Recommendations based on Objective/Purpose
A change I would recommend for this department is for the staff to become more aware of how rounding and pain management affects the patient experience. Another suggestion based on the objective of improving patient experience would be to continue educating staff on how patient experience plays a crucial role in the reimbursement and how it impacts not only the hospital but them as well. I also recommend that the staff should continue performing rounding and pain management as if they were still being measured so that eventually these two areas will occur automatically without even having to think about it. By doing so, it will turn into a habit and will hopefully lead to a more consistent score in these two areas. New staff should also be trained that both monitoring for pain management and rounding is standard practice for the unit. As it is a lot easier to train someone new to get into this habit earlier than it is to try and implement it later after he/she has already established a routine. Staff members that have a higher role in the department must also continue to lead by example as well, in order to instill the importance of these two areas. Lastly, I recommend that the department needs to find a way to motivate and encourage staff to do rounding and pain management effectively with more internal rewards such as staff members seeing the positive impact focusing on these two areas have on patient lives.
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However, if the manager of this department sees improvement and would like too, she can recommend this process to other departments throughout the hospital. This could possibly lead to a positive impact on the hospitals overall score in patient
For the verbal orders and read backs graph needs to be broken down into quarters. This would help address the problems sooner for the next fiscal year. During a department’s grand rounds, it needs to be reiterate the important of verbal orders and read backs are to patients’ safety. The smaller sample size may point to an individual doctor or nurse who needs retraining. This will help with orthopedics department improvement at fast rate and take other department to one hundred percent. The rush of the orders being given may lead to the using of impropriate use of abbreviations. The U abbreviation needs to be address in grand rounds of each department. The reporting of critical results need to address with laboratory staff and nurses, The doctors should be warned that when order something, “stat” to ask for the results within a reasonable amount of time. This will help in patient’s safety because it saves of life.
Providing the best care to each patient starts with providing the proper amount of staff members to each unit. Looking at the needs of different units not only allows administration to see areas for improvement, but also areas that are being handled correctly. Utilizing the indicators provided by The Joint Commission, 4 East, a pediatric medical/surgical floor, has a high rate of falls and nosocomial pressure ulcers that appears to be related to the increase overtime nurses have been working for that floor (Nightingale, 2010). Research has shown increases in adverse events have been related to nurses working over 40 hours a week (Bae, 2012).
The verbal order read back initiated by the hospital has improved with all but one department exceeding a 90% ratio. This will be a focus area for the Ortho department, as they will have a goal to reach of exceed 90% within the remaining accreditation period. We will continue to quantify the results of all departments monthly as well as evaluate the Orhto department to determine if there are any roadblocks to attaining the improvement goal. The second lowest score is currently being achieved by the surgical unit although they are doing well we will target this department for ongoing training. All departments will continue to receive documentation and training in this area.
Adolf Hitler often proclaimed, “Whoever has the youth has the future.” This future would entail the most destructive war in history and the systematic murder of millions of people. This research will study how the Hitler Youth, a youth organization affiliated with the Nationalsozialistische Deutsche Arbeiterpartei (Nazi Party), affected the German population, particularly its members, from 1922 to 1945. Specifically, this research will examine how formal and informal Hitler Youth training influenced its experiencers’ decisions to acquiesce to and perpetrate the Holocaust. This research about the Hitler Youth’s effects on people’s behavior during the Holocaust will analyze the role of Nazism versus preexisting societal trends in cultivating genocidal mindset.
Change is a hard concept for most, but change in the hospital setting can be beneficial for both staff and patients. According to Mclean (2011), “Every change begins with an ending” (p.79). How people respond to change can make the process easy or hard depending on how the change is presented.
Devote effort to focus on patient’s need for help with toileting, pain level, and positioning.
No change: The cost is increasing every year in the health care industry. There is no way to transfer these costs to patients as the services are already costly. Change is the only constant. Change is inevitable for MGH to survive in this industry. There are no pros with this option and several cons such as having no standards, poor communication and coordination between groups and poor maintenance of patient’s track records.
Talking to Strangers by Malcolm Gladwell dives into psychological phenomena dealing with human emotions and thoughts through different scientific studies and real-life events. These psychological traits can explain how interactions between police and civilians can be positive or negative. It’ll also explain many misunderstandings and how police officers can be more alert during investigations. In this paper, using the books' many different topics and theories, there may be ways that communities and police interactions can be improved. There will also be explanations of why bad interactions and misunderstandings come about when looking at certain cases.
One of the major functions of a nurse manager is managing a budget and allocating resources necessary to manage the unit or facility effectively. “Major steps in the budgeting process include gathering information and planning, developing unit budgets, developing cash budgets, negotiating and revising, and using feedback to control budget results and improve future plans”(Yoder-Wise, 2012, p. 244). The nurse manager must be able to accommodate variances and acclimate the budget in both the projections and up-to-date expenditures. Proficiency in managing a unit level budget is essential for both a favorable variance and optimal patient outcomes. Budgeting entails reviewing revenues and expenses, staffing costs, supplies, and capital equipment costs (Contino, 2001). This case study examines personnel, overtime (OT), supplies, travel, equipment, and staff education and the manner in which management can address these factors.
Rounding allows nurses to gather information in a structured way. It’s proactive, not reactive like call light responses. It’s a great way to get a handle on patient problems before they occur. It’s all about providing the best patient-driven health care… The great thing about hourly rounding is that it doesn’t benefit only the patients. (¶ 4).
In recent years, the healthcare industry has seen a significant decline in the quality of patient care it provides. This has been the result of reduced staffing levels, overworked nurses, and an extremely high nurse to patient ratio. The importance of nurse staffing in hospital settings is an issue of great controversy. Too much staff results in costs that are too great for the facility to bear, but too little staffing results in patient care that is greatly hindered. Moreover, the shaky economy has led to widespread budget cuts; this, combined with the financial pressures associated with Medicare and private insurance companies have forced facilities to make due with fewer
Staffing needs affect the nursing department’s budget, staff productivity, the quality of care provided to patients and even the retention of nurses (Jooste, 2013). The nurse manager has to explain to the management of the benefits of change in providing adequate staffing all the time. Adequate staffing helps staff retention. Staff retention saves a lot of money in terms of orienting new people to the unit. Safe staffing always helps in the reduction of falls, infection rates, pressure ulcers, decrease hospital stays and death. Flexible and creative scheduling is essential for retaining staff and promoting a positive work climate (Grohar-Murray & Langan, 2011). Adequate staffing with good staffing ratio will help nurses to concentrate on their patient care which may help in a reduction in medical errors and lawsuits to the hospital.
The results of the study showed that significant increase in patient satisfaction scores, decreased call light usage, and reduction in patients fall rates. One-hour rounding shows higher satisfaction than two hour- rounding. Hypothesis supported the study because the research shows rounding can reduce patient call light usage (Meade, Bursell, Ketelsen , 2006). The theoretical framework that forms the basis of the research is that consistent nursing rounds can meet the basic needs of patient and ultimately reduce call light use and [pic]improve management of patient care while also[pic] increasing [pic]patient satisfaction and[pic] safety.
The Performance measurement strategies that continue to support and participation in the Hospital quality allowance.
Hourly rounding contributes in several key areas to achievement of high levels of patient satisfaction, including quality of care and patient safety. This puts patients at the center of care by building on the fundamental aspects of care, which are so important. Thus by checking in on patients in wards regularly to see whether they are comfortable and have everything they need can produce a number of positive results. Nurses