuracy at Every Step: The Challenge of Medication Reconciliation (n.d.), the most challenge is called medication reconciliation, which is a formal steps of gathering information related to the patient’s medication with accurate current medication list and compared to the doctor’s admission, transfer and discharge orders. Its aim is to prevent medication errors. There are three steps process- Verification (gather medication history), Clarification (confirm the medication with doses, properly) and Reconciliation (documenting with medication information). This challenge is important to obtain accurate information on all patients entering the hospital. Information technology may play an important role in improving
Working as a professional registered nurse in the hospital, I realized how nurses struggle to find balance between devoting the time charting on the computer and spending time taking care of the patients. Moreover, I’ve seen nurses where they get discouraged trying to find this balance between patients and charting. As a bedside nurse, I would love nothing, but to tend to the needs of my patients. The length of time consume on electronic charting all day, take the very essence of bedside nursing away from nurses, which is caring. Reducing the time of nurses being occupied on charting by eliminating redundant tasks while conforming to their standard, are the changes I would like to make. These are a few of the reasons why I wanted to pursue a degree in informatics. I would advocate for nurses everywhere and to become an instrument in providing them a better electronic health system to work on. Pursuing the degree in nursing informatics will benefit me in
Cardiac dysrhythmias come in different degrees of severity. There are heart conditions that you are able to live with and manage on a daily basis and those that require immediate attention. Atrial Fibrillation is one of the more frequently seen types of dysrhythmias (NIH, 2011). The best way to diagnosis a heart condition is by reading a cardiac strip (Ignatavicius &Workman, 2013). Cardiac strips play an chief part in the nursing world allowing the nurse and other trained medical professionals to interpret what the heart is doing. In a normal strip, one can clearly identify a P wave before every QRS complex, which is then followed by a T wave; in Atrial Fibrillation, the Sinoatrial node fires irregularly causing there to be no clear P wave and an irregular QRS complex (Ignatavicius & Workman, 2013). Basically, it means that the atria, the upper chambers of the heart, are contracting too quickly and no clear P wave is identified because of this ‘fibrillation’ (Ignatavicius & Workman, 2013).
In the Intensive Care Unit (ICU), patients are being monitored very closely while their vital signs, their neurological status, and their physical status are being managed with strong medications, lifesaving machines, and the clinical knowledge and skills of trained ICU nurses. Outside of the ICU, it is essential for staff nurses to identify the patient that is clinically deteriorating and in need of urgent intervention.
...ts, electrocardiogram, sonogram and cardiac rehabilitation. As a clinical observer, I found an opportunity to create a solid foundation on patient diagnosis and treatment, and not to mention, long hours with charting and recording patients’ information.
Recognition, response and treatment of deteriorating patients are essential elements of improving patient outcomes and reducing unanticipated inpatient hospital deaths (Fuhrmann et al 2009; Mitchell et al 2010). Appropriate management of the deteriorating patient is often insufficient when not managed in a timely fashion (Fuhrmann et al 2009; Naeem et al 2005; Goldhill 2001). Detection of these clinical changes, coupled with early accurate intervention, may avoid adverse outcomes, including cardiac arrest and deaths (Subbe et al. 2003). The 'Secondary' of the 'Secondary' of the 'Secondary' of the 'Secondary' of the 'Secondary' of the 'Secondary' of the 'Secondary' of the 'Secondary' of the 'Secondary' of the 'Secondary' of the 'Secondary' One of such early interventions may be offered by Roper, Logan, Tierney (1980) called the activities of daily living model.
One of many nationwide initiatives to help reduce the occurrence of unnecessary medical errors and adverse events is the use of the integrated Clinical Decision Support System (CDSS). A CDSS is a system that provides the right information to the right person in a right format through a right channel at the right time of workflow to facilitate better decision-making by clinicians, reduce errors, and also to prevent adverse events (AHRQ, 2008). This proposal is a case based CDSS system that provides point of care clinical decision support, ensures five rights of medication administration (right person, right drug, right dose, right time and right route), and is designed to prevent or reduce the occurrence errors and adverse events at Perpetual Order of Saints Hospital (POSH).
The purpose of this paper is to distinguish, outline, and evaluate the affects that workarounds have on patient safety and quality. According to Alexander, Frith, and Hoy (2015), a workaround is defined as when a problems arise within the workflow and a worker uses an unauthorized way around the health information technology system. This being said, workarounds are present in the hustle and bustle of the stressful hospital workflow, and in return can potentially lead to negative consequences. Therefore, it is essential for health care professionals to recognize the workaround, analyze their workflow, and then develop possible solutions.
Administration of medication is a vital part of the clinical nursing practice however in turn has great potential in producing medication errors (Athanasakis 2012). It has been reported that over 7,000 deaths have occur per year related to medications errors within the US (Flynn, Liang, Dickson, Xie, & Suh, 2012). A patient in the hospital may be exposed to at least one error a day that could have been prevented (Flynn, Liang, Dickson, Xie, & Suh, 2012). Working in a professional nursing practice setting, the primary goal is the nurse and staff places the patient first and provides the upmost quality care with significance on safety. There are several different types of technology that can be used to improve the medication process and will aid staff in reaching a higher level of care involving patient safety. One tool that can and should be utilized in preventing medication errors is barcode technology. The purpose of this paper is to demonstrate how implementing technology can aid patient safety during the medication administration process.
In an effort to improve clinician workflow and enhance patient safety, a healthcare facility has purchased and will soon be introducing a computerized provider order entry (CPOE) system for use within the electronic health record. A pre-deployment evaluation plan will permit the informatics team to appraise the usability of the CPOE and provide administrators with valuable data regarding its successful implementation. This paper describes the formation of this evaluation plan including the goals, methodology, and tools to be used. The final sections cover the ethical implications and dissemination of findings, along with the limitations and opportunities that the study provides.
Nurses form an important role in influencing patient safety from everyday tasks and gradually obtaining the patient vital signs have increasingly been seen as a chore instead of collecting clinical evidence. This then creates an extreme danger to patient’s as irregular monitoring of vital signs prevented early detection of deterioration in a patient’s condition, which postpones transfer to intensive care unit ( Kyriacos U et al 2011; Boulanger, 2009). Due to this, a...
Bradycardia can be very serious. Some of the symptoms are loss of consciousness, heart failure, or death. Slow heart rates are caused by heart block. The hearts natural pace-maker fails to be conducted to the ventricles, the hearts main pumping chambers.