With increase population of patients visiting the emergency room, wait times are getting longer and longer. Not just wait time to see the doctors, but to be triaged by a nurse to see if a true emergency exists. The time a patient walks into the waiting room to the time when a nurse can triage the patient was taking too long. It was not safe for the patients. Furthermore, too much burden fell on the shoulder of one triage nurse. A lean process was created. An aim was to decrease the wait time for a patient to be seen by the triage nurse. The lean team measured times from the moment a patient arrived at the ER to the time when a patient was seen by a nurse. With this data at hand, they came up with a process to not only decrease the time when a patient can be assessed by the triage nurse but to alleviate the pressure on the triage nurse. The solution was to get help to …show more content…
the triage nurse when needed. Sounds simple, but the problem was where to get this extra nurse to help the front line. The team tried to staff by pulling a nurse from the back, from different positions, but eventually, data showed that having a dedicated nurse who was assigned to the role of being the backup nurse showed a decrease in wait time. The lean team applied PDSA methods mentioned in the YouTube. With several continuous measurements and adjustments, the process was able to be meet the aim and solved the situation. Reference Evans, M.
Published on Nov 26, 2014. Quality Improvement in Healthcare. YouTube. Retrieved From https://www.youtube.com/watch?time_continue=7&v=jq52ZjMzqyI
Middleton, B., Bloomrosen, M., Dente, M. A., Hashmat, B., Koppel, R., Overhage, J. M., Payne, T. H., Rosenbloom, S. T., Weaver, C. & Zhang, J. (2013). Enhancing patient safety and quality of care by improving the usability of electronic health record systems: recommendations from AMIA. Retrieved From http://jamia.oxfordjournals.org/content/20/e1/e2.ful
You are right Tran that we are so used to scanning our medications that sometimes nurses don’t check to see if there is a duplicate order. We are not perfect, and we are liable to make a mistake which can be detrimental to the patient. We do need to take accountability for what we are doing. EHR and other technology are there to help us and make our workflow easier, but it should not replace our critical thinking ability. Nurses as the end-users must “take ownership” for working with the EHR system to deliver safe care to patients (Middleton et al.,
2013).
Electronic health information systems prevent errors by involving everyone in a primary health care setting which mainly includes specialists office, emergency department to access the same
Jha, A. K., Burke, M. F., DesRoches, C., Joshi M. S., Kralovec P. D., Campbell E. G., & Buntin M. B. (2011). Progress Toward Meaningful Use: Hospitals’ Adoption of Electronic Health Records. The American Journal of Managed Care, 17, 117-123
Historically, physicians and nurses documented patients’ health information using paper and pencil. This documentation created numerous errors in patients’ medical records. Patient information became lost or destroyed, medication errors occur daily because of illegible handwriting, and patients had to wait long periods to have access to their medical records. Since then technology has changed the way nurses and health care providers care for their patients. Documentation of patient care has moved to an electronic heath care system in which facilities around the world implement electronic health care systems. Electronic health records (EHR) is defined as a longitudinal electronic record of
“Meaningful Use” implemented in July, 2010, set criteria’s for physicians and hospitals to adhere, in order to qualify for certain financial incentives and to be deemed meaningful users (MU) of the EMR. Meaningful use in healthcare is defined as using certified electronic health record to improve quality, safety, efficiency, and reduce mortality and morbidity. There are 3 stages of meaningful use implementation. The requirements for the 3 stages are spread out over a period of 5 years. MU mandates that physicians meet 15 core objectives and hospitals meet 14 core objectives (Hoffman & Pudgurski, 2011). The goal is to in-cooperate the patient and family in their health, empower autonomy to make decisions while improving care in all population.
Some method such as audits, chart reviews, computer monitoring, incident report, bar codes and direct patient observation can improve and decrease medication errors. Regular audits can help patient’s care and reeducate nurses in the work field to new practices. Also reporting of medication errors can help with data comparison and is a learning experience for everyone. Other avenues that has been implemented are computerized physician order entry systems or electronic prescribing (a process of electronic entry of a doctor’s instructions for the treatment of patients under his/her care which communicates these orders over a computer network to other staff or departments) responsible for fulfilling the order, and ward pharmacists can be more diligence on the prescription stage of the medication pathway. A random survey was done in hospital pharmacies on medication error documentation and actions taken against pharmacists involved. A total of 500 hospital were selected in the United States. Data collected on the number of medication error reported, what types of errors were documented and the hospital demographics. The response rate was a total of 28%. Practically, all of the hospitals had policies and procedures in place for reporting medication errors.
The purpose of this paper is to discuss how Electronic Medical Records (EMR), affects healthcare delivery. I will discuss the positives and negatives this issue has on healthcare and how it effects the cost and quality for healthcare services. In addition, I will identify any potential trade-offs to cost or quality. Lastly, I will discuss how the EMR affects my job as well as any challenges or opportunities this issue presents.
