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Critical analysis of patient assessment
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APPENDIX A
Casandra Giron & Kaye Castro
POLICY TITLE:
Implementing an acuity assessment tool for patient care prioritization.
POLICY PURPOSE:
To provide a high quality of care where patients needs are met consistently, as well as benefiting nurse workload and patient assignments.
POLICY STATEMENT:
Acuity assessed at the start and end of a shift using an acuity tool enables a nurse to accurately prioritize patient care based on patient acuity score. Completing acuity scores identifies patient current needs and illness severity, allowing nurses to plan cares that meet the patient’s requirements during the shift.
RATIONALE:
Based on the literature research, attaining acuity scores promoted improvements in the delivery of care, workload of a
The nurse must take five minutes at most to complete the MSAAT and has to make sure everything is complete for accurate long-term rehabilitation services, and onset severity (e.g., extent of an inflammatory process).” (Thomasos et al., 2015, p.40).
Medical-surgical: Nursing speciality in the hospital caring for adult patient with various diagnosis (What is Medical-Surgical Nursing?, 2017).
MSAAT: Abbreviation for “Medical-Surgical Acuity Assessment Tool” which is a tool developed by Casandra and Kaye in replacement of the TEAMS acuity tool. It is a modified and improved version of TEAMS.
TEAMS: Abbreviation for “treatment, education, activities of daily living, medications, and vital signs” (Thomasos et al., 2015, p.42). It is a tool that was used by nurses to measure patient acuity in a “medical-telemetry unit of a 150-bed community hospital in the Southeast” (Thomasos et al., 2015, p.39).
RESPONSIBILITIES:
In order for this policy to be properly implemented in a medical-surgical unit, the hospital must be in agreement to this evidence-based proposal. The nurses are responsible to abide by this policy, complete the MSAAT during their shift and document their findings on their computer system. The nurse managers are responsible in ensuring that the MSAAT criteria are met and that the scores are accurate by conducting regular patient reviews and nurse
...ifferent from the previous paper process in that it will improve and streamline the Nurse Leader’s rounding process through technology that provides automated escalations to other members of the team (CipherHealth, 2016). Through the technology, data can be tracked and trended to improve processes.
Patients expect instant response to call lights due to today’s technological advancements. This can negatively impact nurse stress and cause contempt toward the patient. However, the expectation to respond promptly improves safety and encourages frequent rounding. Also, aiming for high patient satisfaction scores on the HCAHPS/Press Ganey by fulfilling patient requests can overshadow safe, efficient, and necessary healthcare. Although patient satisfaction is important, ultimately, the patient’s health takes precedence over satisfying patient and family requests, especially when those requests are unnecessary, harmful, or take away from the plan of care (Junewicz & Youngner, 2015). The HCAHPS/Press Ganey survey focuses on the patient’s perception of care. The problem with this aspect of the survey is that the first and foremost goal of nurses should not be to increase a patient’s score based on perception. According to an article in Health Facilities Management, the nurse’s top priority is to provide the safest, most quality care possible for patients with the resources they are given (Hurst, 2013). Once this has been accomplished, the nurse can then help the patient realize that the most
4). Examples of how nurses can integrate this competency include; using current practice guidelines and researching into hospital’s policies (Jurado, 2015). According to Sherwood & Zomorodi (2014) nurses should use current evidence based standards when providing care to patients. Nurse B violated one of the rights of medication administration. South Florida State Hospital does not use ID wristbands; instead they use a picture of the patient in the medication cup. Nurse B did not ask the patient to confirm his name in order to verify this information with the picture in the computer. By omitting this step in the process of medication administration, nurse B put the patient at risk of a medication error, which could have caused a negative patient
87). This study took a quantitative approach to show how the implementation of a fast track unit operated by a physician assistant could help to improve wait times for all acuity patients and improve length of stay for lower acuity patients (Theunissen, Lardenoye, Hannemann, Gerritsen, Brink, & Poeze, p. 87). There is a literature review under the heading of introduction included in this article and a theoretical framework is also present; however, most resources that were cited are greater than 5 years old (Theunissen, Lardenoye, Hannemann, Gerritsen, Brink, & Poeze, p. 87-88). Experimental design was used with this study since it examined the implementation of the fast track unit and then evaluation of the effects it had on wait times and length of stay (Keele, p. 41). A power analysis was used to determine sample size needed to show changes of 15 minutes or more in length of stay and wait times (Theunissen, Lardenoye, Hannemann, Gerritsen, Brink, & Poeze, p. 89). The extraneous variables are number of complaints, mortality, acuity level, and presence of complex problems (Theunissen, Lardenoye, Hannemann, Gerritsen, Brink, & Poeze, p. 88-89). The data was collected from the E-care automated information system for emergency departments (Theunissen, Lardenoye,
health care team who, with doctors, provide quality care to patients. In order to do that,
Many nurses face the issue of understaffing and having too much of a workload during one shift. When a unit is understaffed not only do the nurses get burnt out, but the patients also don’t receive the care they deserve. The nurse-patient ratio is an aspect that gets overlooked in many facilities that could lead to possible devastating errors. Nurse- patient ratio issues have been a widely studied topic and recently new changes have been made to improve the problem.