The Quality and Safety Education for Nurses (QSEN’s) goal is to prepare future nurses with the knowledge, skills, and attitudes (KSAs) that are needed to continuously improve the quality and safety of the healthcare systems within which they work. QSEN focuses on six main competencies; patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics. As we have learned in earlier classes these competencies and their KSAs offer a base to help us and other nurses as we continue our education and become RNs. As we will learn in this class these KSAs go hand in hand with health assessment.
The main quality initiative affected by this workaround is patient safety. The hospital switched to computer medication administration as opposed to paper medication administration documentation because it is supposed to be safer. So, when the nurse gets the “wrong medication” message the computer thinks something is wrong, this is a safety net that is built into the computer system. If the nurse were just to administer the medication without any further checks, he or she would be putting patient safety on the line. The policy involved that pertains to this workaround is the “8 rights of medication administration”, which are: right patient, right medication, right dose, right route, right time, right documentation, right reason, and right response (LippincottNursingCenter®, 2011). Each nurse it taught these eight rights of medication administration in nursing school, therefore it is a nursing policy. When this workaround occurs the nurse should use his/her judgment before “scan overriding” and ensure these eight checks before administering the
The nurse to patient ratio is unrealistic in many hospitals. In most cases it is almost impossible to give each patient the true amount of detailed care they really need. This is seen in most cases where there is one nurse assigned to 16 patients and each patient requires a different level of attention. Nurses are pressed for time, forcing them to cut corners, resulting in an increase in nosocomial infections and patient deaths. “The past decade has been a unsettled time for many US hospitals and practicing nu...
Electronic Health Record (EHR) is a digital collection of patient health information instead of paper chart that captures data at the point of collection, supports clinical decision-making and integrates data from multiple sources in any care delivery settings. The health record includes patient’s demographics, progress notes, past medical history, vital signs, medications, immunizations, laboratory data and radiology reports. National Alliance for the Health Information Technology defines EHR as, “ an electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be created, managed, and consulted by authorized clinicians and staff across more
This paper will identify the use of Electronic Health Records and how nursing plays an important role. Emerging in the early 2000’s, utilizing Electronic Health Records have quickly become a part of normal practice. An EHR could help prevent dangerous medical mistakes, decrease in medical costs, and an overall improvement in medical care. Patients are often taking multiple medications, forget to mention important procedures/diagnoses to providers, and at times fail to follow up with providers. Maintaining an EHR could help tack data, identify patients who are due for preventative screenings and visits, monitor VS, & improve overall quality of care in a practice. Nurse informaticists play an important role in the adaptation, utilization, and functionality of an EHR. The impact the EHR could have on a general population is invaluable; therefore, it needs special attention from a trained professional.
Healthcare errors occur at an alarmingly high incidence and are the eighth leading cause of death (IOM, 2000; Langdrigan, Parry, Bones, Goldman, and Sharek, 2010). The Institute for Healthcare Improvement (IHI) has estimated that there are 40,000 incidents of medical errors every day. At least 1.5 million preventable medication errors occur each year in the United States. Nurses, as one of the largest groups of healthcare providers, have new roles and responsibilities to improve patient safety and quality. Nurses can attempt to do this through being educated.
The overall goal for the Quality and Safety Education for Nurses (QSEN) plan is to meet the challenge of educating and preparing future nurses to have the knowledge, skills and attitudes that are essential to frequently progress the quality and safety of the healthcare systems in the continuous improvement of safe practice (QSEN, 2014).Safety reduces the possibility of injury to patients and nurses. It is achieved through system efficiency and individual work performance. Organizations determine which technologies have an effective protocol with efficient practices to support quality and safety care. Guidelines are followed to reduce potential risks of harm to nurses or others. Appropriate policies
In this reflective essay, I will be using the Driscoll’s model of reflection to talk about how my knowledge of quality nursing care has improved since the commencement of this module. Quality nursing care has helped me develop various nursing strategies that will guide me in my first placement and throughout my career in nursing. Furthermore, it has taught me about communicating effectively with patients, I have learnt about verbal communication such as paraphrasing when communicating with patients to ensure that what said is properly understood. I have learnt not to make assumptions about patients and putting them in the middle of their care, taking into account their preferences.
Understanding quality measurement is essential in improving quality. Teams need to be able to understand whether the changes being made are actually leading to improved care and improved outcomes. For data to have an impact on an improvement initiative, providers and staff must understand it, trust it, and use it. Health care organization must understand the measurement of quality provided by the Institute of Medicine (patient outcomes, patient satisfaction, compliance, efficiency, safe, timely, patient centered, and equitable. An organization cannot improve its performance if it does not know how it is performing. Measuring quality improvements is essential as it reflects the quality of care given by the providers and that by comparing performance