Davenport, Joan M., Stacy Estridge, and Dolores M. Zygmont. Medical-surgical nursing. 2nd ed. Upper Saddle River, N.J.: Pearson Prentice Hall, 2008, 66-88.
...r investigation and then devise a plan for best possible action recognizing the rights of the patient and its benefits followed by the application of the chosen intervention with positive outcome in mind (Wells, 2007). Delivery of excellent and quality of care at constant level (NMC, 2008) must be marked in any responsibilities and duties of the care provider to promote exceptional nursing practice
Prioritizing care is one of the first things that nurses learn in their career. Prioritizing requires critical thinking whether it comes to discharging a patient, caring for a patient, or delegating a task to a LPN or CNA. As the charge nurse they must look at the whole picture and not just the tasks that need to be done. The charge nurse is the one makes the assignments for the individual nurses, so if there happens to be a float nurse from a different department they might give them the patients with the lowest acuity depending on the nurse’s experience. The charge nurse must know which patients could be discharged if there was an emergency to arise or not enough hospital beds for those patients who need to be admitted. For example, the nurse is not going to recommend someone who came in with a heart attack; they would most likely recommend someone who is two days post op and is being discharged to a rehab facility in a couple of days. It is the charge nurses duty to make that everyone providing great and safe care to the patient.
Association, A. N. (2010). Nursing Scope and Standards of Practice. (2nd ed.) Maryland: American Nurses Association. Retrieved January 20, 2014 from http://media.wix.com/ugd/8c99f2_4fde86431966e34f2e03bbb137edfee3.pdf
These measure help the leaders to communicate effectively with their staff and to achieve the goals of five pillars and the areas that leader need assistance or coaching and to see how leader are doing when it comes to achieving goals and leaders start focus on the goal to provide quality of care to residents. By measuring the performance of leaders, leaders determine what their top priorities should be, work on their weakness so leaders can align training to desired
I introduced myself to the patient stating that I was a student nurse and gained verbal consent to carry on with the assessment, as a student nurse you must respect patients wishes at all times, if t...
The nurses working with the patients on that same unit would be the once to take part in the survey. Registered nurses and nursing aids are giving organized questionnaire such as overall and tangible workload, administrative duty, and the capacity to fulfill patients order. "This study would undergo statistical examination and outlined as nurse’s perception on the hourly rounding in the elderly acute care floor" ((Deitrick, Baker, Paxton, Flores, & Swavely, 2012).
The patient was transferred into my care via the Emergency Assessment Unit for Surgical Patients (EAUS). I was given handover by the charge nurse who has already pre-a...
Although students were not allowed in the recovery unit, I was able to talk to one of the recovery nurses. I learned that a nurse’s duty of care includes monitoring the patient’s vital signs and level of consciousness, and maintaining airway patency. Assessing pain and the effectiveness of pain management is also necessary. Once patients are transferred to the surgical ward, the goal is to assist in the recovery process, as well as providing referral details and education on care required when the patient returns home (Hamlin, 2010).